The Adjunct Life

The author describes her experiences as a librarian and an adjunct professor at the Graduate School of Library and Information Science at Simmons College in South Hadley, Massachusetts. She enjoys teaching students about library science, and loves her job. She says it can be difficult balancing two jobs, but that the reward of helping create new librarians makes it worth it. It also helps her keep her own skills current.

4. Bericht über den Neureuther Alpenpflanzen-Garten : erstellt von der Alpenvereinssektion Tegernsee

Jos. Steinbacher

Cary's Illustrated and Priced Catalogue: Surgical Instruments, Physicians, Hospital Supplies, and Furnishings, Druggist Sundries, Etc.

Second Edition. Pp.5-61 General Surgical Necessities, Gauze, Antiseptic Sundries, Surgical Sundries, Rubber Bandages, Catheters, Bougies, Splints, Tents, Emergency Bags, Surgeon's Needles, Operating Instruments, Amputating, Forceps, Aspiration, Cases, Catheters and Directors, Pocket Case Instruments, Dissecting and Post-Mortem Pp.62-118 General Operating - Osteotomy, Mastoid, Trephining, Eye Instruments, Aural, Nasal, Mouth and Throat, Tooth Forceps, Laryngoscopic Sets, Hydraulic Air Compressor, Variocele, Genito Urinary Pp. 119-167 Genito Urinary-Lithotrity, Alimentary, Anal and Rectal, Gynaecological, Pessaries, Microscopes, Syringes Pp.168-205 Chemical Apparatus and Glassware, Physician's Cabinets, Office Furniture, Operating Chairs and Tables, Hospital Beds, Cautery, Electrolytic, Batteries Pp.206-246 Cases, Varicose, Braces, Abdominal Supporters, Trusses, Invalid Chairs and Supplies, Sterilizers, Saddle-Bags, Deformity Apparatus Advertisements: Bandages, Abdominal Supporters, Rubber Supplies, Bags, Batteries, Cotton, Microscopes, Hypodermic Tablets, Atomizers, Furniture, Sterilizers, Syringes

UNDERSTANDING INTERRUPTIONS IN HEALTHCARE: DEVELOPING A MODEL

Developing a Model Interruption is a known human factor that contributes to errors and catastrophic events in healthcare as well as other high-risk industries. The landmark Institute of Medicine (IOM) report, To Err is Human, brought attention to the significance of preventable errors in medicine and suggested that interruptions could be a contributing factor. Previous studies of interruptions in healthcare did not offer a conceptual model by which to study interruptions. As a result of the serious consequences of interruptions investigated in other high-risk industries, there is a need to develop a model to describe, understand, explain, and predict interruptions and their consequences in healthcare. Therefore, the purpose of this study was to develop a model grounded in the literature and to use the model to describe and explain interruptions in healthcare. Specifically, this model would be used to describe and explain interruptions occurring in a Level One Trauma Center. A trauma center was chosen because this environment is characterized as intense, unpredictable, and interrupt-driven. The first step in developing the model began with a review of the literature which revealed that the concept interruption did not have a consistent definition in either the healthcare or non-healthcare literature. Walker and Avant’s method of concept analysis was used to clarify and define the concept. The analysis led to the identification of five defining attributes which include (1) a human experience, (2) an intrusion of a secondary, unplanned, and unexpected task, (3) discontinuity, (4) externally or internally initiated, and (5) situated within a context. However, before an interruption could commence, five conditions known as antecedents must occur. For an interruption to take place (1) an intent to interrupt is formed by the initiator, (2) a physical signal must pass a threshold test of detection by the recipient, (3) the sensory system of the recipient is stimulated to respond to the initiator, (4) an interruption task is presented to recipient, and (5) the interruption task is either accepted or rejected by v the recipient. An interruption was determined to be quantifiable by (1) the frequency of occurrence of an interruption, (2) the number of times the primary task has been suspended to perform an interrupting task, (3) the length of time the primary task has been suspended, and (4) the frequency of returning to the primary task or not returning to the primary task. As a result of the concept analysis, a definition of an interruption was derived from the literature. An interruption is defined as a break in the performance of a human activity initiated internal or external to the recipient and occurring within the context of a setting or location. This break results in the suspension of the initial task by initiating the performance of an unplanned task with the assumption that the initial task will be resumed. The definition is inclusive of all the defining attributes of an interruption. This is a standard definition that can be used by the healthcare industry. From the definition, a visual model of an interruption was developed. The model was used to describe and explain the interruptions recorded for an instrumental case study of physicians and registered nurses (RNs) working in a Level One Trauma Center. Five physicians were observed for a total of 29 hours, 31 minutes. Eight registered nurses were observed for a total of 40 hours 9 minutes. Observations were made on either the 0700–1500 or the 1500-2300 shift using the shadowing technique. Observations were recorded in the field note format. The field notes were analyzed by a hybrid method of categorizing activities and interruptions. The method was developed by using both a deductive a priori classification framework and by the inductive process utilizing line-byline coding and constant comparison as stated in Grounded Theory. The following categories were identified as relative to this study: Intended Recipient - the person to be interrupted Unintended Recipient - not the intended recipient of an interruption; i.e., receiving a phone call that was incorrectly dialed Indirect Recipient – the incidental recipient of an interruption; i.e., talking with another, thereby suspending the original activity Recipient Blocked – the intended recipient does not accept the interruption Recipient Delayed – the intended recipient postpones an interruption Self-interruption – a person, independent of another person, suspends one activity to perform another; i.e., while walking, stops abruptly and talks to another person Distraction – briefly disengaging from a task Organizational Design – the physical layout of the workspace that causes a disruption in workflow Artifacts Not Available – supplies and equipment that are not available in the workspace causing a disruption in workflow Initiator – a person who initiates an interruption Interruption by Organizational Design and Artifacts Not Available were identified as two new categories of interruption. These categories had not previously been cited in the literature. Analysis of the observations indicated that physicians were found to perform slightly fewer activities per hour when compared to RNs. This variance may be attributed to differing roles and responsibilities. Physicians were found to have more activities interrupted when compared to RNs. However, RNs experienced more interruptions per hour. Other people were determined to be the most commonly used medium through which to deliver an interruption. Additional mediums used to deliver an interruption vii included the telephone, pager, and one’s self. Both physicians and RNs were observed to resume an original interrupted activity more often than not. In most interruptions, both physicians and RNs performed only one or two interrupting activities before returning to the original interrupted activity. In conclusion the model was found to explain all interruptions observed during the study. However, the model will require an even more comprehensive study in order to establish its predictive value.

Compactor device for large round bales

A compactor device for iarge round bales is disclosed comprising a horizontally disposed cylindrical housing containing a plunger, a double toggle mechanism connected to the plunger, a hydraulic cylinder connected to the double toggle mechanism for driving the plunger, and a stabilizer linkage connected to the plunger and the double toggle mechanism for maintaining the plunger in a vertical position during compaction of a bale.

My ISU Journey

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Soil and Plant Fertility Management for Soybeans

Producers utilizing a two year rotation of corn and soybean often apply fertilizer on a biannual basis, spreading recommended amounts of phosphorus and potassium for both crops prior to corn establishment. This approach minimizes application costs and is in accordance with university fertility recommendations that have found a low probability of fertilizer yield response when soils tested at the medium/optimum level or above. However, the field trials on which these state recommendations were developed are often several decades old. Increases in average corn and soybean yields and associated increases in crop nutrient removal rates have called into question the validity of these recommendations for current production environments. This study investigated the response of soil test levels and grain yield to annual and biannual fertilizer applications made at 1x and 2x rates of current university fertilizer recommendations.

Homenaje a Leopoldo Marechal

Revista del Instituto de Lenguas y Literaturas Modernas, Facultad de Filosofía y Letras, Universidad Nacional de Cuyo. En este número en particular los artículos giran en torno a la temática: "Homenaje a Leopoldo Marechal"

El espacio literario : su configuración en Adán Buenosayres

A partir de una especulación acerca de la preponderancia de trabajos dedicados al estudio del tiempo frente al espacio y sobre la terminología más precisa acerca de este último, se define la “" o “logotopía" como la lectura del espacio en literatura. Se considera este campo como un aspecto legible e interpretable. Se ve en el espacio un terreno que grandes autores (como Kafka, Marechal y Borges, por ejemplo), han sabido utilizar magistralmente alcanzando -tanto por medio de ilustraciones como por disposiciones tipográficas- un nivel de sugestión que supera el efecto de recepción previsible. El análisis acerca del modo de configuración del espacio en Adán Buenosayres permite demostrar ampliamente que el héroe marechaliano es creatura no sólo temporal sino espacial. Aun más, toda la obra narrativa de Marechal se organiza espacialmente. El espacio genera un conjunto de sistemas. Como la imagen de la cultura, su literatura es megasistema. El espacio es percibido por él en concentrada unidad, en ámbitos articulados, dispuestos en armonía y ensamble. Su combinación de espacios intramundanos y trasmundanos, articuldaos entre sí, no son otra cosa que la proyección de su propia concepción del mundo cristiana, del mundo, obra de un Dios creador.