Comparison of Nurse Staffing Based on Changes in Unit-level Workload Associated with Patient Churn

Aim This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers. Background Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes. Method(s) Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical. Result Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts. Conclusion Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn. Implications for nursing management Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements

The development of direct payments in the UK: implications for social justice

Direct payments have been heralded by the disability movement as an important means to achieving independent living and hence greater social justice for disabled people through enhanced recognition as well as financial redistribution. Drawing on data from the ESRC funded project Disabled People and Direct Payments: A UK Comparative Perspective, this paper presents an analysis of policy and official statistics on use of direct payments across the UK. It is argued that the potential of direct payments has only partly been realised as a result of very low and uneven uptake within and between different parts of the UK. This is accounted for in part by resistance from some Labour-controlled local authorities, which regard direct payments as a threat to public sector jobs. In addition, access to direct payments has been uneven across impairment groups. However, from a very low base there has been a rapid expansion in the use of direct payments over the past three years. The extent to which direct payments are able to facilitate the ultimate goal of independent living for disabled people requires careful monitoring

Use of Digital Tools for Horizontal Spread of Agricultural Technologies by Farmers of Kerala

In this digital era, integration of digital tools is common in every sector and agriculture is not an exception. The present study was conducted among the farmers of Kerala who were using various digital tools, during the year 2018-2019. The sample of the study consisted of 120 farmers from three zones of Kerala. Awareness and Preference of the respondents were studied in order to find out the horizontal spread. Based on the results obtained it was found that all farmers were aware about tools like television, mobile phone and social media. Most of the farmers had selected mobile phones as the most preferred tool. Farmers were found to use mobile phones mainly for ‘crop protection’ purposes and social media for ‘marketing’ purposes

Model for U.S. Farm Financial Adjustment Analysis of Alternative Public Policies

As the agricultural sector adjusts to financial stress and constantly changing national and international policies, additional structural changes are expected. The capacity for adjustment through existing agricultural asset markets depends on both the extent of farm restructuring and the resiliency of the markets and agricultural institutions. Research is needed to estimate farm financial restructuring needs and the expected duration of the restructuring process. Projecting the magnitude of change needed for financial stability in agriculture would help in assessing the ability of existing markets and institutions to manage restructuring. Policies to alleviate farm financial stress could then be judged for appropriateness and effectiveness

A Purely Functional Computer Algebra System Embedded in Haskell

We demonstrate how methods in Functional Programming can be used to implement a computer algebra system. As a proof-of-concept, we present the computational-algebra package. It is a computer algebra system implemented as an embedded domain-specific language in Haskell, a purely functional programming language. Utilising methods in functional programming and prominent features of Haskell, this library achieves safety, composability, and correctness at the same time. To demonstrate the advantages of our approach, we have implemented advanced Gr\"{o}bner basis algorithms, such as Faug\`{e}re's $F_4$ and $F_5$, in a composable way.Comment: 16 pages, Accepted to CASC 201

Benchmarking acid and base dopants with respect to enabling the ice V to XIII and ice VI to XV hydrogen-ordering phase transitions

Doping the hydrogen-disordered phases of ice V, VI and XII with hydrochloric acid (HCl) has led to the discovery of their hydrogen-ordered counterparts ices XIII, XV and XIV. Yet, the mechanistic details of the hydrogen-ordering phase transitions are still not fully understood. This includes in particular the role of the acid dopant and the defect dynamics that it creates within the ices. Here we investigate the effects of several acid and base dopants on the hydrogen ordering of ices V and VI with calorimetry and X-ray diffraction. HCl is found to be most effective for both phases which is attributed to a favourable combination of high solubility and strong acid properties which create mobile H3O+ defects that enable the hydrogen-ordering processes. Hydrofluoric acid (HF) is the second most effective dopant highlighting that the acid strengths of HCl and HF are much more similar in ice than they are in liquid water. Surprisingly, hydrobromic acid doping facilitates hydrogen ordering in ice VI whereas only a very small effect is observed for ice V. Conversely, lithium hydroxide (LiOH) doping achieves a performance comparable to HF-doping in ice V but it is ineffective in the case of ice VI. Sodium hydroxide, potassium hydroxide (as previously shown) and perchloric acid doping are ineffective for both phases. These findings highlight the need for future computational studies but also raise the question why LiOH-doping achieves hydrogen-ordering of ice V whereas potassium hydroxide doping is most effective for the 'ordinary' ice Ih.Comment: 18 pages, 7 figures, 1 tabl

Capacitively coupled hydrogen discharges : modeling vs. experiment

This paper presents a systematic characterization of hydrogen capacitively coupled very high frequency discharges, produced within a parallel plate cylindrical setup, by comparing numerical simulations to experimental measurements for various plasma parameters. A good quantitative agreement is found between calculation and experiment for the coupled electrical power and the plasma potential, at various frequencies, pressures and applied voltages. However, the model generally underestimates the electron density and the self-bias potential with respect to measured values. Model predictions for the absolute density of H(n=1) atoms are compared to first diagnostic results, obtained by two-photon absorption laser-induced fluorescence diagnostics at various pressures and frequencies.Fundação para a Ciência e a Tecnologia (FCT) - SFRH/BD/5012/200

A Study to Determine the Knowledge and Practice regarding Biomedical Waste Management among Paramedical Workers in Selected Primary Health Center at Manamadurai in Sivagangai District

PROBLEM STATEMENT: A study to determine the knowledge and practice regarding biomedical waste management among paramedical workers in selected primary health center at Manamadurai in Sivagangai District. METHODOLOGY: The quantitative research approach with descriptive design was used in this study.The purpose of the study to asses the knowledge and practice of biomedical waste management among paramedical workers. Semi structured questionaire to asses the knowledge regarding biomedical waste management verbal response / checklist to asses the practice of biomedical waste management. The Inferential descriptive statistics was used. OBJECTIVES: 1. To assess the knowledge regarding biomedical waste management among Paramedical workers in selected PHC. 2. To assess the practice regarding biomedical waste management among paramedical workers in selected primary health center. 3. To find out the relationship between knowledge and practice regarding biomedical waste management. 4. To find out the association between the knowledge of paramedical workers and selected demographic variable like age, sex, religion and occupation status, income and experience, and training. 5. To find out the association between the practice on biomedical waste management of paramedical workers and selected demographic variables like age, sex, religion, and occupation, income and experience and training HYPOTHESIS: ❖ There is a significant relationship between the knowledge and practice of paramedical workers regarding Biomedical waste management. ❖ There is a significant association between the knowledge and selected variable such as age, sex, religion, marital status and occupation income, and training. ❖ There is a significant association between the practice and selected variable such as age, sex, religion, marital status and occupation income, and training. MAJOR FINDINGS OF THE STUDY: Majority of paramedical workers 37(37%) between above 31 years. ♣ Majority of paramedical workers 84 (84%) were females. ♣ Majority of paramedical workers 70(70%) were married. ♣ Majority of paramedical workers 74(74%)were Hindu ♣ Majority of paramedical workers 37(37%) were general nurse and midwives. ♣ Majority of paramedical workers 48(48%) were 1-5 years of experience. ♣ Majority of paramedical workers 47(47%) were 12,001-17,000 income ♣ Majority of paramedical workers 100 (100%) were attended training. ♣ Majority of paramedical workers have 58% moderate level of knowledge. ♣ Majority of paramedical workers 77% were having moderate level of practice. ♣ Overall results showed that association between knowledge and selected demographic variable such as religion, experience, income, training and occupation. ♣ Overall results showed that there is no association between practice and selected demographic variables such as age, sex, marital status, year of experience income and training. ♣ Overall results showed that there is a relationship between knowledge and practice. The computed ‘r’ value is +0.515 the positive correlation was found between knowledge and practice. Hence it was interpreted that paramedical workers who had adequate knowledge follows satisfied level of practice. RECOMMENDATION FOR FURTHER RESEARCH: ♠ On the basis of present study following recommendation are made. • A similar study could be done with large samples. ♠ An experimental study could be conducted with structured teaching program on knowledge and practice ♠ A similar study could be conducted in the hospital ,nursing homes and clinics. ♠ A similar study could be done on longitudinal basis. ♠ A similar study may be conducted to find the incidence of infectious disease related to biomedical waste management. ♠ A similar study could be conducted with Health care providers. CONCLUSION: From the above findings the investigator would like to conclude that majority of paramedical workers have moderate level of knowledge; but none of them having adequate level of practices. It was noticed that the primary health centers were not providing adequate facilities to practice bio-medical waste management. The concerned authorities should also be vigilant and providing the proper facilities such as dust bin in different colors for the disposal of hospital waste material. The medical officer should create awareness among paramedical workers regarding bio medical waste management in primary health center and also motivate them to do practice of biomedical waste management; The success of the various scheme implemented by the Government through the medical department in eradicating certain diseases depend on the basic implementation of bio-medical waste management. In primary health centre and also motivate them to do practice of biomedical waste management

Modelling the influence of frequency in a low pressure capacitively coupled hydrogen discharge

This paper investigates the dependence of plasma density and self-bias voltage with excitation frequency (13.56-40.68 MHz) using a two-dimensional (2D) fluid model in a low pressure (300 mTorr) radio frequency (RF) capacitively coupled hydrogen discharge. A comparison with experimental results reveals that the model predicts the correct trends of density and self-bias voltage variation with driving frequenc

Modelling and characterization of a low pressure capacitively coupled hydrogen discharge

This paper presents a systematic characterization of a pure hydrogen capacitively coupled radio frequency discharge, produced in a parallel plate cylindrical setup, comparing experimental measurements obtained for such discharge with numerical simulations. A good agreement is found between simulation results and experimental measurements for the discharge main electrical parameters. A comparison of H atom absolute density LIF measurements with simulation results will also be presented