A study of health care reform effects on the function and philosophy of discharge planners: a proposed change in the curriculum for hospital discharge planners

Results and Implications The Medicare data used for the study comes from previous RAND studies and data from a sample community hospital for comparisons of average lengths of stay, post hospital utilization, characteristics of patients who have a propensity to use post hospital care by gender, age and diagnosis. The study examines how reimbursement has effected patient care management therefore changing the hospital discharge planners priorities. The activities where discharge planners spend the majority of their time were stressed the least during their collegiate preparation as rated by the discharge planners through a survey instrument. Patients are experiencing shorter hospital lengths of stay, increase use of post hospital care and discharge planners find themselves spending the majority of their time on DRG optimization/utilization management, communication, securing resources and quality care assessment which totaled 60 percent of their time in an average work week. These areas were less stressed during the discharge planners collegiate education. Only 25 percent to 63 percent of the respondents stated these activities were stressed to highly stressed during their professional education. Changes in the curriculum of registered nurses and social workers who wish to become discharge planners must occur in the areas of health care reimbursement, communication, and particularly in the area of measuring quality of care across a continuum of services. A review of university sample curriculums by title indicates that very little attention is given explicitly to proprietary content which will be driving how our health care system functions now and well into the future. One approach to educating existing staff would be to offer a standardized university curriculum and certification exam to demonstrate proficiency in the new proprietary climate. Education is regarded as a primary strategy for transitioning practitioners into the new roles created by changes occurring in how our health care services are funded

Highly Sensitive Gamma-Spectrometers of GERDA for Material Screening: Part 2

The previous article about material screening for GERDA points out the importance of strict material screening and selection for radioimpurities as a key to meet the aspired background levels of the GERDA experiment. This is directly done using low-level gamma-spectroscopy. In order to provide sufficient selective power in the mBq/kg range and below, the employed gamma-spectrometers themselves have to meet strict material requirements, and make use of an elaborate shielding system. This article gives an account of the setup of two such spectrometers. Corrado is located in a depth of 15 m w.e. at the MPI-K in Heidelberg (Germany), GeMPI III is situated at the Gran-Sasso underground laboratory at 3500 m w.e. (Italy). The latter one aims at detecting sample activities of the order ~0.01 mBq/kg, which is the current state-of-the-art level. The applied techniques to meet the respective needs are discussed and demonstrated by experimental results.Comment: Featured in: Proceedings of the XIV International Baksan School "Particles and Cosmology" Baksan Valley, Kabardino-Balkaria, Russia, April 16-21,2007. INR RAS, Moscow 2008. ISBN 978-5-94274-055-9, pp. 233-238; (6 pages, 4 figures

Results from a Search for Light-Mass Dark Matter with a P-type Point Contact Germanium Detector

We report on several features present in the energy spectrum from an ultra low-noise germanium detector operated at 2,100 m.w.e. By implementing a new technique able to reject surface events, a number of cosmogenic peaks can be observed for the first time. We discuss several possible causes for an irreducible excess of bulk-like events below 3 keVee, including a dark matter candidate common to the DAMA/LIBRA annual modulation effect, the hint of a signal in CDMS, and phenomenological predictions. Improved constraints are placed on a cosmological origin for the DAMA/LIBRA effect.Comment: 4 pages, 4 figures. v2: submitted version. Minimal changes in wording, one reference adde

Search for an Annual Modulation in a P-type Point Contact Germanium Dark Matter Detector

Fifteen months of cumulative CoGeNT data are examined for indications of an annual modulation, a predicted signature of Weakly Interacting Massive Particle (WIMP) interactions. Presently available data support the presence of a modulated component of unknown origin, with parameters prima facie compatible with a galactic halo composed of light-mass WIMPs. Unoptimized estimators yield a statistical significance for a modulation of ~2.8 sigma, limited by the short exposure.Comment: Published version, slightly expanded discussion of ROI uncertainties, one reference adde

The MAJORANA DEMONSTRATOR: A Search for Neutrinoless Double-beta Decay of Germanium-76

The observation of neutrinoless double-beta decay would determine whether the neutrino is a Majorana particle and provide information on the absolute scale of neutrino mass. The MAJORANA Collaboration is constructing the DEMONSTRATOR, an array of germanium detectors, to search for neutrinoless double-beta decay of 76-Ge. The DEMONSTRATOR will contain 40 kg of germanium; up to 30 kg will be enriched to 86% in 76-Ge. The DEMONSTRATOR will be deployed deep underground in an ultra-low-background shielded environment. Operation of the DEMONSTRATOR aims to determine whether a future tonne-scale germanium experiment can achieve a background goal of one count per tonne-year in a 4-keV region of interest around the 76-Ge neutrinoless double-beta decay Q-value of 2039 keV.Comment: Submitted to AIP Conference Proceedings, 19th Particles & Nuclei International Conference (PANIC 2011), Massachusetts Institute of Technology, Cambridge, MA, USA, July 24-29, 2011; 3 pages, 1 figur

The Majorana Project

Building a \BBz experiment with the ability to probe neutrino mass in the inverted hierarchy region requires the combination of a large detector mass sensitive to \BBz, on the order of 1-tonne, and unprecedented background levels, on the order of or less than 1 count per year in the \BBz signal region. The MAJORANA Collaboration proposes a design based on using high-purity enriched Ge-76 crystals deployed in ultra-low background electroformed Cu cryostats and using modern analysis techniques that should be capable of reaching the required sensitivity while also being scalable to a 1-tonne size. To demonstrate feasibility, the collaboration plans to construct a prototype system, the MAJORANA DEMONSTRATOR, consisting of 30 kg of 86% enriched \Ge-76 detectors and 30 kg of natural or isotope-76-depleted Ge detectors. We plan to deploy and evaluate two different Ge detector technologies, one based on a p-type configuration and the other on n-type.Comment: paper submitted for the 2008 Carolina International Symposium on Neutrino Physic

Astroparticle Physics with a Customized Low-Background Broad Energy Germanium Detector

The MAJORANA Collaboration is building the MAJORANA DEMONSTRATOR, a 60 kg array of high purity germanium detectors housed in an ultra-low background shield at the Sanford Underground Laboratory in Lead, SD. The MAJORANA DEMONSTRATOR will search for neutrinoless double-beta decay of 76Ge while demonstrating the feasibility of a tonne-scale experiment. It may also carry out a dark matter search in the 1-10 GeV/c^2 mass range. We have found that customized Broad Energy Germanium (BEGe) detectors produced by Canberra have several desirable features for a neutrinoless double-beta decay experiment, including low electronic noise, excellent pulse shape analysis capabilities, and simple fabrication. We have deployed a customized BEGe, the MAJORANA Low-Background BEGe at Kimballton (MALBEK), in a low-background cryostat and shield at the Kimballton Underground Research Facility in Virginia. This paper will focus on the detector characteristics and measurements that can be performed with such a radiation detector in a low-background environment.Comment: Submitted to NIMA Proceedings, SORMA XII. 9 pages, 4 figure