Easy Hot Pad

This is a how-to publication on making your own hot pads

Anesthesia Preoperative Clinic Referral for Elevated Hba1c Reduces Complication Rate in Diabetic Patients Undergoing Total Joint Arthroplasty

Background: Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery. Objectives: We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA). Patients and Methods: Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled). Those evaluated between in subsequent two-year intervals were referred to primary care for HbA1c ≥ 10% and ≥ 8%, respectively, to improve DM control before surgery. Complications and mortality were quantified postoperatively and at three, six, and twelve months. Length of stay (LOS) and patients requiring a prolonged LOS (\u3e 5 days) were recorded. Results: Patients (197 men, 6 women) underwent 71, 131, and 1 total hip, knee, and shoulder replacements, respectively. Patients undergoing TJA with uncontrolled HbA1c and those with HbA1c \u3c 10%, but not those with HbA1c \u3c 8%, had a higher incidence of coronary disease and hypercholesterolemia than patients without DM. An increase in complication rate was observed in DM patients with uncontrolled HbA1c versus patients without DM (P \u3c 0.001); the complication rate progressively decreased with tighter HbA1c control. More DM patients with preoperative HbA1c that was uncontrolled or ≥ 10% required prolonged LOS versus those without DM (P \u3c 0.001 and P = 0.0404, respectively). Conclusions: APC referral for elevated HbA1c reduces complication rate and the incidence of prolonged hospitalization during the first year after surgery in diabetics undergoing TJA

USING SIMULATION TO EXAMINE CUTTING POLICIES FOR A STEEL FIRM

Minimizing the cost of filling demand is a problem that reaches back to the foundation of operations research. Here we use simulation to investigate various heuristic policies for a one-dimensional, guillotine cutting stock problem with stochastic demand and multiple supply and demand locations. The policies investigated range from a random selection of feasible pieces, to a more strategic search of pieces of a specific type, to a new policy using dual values from a linear program that models a static, deterministic demand environment. We focus on an application in the steel industry and we use real data in our model. We show that simulation can effectively model such a system, and further we exhibit the relative performance of each policy. Our results demonstrate that this new policy provides statistically significant savings over the other policies investigated

Environmental Relocation Policy as Experienced by One Eastern Missouri Dioxin-Contaminated Community

Research on environmental relocation is scant and narrow, focusing on a few aspects of permanent relocation and social impacts of natural disasters. As a result, little is known about the long term social impacts of the Environmental Protection Agency\u27s (EPA) environmental relocation policy. A combined conceptual and theoretical framework of Walter\u27s placeways; Ullberg\u27s disaster memoryscapes; Richardson\u27s remembrance and memorialization; Dynes\u27 social capital; and, Norris, Stevens, Pfefferbaum, Wyche, and Pfefferbaum\u27s work on community resilience guided this phenomenological study with the purpose of better understanding competing and complementary roles of each of these constructs in the context of environmental relocation of one dioxin-contaminated community in Eastern Missouri. Data were collected from archival materials and interviews with 10 adults who were youth, teens, or young adults who lived in the community from 1970 through 1986. All data were coded and analyzed using Moustaka\u27s reflective analysis procedure. Findings confirmed that the loss of place was most significant. The loss of place in this study refers to not only the physical relocation of all the residents of the entire community, but the razing of all the physical structures that were buried in a landfill. A state park was established where the community once existed. Future research to further extend the scholarship on environmental relocation could examine one or more of the other 18 contaminated communities relocated by the EPA to compare and contrast findings. Implications for social change include informing EPA policymakers, legislators, and officials about the long term social impacts in order to improve planning and implementation phases of environmental relocation

Electromagnetic inductance plethysmography is well suited to measure tidal breathing in infants

Reliable, accurate and noninvasive methods for measuring lung function in infants are desirable. Electromagnetic inductance plethysmography has been used to perform infant spirometry and VoluSense Pediatrics (VSP) (VoluSense, Bergen, Norway) represents an updated version of this technique. We aimed to examine its accuracy compared to a validated system measuring airflow via a facemask using an ultrasonic flowmeter. We tested 30 infants with postmenstrual ages between 36 to 43 weeks and weights from 2.3 to 4.8 kg, applying both methods simultaneously and applying VSP alone. Agreement between the methods was calculated using Bland–Altman analyses and we also estimated the effect of applying the mask. Mean differences for all breathing parameters were within ±5.5% and limits of agreement between the two methods were acceptable, except perhaps for peak tidal expiratory flow (PTEF). Application of the facemask significantly increased tidal volume, minute ventilation, PTEF, the ratio of inspiratory to expiratory time and the ratio of expiratory flow at 50% of expired volume to PTEF. VSP accurately measured tidal breathing parameters and seems well suited for tidal breathing measurements in infants under treatment with equipment that precludes the use of a facemask.publishedVersio

The Role of Education in the Sustainable Regeneration of Built Heritage: A Case Study of Malta

Vernacular architecture has great historical, cultural and architectonic value, but also much potential for reducing energy demand. However, the eco-refurbishment of heritage buildings within Mediterranean countries poses particular challenges. The research presented in this paper is part of a wider study aiming to develop an effective framework for the sustainable regeneration of heritage buildings in Malta, using the 17th-century Presidential Palace of San Anton, Attard, as a case study. This paper focuses on the role of education in this field. Through qualitative research, including workshops with stakeholders, a stakeholders focus group and a public questionnaire, the awareness levels, educational background and attitudes of key stakeholders were analysed and assessed, as was the policy framework within which they operate. Interventions were found to be required at all levels. Increased awareness and education, a supportive policy framework, and a shift in the perceptions and attitudes of several key stakeholders were identified as crucial in ensuring that interventions on heritage buildings do not negatively affect their environmental performance, and/or impact their architectural and cultural value. This paper features recommendations outlining a supportive strategy for improving the knowledge base of stakeholders, including students, professionals, the public, policy-makers and operators

4-H Fun with Foods - Lesson 4: Beverages

This publication is part of the 4-H Fun with Foods Guide, Lesson 4 provides tips and recipes for making beverages

4-H Fun with Foods - Lesson 1: Getting Ready to Cook

This publication is part of 4-H Fun with Foods Guide, Lesson 1 focuses on the steps needed when getting ready to cook

4-H Fun with Foods - Lesson 3: Cookies: Drop & Bar

This publication is part of 4-H Fun with Foods Guide, Lesson 3 provides recipes and instructions to make drop and bar cookies