Contribution of activity and skin temperature to the risk of developing pressure ulcers in nursing facility residents

Purpose. The central concepts in pressure ulcer risk are exposure to external pressure caused by inactivity and tissue tolerance to pressure, a factor closely related to blood flow. Inactivity measures are effective in predicting pressure ulcer risk. The purpose of the study is to evaluate whether a physiological measure of skin blood flow improves pressure ulcer risk prediction. Skin temperature regularity and self-similarity, as proxy measures of blood flow, and not previously described, may be undefined pressure ulcer risk factors. The specific aims were to determine whether a sample of nursing facility residents at high risk of pressure ulcers classified using the Braden Scale for Pressure Sore Risk© differ from a sample of low risk residents according to (1) exposure to external pressure as measured by resident activity, (2) tissue tolerance to external pressure as measured by skin temperature, and (3) skin temperature fluctuations and recovery in response to a commonly occurring stressor, bathing and additionally whether (4) scores on the Braden Scale mobility subscale score are related to entropy and the spectral exponent. ^ Methods. A two group observational time series design was used to describe activity and skin temperature regularity and self-similarity, calculating entropy and the spectral exponent using detrended fluctuation analysis respectively. Twenty nursing facility residents wore activity and skin temperature monitors for one week. One bathing episode was observed as a commonly occurring stressor for skin temperature.^ Results. Skin temperature multiscale entropy (MSE), F(1, 17) = 5.55, p = .031, the skin temperature spectral exponent, F(1, 17) = 6.19, p = .023, and the activity mean MSE, F(1, 18) = 4.52, p = .048 differentiated the risk groups. The change in skin temperature entropy during bathing was significant, t(16) = 2.55, p = .021, (95% CI, .04-.40). Multiscale entropy for skin temperature was lowest in those who developed pressure ulcers, F(1, 18) = 35.14, p < .001.^ Conclusions. This study supports the tissue tolerance component of the Braden and Bergstrom conceptual framework and shows differences in skin temperature multiscale entropy between pressure ulcer risk categories, pressure ulcer outcome, and during a commonly occurring stressor. ^

A descriptive and exploratory analysis of occupational injuries at a chemical manufacturing facility

A retrospective study of 1353 occupational injuries occurring at a chemical manufacturing facility in Houston, Texas from January, 1982 through May, 1988 was performed to investigate the etiology of the occupational injury process. Injury incidence rates were calculated for various sub-populations of workers to determine differences in the risk of injury for various groups. Linear modeling techniques were used to determine the association between certain collected independent variables and severity of an injury event. Finally, two sub-groups of the worker population, shiftworkers and injury recidivists, were examined. An injury recidivist as defined is any worker experiencing one or more injury per year. Overall, female shiftworkers evidenced the highest average injury incidence rate compared to all other worker groups analyzed. Although the female shiftworkers were younger and less experienced, the etiology of their increased risk of injury remains unclear, although the rigors of performing shiftwork itself or ergonomic factors are suspect. In general, females were injured more frequently than males, but they did not incur more severe injuries. For all workers, many injuries were caused by erroneous or foregone training, and risk taking behaviors. Injuries of these types are avoidable. The distribution of injuries by severity level was bimodal; either injuries were of minor or major severity with only a small number of cases falling in between. Of the variables collected, only the type of injury incurred and the worker's titlecode were statistically significantly associated with injury severity. Shiftworkers did not sustain more severe injuries than other worker groups. Injury to shiftworkers varied as a 24-hour pattern; the greatest number occurred between 1200-1230 hours, (p = 0.002) by Cosinor analysis. Recidivists made up 3.3% of the population (23 males and 10 females), yet suffered 17.8% of the injuries. Although past research suggests that injury recidivism is a random statistical event, analysis of the data by logistic regression implicates gender, area worked, age and job titlecode as being statistically significantly related to injury recidivism at this facility. ^

Assessment of occupational exposures to organic chemicals in a plastics manufacturing facility

The objective of this dissertation was to design and implement strategies for assessment of exposures to organic chemicals used in the production of a styrene-butadiene polymer at the Texas Plastics Company (TPC). Linear statistical retrospective exposure models, univariate and multivariate, were developed based on the validation of historical industrial hygiene monitoring data collected by industrial hygienists at TPC, and additional current industrial hygiene monitoring data collected for the purposes of this study. The current monitoring data served several purposes. First, it provided information on current exposure data, in the form of unbiased estimates of mean exposure to organic chemicals for each job title included. Second, it provided information on homogeneity of exposure within each job title, through the use of a carefully designed sampling scheme which addressed variability of exposure both between and within job titles. Third, it permitted the investigation of how well current exposure data can serve as an evaluation tool for retrospective exposure estimation. Finally, this dissertation investigated the simultaneous evaluation of exposure to several chemicals, as well as the use of values below detection limits in a multivariate linear statistical model of exposures. ^

The University Compost Facility after Three Years

The University Compost Facility, 52274 260th St., Ames, Iowa has completed three full years of operation. The facility is managed by the ISU Research Farms and has a separate revolving account that receives fees and sales, and pays expenses. The facility is designed to be self-supporting, i.e. not receive allocations for its operations. The facility consists of seven, 80 × 140 ft hoop barns and a new 55 × 120 ft hoop barn, all with paved floors. The facility also has a Mettler-Toledo electronic scale with a 10 ft × 70 ft platform to weigh all materials. Key machinery is 1) compost turner, a used pull-type Aeromaster PT-170, 14 ft wide made by Midwest Biosystems, Tampico, IL; 2) a converted dump truck trailer used to construct windrows and haul material; 3) telehandler, Caterpillar TH407 with cab and 2.75 cubic yard bucket; and 4) tractor, John Deere 7520 (125 hp) with IVT (Infinite Variable Transmission) and front-wheel assist used to pull the turner and dump trailer.

Transport costs, distance, and time : evidence from the Japanese Census of Logistics

Geographic distance is a standard proxy for transport costs under the simple assumption that freight fees increase monotonically over space. Using the Japanese Census of Logistics, this paper examines the extent to which transport distance and time affect freight costs across shipping modes, commodity groups, and prefecture pairs. The results show substantial heterogeneity in transport costs and time across shipping modes. Consistent with an iceberg formulation of transport costs, distance has a significantly positive effect on freight costs by air transportation. However, I find the puzzling results that business enterprises are likely to pay more for short-distance shipments by truck, ship, and railroad transportation. As a plausible explanation, I discuss aggregation bias arising from freight-specific premiums for timely, frequent, and small-batch shipments.

Geographical simulation analysis for logistics enhancement in Asia

This paper presents a simulation of the reduction of several components in trade cost for Asia and examines its impact on the economy. Our simulation model based on the new economic geography embraces seven sectors, including manufacturing and non-manufacturing sectors, and 1,715 regions in 18 countries/economies in Asia, in addition to the two economies of the US and the European Union. The geographical course of transactions among regions is modeled as determined based on firms’ modal choice. The model also includes estimates of some border cost measures such as tariff rates, non-tariff barriers, other border clearance costs, transshipment costs and so on. Our simulation analysis for Asia includes several scenarios involving the improvement/development of routes and the reduction of the above-mentioned border cost. We have shown that the contribution of physical and non-physical infrastructure improvements conducted together is larger than the sum of the contribution by each when conducted independently.

Reverse logistics practices for recovering mobile phones in Spain

The main objective of this article is to characterize the reverse logistics system for mobile phones in Spain. The study includes the characterization of the different actors involved in the reverse logistics system and the description of the most common logistics practices in the sector. We will also opose alternative practices for managing this complex reverse logistics system and finally, we analyse the challenges of the current reverse logistics model. Some alternatives for the current model are location of reception points for end-of-use mobiles, the need to legislate the secondhand mobile phone market, and the location of the necessary recycling centres according to current legislation.

TechnoFusion: new Spanish singular scientific-technical facility for fusion research

Technofusion is the scientific&technical installation for fusion research in Spain, based on three pillars: • It is an open facility to European users. • It is a facility with instrumentation not accesible to small research groups. • It is designed to be closely coordiated with the European Fusion Program. With a budget of 80-100 M€ over five years, several top laboratories will be constructed

Reverse logistics systems for waste generated throughout vehicles life-cycle

Waste produced during the service life of automobiles has received much less attention than end-of-life vehicles themselves. In this paper, we deal with the set up of a reverse logistics system for the collection and treatment of use-phase residues. First, the type of waste arising during vehicles? service life is characterized. Data were collected in collaboration with SIGRAUTO, the product stewardship organization in charge of vehicles? recovery in Spain. Next, three organizational models are proposed. The three alternatives are benchmarked and assessed from a double organizational and operational perspective for the particular case of the Madrid region in Spain

Development of an adequate model for verification of design safety-margins of the HTTR nuclear test facility

This work is based on the prototype High Engineering Test Reactor (HTTR) of the Japan Agency of Energy Atomic (JAEA). Its objective is to describe an adequate deterministic model to be used in the assessment of its design safety margins via damage domains. The concept of damage domain is defined and it is shown its relevance in the ongoing effort to apply dynamic risk assessment methods and tools based on the Theory of Stimulated Dynamics (TSD). To illustrate, we present results of an abnormal control rod (CR) withdrawal during subcritical condition and its comparison with results obtained by JAEA. No attempt is made yet to actually assess the detailed scenarios, rather to show how the approach may handle events of its kind

Conceptual design of the liquid metal laboratory of the TECHNOFUSION facility

The application of liquid metal technology in fusion devices requires R&D related to many phenomena: interaction between liquid metals and structural material as corrosion, erosion and passivation techniques; magneto-hydrodynamics; free surface fluid-dynamics and any other physical aspect that will be needed for their safe reliable operation. In particular, there is a significant shortage of experimental facilities dedicated to the development of the lithium technology. In the framework of the TECHNOFUSION project, an experimental laboratory devoted to the lithium technology development is proposed, in order to shed some light in the path to IFMIF and the design of chamber's first wall and divertors. The conceptual design foresee a development in two stages, the first one consisting on a material testing loop. The second stage proposes the construction of a mock-up of the IFMIF target that will allow to assess the behaviour of a free-surface lithium target under vacuum conditions. In this paper, such conceptual design is addressed.

Characterization of an 241AmBe neutron irradiation facility by different spectrometric techniques

An automated panoramic irradiator with a 3 Ci 241Am-Be neutron source is installed in a bunker-type large room at the Universidad Politécnica de Madrid (UPM). It was recently modified and a neutron spectrometry campaign was organized to characterize the neutron fields in different measurement points along the irradiation bench. Four research groups working with different Bonner Sphere Spectrometers (BSS) and using different spectral unfolding codes took part to this exercise. INFN-LNF used a BSS formed by 9 spheres plus bare detector, with cylindrical, almost point like, 6LiI(Eu) scintillator (4 mm x 4 mm, from Ludlum); UAZ-UPM employed a similar system but with only 6 spheres plus bare detector; UAB worked with a 3He filled proportional counter at 8kPa filling pressure, cylindrical 9 mm x 10 mm (05NH1 from Eurisys) with 11 spheres configuration; and CIEMAT used 12 spheres with an spherical 3He SP9 counter (Centronic Ltd., UK) with very high sensitivity due to the large diameter (3.2 cm) and the filling pressure of the order of 228 kPa. Each group applied a different spectral unfolding method: INFN and UAB worked with FRUIT ver. 3.0 with their own response matrixes; UAZ-UPM used the BUNKIUT unfolding code with the response matrix UTA4 and CIEMAT employed the GRAVEL-MAXED-IQU package with their own response matrix. The paper shows the main results obtained in terms of neutron spectra at fixed distances from the source as well as total neutron fluence rate and ambient dose equivalent rate H*(10) determined from the spectra. The latter are compared with the readings of a common active survey-meter (LB 6411). The small differences in the results of the various groups are discussed.