Applications of Membrane Extraction with a Sorbent Interface

Membrane extraction with a sorbent interface (MESI) is a sample preparation technique with a rugged and simple design allowing for solvent-free, on-line performance. When coupled to gas chromatography (GC), MESI is an extremely promising tool for the analysis of volatile organic compounds (VOCs), as it is selective and sensitive for detecting trace levels of analytes. A new calibration method to be used with the MESI technique is presented herein. The aim of this project was to characterize and quantify the biomarker ethylene in human breath and plant emissions. The MESI-GC system was optimized, and an external calibration curve for ethylene standard was obtained. Qualitative measures were obtained from emissions of the higher plant Arabidopsis thaliana. The dominant calibration method was validated by examining changes in mass transfer trends when flow and temperature conditions were altered. Finally, the dominant calibration method was used to quantify ethylene in real human breath samples from non-smoking and smoking volunteers. Results were consistent with those reported in literature. These findings suggest that the dominant calibration technique is a useful tool for monitoring ethylene in human breath and Arabidopsis

Daily bathing with chlorhexidine-based soap and the prevention of Staphylococcus aureus transmission and infection

OBJECTIVE: Determine if daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and ICU-acquired S. aureus infection among ICU patients. DESIGN: Prospective pre-post-intervention study with control unit SETTING: 1,250 bed tertiary-care teaching hospital PATIENTS: Medical and surgical intensive care unit (ICU) patients METHODS: Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology. RESULTS: The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol [pre-intervention 12.64 vs. post-intervention 10.03 cases/1000 patient-days-at-risk (95% CI: −5.19 – −0.04, p = 0.046)]. There was no significant change in MRSA acquisition in the control ICU during the study period [10.97 pre-June 2005 vs. 11.33/1000 patient-days at risk post-June 2005 (95% CI −37.40 – 15.19, p = 0.40)]. There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002-2007 [19.73 pre-intervention to 15.63 cases per 1000 patient-days at risk post-intervention (95% CI −7.25 – −0.95, p=0.012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 pre-intervention vs. 1.15 infections per 1000 patient-days at risk post-intervention; p=0.001). CONCLUSIONS: Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infections

Measurement, Monitoring, and Evaluation of State Demonstrations to Integrate Care for Dual Eligible Individuals: Massachusetts Evaluation Design Plan.

CMS contracted with RTI International to monitor the implementation of all State demonstrations under the Financial Alignment Initiative, and to evaluate their impact on beneficiary experience, quality, utilization, and cost. The evaluation includes an aggregate evaluation and State-specific evaluations. This report describes the State-specific Evaluation Plan for the Massachusetts demonstration as of December 16, 2013. The evaluation activities may be revised if modifications are made to either the Massachusetts demonstration or to the activities described in the Aggregate Evaluation Plan (Walsh et al., 2013). Although this document will not be revised to address all changes that may occur, the annual and final evaluation reports will note areas where the evaluation as executed differs from this evaluation plan. The goals of the evaluation are to monitor demonstration implementation, evaluate the impact of the demonstration on the beneficiary experience, monitor unintended consequences, and monitor and evaluate the demonstration’s impact on a range of outcomes for the eligible population as a whole and for subpopulations (e.g., people with mental illness and/or substance use disorders and long-term services and supports (LTSS) recipients)

Post-Acute Care Payment Reform Demonstration: Final Report Volume 3 of 4

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References (Section 7: Outcomes: Hospital Readmissions; Section 8: Outcomes: Functional Status; Section 9: Determinants of Resource Intensity: Methods and Analytic Sample Description; Section 10: Determinants of Resource Intensity: Lessons from the CART Analysis; Section 11: Determinants of Resource Intensity: Multivariate Regression Results; Section 12: Conclusions and Review of Findings; References

Post-Acute Care Payment Reform Demonstration: Final Report Volume 2 of 4

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References (Section 7: Outcomes: Hospital Readmissions; Section 8: Outcomes: Functional Status; Section 9: Determinants of Resource Intensity: Methods and Analytic Sample Description; Section 10: Determinants of Resource Intensity: Lessons from the CART Analysis; Section 11: Determinants of Resource Intensity: Multivariate Regression Results; Section 12: Conclusions and Review of Findings; References

Post-Acute Care Payment Reform Demonstration: Final Report Volume 1 of 4

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References (Section 7: Outcomes: Hospital Readmissions; Section 8: Outcomes: Functional Status; Section 9: Determinants of Resource Intensity: Methods and Analytic Sample Description; Section 10: Determinants of Resource Intensity: Lessons from the CART Analysis; Section 11: Determinants of Resource Intensity: Multivariate Regression Results; Section 12: Conclusions and Review of Findings; References

The Australian Natural Disaster Resilience Index: Annual project report 2017-18

Natural hazard management policy directions in Australia – and indeed internationally – are increasingly being aligned to ideas of resilience. However, the definition and conceptualization of resilience in relation to natural hazards is keenly contested within academic literature (Klein et al., 2003; Wisner et al., 2004; Boin et al., 2010; Tierney, 2014). Broadly speaking, resilience to natural hazards is the ability of individuals and communities to cope with disturbances or changes and to maintain adaptive behaviour (Maguire and Cartwright, 2008). Building resilience to natural hazards requires the capacity to cope with the event and its aftermath, as well as the capacity to learn about hazard risks, change behaviour, transform institutions and adapt to a changing environment (Maguire and Cartwright, 2008). The Australian Natural Disaster Resilience Index is a tool for assessing the resilience of communities to natural hazards at a large scale. Using a top down approach, the assessment will provide input to macro-level policy, strategic planning, community planning and community engagement activities at National, State and local government levels. First, it is a snapshot of the current state of natural hazard resilience at a national scale. Second, it is a layer of information for use in strategic policy development and planning. Third, it provides a benchmark against which to assess future change in resilience to natural hazards. Understanding resilience strengths and weaknesses will help communities, governments and organizations to build the capacities needed for living with natural hazards. Design of the Australian Natural Disaster Resilience Index The Australian Natural Disaster Resilience Index will assess resilience based on two sets of capacities – coping capacity and adaptive capacity. We have used a hierarchical structure for the Australian Natural Disaster Resilience Index. Indicators provide the data for a theme – together the indicators measure the status of the theme. We collected approximately 90 indicators across the eight coping and adaptive capacity themes. Indicators were collected at Statistical Area 2 (SA2) resolution where possible. Results of the Australian Natural Disaster Resilience Index The results and initial trends in the eight themes of the Australian Natural Disaster Resilience Index are presented below. It should be noted that these interpretations and maps are subject to further change as the State of Disaster Resilience Report is developed. What is presented here is an overview of the pattern of index values. In all maps, lower index values in brown represent lower disaster resilience and higher index values in green represent higher disaster resilience. Each of the sections is an SA2 division of the ABS

Conceptualizing Ecological Responses to Dam Removal: If You Remove It, What’s to Come?

One of the desired outcomes of dam decommissioning and removal is the recovery of aquatic and riparian ecosystems. To investigate this common objective, we synthesized information from empirical studies and ecological theory into conceptual models that depict key physical and biological links driving ecological responses to removing dams. We define models for three distinct spatial domains: upstream of the former reservoir, within the reservoir, and downstream of the removed dam. Emerging from these models are response trajectories that clarify potential pathways of ecological transitions in each domain. We illustrate that the responses are controlled by multiple causal pathways and feedback loops among physical and biological components of the ecosystem, creating recovery trajectories that are dynamic and nonlinear. In most cases, short-term effects are typically followed by longer-term responses that bring ecosystems to new and frequently predictable ecological condition, which may or may not be similar to what existed prior to impoundment