Measurements of Epidural Space Depth Using Preexisting CT Scans Correlate with Loss of Resistance Depth during Thoracic Epidural Catheter Placement.

Background. Thoracic epidural catheters provide the best quality postoperative pain relief for major abdominal and thoracic surgical procedures, but placement is one of the most challenging procedures in the repertoire of an anesthesiologist. Most patients presenting for a procedure that would benefit from a thoracic epidural catheter have already had high resolution imaging that may be useful to assist placement of a catheter. Methods. This retrospective study used data from 168 patients to examine the association and predictive power of epidural-skin distance (ESD) on computed tomography (CT) to determine loss of resistance depth acquired during epidural placement. Additionally, the ability of anesthesiologists to measure this distance was compared to a radiologist, who specializes in spine imaging. Results. There was a strong association between CT measurement and loss of resistance depth (P < 0.0001); the presence of morbid obesity (BMI > 35) changed this relationship (P = 0.007). The ability of anesthesiologists to make CT measurements was similar to a gold standard radiologist (all individual ICCs > 0.9). Conclusions. Overall, this study supports the examination of a recent CT scan to aid in the placement of a thoracic epidural catheter. Making use of these scans may lead to faster epidural placements, fewer accidental dural punctures, and better epidural blockade.

Placement of Small Vertical Axis Wind Turbine to Maximize Power Generation Influenced by Architectural and Geographic Interfaces in Urban Areas

Current methods for large-scale wind collection are unviable in urban areas. In order to investigate the feasibility of generating power from winds in these environments, we sought to optimize placements of small vertical-axis wind turbines in areas of artificially-generated winds. We explored both vehicular transportation and architecture as sources of artificial wind, using a combination of anemometer arrays, global positioning system (GPS), and weather report data. We determined that transportation-generated winds were not significant enough for turbine implementation. In addition, safety and administrative concerns restricted the implementation of said wind turbines along roadways for transportation-generated wind collection. Wind measurements from our architecture collection were applied in models that can help predict other similar areas with artificial wind, as well as the optimal placement of a wind turbine in those areas.

The exposure to verbal abuse of student nurses gaining placement experience

Clinical placement experience has a key role to play in the socialisation and preparation of future members of the nursing profession. Aggression experienced by healthcare workers is currently receiving considerable attention and student nurses have been identified as a group vulnerable to experiencing workplace abuse (Little 1999). The primary aim of the study is to gain a greater understanding of the nature, severity, frequency and sources of verbal abuse experienced by student nurses in health care settings in the south east of England, using as a definition, “the use of inappropriate words… causing distress” (Department of Health 2003). A convenience sample of 156 third year student nurses of all four branches of one preregistration nursing programme in the south east of England was studied with questionnaires distributed retrospectively; 11 4 student nurses returned the questionnaires equating to a response rate of 73%. Results 46% of respondents reported experiencing verbal abuse, 39% had witnessed other students experiencing verbal abuse and 61% reported that they were aware of other students experiencing verbal abuse. Students reported experiencing threats to kill, racial abuse, sexually orientated verbal abuse and bullying while gaining placement experience. Student nurses are a high risk group for experiencing verbal abuse whilst gaining placement experience.In the literature, mental health and learningdisability settings are viewed as high risk areasfor experiencing aggression (Beech and Leather 2003); this study suggests that student nurses experience verbal abuse in a variety of settings and verbal abuse may be more prevalent on general medical and surgical wards than previously expected.

Computing Zeros of Analytic Functions in the Complex Plane without using Derivatives

A new approach to evaluating all multiple complex roots of analytical function f(z) confined to the specified rectangular domain of complex plane has been developed and implemented in Fortran code. Generally f (z), despite being holomorphic function, does not have a closed analytical form thereby inhibiting explicit evaluation of its derivatives. The latter constraint poses a major challenge to implementation of the robust numerical algorithm. This work is at the instrumental level and provides an enabling tool for solving a broad class of eigenvalue problems and polynomial approximations.

RF performance of a 418-MHz radio telemeter packaged for human vaginal placement

The electrical and communication performance of a 0.8-mu W UHF temperature telemeter designed for human vaginal placement is discussed; a solenoidal loop antenna was used, occupying a volume of 0.1 cm(3). In situ, measured power absorption was between 19-25 dB, resulting in an effective operating range of 10 m. Capacitive loading lowered the antenna's resonant frequency by 1.4% and there was a significant polarization change in the radiated output.