Efforts of hospital system wound care teams to reduce hospital acquired pressure ulcers

New reimbursement policies developed by the Centers for Medicare and Medicaid Services (CMS) are revolutionizing the health care landscape in America. The policies focus on clinical quality and patient outcomes. As part of the new policies, certain hospital acquired conditions have been identified by Medicare as "reasonably preventable". Beginning October 1, 2008, Medicare will no longer reimburse hospitals for these conditions developed after admission, pressure ulcers are among the most common of these conditions.^ In this practice-based culminating experience the objective was to provide a practical account of the process of program development, implementation and evaluation in a public health setting. In order to decrease the incidence of pressure ulcers, the program development team of the hospital system developed a comprehensive pressure ulcer prevention program using a "bundled" approach. The pressure ulcer prevention bundle was based on research supported by the Institute for Healthcare Improvement, and addressed key areas of clinical vulnerability for pressure ulcer development. The bundle consisted of clinical processes, policies, forms, and resources designed to proactively identify patients at risk for pressure ulcer development. Each element of the bundle was evaluated to ensure ease of integration into the workflow of nurses and clinical ancillary staff. Continued monitoring of pressure ulcer incidence rates will provide statistical validation of the impact of the prevention bundle. ^

Overview of Data Management Planning Tools

These Data Management Plans are more comprehensive and complex than in the past. Libraries around the nation are trying to put together tools to help researchers write plans that conform to the new requirements. This session will look at some of these tools.

Collection of data on plant height along the plant diversity gradient in the Jena Experiment (Main Experiment, time series since 2002)

This data set contains a time series of plant height measurements (vegetative and reproductive) from the main experiment plots of a large grassland biodiversity experiment (the Jena Experiment; see further details below). In addition, data on species specific plant heights for the main experiment are available from 2002. In the main experiment, 82 grassland plots of 20 x 20 m were established from a pool of 60 species belonging to four functional groups (grasses, legumes, tall and small herbs). In May 2002, varying numbers of plant species from this species pool were sown into the plots to create a gradient of plant species richness (1, 2, 4, 8, 16 and 60 species) and functional richness (1, 2, 3, 4 functional groups). Plots were maintained by bi-annual weeding and mowing. 1. Plant height was recorded, generally, twice a year just before biomass harvest (during peak standing biomass in late May and in late August). Methodologies of measuring height have varied somewhat over the years. In earlier year the streched plant height was measured, while in later years the standing height without streching the plant was measured. Vegetative height was measured either as the height of the highest leaf or as the length of the main axis of non-flowering plants. Regenerating height was measured either as the height of the highest flower on a plant or as the height of the main axis of flowering. Sampled plants were either randomly selected in the core area of plots or along transects in defined distances. For details refer to the description of individual years. Starting in 2006, also the plots of the management experiment, that altered mowing frequency and fertilized subplots (see further details in the general description of the Jena Experiment) were sampled. 2. Species specific plant height was recorded two times in 2002: in late July (vegetative height) and just before biomass harvest during peak standing biomass in late August (vegetative and regenerative height). For each plot and each sown species in the species pool, 3 plant individuals (if present) from the central area of the plots were randomly selected and used to measure vegetative height (non-flowering indviduals) and regenerative height (flowering individuals) as stretched height. Provided are the means over the three measuremnts per plant species per plot.

Collection of data on soil carbon (particulate and dissolved) in the Jena Experiment (Main Experiment, time series since 2002)

This data set contains three time series of measurements of soil carbon (particular and dissolved) from the main experiment plots of a large grassland biodiversity experiment (the Jena Experiment; see further details below). In the main experiment, 82 grassland plots of 20 x 20 m were established from a pool of 60 species belonging to four functional groups (grasses, legumes, tall and small herbs). In May 2002, varying numbers of plant species from this species pool were sown into the plots to create a gradient of plant species richness (1, 2, 4, 8, 16 and 60 species) and functional richness (1, 2, 3, 4 functional groups). Plots were maintained by bi-annual weeding and mowing. 1. Particulate soil carbon: Stratified soil sampling was performed every two years since before sowing in April 2002 and was repeated in April 2004, 2006 and 2008 to a depth of 30 cm segmented to a depth resolution of 5 cm giving six depth subsamples per core. Total carbon concentration was analyzed on ball-milled subsamples by an elemental analyzer at 1150°C. Inorganic carbon concentration was measured by elemental analysis at 1150°C after removal of organic carbon for 16 h at 450°C in a muffle furnace. Organic carbon concentration was calculated as the difference between both measurements of total and inorganic carbon. 2. Particulate soil carbon (high intensity sampling): In one block of the Jena Experiment soil samples were taken to a depth of 1 m (segmented to a depth resolution of 5 cm giving 20 depth subsamples per core) with three replicates per block ever 5 years starting before sowing in April 2002. Samples were processed as for the more frequent sampling. 3. Dissolved organic carbon: Suction plates installed on the field site in 10, 20, 30 and 60 cm depth were used to sample soil pore water. Cumulative soil solution was sampled biweekly and analyzed for dissolved organic carbon concentration by a high TOC elemental analyzer. Annual mean values of DOC are provided.

Collection of data on particulate and dissolved soil phosphorus in the Jena Experiment (Main Experiment, time series since 2002)

This data set contains two time series of measurements of dissolved phosphorus (organic, inorganic and total with a biweekly resolution) and dissolved inorganic phosphorus with a seasonal resolution. In addition, data on phosphorus from soil samples measured in 2007 and fractionated by different acid-extrations (Hedley fractions) are provided. All data measured at the main experiment plots of a large grassland biodiversity experiment (the Jena Experiment; see further details below). In the main experiment, 82 grassland plots of 20 x 20 m were established from a pool of 60 species belonging to four functional groups (grasses, legumes, tall and small herbs). In May 2002, varying numbers of plant species from this species pool were sown into the plots to create a gradient of plant species richness (1, 2, 4, 8, 16 and 60 species) and functional richness (1, 2, 3, 4 functional groups). Plots were maintained by bi-annual weeding and mowing. 1. Dissolved phosphorus in soil solution: Suction plates installed on the field site in 10, 20, 30 and 60 cm depth were used to sample soil pore water. Cumulatively extracted soil solution was collected every two weeks from October 2002 to May 2006. The biweekly samples from 2002, 2003 and 2004 were analyzed for dissolved organic phosphorus (DOP), dissolved inorganic phosphorus (PO4P) and dissolved total phosphorus (TDP) by Continuous Flow Analyzer (CFA SAN ++, SKALAR [Breda, The Netherlands]). 2. Seasonal values of dissolved inorganic phosphorus in soil solution were calculated as volume-weighted mean values of the biweekly measurements (spring = March to May, summer = June to August, fall = September to November, winter = December to February). 3. Phosphorus fractions in soil: Five independent soil samples per plot were taken in a depth of 0-15 cm using a soil corer with an inner diameter of 1 cm. The five samples per plot were combined to one composite sample per plot. A four-step sequential P fractionation (Hedley fractions) was applied and concentrations of P fractions in soil were measured photometrically (molybdenum blue-reactive P) with a Continuous Flow Analyzer (Bran&Luebbe, Germany).

Collection of data on particulate and dissolved soil nitrogen in the Jena Experiment (Main Experiment, time series since 2002)

This data set contains four time series of particulate and dissolved soil nitrogen measurements from the main experiment plots of a large grassland biodiversity experiment (the Jena Experiment; see further details below). In the main experiment, 82 grassland plots of 20 x 20 m were established from a pool of 60 species belonging to four functional groups (grasses, legumes, tall and small herbs). In May 2002, varying numbers of plant species from this species pool were sown into the plots to create a gradient of plant species richness (1, 2, 4, 8, 16 and 60 species) and functional richness (1, 2, 3, 4 functional groups). Plots were maintained by bi-annual weeding and mowing. 1. Total nitrogen from solid phase: Stratified soil sampling was performed every two years since before sowing in April 2002 and was repeated in April 2004, 2006 and 2008 to a depth of 30 cm segmented to a depth resolution of 5 cm giving six depth subsamples per core. In 2002 five samples per plot were taken and analyzed independently. Averaged values per depth layer are reported. In later years, three samples per plot were taken, pooled in the field, and measured as a combined sample. Sampling locations were less than 30 cm apart from sampling locations in other years. All soil samples were passed through a sieve with a mesh size of 2 mm in 2002. In later years samples were further sieved to 1 mm. No additional mineral particles were removed by this procedure. Total nitrogen concentration was analyzed on ball-milled subsamples (time 4 min, frequency 30 s-1) by an elemental analyzer at 1150°C (Elementaranalysator vario Max CN; Elementar Analysensysteme GmbH, Hanau, Germany). 2. Total nitrogen from solid phase (high intensity sampling): In block 2 of the Jena Experiment, soil samples were taken to a depth of 1m (segmented to a depth resolution of 5 cm giving 20 depth subsamples per core) with three replicates per block ever 5 years starting before sowing in April 2002. Samples were processed as for the more frequent sampling but were always analyzed independently and never pooled. 3. Mineral nitrogen from KCl extractions: Five soil cores (diameter 0.01 m) were taken at a depth of 0 to 0.15 m (and between 2002 and 2004 also at a depth of 0.15 to 0.3 m) of the mineral soil from each of the experimental plots at various times over the years. In addition also plots of the management experiment, that altered mowing frequency and fertilized subplots (see further details below) were sampled in some later years. Samples of the soil cores per plot (subplots in case of the management experiment) were pooled during each sampling campaign. NO3-N and NH4-N concentrations were determined by extraction of soil samples with 1 M KCl solution and were measured in the soil extract with a Continuous Flow Analyzer (CFA, 2003-2005: Skalar, Breda, Netherlands; 2006-2007: AutoAnalyzer, Seal, Burgess Hill, United Kingdom). 4. Dissolved nitrogen in soil solution: Glass suction plates with a diameter of 12 cm, 1 cm thickness and a pore size of 1-1.6 µm (UMS GmbH, Munich, Germany) were installed in April 2002 in depths of 10, 20, 30 and 60 cm to collect soil solution. The sampling bottles were continuously evacuated to a negative pressure between 50 and 350 mbar, such that the suction pressure was about 50 mbar above the actual soil water tension. Thus, only the soil leachate was collected. Cumulative soil solution was sampled biweekly and analyzed for nitrate (NO3-), ammonium (NH4+) and total dissolved nitrogen concentrations with a continuous flow analyzer (CFA, Skalar, Breda, The Netherlands). Nitrate was analyzed photometrically after reduction to NO2- and reaction with sulfanilamide and naphthylethylenediamine-dihydrochloride to an azo-dye. Our NO3- concentrations contained an unknown contribution of NO2- that is expected to be small. Simultaneously to the NO3- analysis, NH4+ was determined photometrically as 5-aminosalicylate after a modified Berthelot reaction. The detection limits of NO3- and NH4+ were 0.02 and 0.03 mg N L-1, respectively. Total dissolved N in soil solution was analyzed by oxidation with K2S2O8 followed by reduction to NO2- as described above for NO3-. Dissolved organic N (DON) concentrations in soil solution were calculated as the difference between TDN and the sum of mineral N (NO3- + NH4+).

Study of the Influence of Reference System in Surface Finishing Parameters Evaluation.

In the present paper the influence of the reference system with regard to the characterization of the surface finishing is analyzed. The effect of the reference system’s choice on the most representative surface finishing parameters (e.g. roughness average Ra and root mean square values Rq) is studied. The study can also be applied to their equivalent parameters in waviness and primary profiles. Based on ISO and ASME standards, three different types of regression lines (central, mean and orthogonal) are theoretically and experimentally analyzed, identifying the validity and applicability fields of each one depending on profile’s geometry. El presente trabajo realiza un estudio de la influencia que supone la elección del sistema de referencia en la determinación los valores de los parámetros más relevantes empleados en la caracterización del acabado superficial tales como la rugosidad media aritmética Ra o la rugosidad media cuadrática Rq y sus equivalentes en los perfiles de ondulación y completo. Partiendo de la definición establecida por las normas ISO y ASME, se analizan tres tipos de líneas de regresión cuadrática (línea central, línea media y línea ortogonal), delimitando los campos de validez y de aplicación de cada una de ellas en función de la geometría del perfil. Para ello se plantean diversos tipos de perfiles y se desarrolla un estudio teórico y experimental de los mismos.

Linked Opinions: Describing Sentiments on the Structured Web of Data

In the paper we report on the results of our experiments on the construction of the opinion ontology. Our aim is to show the benefits of publishing in the open, on the Web, the results of the opinion mining process in a structured form. On the road to achieving this, we attempt to answer the research question to what extent opinion information can be formalized in a unified way. Furthermore, as part of the evaluation, we experiment with the usage of Semantic Web technologies and show particular use cases that support our claims.

Cross-lingual Linking on the Multilingual Web of Data (position statement)

Recently, the Semantic Web has experienced signi�cant advancements in standards and techniques, as well as in the amount of semantic information available online. Even so, mechanisms are still needed to automatically reconcile semantic information when it is expressed in di�erent natural languages, so that access to Web information across language barriers can be improved. That requires developing techniques for discovering and representing cross-lingual links on the Web of Data. In this paper we explore the different dimensions of such a problem and reflect on possible avenues of research on that topic.

Challenges for the Multilingual Web of Data

The Web has witnessed an enormous growth in the amount of semantic information published in recent years. This growth has been stimulated to a large extent by the emergence of Linked Data. Although this brings us a big step closer to the vision of a Semantic Web, it also raises new issues such as the need for dealing with information expressed in different natural languages. Indeed, although the Web of Data can contain any kind of information in any language, it still lacks explicit mechanisms to automatically reconcile such information when it is expressed in different languages. This leads to situations in which data expressed in a certain language is not easily accessible to speakers of other languages. The Web of Data shows the potential for being extended to a truly multilingual web as vocabularies and data can be published in a language-independent fashion, while associated language-dependent (linguistic) information supporting the access across languages can be stored separately. In this sense, the multilingual Web of Data can be realized in our view as a layer of services and resources on top of the existing Linked Data infrastructure adding i) linguistic information for data and vocabularies in different languages, ii) mappings between data with labels in different languages, and iii) services to dynamically access and traverse Linked Data across different languages. In this article we present this vision of a multilingual Web of Data. We discuss challenges that need to be addressed to make this vision come true and discuss the role that techniques such as ontology localization, ontology mapping, and cross-lingual ontology-based information access and presentation will play in achieving this. Further, we propose an initial architecture and describe a roadmap that can provide a basis for the implementation of this vision.