Performance of mechanical ventilators at the patient's home: a multicentric quality control study

Background: Quality control procedures vary considerably among the providers of equipment for home mechanical ventilation (HMV). Methods: A multicentre quality control survey of HMV was performed at the home of 300 patients included in the HMV programmes of four hospitals in Barcelona. It consisted of three steps: (1) the prescribed ventilation settings, the actual settings in the ventilator control panel, and the actual performance of the ventilator measured at home were compared; (2) the different ventilator alarms were tested; and (3) the effect of differences between the prescribed settings and the actual performance of the ventilator on non-programmed readmissions of the patient was determined. Results: Considerable differences were found between actual, set, and prescribed values of ventilator variables; these differences were similar in volume and pressure preset ventilators. The percentage of patients with a discrepancy between the prescribed and actual measured main ventilator variable (minute ventilation or inspiratory pressure) of more than 20% and 30% was 13% and 4%, respectively. The number of ventilators with built in alarms for power off, disconnection, or obstruction was 225, 280 and 157, respectively. These alarms did not work in two (0.9%), 52 (18.6%) and eight (5.1%) ventilators, respectively. The number of non-programmed hospital readmissions in the year before the study did not correlate with the index of ventilator error. Conclusions: This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation.

Consumer Advisory Bulletin, Credit Cards vs. Nailing Down Home Repair Rip-Offs & Disputes, April 2011

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: Nailing Down Home Repair Rip-Offs & Disputes

A reusable smart interface for gas sensor resistance measurement

The advances of the semiconductor industry enable microelectromechanical systems sensors, signal conditioning logic and network access to be integrated into a smart sensor node. In this framework, a mixed-mode interface circuit for monolithically integrated gas sensor arrays was developed with high-level design techniques. This interface system includes analog electronics for inspection of up to four sensor arrays and digital logic for smart control and data communication. Although different design methodologies were used in the conception of the complete circuit, high-level synthesis tools and methodologies were crucial in speeding up the whole design cycle, enhancing reusability for future applications and producing a flexible and robust component.

Application of a floating well concept to a latch-up-free, low-cost, smart power high-side switch technology

The aim of this brief is to present an original design methodology that permits implementing latch-up-free smart power circuits on a very simple, cost-effective technology. The basic concept used for this purpose is letting float the wells of the MOS transistors most susceptible to initiate latch-up.

Positional therapy for obstructive sleep apnea: an objective measurement of patients' usage and efficacy at home.

BACKGROUND: Positional therapy that prevents patients from sleeping supine has been used for many years to manage positional obstructive sleep apnea (OSA). However, patients' usage at home and the long term efficacy of this therapy have never been objectively assessed.¦METHODS: Sixteen patients with positional OSA who refused or could not tolerate continuous positive airway pressure (CPAP) were enrolled after a test night study (T0) to test the efficacy of the positional therapy device. The patients who had a successful test night were instructed to use the device every night for three months. Nightly usage was monitored by an actigraphic recorder placed inside the positional device. A follow-up night study (T3) was performed after three months of positional therapy.¦RESULTS: Patients used the device on average 73.7 ± 29.3% (mean ± SD) of the nights for 8.0 ± 2.0 h/night. 10/16 patients used the device more than 80% of the nights. Compared to the baseline (diagnostic) night, mean apnea-hypopnea index (AHI) decreased from 26.7 ± 17.5 to 6.0 ± 3.4 with the positional device (p<0.0001) during T0 night. Oxygen desaturation (3%) index also fell from 18.4 ± 11.1 to 7.1 ± 5.7 (p = 0.001). Time spent supine fell from 42.8 ± 26.2% to 5.8 ± 7.2% (p < 0.0001). At three months (T3), the benefits persisted with no difference in AHI (p = 0.58) or in time spent supine (p = 0.98) compared to T0 night. The Epworth sleepiness scale showed a significant decrease from 9.4 ± 4.5 to 6.6 ± 4.7 (p = 0.02) after three months.¦CONCLUSIONS: Selected patients with positional OSA can be effectively treated by a positional therapy with an objective compliance of 73.7% of the nights and a persistent efficacy after three months.

Smart Planning in Iowa - A Guide to Principles, Strategies and Policy Tools

This guide was created to aid communities in the process of smart planning and is organized around the 10 Smart Planning Principles signed into Iowa law in 2010. A general description of the concept, strategies for encouraging use, policy tools for implementation, and a current Iowa example are presented for each Principle. In addition, a brief list of resources is provided to help local governments, community organizations and citizen planners find information and ideas on community involvement and incorporation of smart planning concepts in every day decisions.

Archaeology on the Road, July 2011

Not only are we excited that Team Archaeology is back for our third ride, we are energized to be part of a “Human and Natural History” partnership that allows us expanded opportunities to share the story of Iowa’s amazing past. Once again there will be archaeologists along for the ride, as well as at Expo and this year at roadside locations Day One, Five and Six. Don’t hesitate to ask about the history of the first people to travel this landscape as well as the stories of each generation that has contributed to what we know of ourselves today. We will also feature information about the landscape and natural resources of Iowa you will encounter along the route through our partnering colleagues specializing in geology, hydrology, and other earth sciences. Enjoy using this booklet as your guide to the week’s activities and please help yourself to free materials from our outreach booth about our shared past and the natural world we depend on. Ride smart, be safe, and when you get home, be sure to tell your friends and neighbors about Iowa archaeology!

Report on the Iowa Veterans Home and the Iowa Department of Veterans Affairs for the year ended June 30, 2010

Report on the Iowa Veterans Home and the Iowa Department of Veterans Affairs for the year ended June 30, 2010

Agency Fact Sheet, Department of Veterans' Home, FY2007

This document produced by the Iowa Department of Administrative Services has been developed to provide a multitude of information about executive branch agencies/department on a single sheet of paper. The facts provides general information, contact information, workforce data, leave and benefits information and affirmative action data.

¿Mereixen els mals de l'home contemporani un tractament "acrític" basat en la Saviesa Antiga?

L'objectiu d'aquest article és presentar una análisi crítica de l'assaig de Giovane Reale, Saggezza antica. Terapia per i mali dll'uomo d'oggi, complementant l'adhesió de l'autor italià al pensament grec més metafísic amb el recordatori de moltes més savieses gregues d'índole diferent que paga la pena de tenir en compte per aplicar, emprant les seves paraules, una teràpia correcta als mals de l'home contemporani.