Analysis of Patient Fall Data

Patient falls are common adverse events that occur in all healthcare environments. Patient falls are a common cause of morbidity ("disability caused by accident") and the leading cause of nonfatal injuries producing trauma-related hospitalizations in the United States. Patient falls result in longer hospital stays, attendant increases in medical costs and reduced quality of life for the patients who experience these events. The purpose of this thesis was to examine the patient fall data collected by a community based acute teaching hospital. These data were then analyzed by a variety of analytical methods to determine if there are correlations related to location and timing of the falls, as well as the characteristics of the patients who fell. Conclusions were then made as to possible improvements in methods to monitor patients to reduce patient fall rate. The major results of this analysis were: (1) statistical methods were found to be useful in providing an improved understanding of the characteristics of the patient fall data and thus allow hospital staff to rely on quantitative metrics to make decisions of how to try and reduce patient fall rates, (2) the time intervals between consecutive fall events were found to be distributed exponentially, (3) the hospital-wide hospital monthly fall rate goals, as well as the individual hospital unit patient fall rate goals were shown to be regularly exceeded by the measured data, and (5) review of the fall score screen values used to assess the risk for patient falls, while overall a predictor of patient who did and did not fall, was not a good predictor for determining if individual patients would fall. As a result of this study, a number of specific recommendations will proposed to the hospital as a means to potentially improve the methods for addressing patient falls. A hospital-wide cultural change had been commenced in June 2007 to attempt to reduce the rate of patient falls. The effect of implementing this program will be followed by observing whether the over-all hospital and unit monthly fall rates are reduced

Reception of the Common Law in Missouri: Section 1.010 as Interpreted by the Supreme Court of Missouri

This is an article of first impression, the very essence of which is to explore the meaning of Missouri’s reception statute of the common law as embodied within the four corners of Missouri Revised Statutes Section 1.010. How we think of our reception statute and the meaning of the “common law” will, to a degree, shape the future of the law, its institutions, and ultimately our lives. Missouri’s reception of the common law is codified under Missouri Revised Statutes Section 1.010 (2000). This Article discusses the significance of the phrase “fourth year of the reign of James the First” in Missouri’s reception statute of the common law

Mercury accumulation in fishes from tropical aquatic ecosystems in the Niger Delta, Nigeria

Fishes are important biomarkers of trace elements in aquatic ecosystems, and are used to evaluate the status of water pollution by mercury in tropical aquatic ecosystems in Nigeria. Common fishes, Chrysichthys nigrodigitatus,Brycinus nurse, Hemichromis fasciatus, Lutianus ava, Oreochromis nilotica, Pomadasys jubelini, Stellifer stellifer and Tilapia guineensis were analysed for Hg accumulation using the cold vapour atomic absorption spectrophotometry technique. The results showed that Hg concentration in P. jubelini was relatively the highest, with a mean concentration of 0.063 ± 0.03 mg kg–1. Other concentration values were 0.044 ± 0.031 mg kg–1 for O. nilotica, 0.026 ± 0.013 mg kg–1 for B. nurse, 0.034 ± 0.034 mg kg–1 for H. fasciatus, 0.023 ± 0.020 mg kg–1 for C. nigrodigitatus and 0.33 ± 0.016 mg kg–1 for L. ava. Concentrations of Hg accumulated by the fishes were low and within internationally accepted limit, not likely to cause mercury poisoning. Because of the high Hg accumulating potential of P. jubelini, it is recommended as a biomarker for assessment of Hg toxicity in a tropical aquatic environment

Petroleum Hydrocarbons Contamination of Sediments and Accumulation in Tympanotonus fuscatus var. radula from the Qua Iboe Mangrove Ecosystem, Nigeria

The pollution of coastal ecosystems as a result of petroleum-related activities is increasing, and the literature on occurrence, levels and seasonal dynamics of petroleum hydrocarbons in sediments and biota from the impacted areas of the Niger Delta, Nigeria, is practically scanty. This study was set out to provide information on the status of contamination by petroleum hydrocarbons in Tympanotonus fuscatus var. radula and sediments from Qua Iboe Estuary, Nigeria. Analyses for total petroleum hydrocarbons (TPHs) were performed on Tympanotonus fuscatus var. radula and sediment extracts using gas chromatograph with flame ionization detector (GC-FID). Seventy-two samples each of mangrove epipellic (intertidal) and benthic (subtidal) sediments, and T. fuscatus var. radula were analysed monthly between June 2003 and February 2004, covering peak periods of the wet and dry seasons. Results revealed that the TPHs level in sediments and T. fuscatus were highly variable. It ranged between 18.01 ± 0.04 and 210.23 ± 1.18 μg g–1 dry wt of epipellic sediment, 5.00 ± 0.82 and 232.00 ± 3.23 μg g–1 dry wt of benthic sediment and 9.40 ± 1.0 and 23.27 ± 1.0 μg g–1 dry wt of T. fuscatus. Summary continuous descriptives and correlation analyses revealed that TPH levels of the epipellic and benthic sediments showed a significant relation (r = 0.54, CI = 0.18–0.78), and correlated with levels in T. fuscatus. The overall levels of TPHs in the Qua Iboe Estuary when compared to similar ecosystems with substantial industrial and domestic coastal activities worldwide, revealed a moderate to high level of mineral hydrocarbon pollutio

Localization and Characterization of a 7.3-kDa Region of Caldesmon Which Reversibly Inhibits Actomyosin ATPase Activity

Cleavage of caldesmon with chymotrypsin yields a series of fragments which bind both calmodulin and actin and inhibit the binding of myosin subfragments to actin and the subsequent stimulation of ATPase activity. Several of these fragments have been purified by cation exchange chromatography and their amino-terminal sequences determined. The smallest fragment has a molecular mass of about 7.3 kDa and extends from Leu597 to Phe665. This polypeptide inhibits the actin-activated ATPase of myosin S-1; this inhibition is augmented by smooth muscle tropomyosin and relieved by Ca2+- calmodulin. The binding of the 7.3-kDa fragment to actin is competitive with the binding of S - 1 to actin. Thus, this polypeptide has several of the important features characteristic of intact caldesmon. However, although an intact caldesmon molecule covers between six and nine actin monomers, the 7.3-kDa fragment binds to actin in a 1:1 complex. Comparison of this fragment with others suggests that a small region of caldesmon is responsible for at least part of the interaction with both calmodulin and actin. Originally published in the Journal of Biological Chemistry, vol. 267, No. 23, 199

Potential of Bioethanol as a Household Fuel for Middle-Income Urban Kenya: A Case Study of Nairobi City.

Access to clean sources of energy constitutes a necessary condition for poverty alleviation. Provision of modern energy services is essential to improving the livelihood of households in the developing world. This study addresses both the demand and supply of bioethanol as a household fuel in urban Kenya. On the demand side, the study establishes that there is demand for clean fuels. The study establishes that households prefer the clean and convenient fuels. Even though LPG and electricity are indicated as expensive, they are the preferred fuels for cooking and lighting respectively. On the supply side, the study reviews the production of bioethanol from sugarcane and sweet sorghum. It is established that Kenya has suitable climate and land is available to grow sugarcane and sweet sorghum to supply bioethanol. Bioethanol is a modern clean fuel similar in characteristics to LPG and therefore can replace it as a household fuel. Bioethanol production and use will stimulate rural development. Keywords: bioethanol, household fuel, Keny

Microbial population dynamics as a function of sediment salinity gradients in the Qua Iboe Estuary mangrove swamp (Nigeria).

In this investigation the extent to which sediment salinity gradients can be used to predict the sensitivity of microbial populations in mangrove ecosystem was investigated. The microbial groups monitored were heterotrophic bacteria, coliform bacteria, actinomycetes, fungi and yeasts. Pearson's Product-Moment Correlation (r) analyses were done on Log10-transformed estimates of population densities. The values obtained from the intertidal (epipellic) and subtidal (benthic) sediments were less than the critical value of 0.707 (n=8, p=0.05). This indicates that salinity was less closely related to the microbial population densities. A positive but insignificant relationship was found for fungi (r=0.03) in intertidal sediment. The total heterotrophic bacteria (r=-0.69), coliforms (r=-0.54), actinomycetes (r=-0.43) and yeasts (r=-0.56) were negatively affected by salinity in epipellic sediment. But in the benthic sediment, total heterotrophic bacteria (r=0.55) and unexpectedly, the fungi (r=0.58) and actinomycetes (r=0.29) exhibited positive but insignificant correlations while coliform and yeast counts in the benthic sediments were negatively influenced by salinity. However the coefficient of determinations (R2) revealed that total heterotrophic bacteria (48.06%) and yeasts (31.18%) were more extensively distributed in the intertidal sediments than coliforms. (29.38%,actinomycetes (18.68%) and fungi (0.09%). In contrast, the fungi (33.48%) demonstrated a wider distribution in benthic sediment. This may be ascribed to their existence, mostly as dormant, but culturable spores in the anoxic bottom sediment. The weak relationship exhibited by coliforms further confirms their usefulness as indicator of faecal contamination in estuarine ecosystem

Application of correlation analysis in assessment of relationships between mineral hydrocarbon levels and hydrocarbonoclastic bacteria count in tropical mangrove estuarine sediments

Pearson’s Product-Moment correlation analysis of the relationships between total hydrocarbon content (THC) and hydrocarbon utilizing bacteria population (HUB) in mangrove sediments and overlying water of the Qua Iboe Estuary, Nigeria was carried out. The results show that there was in general a close relationship between the two variables, but also a large amount of variation not explained by the analysis. The strongest positive relationships (p = 0.05) were found for THC in epipellic (intertidal) sediment and water (r = 0.65) while the relationship between THC in benthic (subtidal) sediment and water (r = 0.028) was weak, and positively insignificant (p = 0.05). A correlation of HUB densities on THC in benthic sediment was strong and positive (r = 0.91) but characterized by high HUB/HET ratios. That is, the strength of the relationship with respect to the oil degrading potentials of the bacterial was fairly low. In contrast, the relationships between the two variables in epipellic sediment (r = 0.66) was positively significant (p = 0.05) but with a substantial presence of heterotrophic bacteria. This implies that a quick-analysis of hydrocarbon content in epipellic sediment in relation to hydrocarbon utilizing bacteria densities following an oil spill is reliable. However, such analysis on benthic sediment may not be reliable in estuarine environment with chronic exposure to crude oil pollution. This is despite the wide distribution of HUB (82.4% in benthic sediment, 43.1% in epipellic sediment, and 33.3% in surface water) in the ecosystem as revealed by the coefficient of determinations (R2) values