Implementation of Staff Education to Standardize the Use of Positions During the First Stage of Labor

This project aims to educate labor and delivery (L&D) nurses on effective laboring positions that can aid fetal descent during the first stage of labor. In an L&D unit of a south Bay Area County hospital, there is a lack of standardization of knowledge and practices on laboring positions among the nursing staff. Evidence shows that upright positions and frequent mobility are effective in shortening the duration of labor and minimizing unnecessary cesarean deliveries. Based on the evidence, a project was implemented using verbal education of evidence-based laboring positions. An educational handout was also provided along with a recorded video presentation that can be utilized for staff development training. To evaluate the success of the educational training, staff nurses completed a pre-and post-education survey to gauge their confidence level in implementing the laboring positions. Despite the limited timeframe and small pool of participants, the survey results show a significant increase in confidence levels among the nursing staff after receiving the educational training

Passive Tracking System and Method

System and methods are disclosed for passively determining the location of a moveable transmitter utilizing a pair of phase shifts at a receiver for extracting a direction vector from a receiver to the transmitter. In a preferred embodiment, a phase difference between the transmitter and receiver is extracted utilizing a noncoherent demodulator in the receiver. The receiver includes antenna array with three antenna elements, which preferably are patch antenna elements placed apart by one-half wavelength. Three receiver channels are preferably utilized for simultaneously processing the received signal from each of the three antenna elements. Multipath transmission paths for each of the three receiver channels are indexed so that comparisons of the same multipath component are made for each of the three receiver channels. The phase difference for each received signal is determined by comparing only the magnitudes of received and stored modulation signals to determine a winning modulation symbol

Ultra-Wideband Angle-of-Arrival Tracking Systems

Systems that measure the angles of arrival of ultra-wideband (UWB) radio signals and perform triangulation by use of those angles in order to locate the sources of those signals are undergoing development. These systems were originally intended for use in tracking UWB-transmitter-equipped astronauts and mobile robots on the surfaces of remote planets during early stages of exploration, before satellite-based navigation systems become operational. On Earth, these systems could be adapted to such uses as tracking UWB-transmitter-equipped firefighters inside buildings or in outdoor wildfire areas obscured by smoke. The same characteristics that have made UWB radio advantageous for fine resolution ranging, covert communication, and ground-penetrating radar applications in military and law-enforcement settings also contribute to its attractiveness for the present tracking applications. In particular, the waveform shape and the short duration of UWB pulses make it possible to attain the high temporal resolution (of the order of picoseconds) needed to measure angles of arrival with sufficient precision, and the low power spectral density of UWB pulses enables UWB radio communication systems to operate in proximity to other radio communication systems with little or no perceptible mutual interference

Noncoherent Tracking of a Source of a Data-Modulated Signal

A proposed tracking receiver system containing three suitably positioned antenna elements and special signal-processing equipment would determine the direction of incidence of a microwave signal containing spread-spectrum digital data modulation. If the system were to contain two sets of antenna elements separated by a known baseline, it could determine the location of the transmitter as the intersection of the lines of incidence on the two antennas. Such systems could be used for diverse purposes in outer space and on Earth, including tracking astronauts and small robotic spacecraft working outside a spacecraft or space station, and locating cellular telephones from which distress calls have been made. The principle of operation does not require the transmission of a special identifying or distress signal by the cellular telephone or other transmitter to be tracked; instead, the system could utilize the data signal routinely sent by the transmitter, provided that the signal had the characteristics needed for processing

Microwave Tissue Soldering for Immediate Wound Closure

A novel approach for the immediate sealing of traumatic wounds is under development. A portable microwave generator and handheld antenna are used to seal wounds, binding the edges of the wound together using a biodegradable protein sealant or solder. This method could be used for repairing wounds in emergency settings, by restoring the wound surface to its original strength within minutes. This technique could also be utilized for surgical purposes involving solid visceral organs (i.e., liver, spleen, and kidney) that currently do not respond well to ordinary surgical procedures. A miniaturized microwave generator and a handheld antenna are used to deliver microwave energy to the protein solder, which is applied to the wound. The antenna can be of several alternative designs optimized for placement either in contact with or proximity to the protein solder covering the wound. In either case, optimization of the design includes the matching of impedances to maximize the energy delivered to the protein solder and wound at a chosen frequency. For certain applications, an antenna could be designed that would emit power only when it is in direct contact with the wound. The optimum frequency or frequencies for a specific application would depend on the required depth of penetration of the microwave energy. In fact, a computational simulation for each specific application could be performed, which would then match the characteristics of the antenna with the protein solder and tissue to best effect wound closure. An additional area of interest with potential benefit that remains to be validated is whether microwave energy can effectively kill bacteria in and around the wound. Thus, this may be an efficient method for simultaneously sterilizing and closing wounds. Using microwave energy to seal wounds has a number of advantages over lasers, which are currently in experimental use in some hospitals. Laser tissue welding is unsuitable for emergency use because its large, bulky equipment cannot be easily moved between operating rooms, let alone relocated to field sites where emergencies often occur. In addition, this approach is highly dependent on the uniformity and thickness of the protein solder as well as the surgeon s skills. In contrast, the use of microwave energy is highly tolerant of the thickness of the protein solder, level of fluids in and around the wound, and other parameters that can adversely affect the outcome of laser welding. However, controlling the depth of penetration of the microwave energy into the wound is critical for achieving effective wound sealing without damaging the adjacent tissue. In addition, microspheres that encapsulate metallic cores could also be incorporated into the protein solder to further control the depth of penetration of the microwave energy

Methods and apparatus for microwave tissue welding for wound closure

Methods and apparatus for joining biological tissue together are provided. In at least one specific embodiment, a method for joining biological tissue together can include applying a biological solder on a wound. A barrier layer can be disposed on the biological solder. An antenna can be located in proximate spatial relationship to the barrier layer. An impedance of the antenna can be matched to an impedance of the wound. Microwaves from a signal generator can be transmitted through the antenna to weld two or more biological tissue pieces of the wound together. A power of the microwaves can be adjusted by a control circuit disposed between the antenna and the signal generator. The heating profile within the tissue may be adjusted and controlled by the placement of metallic microspheres in or around the wound

The impact of environmental and climatic variation on the spatiotemporal trends of hospitalized pediatric diarrhea in Ho Chi Minh City, Vietnam.

It is predicted that the integration of climate-based early warning systems into existing action plans will facilitate the timely provision of interventions to diarrheal disease epidemics in resource-poor settings. Diarrhea remains a considerable public health problem in Ho Chi Minh City (HCMC), Vietnam and we aimed to quantify variation in the impact of environmental conditions on diarrheal disease risk across the city. Using all inpatient diarrheal admissions data from three large hospitals within HCMC, we developed a mixed effects regression model to differentiate district-level variation in risk due to environmental conditions from the overarching seasonality of diarrheal disease hospitalization in HCMC. We identified considerable spatial heterogeneity in the risk of all-cause diarrhea across districts of HCMC with low elevation and differential responses to flooding, air temperature, and humidity driving further spatial heterogeneity in diarrheal disease risk. The incorporation of these results into predictive forecasting algorithms will provide a powerful resource to aid diarrheal disease prevention and control practices in HCMC and other similar settings

Risk factors for the development of severe typhoid fever in Vietnam

Background Typhoid fever is a systemic infection caused by the bacterium Salmonella enterica serovar Typhi. Age, sex, prolonged duration of illness, and infection with an antimicrobial resistant organism have been proposed risk factors for the development of severe disease or fatality in typhoid fever. Methods We analysed clinical data from 581 patients consecutively admitted with culture confirmed typhoid fever to two hospitals in Vietnam during two periods in 1993–1995 and 1997–1999. These periods spanned a change in the antimicrobial resistance phenotypes of the infecting organisms i.e. fully susceptible to standard antimicrobials, resistance to chloramphenicol, ampicillin and trimethoprim-sulphamethoxazole (multidrug resistant, MDR), and intermediate susceptibility to ciprofloxacin (nalidixic acid resistant). Age, sex, duration of illness prior to admission, hospital location and the presence of MDR or intermediate ciprofloxacin susceptibility in the infecting organism were examined by logistic regression analysis to identify factors independently associated with severe typhoid at the time of hospital admission. Results The prevalence of severe typhoid was 15.5% (90/581) and included: gastrointestinal bleeding (43; 7.4%); hepatitis (29; 5.0%); encephalopathy (16; 2.8%); myocarditis (12; 2.1%); intestinal perforation (6; 1.0%); haemodynamic shock (5; 0.9%), and death (3; 0.5%). Severe disease was more common with increasing age, in those with a longer duration of illness and in patients infected with an organism exhibiting intermediate susceptibility to ciprofloxacin. Notably an MDR phenotype was not associated with severe disease. Severe disease was independently associated with infection with an organism with an intermediate susceptibility to ciprofloxacin (AOR 1.90; 95% CI 1.18-3.07; p = 0.009) and male sex (AOR 1.61 (1.00-2.57; p = 0.035). Conclusions In this group of patients hospitalised with typhoid fever infection with an organism with intermediate susceptibility to ciprofloxacin was independently associated with disease severity. During this period many patients were being treated with fluoroquinolones prior to hospital admission. Ciprofloxacin and ofloxacin should be used with caution in patients infected with S. Typhi that have intermediate susceptibility to ciprofloxacin

Viral Etiology of Encephalitis in Children in Southern Vietnam: Results of a One-Year Prospective Descriptive Study

Viral encephalitis is associated with high morbidity and mortality in Vietnam. However little is known about the causes of the disease due to a lack of diagnostic facilities in this relatively resource-poor setting. Knowledge about the etiologies and clinical outcome of viral encephalitis is necessary for future design of intervention studies targeted at improvement of clinical management, treatment and prevention of the disease. We report the viral agents, clinical outcome and prognostic factors of mortality of encephalitis in children admitted to a referral hospital for children in southern Vietnam. We show that about one third of the enrolled patients die acutely, and that mortality is independently associated with patient age and Glasgow Coma Scale on admission. Japanese encephalitis, dengue virus and enterovirus (including enterovirus 71) are the major viruses detected in our patients. However, more than half of the patients remain undiagnosed, while mortality in this group is as high as in the diagnosed group. This study will benefit clinicians and public health in terms of clinical management and prevention of childhood encephalitis in Vietnam