Preliminary Concerns of PL 100-203 and Nursing Home Reform: Implications for Nurse Aide Training

Public Law 100-203, the “Omnibus Budget Reconciliation Act of 1987,” Subtitle C Nursing Home Reform has a dramatic impact on nursing homes and health occupations education. The requirements of the new law stipulate 75 hours of content specific preservice education for nurse aides employed in nursing homes. This stipulation impacts on existing health occupations education programs that prepare entry level workers for careers in the health industry

Use of microbiology tests in the era of increasing AMR rates- a multicentre hospital cohort study

Background: Effective use of microbiology test results may positively influence patient outcomes and limit the use of broad-spectrum antibiotics. However, studies indicate that their potential is not fully utilized. We investigated microbiology test ordering practices and the use of test results for antibiotic decision-making in hospitals. Methods: A multicentre cohort study was conducted during five months in 2014 in Medical departments across three hospitals in Western Norway. Patients treated with antibiotics for sepsis, urinary tract infections, skin and soft tissue infections, lower respiratory tract infections or acute exacerbations of chronic obstructive pulmonary disease were included in the analysis. Primary outcome measures were degree of microbiology test ordering, compliance with microbiology testing recommendations in the national antibiotic guideline and proportion of microbiology test results used to inform antibiotic treatment. Data was obtained from electronic- and paper medical records and charts and laboratory information systems. Results: Of the 1731 patient admissions during the study period, mean compliance with microbiology testing recommendations in the antibiotic guideline was 89%, ranging from 81% in patients with acute exacerbations of chronic obstructive pulmonary disease to 95% in patients with sepsis. Substantial additional testing was performed beyond the recommendations with 298/606 (49%) of patients with lower respiratory tract infections having urine cultures and 42/194 (22%) of patients with urinary tract infections having respiratory tests. Microbiology test results from one of the hospitals showed that 18% (120/672) of patient admissions had applicable test results, but only half of them were used for therapy guidance, i.e. in total, 9% (63/672) of patient admissions had test results informing prescription of antibiotic therapy. Conclusions: This study showed that despite a large number of microbiology test orders, only a limited number of tests informed antibiotic treatment. To ensure that microbiology tests are used optimally, there is a need to review the utility of existing microbiology tests, test ordering practices and use of test results through a more targeted and overarching approach

Recherche et réalisation de nouveaux alliages de niobium résistant à haute température

Cette étude, financée par la D. G. R. S. T., avait pour but de développer de nouveaux alliages de niobium pour l'utilisation à haute température. Les caractéristiques recherchées étaient : une résistance au fluage élevée, une bonne malléabilité et une densité raisonnable. Parmi les compositions retenues, deux présentent des compromis intéressants : — le WD 15 (Nb 9 W 6 Mo 4 Hf 0,2 C). Cet alliage, traité 2 h à 2 000 °C et trempé à l'huile a, sur barres rétreintes, un σR-100 h à 1 200 °C de 19,6 hbar. Son allongement de rupture à toutes températures, dans cet état de traitement, est au moins égal à 10 % ; — le W 6 B (Nb 6 W 2 Zr 2 Hf 0,2 C, 0,2 B). Cet alliage, dont la malléabilité est excellente, a un σR-100 h à 1 200 °C de 14,6 hbar sur tôles laminées, traitées 2 h à 2 000 °C et trempées à l'huile

Recherche et réalisation de nouveaux alliages de niobium résistant à haute température

The present study, sponsored by the D. G. R. S. T., was designed to develop niobium base alloys suitable for application at high temperatures. Properties required were : high creep strength, good fabricability and moderate density. Two alloy formulations are attractive : — WD 15 (Nb 9 W 6 Mo 4 Hf 0.2 C). This alloy, heat treated 2 hours at 2 000 °C and oil quenched, has a one hundred hours rupture strength of 19.6 hbar. Rupture elongation is over ten per cent at any temperature. — W 6 B (Nb 6 W 2 Zr 2 Hf 0.2 C, 0.2 B). This alloy, which has an excellent workability, has a one hundred hours rupture strength of 14.5 hbar, on rolled sheets treated 2 hours at 2 000 °C and oil quenched.Cette étude, financée par la D. G. R. S. T., avait pour but de développer de nouveaux alliages de niobium pour l'utilisation à haute température. Les caractéristiques recherchées étaient : une résistance au fluage élevée, une bonne malléabilité et une densité raisonnable. Parmi les compositions retenues, deux présentent des compromis intéressants : — le WD 15 (Nb 9 W 6 Mo 4 Hf 0,2 C). Cet alliage, traité 2 h à 2 000 °C et trempé à l'huile a, sur barres rétreintes, un σR-100 h à 1 200 °C de 19,6 hbar. Son allongement de rupture à toutes températures, dans cet état de traitement, est au moins égal à 10 % ; — le W 6 B (Nb 6 W 2 Zr 2 Hf 0,2 C, 0,2 B). Cet alliage, dont la malléabilité est excellente, a un σR-100 h à 1 200 °C de 14,6 hbar sur tôles laminées, traitées 2 h à 2 000 °C et trempées à l'huile