Building a transitional care checklist in rheumatology: A Delphi-like survey.

To design a transitional care checklist to be used by and facilitate the work of health professionals in providing transitional care for children with a chronic rheumatologic disease and their families. A Delphi-like study among an international expert panel was carried out in four steps: (1) a working group of 6 specialists established a draft; (2) a web-survey among a panel of international experts evaluated it; (3) a 2-day consensus conference with an expert panel discussed items not reaching agreement; (4) a web-survey among the panel of international experts with the list of reformulated items. The first draft of the checklist included 38 items in 3 phases of transition and 5 age groups. Thirty-three international experts evaluated the checklist reaching≥80% agreement for 26 items and ≤80% for 12. The consensus conference of 12 experts discussed and redefined the 12 items. Twenty-five international experts filled out the web-survey and all items reached a minimum of 80% agreement except one. The final checklist was reached. This Delphi-like study defined what themes should be included and at what age they need to be addressed with patients with a chronic rheumatology disease and their families during transition. This checklist reached a strong international and interdisciplinary consensus while examining transition in a broad way. It should now be spread widely to health professionals to be used by all those who care for adolescents aged≥12 years at times of transition. It could be transposed to most chronic conditions. Recommendations for further research are given

Accumulation and transport of microbial-size particles in a pressure protected model burn unit: CFD simulations and experimental evidence

<p>Abstract</p> <p>Background</p> <p>Controlling airborne contamination is of major importance in burn units because of the high susceptibility of burned patients to infections and the unique environmental conditions that can accentuate the infection risk. In particular the required elevated temperatures in the patient room can create thermal convection flows which can transport airborne contaminates throughout the unit. In order to estimate this risk and optimize the design of an intensive care room intended to host severely burned patients, we have relied on a computational fluid dynamic methodology (CFD).</p> <p>Methods</p> <p>The study was carried out in 4 steps: i) patient room design, ii) CFD simulations of patient room design to model air flows throughout the patient room, adjacent anterooms and the corridor, iii) construction of a prototype room and subsequent experimental studies to characterize its performance iv) qualitative comparison of the tendencies between CFD prediction and experimental results. The Electricité De France (EDF) open-source software <it>Code_Saturne</it>^®(<url>http://www.code-saturne.org</url>) was used and CFD simulations were conducted with an hexahedral mesh containing about 300 000 computational cells. The computational domain included the treatment room and two anterooms including equipment, staff and patient. Experiments with inert aerosol particles followed by time-resolved particle counting were conducted in the prototype room for comparison with the CFD observations.</p> <p>Results</p> <p>We found that thermal convection can create contaminated zones near the ceiling of the room, which can subsequently lead to contaminate transfer in adjacent rooms. Experimental confirmation of these phenomena agreed well with CFD predictions and showed that particles greater than one micron (i.e. bacterial or fungal spore sizes) can be influenced by these thermally induced flows. When the temperature difference between rooms was 7°C, a significant contamination transfer was observed to enter into the positive pressure room when the access door was opened, while 2°C had little effect. Based on these findings the constructed burn unit was outfitted with supplemental air exhaust ducts over the doors to compensate for the thermal convective flows.</p> <p>Conclusions</p> <p>CFD simulations proved to be a particularly useful tool for the design and optimization of a burn unit treatment room. Our results, which have been confirmed qualitatively by experimental investigation, stressed that airborne transfer of microbial size particles via thermal convection flows are able to bypass the protective overpressure in the patient room, which can represent a potential risk of cross contamination between rooms in protected environments.</p

Non-invasive single bunch monitoring for ps pulse radiolysis

A single-shot electro-optic (EO) diagnostic has been installed on the ELYSE photocathode RF gun accelerator to monitor the electron bunch at the place and under the conditions of the ps pulse radiolysis experiments. The EO signal is due to the coulombic field of the electron bunch and to a contribution of a free-space THz radiation generated by the same electron pulse. This signal is recorded shot-to-shot at the repetition rate of the accelerator. The jitter of the arrival time of the electron bunch is characterized for the first time with a non-invasive method and is confirmed to be around 1 ps. © 2009 Elsevier Ltd. All rights reserved

Non-invasive single bunch monitoring for ps pulse radiolysis

A single-shot electro-optic (EO) diagnostic has been installed on the ELYSE photocathode RF gun accelerator to monitor the electron bunch at the place and under the conditions of the ps pulse radiolysis experiments. The EO signal is due to the coulombic field of the electron bunch and to a contribution of a free-space THz radiation generated by the same electron pulse. This signal is recorded shot-to-shot at the repetition rate of the accelerator. The jitter of the arrival time of the electron bunch is characterized for the first time with a non-invasive method and is confirmed to be around 1 ps. © 2009 Elsevier Ltd. All rights reserved

Absolute calibration for a broad range single shot electron spectrometer

International audienceThis article gives a detailed description of a single shot electron spectrometer which was used to characterize electron beams produced by laser-plasma interaction. Contrary to conventional electron sources, electron beams from laser-plasma accelerators can produce a broad range of energies. Therefore, diagnosing these electron spectra requires specific attention and experimental development. Here, we provide an absolute calibration of the Lanex Kodak Fine screen on a laser-triggered radio frequency picosecond electron accelerator. The efficiency of scintillating screens irradiated by electron beams has never been investigated so far. This absolute calibration is then compared to charge measurements from an integrating current transformer for quasimonoenergetic electron spectra from laser-plasma interaction