The impact of a post-take ward round pharmacist on the risk score and enactment of medication-related recommendations

There is a scarcity of published research describing the impact of a pharmacist on the post-take ward round (PTWR) in addition to ward-based pharmacy services. The aim of this paper was to evaluate the impact of clinical pharmacists' participation on the PTWR on the risk assessment scores of medication-related recommendations with and without a pharmacist. This includes medication-related recommendations occurring on the PTWR and those recommendations made by the ward-based pharmacist on the inpatient ward. A pre-post intervention study was undertaken that compared the impact of adding a pharmacist to the PTWR compared with ward-based pharmacist services alone. A panel reviewed the risk of not acting on medication recommendations that was made on the PTWR and those recorded by the ward-based pharmacist. The relationship between the risk scores and the number and proportion of recommendations that led to action were compared between study groups. There were more medication-related recommendations on the PTWR in the intervention group when a pharmacist was present. Proportionately fewer were in the 'very high and extreme' risk category. Although there was no difference in the number of ward pharmacist recommendations between groups, there was a significantly higher proportion of ward pharmacist recommendations in the "very high and extreme" category in those patients who had been seen on a PTWR attended by a pharmacist than when a pharmacist was not present. There were a greater proportion of "low and medium" risk actionable medication recommendations actioned on the PTWR in the intervention group; and no difference in the risk scores in ward pharmacist recommendations actioned between groups. Overall, the proportion of recommendations that were actioned was higher for those made on the PTWR compared with the ward. The addition of a pharmacist to the PTWR resulted in an increase in low, medium, and high risk recommendations on the PTWR, more very high and extreme risk recommendations made by the ward-based pharmacist, plus an increased number of recommendations being actioned during the patients' admission

Medium power hydrogen arcjet performance

An experimental investigation was performed to evaluate hydrogen arcjet operating characteristics in the range of 1 to 4 kW. A series of nozzles were operated in modular laboratory thrusters to examine the effects of geometric parameters such as constrictor diameter and nozzle divergence angle. Each nozzle was tested over a range of current and mass flow rates to explore stability and performance. In the range of mass flow rates and power levels tested, specific impulse values between 650 and 1250 sec were obtained at efficiencies between 30 and 40 percent. The performance of the two larger half angle (20, 15 deg) nozzles was similar for each of the two constrictor diameters tested. The nozzles with the smallest half angle (10 deg) were difiicult to operate. A restrike mode of operation was identified and described. Damage in the form of melting was observed in the constrictor region of all the nozzle inserts tested. Arcjet ignition was also difficult in many tests and a glow discharge mode that prevents starting was identified

BALL SIZE AND WEIGHT EFFECTS ON THROWING KINEMATICS AND KINETICS IN YOUTH BASEBALL ATHLETES

In baseball, youth players play on smaller fields with shorter base path distance, pitching distance, and smaller mounds. Despite this, the baseball itself remains unchanged for youth athletes. This prospective cohort analyzed the kinematics and kinetics of 38 youth baseball pitchers while using modified sized and weighted baseballs. An ANOVA was used to determine statistical significance amongst ball modifications. ANOVA results show significance between the 3oz-5oz baseball with the 3oz baseball decreasing elbow varus torque. This is a preliminary study on the effects of modified baseballs on youth athletes

An analysis of the economic viability of farm credit system banks and combined associations

March 1991Date on cover: April 1991.Title on cover: Analysis of the viability of farm credit system banks and combined associations.Includes bibliographical references (pages 118-121)

Salvaging Detection of Early-Stage Ovarian Malignancies When CA125 Is Not Informative

Background: Ovarian cancer is the deadliest gynecologic cancer, with no recommended screening test to assist with early detection. Cancer antigen 125 (CA125) is a serum biomarker commonly used by clinicians to assess preoperative cancer risk, but it underperforms in premenopausal women, early-stage malignancies, and several histologic subtypes. OVA1 is a multivariate index assay that combines CA125 and four other serum proteins to assess the malignant risk of an adnexal mass. Objective: To evaluate the performance of OVA1 in a cohort of patients with low-risk serum CA125 values. Study Design: We analyzed patient data from previous collections (N = 2305, prevalence = 4.5%) where CA125 levels were at or below 67 units/milliliter (U/mL) for pre-menopausal women and 35 U/mL for post-menopausal women. We compare the performance of OVA1 to CA125 in classifying the risk of malignancy in this cohort, including sensitivity, specificity, positive and negative predictive values. Results: The overall sensitivity of OVA1 in patients with a low-risk serum CA125 was 59% with a false-positive rate of 30%. OVA1 detected over 50% of ovarian malignancies in premenopausal women despite a low-risk serum CA125. OVA1 also correctly identified 63% of early-stage cancers missed by CA125. The most common epithelial ovarian cancer subtypes in the study population were mucinous (25%) and serous (23%) carcinomas. Despite a low-risk CA125, OVA1 successfully detected 83% of serous, 58% of mucinous, and 50% of clear cell ovarian cancers. Conclusions: As a standalone test, CA125 misses a significant number of ovarian malignancies that can be detected by OVA1. This is particularly important for premenopausal women and early-stage cancers, which have a much better long-term survival than late-stage malignancies. Using OVA1 in the setting of a normal serum CA125 can help identify at-risk ovarian tumors for referral to a gynecologic oncologist, potentially improving overall survival

Evaluation of Solid Boron Stainless Steel Shim-Safety Rods for the Ford Nuclear Reactor

http://deepblue.lib.umich.edu/bitstream/2027.42/85776/1/MMPP-110-3 December 1961.PDF-

Deformation of the Ford Nuclear Reactor Shim-Safety Rods

http://deepblue.lib.umich.edu/bitstream/2027.42/85750/1/MMPP 110-2 December 1960.PDF15