Identifying the scope for savings at inpatient episode level:an illustration applying DEA to chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is characterized by a largely irreversible obstruction of the airways, and is one of the leading causes of chronic morbidity and mortality worldwide. This paper illustrates the use of Data Envelopment Analysis (DEA) to assess the potential for cost savings at COPD inpatient episode level. The analysis uses the length of stay of each episode as a surrogate for expenditure on that episode while allowing for the medical condition of the patient and the quality of care received. We find substantial possible reductions in length of stay which would translate to cost savings. The paper also explores differences both between hospitals and between care teams within hospitals so that cost efficient protocols of treatment can be identified and disseminated.

Effects of nutrition education on the nutrition knowledge of future aerobic dance instructors

The effectiveness of nutrition education on the nutrition knowledge of future aerobic instructors was studied. Forty-seven subjects participated in the study. The experimental group (n=31) chose to and paid for a two-hour per week session of structured nutrition education for four weeks, the control group (n=16) did not. A nutrition knowledge test was completed by all subjects before and after the intervention. Results were analyzed for relationships between subject's nutrition knowledge and age, gender, educational background, income, and body mass index. No significant differences were found between the groups. The results showed that prior to any formal nutrition education, fitness instructors in the experimental and control groups had low nutrition knowledge (8.06%±16.4% and 4.38%±4.12%, respectively). Post-intervention nutrition knowledge significantly improved (p

Data compilation on the biological response to ocean acidification: environmental and experimental context of data sets and related literature

The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

Scope & nature of young sudden cardiac death in Newfoundland & Labrador

Introduction: Sudden cardiac death (SCD) in young people (ages 2-40) is a tragedy for families and communities alike. It has multiple causes, one of which is an underlying genetic arrhythmogenic cardiomyopathy. A study from Ontario (ON) using a 2008 cohort assessed the incidence of SCD in persons aged 2-40 years to be 2.64/100,000 person-years. We hypothesized that Newfoundland & Labrador (NL) may have a higher incidence of early SCD in ages 2-40 due to possible underlying genetic causes given the historical genetic isolation of the population and the founder mutations already identified (ex. PKP2, RYR2, TMEM43). Methods: We ascertained cases of sudden death from the comprehensive Medical Examiners’ provincial database for the years 2008 and 1997; 2008 as a direct comparison to ON, and 1997 as it represented a time when the implantable cardioverter-defibrillator was not available in NL. Each case of sudden death was individually analyzed to determine likelihood of SCD. Results: There were 119 cases in 2008 and 157 cases in 1997. The incidence of SCD for ages 2-40 in 2008 was 7.32/100,000 persons. This was significantly higher than the incidence in Ontario. The incidence of SCD was not significantly higher in 1997 than 2008. Coronary artery disease was a major cause of death in all cohorts, similar to Ontario (non-significant difference). Conclusion: In general, there was a trend of more arrhythmogenic deaths in the young and more structural cardiac deaths as age increased. This reflects the cause of SCD in the young is often genetic in nature, while older deaths are often due to coronary artery disease, a disease heavily influenced by environment. To conclude, SCD in NL occurs at a higher incidence than ON, further research is needed on the topic.

Weather forecaster working at radar scope at U.S. Weather Service

Inscriptions: Verso: [stamped] Photograph by Freda Leinwand. [463 West Street, Studio 229G, New York, NY 10014].

The cardioprotective effect of a short-term aerobic exercise program and the mitochondrial permeability transition pore of the Rat

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The cardioprotective effect of a short-term aerobic exercise program and the mitochondrial permeability transition pore of the Rat

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

(Table, Appendix C) Metal content of nodules at Sea Scope stations based upon XRF analyses at the Ore Microscopy Laboratory, Washington State Unicersity, USA

New information on possible resource value of sea floor manganese nodule deposits in the eastern north Pacific has been obtained by a study of records and collections of the 1972 Sea Scope Expedition. Nodule abundance (percent of sea floor covered) varies greatly, according to photographs from eight stations and data from other sources. All estimates considered reliable are plotted on a map of the region. Similar maps show the average content of Ni, Cu, Mn and Co at 89 stations from which three or more nodules were analyzed. Variations in nodule metal content at each station are shown graphically in an appendix, where data on nodule sizes are also given. Results of new analyses of 420 nodules from 93 stations for mn, fe, ni, cu, CO, and zn are listed in another appendix. Relatively high Ni + Cu content is restricted chiefly to four groups of stations in the equatorial region, where group averages are 1.86, 1.99, 2.47, and 2.55 weight-percent. Prepared for United States Department of the Interior, Bureau of Mines. Grant no. GO284008-02-MAS. - NTIS PB82-142571.

Measuring Scope of Practice Enactment among Primary Care Registered Nurses in Ontario

Background: Primary care is the sector of health care in which patients first establish contact with the health system, are provided person-focused care over time for all new or common needs, and receive coordinated integrated health services provided elsewhere by other members of the health care team. Registered Nurses (RNs) in Canada provide care within this sector in varying roles. The extent to which RNs enact their full scope of practice in primary care settings in Canada is not known. The Actual Scope of Practice questionnaire (ASCOP) is a 26 item Likert scale questionnaire developed by researchers in Canada and validated in the acute care setting to measure the extent to which RNs apply the knowledge, skills and competencies of the professional full scope of practice. Similar to the acute care setting, there is a need to measure scope of practice enactment in the primary care setting. Objectives: The overall aim of this thesis was to measure scope of practice enactment in the primary care setting. Two research objectives were addressed: (1) to revise and adapt the ASCOP questionnaire for use in the primary care setting, and (2) to determine internal consistency, construct validity, and sensitivity of the modified instrument, the ASCOP-PC. Methods: To address the first objective, a narrative literature review and synthesis and an expert panel review was conducted. To address the second objective a cross-sectional survey of 178 RNs working in primary care organizations in Ontario was conducted Results: The ASCOP, with few modifications, addressed key attributes of nursing scope of practice in the primary care setting. The ASCOP-PC yielded acceptable alpha coefficients ranging from 0.66 to 0.91 and explained variances from 44.2 to 62.6. Total mean score of 5.16 suggests that RNs within these models of care almost always engage in activities reflected in the ASCOP-PC. Interpretation: Findings from this study support the use of a the modified ASCOP questionnaire as a reliable and valid measure of scope of practice enactment among primary care nurses in the primary care setting.

Operating cost based cruise speed reduction for ground delay programs: Effect of scope length

Ground delay programs typically involve the delaying of aircraft that are departing from origin airports within some set distance of a capacity constrained destination airport. Long haul flights are not delayed in this way. A trade-off exists when fixing the distance parameter: increasing the ‘scope’ distributes delay among more aircraft and may reduce airborne holding delay but could also result in unnecessary delay in the (frequently observed) case of early program cancellation. In order to overcome part of this drawback, a fuel based cruise speed reduction strategy aimed at realizing airborne delay, was suggested by the authors in previous publications. By flying slower, at a specific speed, aircraft that are airborne can recover part of their initially assigned delay without incurring extra fuel consumption if the ground delay program is canceled before planned. In this paper, the effect of the scope of the program is assessed when applying this strategy. A case study is presented by analyzing all the ground delay programs that took place at San Francisco, Newark Liberty and Chicago O’Hare International airports during one year. Results show that by the introduction of this technique it is possible to define larger scopes, partially reducing the amount of unrecovered delay.

Sustainable Catalysis : Rational Pd Loading on MIL-101Cr-NH2 for More Efficient and Recyclable Suzuki-Miyaura Reactions

Palladium nanoparticles have been immobilized into an amino-functionalized metal-organic framework (MOF), MIL-101Cr-NH2, to form Pd@MIL-101Cr-NH2. Four materials with different loadings of palladium have been prepared (denoted as 4-, 8-, 12-, and 16wt%Pd@MIL-101Cr-NH2). The effects of catalyst loading and the size and distribution of the Pd nanoparticles on the catalytic performance have been studied. The catalysts were characterized by using scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier-transform infrared (FTIR) spectroscopy, powder X-ray diffraction (PXRD), N-2-sorption isotherms, elemental analysis, and thermogravimetric analysis (TGA). To better characterize the palladium nanoparticles and their distribution in MIL-101Cr-NH2, electron tomography was employed to reconstruct the 3D volume of 8wt%Pd@MIL-101Cr-NH2 particles. The pair distribution functions (PDFs) of the samples were extracted from total scattering experiments using high-energy X-rays (60keV). The catalytic activity of the four MOF materials with different loadings of palladium nanoparticles was studied in the Suzuki-Miyaura cross-coupling reaction. The best catalytic performance was obtained with the MOF that contained 8wt% palladium nanoparticles. The metallic palladium nanoparticles were homogeneously distributed, with an average size of 2.6nm. Excellent yields were obtained for a wide scope of substrates under remarkably mild conditions (water, aerobic conditions, room temperature, catalyst loading as low as 0.15mol%). The material can be recycled at least 10times without alteration of its catalytic properties.