Ankle Sprain Injuries in the ED: Assessing Quality of Discharge Instructions and Compliance of Physicians with Ottawa Ankle Rules

Annually a large number of patients seen in the emergency department are diagnosed with an ankle sprain. If not treated properly, these injuries can result in long term complications such as pain, swelling and instability. Appropriate patient discharge instructions using evidence based treatment principles can be utilized to avoid these complications. Many patients seen in the emergency department with a final diagnosis of ankle sprain receive x-rays to rule out a fracture, despite the development of the Ottawa Ankle Rules (OAR) to determine when x-rays are necessary. Use of the Ottawa Ankle Rules has been shown to decrease the number of necessary x-rays by 35%. In this study, we conducted a retrospective chart review of patients discharged from theUniversityHospitalemergency department with a diagnosis of ankle sprain to determine: a) the quality and content of treatment and discharge instructions, b) the compliance with the Ottawa Ankle Rules for the determination of ordering an x-ray. We found there to be inadequate documentation of the use of OAR in the Emergency department and that the discharge instructions given to patients were not at a level that would provide for the best recovery from the injur

1-Methylcyclopropene maintains postharvest quality in Norwegian apple fruit

Norwegian fruit production is mostly destined for the local market and can suffer from poor-quality retention during storage. 1-Methylcyclopropene (1-MCP) is an inhibitor of ethylene perception used to maintain the physical and functional quality of pome fruit. Extensive work has been carried out on the effect of 1-MCP on apples, but not on cultivars grown in Norway. In this work, the potential of 1-MCP application (0.625 ml l −1 for 24 h at 0 ± 1℃) for ripening control of the apple cultivars ‘Aroma’, ‘Red Gravenstein’, and ‘Summered’ was studied during 1 and 1.5 months of cold storage; both scenarios were followed by five days of shelf life. The application of 1-MCP reduced softening by an average of 12% in ‘Aroma’, ‘Red Gravenstein’, and ‘Summered’ apples when cold stored for both 1 and 1.5 months as compared to control. External colour remained similar to initial values in 1-MCP fruit when compared to control apples, which presented a significant skin darkening. This indicated a delay in the ripening process. 1-MCP treatment did not affect total soluble solids content. ‘Aroma’ samples treated with 1-MCP showed a low sucrose hydrolysis, indicating a slower ripening process. This work confirms that 1-MCP postharvest treatment shows great potential for maintenance of apple cvs. in Norway during cold storage and shelf life

Impact Of Urbanisation And Its Effect On Coastal Communities In Chennai Region

Impact of Urbanisation in India is the process resulting into increase in the proportion o furban population to the total population in an area. The coastline of India is characterised by several ecosystems and resources. The population in cities is generally increasing because they provide easy access to ocean, rivers beaches and other natural areas and are a good source for raw material and food. In India, Chennai is the fifth-largest city and 36th- largest urban area by population in the world. The Quality of Living Survey rated Chennai as the safest coastal city in India. As a growing metropolitan city in a developing country, Chennai confronts substantial pollution and other logistical and socio-economic problems. The objective of the study is to identify the environmental pollution hotspots and preparing an environment management plan that includes rehabilitation and mitigation measures. The study draws the importance to maintain a balance between the ecology and economy in the region to ensure sustainable development. On the other hand, suggesting the measures to face the problems related to salinity ingress in land and water resources, depletion and degradation of coastal ecosystems and natural resources, pollution of resources like sewage intrusion, garbage disposal, etc, which have impacted on the life and livelihoods of people in multiple ways. Innovative approaches are needed to regulate the processes of salinisation and to manage to live with it since it cannot be eliminated.Keywords: Impact of Urbanisation, Coastal Environment, Sustainable Development

Development and Preliminary Evaluation of a Spray Deposition Sensing System for Improving Pesticide Application

An electronic, resistance-based sensor array and data acquisition system was developed to measure spray deposition from hydraulic nozzles. The sensor surface consisted of several parallel tin plated copper traces of varying widths with varying gap widths. The system contained an embedded microprocessor to monitor output voltage corresponding to spray deposition every second. In addition, a wireless module was used to transmit the voltage values to a remote laptop. Tests were conducted in two stages to evaluate the performance of the sensor array in an attempt to quantify the spray deposition. Initial tests utilized manual droplet placement on the sensor surface to determine the effects of temperature and droplet size on voltage output. Secondary testing utilized a spray chamber to pass nozzles at different speeds above the sensor surface to determine if output varied based on different application rates or spray droplet classification. Results from this preliminary analysis indicated that manual droplets of 5 and 10 mL resulted in significantly different values from the sensors while temperature did not consistently affect output. Spray chamber test results indicated that different application rates and droplet sizes could be determined using the sensor array

Development and Preliminary Evaluation of an Integrated Individual Nozzle Direct Injection and Carrier Flow Rate Control System for Pesticide Applications

Direct injection systems for agricultural spray applications continue to present challenges in terms of commercialization and adoption by end users. Such systems have typically suffered from lag time and mixing uniformity issues, which have outweighed the potential benefits of keeping chemical and carrier separate or reducing improper tank-mixed concentration by eliminating operator measurements. The proposed system sought to combine high-pressure direct nozzle injection with an automated variable-flow nozzle to improve chemical mixing and response times. The specific objectives were to: (1) integrate a high-pressure direct nozzle injection system with variable-flow carrier control into a prototype for testing, (2) assess the chemical metering accuracy and proper mixing at different combinations of injection valve frequency and duty cycle along with chemical pressure, and (3) assess the ability of the control system to ensure proper chemical dilutions and concentrations in the nozzle effluent resulting from step changes in target application rates. Laboratory experiments were conducted using the combined system. Results of these experiments showed that the open-loop control of the injectors could provide a means of accurately metering the chemical concentrate into the carrier stream. Chemical injection rates could be achieved with an average error of 5.4% compared to the target rates. Injection at higher duty cycles resulted in less error in the chemical concentration predictions. Discrete Fourier transform analysis showed that the injection frequency was noticeable in the nozzle effluent when the injector was operated at 3.04 MPa and 5 Hz (particularly at lower duty cycles). Increasing the injection pressure and operating frequency to 5.87 MPa and 7 Hz, respectively, improved mixing, as the injection frequency component was no longer noticed in the effluent samples. The variable-flow nozzle was able to maintain appropriate carrier flow rates to achieve product label chemical concentrations. In one case, the maximum allowable concentrate was exceeded, although the nozzle was able to recover in 0.5 s. Steady-state errors ranged from 2.5% to 7.5% for chemical concentrations compared to the selected chemical to carrier ratio (0.03614). This test scenario represented an application rate of 4.68 L ha-1 with velocity increases from 4.0 to 7.1 m s-1 and decreases from 7.1 to 4.0 m s-1, which were typical of the example field application data

Addressing Health Disparities Among Homeless in Alachua County through Community-Based Participatory Research.

Introduction. In states such as Florida that did not expand Medicaid, a large number of economically disadvantaged individuals do not qualify for subsidies to buy health insurance through the Affordable Care Act (ACA) 2. This leaves the health needs of Florida’s homeless population largely unaddressed. Nearly 48.1% of Alachua County’s homeless population has disabling conditions 16. This confirms a pressing need to understand the homeless population\u27s healthcare needs, knowledge, and barriers in accessing healthcare. Methods. We used a Community-Based Participatory Research model in conducting health fairs and needs assessment surveys, incentivizing participation, and providing education about existing resources. The surveys were conducted at two homeless meal service sites and consisted of 22 questions regarding access to healthcare, utilization, and satisfaction. Health fairs consisted of blood pressure, blood glucose, and mental health screening. Patient participation was encouraged through games, prizes and food. Results. Of the population we surveyed, 100% have income levels below $11,490, therefore all uninsured fall into the ACA coverage gap. Those less than 65 years of age do not qualify for Medicare unless disabled. Some qualify for Medicaid as shown in tables. Fifty-eight percent were uninsured and did not get any treatment for their illnesses. Additionally, 67% had no knowledge of free local healthcare clinics. Discussion/Conclusion. The majority of this population falls into the ACA Coverage Gap, lacks knowledge about free community clinics, and inappropriately uses the ED. Future implications of this research involve advocacy to expand Medicaid in Florida and enroll those who are eligible for health insurance. Vital goals include outreach by free healthcare clinics to make healthcare more accessible, as well as building trust with the community through continued outreach initiatives. A community-Based Participatory Research Model is an effective tool to increasing collaboration among diverse members of the community in order to bring meaningful and positive change to the health of populations

Development and Preliminary Evaluation of a Spray Deposition Sensing System for Improving Pesticide Application

An electronic, resistance-based sensor array and data acquisition system was developed to measure spray deposition from hydraulic nozzles. The sensor surface consisted of several parallel tin plated copper traces of varying widths with varying gap widths. The system contained an embedded microprocessor to monitor output voltage corresponding to spray deposition every second. In addition, a wireless module was used to transmit the voltage values to a remote laptop. Tests were conducted in two stages to evaluate the performance of the sensor array in an attempt to quantify the spray deposition. Initial tests utilized manual droplet placement on the sensor surface to determine the effects of temperature and droplet size on voltage output. Secondary testing utilized a spray chamber to pass nozzles at different speeds above the sensor surface to determine if output varied based on different application rates or spray droplet classification. Results from this preliminary analysis indicated that manual droplets of 5 and 10 μL resulted in significantly different values from the sensors while temperature did not consistently affect output. Spray chamber test results indicated that different application rates and droplet sizes could be determined using the sensor array