104 research outputs found

    Amazon.com vs. EBSCO’s GOBI Library Solutions: Evaluating New and Used Book Vendors While Building a Diverse Collection

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    This article will share a small college’s comparison of the benefits and challenges that occurred when ordering a curated list of new and used print books from EBSCO’s GOBI Library Solutions, a traditional book jobber, instead of Amazon.com, a book retailer. The researchers analyzed the acquisition process, final purchase cost, and reconciliation workflow between the two vendors. Results from this study revealed a 3.1% final cost difference between the two vendors. Additionally, this case study addressed the workflow undertaken to build a curated list of new and used LGBTQ and Title IX print books. This research contributed to the literature as scholarship that compared titles in academic libraries between one subject area, gender studies, in combination with an assessment of the collection development, acquisition, and ordering software tools provided to academic libraries from a traditional book jobber and a book retailer was scant

    Prevalence of maternal complications and neonatal outcomes at a Midwest academic health center

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    Introduction: The University of Iowa Hospitals and Clinics (UIHC) serves as the main referral center for Iowa and has seen increased delivery volumes following many hospital closures across the state. Maternal characteristics are also shifting as pre-pregnancy obesity of reproductive-age women is increasing nationally and in Iowa; average maternal age at first delivery has also increased over time. The aim of the current study was to characterize the outcomes of the delivering population at UIHC over a one-year period to better understand the population we serve, as well as compare our population to state and national delivering populations. Methods: This study is a secondary analysis of a pre-existing prospectively gathered database related to COVID-19 in pregnancy. The current study included all pregnant patients who delivered or underwent procedures for a spontaneous or induced second-trimester abortion on the labor and delivery unit at UIHC between May 1, 2020, and April 30, 2021. Demographic and clinical data including maternal characteristics, delivery information, maternal complications, and neonatal outcomes were obtained from the electronic medical record and double entered in a Research Electronic Data Capture (REDCap) database. Continuous and categorical variables were summarized using medians and ranges. Results: The median maternal age among the 2497 delivering patients was 30 (IQR 26, 33). The median pre-delivery body mass index (BMI) was 32 (IQR 28, 37), which included 439 patients (17.6%) with BMI >40 at time of delivery. 1769 (70.8%) patients listed White as their self-defined race and 2275 (91.0%) listed English as their preferred language. 23% had hypertensive disease of pregnancy. The patients delivered a total of 2603 neonates, with 907 (34.8%) born by cesarean section. 18.7% of deliveries were preterm and 16.6% of neonates had low birth weight. Discussion: The delivering population at UIHC has a high rate of obesity and preeclampsia, both of which place patients at higher risk for other obstetric complications. The cesarean section rate was significantly higher than the national rate of 31.8% (p=0.0017). Understanding common complications in our changing population will better equip providers to care for these patients; providing these data also creates a resource for other researchers

    Hospital-Level Nicu Capacity, Utilization, and 30-Day Outcomes in Texas

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    IMPORTANCE: Risk-adjusted neonatal intensive care unit (NICU) utilization and outcomes vary markedly across regions and hospitals. The causes of this variation are poorly understood. OBJECTIVE: to assess the association of hospital-level NICU bed capacity with utilization and outcomes in newborn cohorts with differing levels of health risk. DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study included all Medicaid-insured live births in Texas from 2010 to 2014 using linked vital records and maternal and newborn claims data. Participants were Medicaid-insured singleton live births (LBs) with birth weights of at least 400 g and gestational ages between 22 and 44 weeks. Newborns were grouped into 3 cohorts: very low birth weight (VLBW; \u3c1500 \u3eg), late preterm (LPT; 34-36 weeks\u27 gestation), and nonpreterm newborns (NPT; ≥37 weeks\u27 gestation). Data analysis was conducted from January 2022 to October 2023. EXPOSURE: Hospital NICU capacity measured as reported NICU beds/100 LBs, adjusted (ie, allocated) for transfers. MAIN OUTCOMES AND MEASURES: NICU admissions and special care days; inpatient mortality and 30-day postdischarge adverse events (ie, mortality, emergency department visit, admission, observation stay). RESULTS: The overall cohort of 874 280 single LBs included 9938 VLBW (5054 [50.9%] female; mean [SD] birth weight, 1028.9 [289.6] g; mean [SD] gestational age, 27.6 [2.6] wk), 63 160 LPT (33 684 [53.3%] female; mean [SD] birth weight, 2664.0 [409.4] g; mean [SD] gestational age, 35.4 [0.8] wk), and 801 182 NPT (407 977 [50.9%] female; mean [SD] birth weight, 3318.7 [383.4] g; mean [SD] gestational age, 38.9 [1.0] wk) LBs. Median (IQR) NICU capacity was 0.84 (0.57-1.30) allocated beds/100 LB/year. For VLBW newborns, NICU capacity was not associated with the risk of NICU admission or number of special care days. For LPT newborns, birth in hospitals with the highest compared with the lowest category of capacity was associated with a 17% higher risk of NICU admission (adjusted risk ratio [aRR], 1.17; 95% CI, 1.01-1.33). For NPT newborns, risk of NICU admission was 55% higher (aRR, 1.55; 95% CI, 1.22-1.97) in the highest- vs the lowest-capacity hospitals. The number of special care days for LPT and NPT newborns was 21% (aRR, 1.21; 95% CI,1.08-1.36) and 37% (aRR, 1.37; 95% CI, 1.08-1.74) higher in the highest vs lowest capacity hospitals, respectively. Among LPT and NPT newborns, NICU capacity was associated with higher inpatient mortality and 30-day postdischarge adverse events. CONCLUSIONS AND RELEVANCE: In this cohort study of Medicaid-insured newborns in Texas, greater hospital NICU bed supply was associated with increased NICU utilization in newborns born LPT and NPT. Higher capacity was not associated with lower risk of adverse events. These findings raise important questions about how the NICU is used for newborns with lower risk

    Commissioning of the vacuum system of the KATRIN Main Spectrometer

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    The KATRIN experiment will probe the neutrino mass by measuring the beta-electron energy spectrum near the endpoint of tritium beta-decay. An integral energy analysis will be performed by an electro-static spectrometer (Main Spectrometer), an ultra-high vacuum vessel with a length of 23.2 m, a volume of 1240 m^3, and a complex inner electrode system with about 120000 individual parts. The strong magnetic field that guides the beta-electrons is provided by super-conducting solenoids at both ends of the spectrometer. Its influence on turbo-molecular pumps and vacuum gauges had to be considered. A system consisting of 6 turbo-molecular pumps and 3 km of non-evaporable getter strips has been deployed and was tested during the commissioning of the spectrometer. In this paper the configuration, the commissioning with bake-out at 300{\deg}C, and the performance of this system are presented in detail. The vacuum system has to maintain a pressure in the 10^{-11} mbar range. It is demonstrated that the performance of the system is already close to these stringent functional requirements for the KATRIN experiment, which will start at the end of 2016.Comment: submitted for publication in JINST, 39 pages, 15 figure

    Commissioning of the vacuum system of the KATRIN Main Spectrometer

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    The KATRIN experiment will probe the neutrino mass by measuring the -electron energy spectrum near the endpoint of tritium -decay. An integral energy analysis will be performed by an electro-static spectrometer (“Main Spectrometer”), an ultra-high vacuum vessel with a length of 23.2 m, a volume of 1240m3, and a complex inner electrode system with about 120 000 individual parts. The strong magnetic field that guides the -electrons is provided by super-conducting solenoids at both ends of the spectrometer. Its influence on turbo-molecular pumps and vacuum gauges had to be considered. A system consisting of 6 turbo-molecular pumps and 3 km of non-evaporable getter strips has been deployed and was tested during the commissioning of the spectrometer. In this paper the configuration, the commissioning with bake-out at 300 C, and the performance of this system are presented in detail. The vacuum system has to maintain a pressure in the 1011^{-11} mbar range. It is demonstrated that the performance of the system is already close to these stringent functional requirements for the KATRIN experiment, which will start at the end of 2016

    Nurse mentorship program implementation to enculturate nurses to an intensive care unit

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    Intensive care unit (ICU) nursing can be challenging due to stress, unpredictability, and complexity of patients. Nurse mentorship has been recognized as an effective means of helping support and develop individuals. Nurses who are new to an ICU setting may feel overwhelmed or inadequately prepared for the scope of challenges faced during the period of transition following orientation. The medical/surgical/transplant ICU at a Midwestern, teaching healthcare institution is a complex and challenging nursing practice affected by nursing turnover. Facilitating nurses\u27 transition into an ICU and enculturating nurses who are new to an ICU has been achieved through a hybrid nurse mentorship program. The hybrid nurse mentorship program includes monthly one-to-one mentorship combined with quarterly group mentoring. This project\u27s purpose is to implement an enhanced hybrid nurse mentorship program designed to enculturate nurses into the medical/surgical/transplant ICU to improve the patient experience at a Midwestern, teaching healthcare institution. Jean Watson\u27s Theory of Human Caring / Philosophy and Science of Caring provides the theoretical framework for the transpersonal caring relationship guiding the nurse mentorship relationship. The metaphor of connecting puzzle pieces represents the evolving connection and progression of the mentor-mentee relationship(s) in the nurse mentorship program. Effectiveness of the hybrid nurse mentorship program is assessed and evaluated on an ongoing basis. This enhanced hybrid nurse mentorship program has provided opportunities for connection among mentees and mentors, increased staff nurse satisfaction, and aims to improve staff nurse retention to improve the quality of patient care, resulting in optimal patient experiences and potentially patient outcomes
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