Fall Prevention: Responder 5 Bed Connectors

This paper explores falls, a sentinel event plaguing hospitals in the United States and internationally. Falls are a major contributor to negative patient outcomes and a source of financial strain for hospitals. One particular fall prevention intervention, Responder 5 bed alarms, was explored. A literature review on falls was conducted to study the effectiveness of bed alarms. Capezuti et al. (2009) found bed alarms to be error prone and stress the importance of patient risk factor assessment and using bed alarms as a multifactorial approach to fall prevention. Shorr et al. (2012) came to a similar conclusion after conducting a study on one unit of an urban hospital. The researchers increased the use of bed alarms but found that increased alarm usage did not result in reduced fall rates. University of San Francisco students undertook quality improvement work at a large metropolitan hospital suffering from high fall rates. Responder 5 bed alarm connectivity was studied to better understand factors contributing to falls. Forty nurses on one unit were interviewed and 83 fall risk patient’s beds were assessed. Ten out of the 83 beds (12%) assessed were connected to Responder 5. The data reveals lack of knowledge and underutilization of Responder 5. An intervention of an educational material was created. Once this intervention is implemented, future root cause analysis will be conducted to continue to understand and reduce fall rates at the hospital

How to deal with sparse macroseismic data : Reflections on earthquake records and recollections in the Eastern Baltic Shield

This study discusses the scope of historical earthquake analysis in low-seismicity regions. Examples of non-damaging earthquake reports are given from the Eastern Baltic (Fennoscandian) Shield in north-eastern Europe from the 16th to the 19th centuries. The information available for past earthquakes in the region is typically sparse and cannot be increased through a careful search of the archives. This study applies recommended rigorous methodologies of historical seismology developed using ample data to the sparse reports from the Eastern Baltic Shield. Attention is paid to the context of reporting, the identity and role of the authors, the circumstances of the reporting, and the opportunity to verify the available information by collating the sources. We evaluate the reliability of oral earthquake recollections and develop criteria for cases when a historical earthquake is attested to by a single source. We propose parametric earthquake scenarios as a way to deal with sparse macroseismic reports and as an improvement to existing databases.This study discusses the scope of historical earthquake analysis in low-seismicity regions. Examples of non-damaging earthquake reports are given from the Eastern Baltic (Fennoscandian) Shield in north-eastern Europe from the 16th to the 19th centuries. The information available for past earthquakes in the region is typically sparse and cannot be increased through a careful search of the archives. This study applies recommended rigorous methodologies of historical seismology developed using ample data to these sparse reports from the Eastern Baltic Shield. Attention is paid to the context of the reporting, the identity and role of the authors, the circumstances of the reporting, and the opportunity to verify the available information by collating the sources. We evaluate the reliability of oral earthquake recollections and develop criteria for cases when a historical earthquake is attested to by a single source. We propose parametric earthquake scenarios as a way to deal with sparse macroseismic reportsand as an improvement to existing databases.Peer reviewe

Molecular genetic analysis of paediatric low-grade astrocytoma

The thesis describes the molecular genetic analysis of fifty low-grade paediatric astrocytomas. DNA copy number changes were investigated in paediatric low-grade astrocytomas (WHO grade I and II), using array comparative genomic hybridisation and Affymetrix 250K and 6.0 SNP arrays. A discrete region of DNA copy number gain was identified at chromosome 7q34, primarily although not exclusively in pilocytic astrocytomas of the cerebellum. Further analysis of this region, by PCR and sequencing, demonstrated the presence of gene fusions between KIAA1549 and BRAF. Five KIAA1549- BRAF fusion variants were subsequently identified. A further gene fusion between SRGAP3 and RAF1 was also found in a single tumour with DNA copy number gain at chromosome 3p25. The fusion genes lacked the auto-inhibitory domains of BRAF and RAF1. These were replaced in-frame by N-terminal segments of KIAA1549 and SRGAP3, respectively, conferring constitutive kinase activity. Sequencing confirmed the presence of activating mutations in KRAS and BRAF in three tumours where gene fusions were not identified. Both gene fusions and activating mutations were shown to cause activation of the ERK/MAP kinase pathway by Western blotting. Further sequencing was performed of CDKN2A, PTEN and IDH1/2 to assess the frequency of abnormalities in paediatric low-grade astrocytoma. These genes have previously been found to contain aberrations within adult high-grade astrocytomas. To date, no significant aberrations have been identified in the paediatric astrocytoma samples examined. This confirms previous findings in adult and paediatric astrocytomas, which appear to show distinct molecular changes depending on patient age. Gene fusions or activating mutations were identified in 100% pilocytic astrocytomas studied and were also found in 28% of grade II astrocytomas. These findings highlight the importance of the ERK/MAPK pathway both in the development of paediatric low-grade astrocytomas and as a possible therapeutic target. Gene fusions may provide a means of molecular classification for pilocytic astrocytomas in the future

Information background of 11th-15th centuries earthquakes located by the current catalogues in Vrancea (Romania)

Earthquake catalogues for Romania supply for 11th–15th century earthquakes located in the region of Vrancea records that consist of a complete set of parameters, including magnitude and depth. Scope of this paper is to verify the reliability and consistency of these parameters with the informative background as explicitly referenced by the catalogues. After retrieving the original sources they mention, the set of data appeared to be related almost exclusively to the Russian plain and too poor to be at the very origin of the parameter assessment. Data for 19th–20th century earthquakes, such as instrumental locations and CMT solutions, added to the understanding of the macroseismic response of the Russian plain to Vrancea earthquakes. On the one hand, the investigation and analysis of historical earthquake records for the fourteen events listed by the catalogues in the 11th–15th centuries has shown that for three earthquakes (1022, 1038, 1258) no primary sources could be traced, and three more earthquakes (1091, 1170 and 1328) are attested only by scarcely reliable records and had to be classified as doubtful, and one (1473) is simply a duplication of the 1471 event. On the other hand, the availability of data on recent earthquakes that may be compared to historical ones in terms of macroseismic effects allowed the authors to agree with the previous catalogue compilers’ solution with regard to both magnitude and depth of the past earthquakes for which do exist reliable primary historical records

A Reappraisal of the Luroy, Norway, Earthquake of 31 August 1819

Archives and libraries were visited to find previously unknown documents testifying to the Luroy, Norway, earthquake of 31 August 1819 in northernmost continental Europe. The focus here is on Sweden, Finland, and Russia, which are important for determining the area of perceptibility east of Norway. The new written sources include 12 notes or entries in original archived documents, six contemporary newspaper reports, and two recollections written down years later. The original documentation uncovered is contributory to establishing the authenticity of the observations in Finland and Sweden. The dates of the original documentation allow tracing of the dissemination of eyewitness accounts in writing from the inner area of perceptibility southward to the larger documentation and population centers. New sources of information include weather reports of the Royal Swedish Academy of Sciences, minutes of its meetings, and correspondence sent to the Senate in Finland. The minutes of meetings of the Academy indicate that ample data were collected in the Swedish province of Vasterbotten. We found no original Russian documentation but uncovered national newspapers that are more reliable than the previously used Parisian newspaper. To increase transparency, we provide the first list of macroseismic data points (MDPs) including the respective documentation that testify to the Luroy earthquake. A macroseismic intensity was assigned to a locality, using the European Macroseismic Scale of 1998, when adequate information was available. Accounting for the uncertainty of intensity assessment, the magnitude was estimated as moment magnitude M = 5.9 +/- 0.2, reconfirming the ranking as the largest onshore or nearshore earthquake in the historical seismicity record of Fennoscandia. In addition to the reappraisal of the 31 August 1819 earthquake, a macroseismic map is provided for the earthquake of 17 February 1819, which was felt in northern Finland and Sweden. Some of its MDPs were previously associated with the Luroy earthquake.Peer reviewe

Earthquake activity in Finland and the Russian North in December 1758 : rare reports and their interpretation

This investigation focuses on two historical earthquakes that occurred in the border region between Finland and Russian North in December 1758. They were close together in time and their magnitudes are among the largest observed in the region. We thoroughly searched for contemporary Russian and Scandinavian documentation on earthquake activity in several libraries in Moscow, Helsinki, Stockholm and Copenhagen. We found two primary reports, one from the Russian North and the other from Finland. The context and content of the reports indicate that they are independent and related to the dates of December 17 and December 31, 1758. The first occurrence was reportedly observed in Kandalaksha, Knyazhnaya Guba, Kovda, Chernaya reka and krest Vzista, and the second in Inari, Utsjoki, and Karasjok. We compiled macroseismic maps for both earthquakes and sets of possible parametric solutions that fit the sparse information available. We identified two types of uncertainty in epicenter and magnitude determination: one that stems from the ambiguity of intensity assessment at localities and the other from the spatial distribution of the data points. If no single solution is the best, we propose that all possible solutions be included in earthquake catalogs.This investigation focuses on two historical earthquakes that occurred in the border region between Finland and Russian North in December 1758. They were close together in time and their magnitudes are among the largest observed in the region. We thoroughly searched for contemporary Russian and Scandinavian documentation on earthquake activity in several libraries in Moscow, Helsinki, Stockholm and Copenhagen. We found two primary reports, one from the Russian North and the other from Finland. The context and content of the reports indicate that they are independent and related to the dates of December 17 and December 31, 1758. The first occurrence was reportedly observed in Kandalaksha, Knyazhnaya Guba, Kovda, Chernaya reka and krest Vzista, and the second in Inari, Utsjoki, and Karasjok. We compiled macroseismic maps for both earthquakes and sets of possible parametric solutions that fit the sparse information available. We identified two types of uncertainty in epicenter and magnitude determination: one that stems from the ambiguity of intensity assessment at localities and the other from the spatial distribution of the data points. If no single solution is the best, we propose that all possible solutions be included in earthquake catalogs.Peer reviewe

Testing the Environmental Seismic Intensity Scale on Data Derived from the Earthquakes of 1626, 1759, 1819, and 1904 in Fennoscandia, Northern Europe

Earthquake environmental effects (EEEs) were compiled for the earthquakes of 1626, 1759, 1819, and 1904 in the Fennoscandian Peninsula, northern Europe. The principal source of information was the contemporary newspaper press. Macroseismic questionnaires collected in 1759 and 1904 were also consulted. We prepared maps showing newly discovered EEEs together with previously known EEEs and analyzed their spatial distribution. We assigned intensities based on the 2007 Environmental Seismic Intensity (ESI) scale to 27 selected localities and compared them to intensities assigned based on the 1998 European Macroseismic Scale. While the overall agreement between the scales is good, intensities may remain uncertain due to the sparsity of written documentation. The collected data sets are most probably incomplete but still show that EEEs are not unprecedented cases in the target region. The findings include landslides and rockfalls as well as cascade effects with a risk potential and widespread water movements up to long distances. The winter earthquake of 1759 cracked ice over a large area. This investigation demonstrates that the ESI scale also has practical importance for regions with infrequent EEEs

On the Effect of Synthetic and Real Data Properties on Seismic Intensity Prediction Equations

The present investigation focuses on the effect of input data properties on the estimation of seismic intensity prediction equation (IPE) coefficients. Emphasis is placed on small-tomoderate magnitude earthquakes. Synthetic intensity data points (IDPs) are created using a given IPE, assuming independence of azimuth. Extensive simulations are performed for single earthquakes and a synthetic database. Tests of single earthquakes show that increasing the sample size narrows the range of obtained coefficients. The larger the difference between the shortest and longest distance of IDPs from the epicentre, the narrower is this range. A short radius of perceptibility is more rapidly saturated with new data points than a long one. The synthetic database is used to examine the effect of magnitude and depth errors. The performance of synthetic data gives a model with which the real data can be compared. The attenuation coefficient appears stable against magnitude errors of +/- 0.2 units, but starts to be overestimated as magnitude errors increase. Assuming an erroneous regional depth easily leads to intensity differences of 1 degree. The mean coefficient values deviate from the correct ones and tend to increase with depth. The results resemble the synthetic ones, but imply larger uncertainties. The attenuation coefficient, m, appears to be the least sensitive coefficient to errors. Real data from seven post-1965 earthquakes in the magnitude range of 4.0-5.2 were retrieved from the intensity database of the United Kingdom.Peer reviewe