An assessment of failure to rescue derived from routine NHS data as a nursing sensitive patient safety indicator (report to Policy Research Programme)

Objectives: This study aims to assess the potential for deriving 2 mortality based failure to rescue indicators and a proxy measure, based on exceptionally long length of stay, from English hospital administrative data by exploring change in coding practice over time and measuring associations between failure to rescue and factors which would suggest indicators derived from these data are valid.Design: Cross sectional observational study of routinely collected administrative data.Setting: 146 general acute hospital trusts in England.Participants: Discharge data from 66,100,672 surgical admissions (1997 to 2009).Results: Median percentage of surgical admissions with at least one secondary diagnosis recorded increased from 26% in 1997/8 to 40% in 2008/9. The failure to rescue rate for a hospital appears to be relatively stable over time: inter-year correlations between 2007/8 and 2008/9 were r=0.92 to r=0.94. No failure to rescue indicator was significantly correlated with average number of secondary diagnoses coded per hospital. Regression analyses showed that failure to rescue was significantly associated (p<0.05) with several hospital characteristics previously associated with quality including staffing levels. Higher medical staffing (doctors + nurses) per bed and more doctors relative to the number of nurses were associated with lower failure to rescue. Conclusion: Coding practice has improved, and failure to rescue can be derived from English administrative data. The suggestion that it is particularly sensitive to nursing is not clearly supported. Although the patient population is more homogenous than for other mortality measures, risk adjustment is still required

Longitudinal Spin Asymmetry and Cross Section of Inclusive pi0 Production in Polarized p+p Collisions at RHIC

We present the first measurement of the cross section and the double longitudinal spin asymmetry of inclusive pi0 production in polarized p+p collisions at Sqrt(s) = 200 GeV at mid-rapidity with the STAR detector, using the barrel electromagnetic calorimeter. The measured cross section is compared to NLO pQCD calculations and can provide constraints on the pion fragmentation functions. Fragmentation is studied directly by measuring the momentum fraction of pi0 in jets, a quantity that is affected by the fragmentation process and jet reconstruction effects. The double longitudinal spin asymmetry is compared to NLO pQCD calculations based on different assumptions for the gluon polarization in the nucleon to provide constraints on delta g/g. At the present level of statistics the measured asymmetry disfavors a large positive gluon polarization, but can not yet distinguish between other scenarios.Comment: 4 pages, 2 figures, submitted to the proceedings of the 17th International Spin Physics Symposium (SPIN2006), Kyoto, Japan, October 2 to 7, 200

Predicting the flexural load–deflection response of steel fibre reinforced concrete from strain, crack-width, fibre pull-out and distribution data

A semi-analytical model is presented, based on conventional principles of mechanics, to predict the flexure behaviour of steel fibre reinforced concrete. The model uses a stress-block approach to represent the stresses that develop at a cracked section by three discrete stress zones: (a) a compressive zone; (b) an uncracked tensile zone; and (c) a cracked tensile zone. It is further shown that the stress-block, and hence flexural behaviour, is a function of five principal parameters: compressive stress–strain relation; tensile stress–strain relation; fibre pull-out behaviour; the number and distribution of fibres across the cracked section in terms of their positions, orientations and embedment lengths; and the strain/crack-width profile in relation to the deflection of the beam. An experimental investigation was undertaken on both cast and sprayed specimens to obtain relationships for use in the model. The results of the study showed a reasonable agreement between the model predictions and experimental results. However, the accuracy of the model is probably unacceptable for it to be currently used in design. A subsequent analysis highlighted the single fibre pull-out test and the sensitivity of the strain analysis tests as being the main cause of the discrepancies

Flexural strain and crack width measurement of steel-fibre-reinforced concrete by optical grid and electrical gauge methods

A research programme is discussed, which has investigated the fracture of steel-fibre-reinforced sprayed concrete under flexural loading, with the aim of developing a stress-block model to predict flexural behaviour in the form of a load–deflection response. This paper reports the work associated with establishing the strain and crack width profiles in relation to mid-span beam deflection. A strain analysis technique is described, which combines the use of electrical strain gauges with a semiautomated grid method (using digital image processing) for measuring and monitoring the strain and crack width profile over the depth of a fibre-reinforced beam during a flexural test. This novel strain analysis technique has established strain/crack width data, which forms a key part of a stress-block approach for predicting residual flexural strength, an essential requirement of a much needed design rationale for steel-fibre-reinforced concrete

An Integrated Tracker for STAR

The STAR experiment at the Relativistic Heavy Ion Collider RHIC studies the new state of matter produced in relativistic heavy ion collisions and the spin structure of the nucleon in collisions of polarized protons. In order to improve the capabilities for heavy flavor measurements and the reconstruction of charged vector bosons an upgrade of the tracking system both in the central and the forward region is pursued. The integrated system providing high resolution tracking and secondary vertex reconstruction capabilities will use silicon pixel, strip and GEM technology.Comment: 4 pages, 2 figures, to be published in the Proceedings of the 9th Conference on the Intersections of Particle and Nuclear Physics (CIPANP 2006), Rio Grande, Puerto Rico, May 30 - June 3, 200

Inclusive Hadron Production in p+p Collisions at STAR

The STAR experiment at RHIC has measured a variety of inclusive hadron cross sections in $p+p$ collisions at Sqrt(s) = 200 GeV. Measurements of the differential cross section for inclusive charged pion production at mid rapidity and for inclusive neutral pion production at forward rapidity (3.0 < eta < 4.2) as well as the first preliminary result from STAR for the differential cross section for inclusive neutral pion production near mid rapidity are presented. These cross sections are compared to next-to-leading order perturbative QCD calculations and can provide constraints on the pion fragmentation functions. Good agreement between data and pQCD has been found for all three cross sections.Comment: 4 pages, 1 figure, to be published in the Proceedings of the 9th Conference on the Intersections of Particle and Nuclear Physics (CIPANP 2006), Rio Grande, Puerto Rico, May 30 - June 3, 2006, v2 with updated reference

Global warming and geothermal profiles: the surface rock-temperature response in South Africa

Southern hemisphere and South African regional air temperature anomalies for the period 1860–1996 are compared to borehole‐derived surface rock‐temperature anomalies to assess the extent to which surface rock temperatures reflect possible global warming in South Africa. The warming of the southern hemisphere since the mid‐nineteenth century is evident in the regional air temperatures for South Africa. Following a temperature increase to a maximum in the 1920s, the climate cooled until strong warming recommenced in the mid 1970s. Highest temperatures have been experienced in the 1990s. Borehole‐derived surface rock temperatures followed a similar pattern, but with a lag of a few decades in the case of the 1920s maximum. The overall warming trend is clearly evident in the rock temperatures. Despite uncertainties in the different data sets, an encouraging degree of agreement exists between the increase in rock temperatures during the twentieth century, the corresponding regional South African air temperature increase and the southern hemisphere counterpart

Identification of single-site gold catalysis in acetylene hydrochlorination

There remains considerable debate over the active form of gold under operating conditions of a recently validated gold catalyst for acetylene hydrochlorination. We have performed an in situ x-ray absorption fine structure study of gold/carbon (Au/C) catalysts under acetylene hydrochlorination reaction conditions and show that highly active catalysts comprise single-site cationic Au entities whose activity correlates with the ratio of Au(I):Au(III) present. We demonstrate that these Au/C catalysts are supported analogs of single-site homogeneous Au catalysts and propose a mechanism, supported by computational modeling, based on a redox couple of Au(I)-Au(III) species. View Full Tex

Synthesis and characterization of a tertiary amine:boric acid (1:1) co-crystal and a neutral zwitterionic diamine pentaboron adduct

The syntheses of the 4,4′-trimethylenebis(N-methylpiperidine):boric acid (1:1) co-crystal, 4,4′-(1-MeNC5H9)2(CH2)3.B(OH)3 (1), and a zwitterionic tetrahydroxidohexaoxidopentaboron adduct, [B5O6(OH)4(κN-NH2CH2CH2NHEt2).H2O (2), (NH2CH2CH2NEt2 = deen) from appropriate combinatorial libraries primed with B(OH)3, are reported together with their spectroscopic (NMR, IR) and single-crystal XRD characterization data. Solid-state H-bond interactions are the likely strong drivers for their formation, and these are described in detail. H-bond networks present in co-crystal 1 include C22(16), R22(8), and R66(36) whilst zwitterionic pentaboron derivative 2 has three R22(8) intermolecular H-bond interactions and the Et2NH- group is involved in a S(7) intramolecular H-bond. Thermal (TGA/DSC) data are also reported for 1 which thermally decomposes to B2O3, in a multistage process: dehydration (60–70 °C) and oxidation and further dehydration (90–700 °C).</p