A European survey on current practices in epilepsy monitoring units and implications for patients' safety.

OBJECTIVE: This study aimed to survey current practices in European epilepsy monitoring units (EMUs) with emphasis on safety issues. METHODS: A 37-item questionnaire investigating characteristics and organization of EMUs, including measures for prevention and management of seizure-related serious adverse events (SAEs), was distributed to all identified European EMUs plus one located in Israel (N=150). RESULTS: Forty-eight (32%) EMUs, located in 18 countries, completed the questionnaire. Epilepsy monitoring unit beds are 1-2 in 43%, 3-4 in 34%, and 5-6 in 19% of EMUs; staff physicians are 1-2 in 32%, 3-4 in 34%, and 5-6 in 19% of EMUs. Personnel operating in EMUs include epileptologists (in 69% of EMUs), clinical neurophysiologists trained in epilepsy (in 46% of EMUs), child neurologists (in 35% of EMUs), neurology and clinical neurophysiology residents (in 46% and in 8% of EMUs, respectively), and neurologists not trained in epilepsy (in 27% of EMUs). In 20% of EMUs, patients' observation is only intermittent or during the daytime and primarily carried out by neurophysiology technicians and/or nurses (in 71% of EMUs) or by patients' relatives (in 40% of EMUs). Automatic detection systems for seizures are used in 15%, for body movements in 8%, for oxygen desaturation in 33%, and for ECG abnormalities in 17% of EMUs. Protocols for management of acute seizures are lacking in 27%, of status epilepticus in 21%, and of postictal psychoses in 87% of EMUs. Injury prevention consists of bed protections in 96% of EMUs, whereas antisuffocation pillows are employed in 21%, and environmental protections in monitoring rooms and in bathrooms are implemented in 38% and in 25% of EMUs, respectively. The most common SAEs were status epilepticus reported by 79%, injuries by 73%, and postictal psychoses by 67% of EMUs. CONCLUSIONS: All EMUs have faced different types of SAEs. Wide variation in practice patterns and lack of protocols and of precautions to ensure patients' safety might promote the occurrence and severity of SAEs. Our findings highlight the need for standardized and shared protocols for an effective and safe management of patients in EMUs.

Modified atmosphere packaging extending the storage life of 'douradão' peach

'Douradão' peach is a perishable product and when cold stored is subject to chilling injury. The objective of the experiment was to evaluate the effect of modified atmosphere packaging (MAP) and cold storage on quality and storage life of these peaches. Fruits were packed in polypropylene (PP) trays and placed inside low density polyethylene (LDPE) bags (30, 50, 60, 75 μm thickness) with active modified atmosphere (10 kPa CO2 + 1.5kPa O2, balance N2). The control was made with peaches held in nonwrapped PP trays. Fruits were kept at 1 ± 1 °C and 90 ± 5% relative humidity (RH) for 28 days and CO2 and O2 within packages was monitored every two days. After 14, 21 and 28 days, samples were withdrawn from MAP and kept in air at 25 ± 1 °C and 90 ± 5% RH for ripening. On the day of removal from the cold storage and after 4 days, peaches were evaluated for weight loss, decay incidence, flesh firmness, woolliness incidence, soluble solids content (SSC), titratable acidity (TA) and juice content. The results showed that MAP had influence on reducing weight loss and prevented postharvest decay. MAP of 1-2 kPa O2 and 3-6 kPa CO2 at 1 °C (from 50 and 60 μm LDPE films) were effective for keeping good quality of 'Douradão' peaches during 28 days of storage, the ripe fruits showed reduced incidence of woolliness, adequate juiciness and flesh firmness. Packages of 30 and 75 μm LDPE films were ineffective for reducing woolliness during cold storage. MAP fruits showed lower SSC and no relevant effect on TA. Control fruits did not present marketable conditions after 14 days of cold storage.

Nuevos datos sobre los yacimientos wurmienses del litoral catalán

We present a new bed of cold Malacological fauna of the Wrm in the Catalan littoral, one af its species is dated for the first time iii the hlediterranean (Sipho curtus). We point out the predorninance of Gasteropoda as regards Bivalves in comparison with the other cold beds known.

Cancer incidence in Vaud (2003-2007)

CANCER CARE FACILITIES: In 2005, the registration area had about 3200 hospital beds available for cancer diagnosis and treatment (about 5 per 1000 residents). There were about 3600 hospital medical residents and private practitioners (1 per 180 residents). The canton has a major, multidisciplinary, public university oncology and radiotherapy centre and two private radiotherapy units (available to all residents), as well as several peripheral (mostly hospital-based) medical and surgical oncology facilities and specialists. REGISTRY STRUCTURE AND METHODS: The registry is part of the Cancer Epidemiology Unit of the Institute of Social and Preventive Medicine within the Faculty of Biology and Medicine of the University of Lausanne. Notiĺcation is voluntary. The registry's main sources of information are the University Institute of Pathology at the University of Lausanne and three major private pathology laboratories. Passive and active follow-up are conducted. Data on all deaths in the canton (including cancer deaths) are available. Other features of the registry are good registration of non-melanoma skin cancers, linkage of reports of selected preneoplastic conditions to the registry database (to study subsequent cancer risk), analysis.

Effects of modified atmosphere packaging on ripening of 'Douradão' peach related to pectolytic enzymes activities and chilling injury symptoms

The present study evaluated the effects of modified atmosphere packaging on inhibition of the development of chilling injury symptoms in 'Douradão' peach after cold storage and the possible involvement of cell wall enzymes. Fruits were harvested at the middle stadium of ripening, packed in polypropylene trays and placed inside low density polyethylene (LDPE) bags (30, 50, 60 and 75 µm of thickness) with active modified atmosphere (10 kPa CO2 + 1.5 kPa O2, balance N2). The following treatments were tested: Control: peaches held in nonwrapped trays; MA30: LDPE film - 30 µm; MA50: LDPE film - 50 µm; MA60: LDPE film - 60 µm and MA75: LDPE film - 75 µm. Fruits were kept at 1±1ºC and 90±5% relative humidity (RH) for 28 days. After 14, 21 and 28 days, samples were withdrawn from MAP and kept in air at 25±1ºC and 90±5% RH for ripening. On the day of removal and after 4 days, peaches were evaluated for woolliness incidence, pectolytic enzymes activities. The respiratory rate and ethylene synthesis were monitored during 6 days of ripening. The results showed that MA50 and MA60 treatments had positive effect on the inhibition of the development of woolly texture and reduced pectin methylesterase activity on the ripe fruits, keeping good quality of 'Douradão' peach during 28 days of cold storage. The treatments Control, MA30 and MA75 showed higher woolliness incidence and did not present marketable conditions after 14 days of cold storage.

Stratigraphy and petrology of the Miocene Montjuic delta: (Barcelona, Spain).

The Neogene rift in the Catalan Coastal Ranges, which is located in the NE part of the Eastern Iberian Margin, corresponds to a system of grabens formed at the nort h - we s t e rn edge of the Valencia Trough. In the central part of the Catalan Coastal Ranges are the Valls - Peneds half-graben in the onshore and the Barcelona half-graben in the offshore, which are separated by the Garraf and the Collserola-Montnegre horsts. Montjuc hill is a tilted block, which is located to the S of the Barcelona city, between the Collserola-Montn egre horst and the Barcelona half-graben . The Middle Miocene section of Montjuc is constituted by an alternation of conglomerate, sandstone, mudstone and marlstone beds. The Montjuc section was divided into four lithostratigraphic units from base to top: (1) The Morrot conglomerate and sandstone Unit, interpreted as delta plain deposits; (2) the Castell conglomerate, sandstone and mudstone Unit considered as proximal delta front deposits; (3) the Miramar marlstone Unit attributed

Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

Background: Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smokefree Hospitals before and after a comprehensive national smoking ban. Methods: We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two crosssectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results: The mean of the implementation score of tobacco control policies was 52.4 (95% CI:45.4-59.5) in 2005 and 71.6 (95% CI: 67.0-76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35-39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion: The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network.

Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

Background: Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smokefree Hospitals before and after a comprehensive national smoking ban. Methods: We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two crosssectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results: The mean of the implementation score of tobacco control policies was 52.4 (95% CI:45.4-59.5) in 2005 and 71.6 (95% CI: 67.0-76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35-39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion: The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network.

Sairaalan tarkkailuosaston hyödyt ja kustannukset

Työn tavoitteena oli tutkia Etelä-Karjalan keskussairaalaan mahdollisesti perustettavan yhdistelmätarkkailuosaston kannattavuutta määrittämällä osaston kustannukset ja hyödyt. Määritettyjen kustannusten avulla vertailtiin päivystys-potilaiden eri hoitoketjuvaihtoehtoja. Lähdeaineistona työssä käytettiin sairaalan omia materiaaleja ja tilastoja, henkilöstön haastatteluja sekä muita kirjallisuuslähteitä. Kirjallisuuden mukaan sairaalan ylikuormitus johtuu sen huonosta potilasvirtojen kulusta, jota voidaan parantaa joko toimintaa tehostamalla tai investoimalla uusiin resursseihin. Eräs vaihtoehto ylikuormituksen purkuun on tarkkailuosaston perustaminen, joka ei ole vain lisätila vaan potilasvirtojen ohjauskeino. Tehtyjen laskemien mukaan Etelä-Karjalan keskussairaalan tarkkailuosasto vaikuttaisi kannattavalta. Tarkkailuosaston kustannukset vuodessa olisivat 1 099 745 €, tuotot 1 170 108 € ja voitto 70 363 €. Osaston perustamiskustannukset olisivat 950 324 €. Hoitoketjujen potilaskohtaisen kannattavuuden mukaan päivystyspotilaiden tarkkailu ja lyhytaikainen hoito kannattaisi tehdä joko vuodeosastoilla tai tarkkailuosastolla, mutta ei tappiota tuottavalla ensiapupoliklinikalla. Tarkkailuosastosta olisi taloudellisten tekijöiden lisäksi myös muita hyötyjä ja haittoja sairaalan sidosryhmille. Sairaalan valitsemasta ylikuormituksen vähentämiskeinosta riippumatta, on sen tärkeätä aloittaa jo lähivuosina valmistautuminen väestön ikääntymisen aiheuttamaan lisääntyvään kuormitukseen.

Hermetic sealing of food packaging trays

Suojakaasupakkaaminen on lisääntynyt voimakkaasti viime vuosina elintarvikkeiden pakkaamisessa sillä pakkaamalla elintarvike suojakaasuun voidaan sen hyllyikää pidentää ilman säilöntäaineita. Tällainen pakkaaminen vaatii kuitenkin täysin kaasutiiviin pakkauksen, jonka kaasunläpäisevyys on myös alhainen. Yleisimmin käytetyt pakkausmateriaalit suojakaasupakkaamisessa ovat monikerroksiset muovimateriaalit, joissa yhdistyy monen eri muovin parhaimmat ominaisuudet. Yleisimmin käytettyjä muovilaatuja näissä monikerrosrakenteissa ovat PE, PET, PA ja EVOH polymeerit. Myös muita perinteisiä polymeerejä käytetään jonkin verran näissä rakenteissa. Uudemmat muovilaadut, kuten biohajoavat muovit, eivät ole vielä yleistyneet kaupallisessa käytössä pääasiallisesti niiden korkean hinnan vuoksi. Muovisten pakkausten korvaamista esimerkiksi muovipäällystetyillä kartonkipakkauksilla on viime vuosien aikana tutkittu enenevissä määrin. Muovipakkausten korvaamista helpommin kierrätettävillä ja mahdollisesti biohajoavilla materiaaleilla edistävät EU:n direktiivit, jotka käsittelevät pakkausjätteen käsittelyä. Kartonkivuokien saumaamista kaasutiiviisti tutkittiin myös tässä työssä. Tavoitteena oli löytää pakkaus, joka soveltuisi kanasuikaleiden pakkaamiseen suojakaasuun. Kana on herkkä mikrobiologiselle hajoamiselle, minkä johdosta se tulee pakata suojakaasuun jossa happipitoisuuden tulee olla alle 1 % pakkauspäivästä viimeiseen käyttöpäivään saakka. Suorittamalla erilaisia tiiveystutkimuksia voitiin osoittaa, että kartonkivuoka on mahdollista saumata kaasutiiviisti luotettavalla tavalla. Tämä vaatii kuitenkin kartonkivuokien valmistuksen optimoimista päällystemuovikerroksen ja kartongin paksuuden mukaan sekä kannen saumaamista optimoiduilla saumausparametreilla. Tiivein vuoka saavutettiin muovifilmikannella, jonka saumaus perustui samaan muoviin kuin vuoan saumaus. Polyeteenillä saavutettiin tiivein ja kestävin saumaustulos.

CFD study of penetration and mixing of fuel in a circulating fluidized bed furnace

The aim of this thesis is to study the mixing of fuel and, also to some extent, the mixing of air in a circulating fluidized bed boiler. In the literature survey part of this thesis, a review is made of the previous experimental studies related to the fuel and air mixing in the circulating fluidized beds. In the simulation part of it the commercial computational fluid dynamics software (FLUENT) is used with the Eulerian multiphase model for studying the fuel mixing in the two and three-dimensional furnace geometries. The results of the three-dimensional simulations are promising and, therefore suggestions are made for the future simulations. The two-dimensional studies give new information of the effects of the fluidization velocity, fuel particle size and fuel density on the fuel mixing. However, the present results show that three-dimensional models produce more realistic representation of the circulating fluidized bed behavior.

Effect of sex and prior exposure to a cafeteria diet on the distribution of sex hormones between plasma and blood cells

It is generally assumed that steroid hormones are carried in the blood free and/or bound to plasma proteins. We investigated whether blood cells were also able to bind/carry sex-related hormones: estrone, estradiol, DHEA and testosterone. Wistar male and female rats were fed a cafeteria diet for 30 days, which induced overweight. The rats were fed the standard rat diet for 15 additional days to minimize the immediate effects of excess ingested energy. Controls were always kept on standard diet. After the rats were killed, their blood was used for 1) measuring plasma hormone levels, 2) determining the binding of labeled hormones to washed red blood cells (RBC), 3) incubating whole blood with labeled hormones and determining the distribution of label between plasma and packed cells, discounting the trapped plasma volume, 4) determining free plasma hormone using labeled hormones, both through membrane ultrafiltration and dextrancharcoal removal. The results were computed individually for each rat. Cells retained up to 32% estrone, and down to 10% of testosterone, with marked differences due to sex and diet (the latter only for estrogens, not for DHEA and testosterone). Sex and diet also affected the concentrations of all hormones, with no significant diet effects for estradiol and DHEA, but with considerable interaction between both factors. Binding to RBC was non-specific for all hormones. Estrogen distribution in plasma compartments was affected by sex and diet. In conclusion: a) there is a large non-specific RBC-carried compartment for estrone, estradiol, DHEA and testosterone deeply affected by sex; b) Prior exposure to a cafeteria (hyperlipidic) diet induced hormone distribution changes, affected by sex, which hint at sex-related structural differences in RBC membranes; c) We postulate that the RBC compartment may contribute to maintain free (i.e., fully active) sex hormone levels in a way similar to plasma proteins non-specific binding.

Comparison of different methods to forecast hospital bed needs

Objectives : This study compares three methods to forecast the number of acute somatic hospital beds needed in a Swiss academic hospital over the period 2010-2030. Design : Information about inpatient stays is provided through a yearly mandatory reporting of Swiss hospitals, containing anonymized data. Forecast of the numbers of beds needed compares a basic scenario relying on population projections with two other methods in use in our country that integrate additional hypotheses on future trends in admission rates and length of stay (LOS).

Approach to the Lower Pliocene marine-continental correlation from southern Spain. The micrommamal site of Alhaurín el Grande-1 (Málaga Basin, Betic Cordillera, Spain)

A new micromammal site at Alhaurín el Grande (Málaga, southern Spain) located above early Pliocene marine deposits allows an approach to the marine-continental correlation for this age. The early Pliocene marine filling throughout the Málaga Basin is developed in three transgressive-regressive sequences (Pl-1, Pl-2, and Pl-3 units) bounded by discontinuities. At the top of the intermediate sequence Pl-2, peaty sediments have yielded fossils of Rodentia, Lagomorpha, Insectivora, and Crocodylia. The presence of Cricetus barrieri Mein & Michaux, 1970 in combination with murids, both of primitive morphology, such as Apodemus gudrunae Van de Weerd, 1976, and more advanced forms (i.e. Occitanomys brailloni Michaux, 1969 and Stephanomys donnezani cordii Ruiz Bustos, 1986), points to an early Ruscinian age (MN 14 biozone). Based on the planktonic foraminifers, the biostratigraphic data indicate that marine sediments just below the micromammal beds belong to the MPl-2 biozone of the early Zanclean. Available paleomagnetic data from the marine sediments show that the micromammal bed must be located between the normal geomagnetic subchron C3n3n (4.89-4.80 Ma) and the subchron C3n2n (4.63-4.49 Ma), limiting the age of this site to the late part of the early Zanclean.

Oxidized oils and dietary zinc and alpha-tocopheryl acetate supplementation: effects on rabbit plasma, liver and meat fatty acid composition and meat Zn, Cu, Fe and Se content

The effects of the addition of heated oils to feeds (3%, w/w) and the dietary supplementation with a-tocopheryl acetate (TA; 100 mg/kg) and Zn (200 mg/kg) on rabbit tissue fatty acid (FA) composition and on the Zn, Cu, Fe and Se content in meat were assessed. Heating unrefined sunflower oil (SO) at 558C for 245 h increased its content in primary oxidation products and reduced its a-tocopherol content. However, this did not significantly affect tissue FA composition. Heating SO at 1408C for 31 h increased its content in secondary oxidation products and in some FA isomers asc9,t11-CLA and di-trans CLA. This led to increases in di-trans CLA in liver and in t9,c12-18:2 in meat. The c9,t11-CLA was the most incorporated CLA isomer in tissues. The dietary supplementation with a-TA did not affect the FA composition of plasma, liver or meat. The cooking of vacuum-packed rabbit meat at 788C for 5 min reduced significantly but slightly its polyunsaturated FA content. The dietary supplementation with Zn did not modify the content of Zn, Fe or Se in meat, but it reduced its Cu content. On the other hand, it increased the content of some FAs in meat when SO heated at 1408C for 31 h was added to feeds.