Weight-based heparin dosing: clinical response and resource utilization

The objective of this study was to assess a weight-based heparin (WBH) nomogram (80-U/kg bolus, 18-U/kg-per-hour initial infusion) and determine its clinical performance and impact on resource utilization. All patients treated with heparin for venous thromboembolism or unstable angina during a 15-week study period were included in this retrospective, chart-review study. Three groups were identified: patients treated with WBH, patients whose regimen deviated from the weight-based nomogram (DEV), and matched historical controls (HCs). In patients receiving heparin for more than 24 hours, those treated with WBH achieved threshold activated partial thromboplastin time (aPTT) levels significantly faster than did HC or DEV patients. However, 42% of WBH-treated patients were found to have initial supratherapeutic responses. Logistic regression analysis identified age > or =67 years, prior warfarin therapy within 7 days of heparin, and high initial infusion rate as predictive of a supratherapeutic aPTT response; smoking was predictive of a subtherapeutic response. Bleeding events were not significantly different between groups. An infusion rate of 15 U/kg per hour was found to closely approximate our population's actual heparin infusion requirement. Resource utilization was significantly different between the WBH and HC groups in terms of nursing interventions at 48 to 72 hours. We concluded that WBH rapidly drives patients' aPTT response above the therapeutic threshold for heparin; however, prudent adjustment of the initial infusion rate is necessary to avoid a supratherapeutic aPTT response. Our data support a nomogram with an initial infusion rate of 15 U/kg per hour.     

Stroke 2: expanding the nurse's role in stroke rehabilitation

This article, the second of two considering the nurse's role in stroke rehabilitation, focuses on potential nursing contributions in a number of areas. There is scope, particularly in the community, to develop a far greater nursing role in both the acute and the postacute phases of rehabilitation. However, nurses often have ambivalent attitudes towards rehabilitation--seeing acute care as more prestigious and important. Such attitudes are developed and reinforced in basic training which gives relatively little emphasis to chronic illness.     

Improvement in resource utilization after development of a clinical pathway for patients with pressure ulcers

The aim of this work was to assess the relationship between GH-binding protein (GHBP) and leptin. Both peptides are nutritionally regulated, but the recent implication of a role for leptin in the GH axis requires further study. To avoid the sexual dimorphism in leptin values, we performed leptin standardization according to gender (SD score-leptin). The relationship between SD score-leptin and GHBP was studied in 128 adults with different nutritional status [8 groups according to body mass index (BMI)], ranging from severely underweight anorexia nervosa to highly morbid obesity. Both GHBP and SD score-leptin significantly increased according to BMI within the range from 18-27 kg/m2, whereas no significant differences were found among underweight groups (BMI, < 18 kg/m2) or among obesity grades (BMI, > 27 kg/m2). We found a strong correlation between GHBP and SD score-leptin (r = 0.8; P < 0.0001). Multiple regression analysis revealed SD score-leptin to be a significant determinant of GHBP, accounting for 64% of the variation, whereas BMI did not contribute further to explaining changes in GHBP. This suggests a physiological pathway involving both GHBP (the soluble fraction of GH receptor) and leptin. Thus, we might speculate that leptin could be the signal that induces the related nutritional changes observed in GHBP/GH receptor expression.     

Demographic and socioeconomic predictors of dental care utilization

Nitric oxide (NO) is detectable in the exhaled gas of adults during spontaneous respiration and, according to current knowledge, mainly originates from the paranasal sinuses. We studied total NO excretion rates by chemiluminescence in preterm infants whose paranasal sinuses are known to be only partially pneumatized. NO excretion was 7.15 +/- 1.13 nl/min (mean +/- SD, range 6.33-9.36 nl/min) measured from spontaneously exhaled nasal gas (n = 6) and 0.3 +/- 0.05 nl/min (range 0.26-0.36 nl/min) measured from the lower airways in intubated individuals (n = 3). These values are considerably lower than those reported for older children and adults. Body weight-related amounts of NO excretion, however, seem comparable between infants and adults.     

白云鄂博矿产资源综合利用的前景

白云鄂博矿床是一个大型的铁-铌-稀土多金属矿床，随着矿山开采规模的扩大和选冶技术的发展，对矿体中产出的矿产资源进行综合利用已成为可能，这样不仅能充分利用产出的矿产资源、减少浪费而且可以大幅度提高矿山经济效益。     

MMPI predictors of outpatient medical utilization rates following psychotherapy.

Studied data from 194 adult outpatients in a private medical center to determine whether the Minnesota Multiphasic Personality Inventory (MMPI) or a utilization prediction scale (UPS) predicted decrease in outpatient medical utilization following psychotherapy. Although none of the 13 MMPI scales discriminated differences, a UPS cutoff score correctly categorized 75% of the original sample. When the UPS was applied to a cross-validation sample, two-thirds were correctly identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

浅谈农业废弃物处理与资源化利用

生物质属于可再生资源,在我国含量丰富,生物质材料炭化后的产物在储能、吸附等领域得到了广泛应用. 研究生物质材料的炭化过程,有利于生物质炭的有效利用. 总结了生物质材料炭化过程中,生物质的种类和炭化条件（包括炭化温度、预处理等）对炭化产物中碳的结构、形态、性质的影响,期望为生物质炭化产物的有效利用提供理论基础. 同时总结了在催化剂作用下,利用生物质材料炭化来制备碳纳米管,并分析了生物质材料中木质素和纤维素等组分对碳纳米管制备的影响. 在此基础上,展望了生物质材料在含碳耐火材料中的应用前景,以期为制备低成本和高性能的新型含碳耐火材料提供思路.     

氮气资源综合利用及系统改进

针对长钢在氮气资源利用方面存在的诸多问题,主要从资源配置、装备、系统运行及应急保障等方面进行改进和完善,并且取得积极效果.     

The cost-effective delivery of rehabilitation psychology services: The responsible utilization of paraprofessionals.

The new and rapidly changing health care environment necessitates innovation on the part of rehabilitation psychology to achieve cost-effectiveness. This innovation could take the form of rehabilitation psychologists' responsibly using bachelor's-level technicians, or paraprofessionals, in the delivery of clinical services. This article proposes a pyramid model of rehabilitation psychology service delivery using paraprofessionals and psychology trainees. Specific clinical activities appropriate for paraprofessionals are outlined. Controversies regarding use of bachelor's-level paraprofessionals and the inflationary process of over-credentialing doctoral-level psychologists are discussed. It is proposed that psychology interns and residents be cross-trained in allied health skills so that psychology trainees can provide clinical support to other health care disciplines, thereby improving the cost-effectiveness of, and preserving, hospital-based psychology training programs. The article emphasizes the need for doctoral-level rehabilitation psychologists to adopt administrative roles in medical settings in order to implement innovative service models. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Humeral head osteonecrosis: clinical course and radiographic predictors of outcome

A register of the Guillain-Barrè syndrome (GBS) has been started in Lombardy on February 1 1994, aiming at: 1) Making more correct estimates of the incidence and time and geographic trends of the disease; 2) Having a target population which serves for reference for analytical and experimental epidemiological studies; 3) Contributing to the validation of selected diagnostic procedures; 4) Implementing an audit of the diagnosis and treatment of GBS; 5) Collecting biochemical, hemathological and electrophysiological data to be stored in ad-hoc data-banks. In a pilot study undertaken during the period February 1 1994-May 31 1995 a total of 109 patients (M 63; F 46) were recruited in 32 hospitals. The crude annual incidence rate of GBS was 0.92 per 100,000 population. Typical GBS had been diagnosed in 87% of cases, followed by atypical GBS (7%). The disease could not be classified according to the available criteria in 6% of cases. Electrophysiological features suggesting demyelination were present in 29% of cases; axonopathy was documented in 14%, and mixed patterns in 34%. Plasma exchange was the suggested treatment in 51% of cases, followed by immunoglobulins (24%) and steroids (23%).     

宝钢烧结资源综合利用的生产实践

对宝钢烧结采用的OG泥浆、小球及直接配入混匀矿等不同方法综合利用冶金粉尘和副产品的生产实践进行了总结,着重分析了不同冶金粉尘和副产品及其配入方式、用量等对烧结的影响,并对目前存在问题及将来的发展做了初步探讨。     

2003年资源节约综合利用重点工作安排

认真贯彻落实党的十六大精神 ,以“三个代表”重要思想为指导 ,按照走新型工业化道路和实施可持续发展战略的要求 ,以提高资源利用效率、保护环境、增强企业竞争力为目标 ,加强法规建设 ,强化政策导向 ,依靠技术进步 ,夯实基础管理 ,建立和完善与社会主义市场经济体制相适应的资源节约综合利用宏观管理体系和运行机制 ,促进经济与资源、环境的协调发展。着力抓好以下重点工作 :1　以节水、节能为重点 ,促进企业节能降耗 ,提高资源利用效率1 1　工业节水(1)完善节水标准体系 ,促进用水效率提高。拟选择啤酒、酒精、机械、有色金属等行业的部…     

废弃SCR脱硝催化剂资源化利用研究进展

废弃SCR脱硝催化剂是一种危险废物,同时又含有多种有价成分。通过分析国内外废弃催化剂资源化利用的主要方法、原理、途径及优缺点,得到能够充分回收钒钨钛资源的有效方法主要为废弃SCR脱硝催化剂浸出-浸出液净化分离回收钒钨-浸出渣酸洗焙烧回收钛,其中浸出过程比较适合采用碱式焙烧-水浸法;浸出液净化分离过程比较适合采用化学沉淀法或溶剂萃取结合化学沉淀法。此外,展望了废弃SCR脱硝催化剂资源化利用的研究方向。     

金属矿山尾矿资源利用状况与建议

通过对金属矿山尾矿资源现状进行综合分析,依据中国尾矿资源开发利用的实际情况,提出了对尾矿资源研究要加大科技投入,加强政策扶持及导向,拓宽尾矿资源的利用率,完善管理制度,建立尾矿资源信息化数据系统等建议,对中国金属矿山尾矿资源的开发利用具有较大的现实意义。     

LF精炼渣的气化脱硫及资源化利用

针对我国30多家钢铁企业LF精炼渣处理现状及利用模式进行详细调研发现:LF精炼渣处理方式较为简单, 利用层次低, 资源浪费严重.同时, LF精炼渣具有光学碱度、硫容量和硫分配比高, 熔化温度和黏度较低的特点, 可以在冶金内循环利用, 但渣中硫的富集成为其在冶金内循环利用中的限制环节.基于此, 开展LF精炼渣氧化除硫试验及冶金回用分析研究.结果表明:LF精炼渣中的硫可被O₂氧化成SO₂;在1370℃和1400℃时, 吹气10 min除硫率可达47%以上, 而吹气60 min后除硫率基本可达90%以上, 吹空气除硫效果明显, 完全满足LF精炼渣冶金回用时对硫含量的要求.最终提出了一种简单高效且与现行生产工艺结合较好的LF精炼渣在冶金中再利用的新思路.     

Predicting resource utilization in a comprehensive center: an evaluation of three alternative methods

Three alternative methods for obtaining anticipated resource utilization information for comprehensive mental health centers are proposed. The methods differ on two dimensions, sample selection and statistical technique. Using an admission cohort rather than a discharge cohort and eliminating patients who terminated treatment against medical advice permitted a refined prediction. Although no significant differences were found between the chi-square and multiple-regression techniques, the latter resulted in a substantially greater degree of flexibility.     

Women's utilization of outpatient psychiatric services: Some emerging priorities for rehabilitation psychologists.

Provides a brief profile of women's utilization of outpatient psychiatric services, based on a 1975 survey conducted by the National Institute of Mental Health, and focusing on population characteristics that have special implications for rehabilitation psychologists, including race, age, marital status, diagnosis, and type of treatment. Findings reveal that more than 60% of adult admissions (aged 18–64 yrs) were female. Black females had the highest admission rate, followed by Black males, White females, and White males. Most female admissions 14 yrs or older, both Black and White, were married, and depression was the leading diagnosis, suggesting that developing effective rehabilitation strategies for women will require special attention to the causes and consequences of depression. Results also indicate that minorities were less likely than Whites to receive individual psychotherapy, and more than 40% of clients diagnosed as having a depressive disorder received drug therapy. Sources of information on mental health of women and minorities are identified, including reviews of the literature, journals, and research centers that deal specifically with the mental health needs of special populations. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)