Performing an aseptic technique in a community setting : fact or fiction?

Background - Maintaining the principles of asepsis when performing wound care and other invasive procedures is one of the fundamental approaches of preventing healthcare-acquired infection. Such an approach has been advocated for community practitioners. Literature - The performance of an aseptic technique is an under-researched area. The few studies that have been conducted have identified how strict adherence to the technique is difficult and contamination of hands/gloves is common and that community nurses often have a fatalistic view about whether asepsis is possible in a community setting. Aim - The overall aim of this research project was to examine how experienced practitioners have adapted the aseptic technique within a community setting and to what extent the changed procedure still adhered to the principles of asepsis. Methods - This study used a mixture of non-participant observation and individual semi-structured interviews to examine adherence to the principles of the aseptic technique among the district nurses. Data were collected from one Trust in England with a total of 10 district nurses taking part and 30 aseptic procedures been observed. Results - The results show that almost all of the staff understood the principles of asepsis and had adapted the standard procedure for use in a patient’s home. Common challenges included wound cleaning using a single nurse procedure, the contents of the pack and the home environment. The research also identified misconceptions about clean versus aseptic procedures and a lack of training for staff. Conclusions - This study highlights the challenges of maintaining the principles of asepsis in a home environment and the fact that district nurses are often relied upon to find creative solutions to such challenges. The study also highlights issues around the implementation of evidence-based practice and the need for clearer guidance about how evidence should be used alongside existing procedures

Estimability and efficiency in nearly orthogonal 2[m1] x 3[m2] deletion designs

This article considers single replicate factorial experiments in incomplete blocks. A single replicate 2^m1 x 3^m2 deletion design in 3 incomplete blocks is obtained from a single replicate 3^m, where m = m_1 + m_2, preliminary design by deleting all runs (or treatment combinations) with the first m_1 factors at the level two. A systematic method for determining the unbiasedly estimable (u.e.) and not unbiasedly estimable (n.u.e.) factorial effects is provided. It is shown that for m_2 > 0 all factorial effects of the type F( α_1 · · · α_m_1 , α_(m_1 +1) · · · α_m), where α_i; = 0, l for i = 1, · · ·, m_1, α_i; = 0, 1, 2 for i = m_(1+1), · · ·, m, with (α_1 · · · α_m) != (0 · · · 0), and (α_m,+l · · · _m) != α(l · · · 1) for a= 1, 2, are u.e. and the remaining factorial effects are n.u.e. It is noted that (2^m_1 - 1) factorial effects of 2^m_1 factorial experiments and (3^m_2) factorial effects of 3^m, factorial experiments, which are embedded in 2^m_1 x 3^m, factorial experiments, are u. e. The 2 x 3m-l deletion designs were considered in the work of Voss (1986). Defining factorial effects of a 2^m_1 x 3^m, factorial experiment in a form different than in Voss (1986), we develop a simple representation of u.e. and n. u. e. factorial effects. In this representation, there are (2^(m_1 + 1) + 1) n. u. e. factorial effects of the type F( α_1 · · · α_m_1, α· · · α). This number is smaller than the corresponding number of n. u. e. factorial effects in the representation of Voss (1986). The relative efficiency expressions, and their bounds, in the estimation of factorial effects of 2^m_1 x 3^m_2 deletion designs are also given

A prediction of 3-D viscous flow and performance of the NASA low-speed centrifugal compressor

A prediction of the 3-D turbulent flow in the NASA Low-Speed Centrifugal Compressor Impeller has been made. The calculation was made for the compressor design conditions with the specified uniform tip clearance gap. The predicted performance is significantly worse than that predicted in the NASA design study. This is explained by the high tip leakage flow in the present calculation and by the different model adopted for tip leakage flow mixing. The calculation gives an accumulation for high losses in the shroud/pressure-side quadrant near the exit of the impeller. It also predicts a region of meridional backflow near the shroud wall. Both of these flow features should be extensive enough in the NASA impeller to allow detailed flow measurements, leading to improved flow modelling. Recommendations are made for future flow studies in the NASA impeller

Bridge damage detection based on vibration data: past and new developments

Overtime, bridge condition declines due to a number of degradation processes such as creep, corrosion, and cyclic loading, among others. Traditionally, vibration-based damage detection techniques in bridges have focused on monitoring changes to modal parameters. These techniques can often suffer to their sensitivity to changes in environmental and operational conditions, mistaking them as structural damage. Recent research has seen the emergence of more advanced computational techniques that not only allow the assessment of noisier and more complex data but also allow research to veer away from monitoring changes in modal parameters alone. This paper presents a review of the current state-of-the-art developments in vibration-based damage detection in small to medium span bridges with particular focus on the utilization of advanced computational methods that avoid traditional damage detection pitfalls. A case study based on the S101 bridge is also presented to test the damage sensitivity to a chosen methodology.Peer ReviewedPostprint (published version

"The Measurement of Chronic and Transitory Poverty: with Application to the United States"

This paper proposes a method of measuring chronic and transitory poverty based on any additively-decomposable index of aggregate poverty. Chronic poverty and transitory poverty in the United States are measured using data from the Panel Study of Income Dynamics (1987 interviewing year). In an attempt to identify the most impoverished subpopulations, poverty indices are decomposed according to race, type of household and educational qualifications of the head of the household.

LDEF materials data bases

The Long Duration Exposure Facility (LDEF) and the accompanying experiments were composed of and contained a wide variety of materials representing the largest collection of materials flown in low Earth orbit (LEO) and retrieved for ground based analysis to date. The results and implications of the mechanical, thermal, optical, and electrical data from these materials are the foundation on which future LEO space missions will be built. The LDEF Materials Special Investigation Group (MSIG) has been charged with establishing and developing data bases to document these materials and their performance to assure not only that the data are archived for future generations but also that the data are available to the spacecraft user community in an easily accessed, user-friendly form. This paper discusses the format and content of the three data bases developed or being developed to accomplish this task. The hardware and software requirements for each of these three data bases are discussed along with current availability of the data bases. This paper also serves as a user's guide to the MAPTIS LDEF Materials Data Base

Diplomas for Learning, not Seat Time: The Impacts of New York Regents Examinations

[Excerpt] New York State has been administering curriculum-based Regents Examinations to high school students ever since June 1878. As Sherman Tinkelman, Assistant Commissioner for Examinations and Scholarships described in a 1966 report: The Regents examinations are closely related to the curriculum in New York State. They are, as you can see, inseparably intertwined. One supports and reinforces the other.... These instruments presuppose and define standards.... They are a strong supervisory and instructional tool-- and deliberately so. They are effective in stimulating good teaching and good learning practices (Tinkelman, 1966 p. 12)

The regularity of the boundary of a multidimensional aggregation patch

Let $d \geq 2$ and let $N(y)$ be the fundamental solution of the Laplace equation in $R^d$ We consider the aggregation equation $$\frac{\partial \rho}{\partial t} + \operatorname{div}(\rho v) =0, v = -\nabla N * \rho$$ with initial data $\rho(x,0) = \chi_{D_0}$, where $\chi_{D_0}$ is the indicator function of a bounded domain $D_0 \subset R^d.$ We now fix $0 < \gamma < 1$ and take $D_0$ to be a bounded $C^{1+\gamma}$ domain (a domain with smooth boundary of class $C^{1+\gamma}$). Then we have Theorem: If $D_0$ is a $C^{1 + \gamma}$ domain, then the initial value problem above has a solution given by $$\rho(x,t) = \frac{1}{1 -t} \chi_{D_t}(x), \quad x \in R^d, \quad 0 \le t < 1$$ where $D_t$ is a $C^{1 + \gamma}$ domain for all $0 \leq t < 1$

The preliminary Long Duration Exposure Facility (LDEF) materials data base

A preliminary Long Duration Exposure Facility (LDEF) Materials Data Base was developed by the LDEF Materials Special Investigation Group (MSIG). The LDEF Materials Data Base is envisioned to eventually contain the wide variety and vast quantity of materials data generated for LDEF. The data is searchable by optical, thermal, and mechanical properties, exposure parameters (such as atomic oxygen flux), and author(s) or principal investigator(s). The LDEF Materials Data Base was incorporated into the Materials and Processes Technical Information System (MAPTIS). MAPTIS is a collection of materials data which was computerized and is available to engineers, designers, and researchers in the aerospace community involved in the design and development of spacecraft and related hardware. This paper describes the LDEF Materials Data Base and includes step-by-step example searches using the data base. Information on how to become an authorized user of the system is included

Explicit finite-volume time-marching calculations of total temperature distributions in turbulent flow

A method was developed which calculates two-dimensional, transonic, viscous flow in ducts. The finite volume, time-marching formulation is used to obtain steady flow solutions of the Reynolds-averaged form of the Navier-Stokes equations. The entire calculation is performed in the physical domain. This paper investigates the introduction of a new formulation of the energy equation which gives improved transient behavior as the calculation converges. The effect of variable Prandtl number on the temperature distribution through the boundary layer is also investigated. A turbulent boundary layer in an adverse pressure gradient (M = 0.55) is used to demonstrate the improved transient temperature distribution obtained when the new formulation of the energy equation is used. A flat plate turbulent boundary layer with a supersonic free-stream Mach number of 2.8 is used to investigate the effect of Prandtl number on the distribution of properties through the boundary layer. The computed total temperature distribution and recovery factor agree well with the measurements when a variable Prandtl number is used through the boundary layer