What influences patients' reports of three aspects of hospital services?

OBJECTIVES: Market forces make it essential to know what policies and actions influence patients' reports of hospital services. No studies have examined the role of patient characteristics, labor quality and staff characteristics, nonlabor resources, managerial practices, and employee attitudes within a single investigation. METHODS: The authors collected, simultaneously, data about labor, management and service processes, nonlabor resources, and employee attitudes on 117 nonintensive medical-surgical inpatient units in 17 hospitals selected from a pool of 69 institutions within a metropolitan area by a stratified random sample. Of the 2,595 patients who agreed to participate, 2,051 (79%) completed telephone interviews regarding their experiences with physical care, education, and pain management services within 26 days of hospital discharge. RESULTS: A significant amount of variation in patients' service reports was explained (adjusted R2 = 0.41 physical care, 0.35 pain management, 0.44 education). Although the predictors varied for each service report, patient characteristics, especially those related to personal resources, had a large explanatory role. A labor assignment pattern that could explain why earlier studies found labor quality and staff characteristics to have only a weak role in the prediction of patients' service reports was noted. CONCLUSIONS: The results related to patient characteristics may indicate opportunities to improve care by confronting service design strategies that erroneously rely on a homogeneous patient population. Measurement challenges identified by this study must be addressed to determine the role of labor quantity and staff characteristics.     

Hydride Vapor Phase Epitaxy of GaN Thick Films by the Consecutive Deposition Process Using GaCl3

GaN buffer and main layers were grown by the conventional hydride vapor phase epitaxy technique using GaCl₃ consecutively. The deposited buffer layers were investigated by atomic force microscopy and X-ray analysis. To examine the behavior of the buffer layers at main layer growth temperature, heat treatment was conducted at 900°C. Based on the results of the buffer layer study, GaN thick films were grown at 1050°C. Optimum deposition conditions of buffer layer from the buffer and main layer studies generally coincided. On the φ scanning pattern, the GaN films grown on (0001) Al₂O₃ were single-crystalline. Band-edge emission dominated photoluminescence was observed at room temperature.     

A PLL clock generator with 5 to 10 MHz of lock range formicroprocessors

A microprocessor clock generator based on an analog phase-locked loop (PLL) is described for deskewing the internal logic control lock to an external system lock. This PLL is fully generated onto a 1.2-million-transistor microprocessor in 0.8-μm CMOS technology without the need for external components. It operates with a lock range from 5 to 110 MHz. The clock skew is less than 0.1 ns, with a peak-to-peak jitter of less than 0.3 ns for a 50-MHz system clock frequency     

Phase Transformations in Dicalcium Silicate: II, TEM Studies of Crystallography, Microstructure, and Mechanisms

The crystallography, microstructures, and phase transformation mechanisms in dicalcium silicate (Ca₂SiO₄) were studied by TEM. Three types of superlattice structures were observed in the α'_L and β phases. Almost all β grains were twinned and strained. Symmetry-related domain structures inherited from previous high-temperature transformations were observed in β grains. Both the α→α'_H and α'_L→β transformations were considered to be ferroelastic, and spontaneous strains were calculated. In terms of the crystal structures, the major driving force for the β→γ transformation is proposed to be strains and cation charge repulsions in the β structure. This mechanism can be displacive, but it needs to overcome a comparatively high energy barrier.     

Genetic definition of a new bovine papillomavirus type 1 open reading frame, E5B, that encodes a hydrophobic protein involved in altering host-cell protein processing

We have previously observed that bovine papillomavirus type 1 (BPV-1) induces the appearance of five cellular proteins in C127 mouse fibroblasts, four of which appear to arise by altered processing of resident endoplasmic reticulum proteins. Studies of various cell lines revealed that expression of the 3' end of the BPV early region was sufficient for induction of these changes. To identify the BPV gene responsible, we have utilized the simian virus 40 (SV40)/BPV-1 recombinant virus Pava-1, which expresses the 3' end of the BPV early region behind an SV40 early promoter. C127 cells infected with Pava-1 for 48 h show the expected BPV-associated alterations, as do cells infected with Pava constructs mutated in the E5 or E2 genes. However, a mutation in the start codon of a previously ignored open reading frame extending from nucleotides 4013 to 4170 (E5B) eliminated the BPV-associated changes. Similar results were obtained with COS cells infected with the Pava mutants and C127 cells transformed by full-length mutated BPV. Despite its influence on the processing of cellular endoplasmic reticulum proteins, this mutation in E5B did not alter BPV-transforming efficiency or the ability of transformants to form colonies in soft agar. The E5B open reading frame encodes a hydrophobic 52-amino-acid polypeptide that shares structural similarities with HPV6 E5A and HPV16 E5. Speculations on a role for E5B in the viral life cycle are discussed.     

Deactivation of copper-ion-exchanged hydrogen-mordenite-type zeolite catalyst by SO2 for no reduction by NH3

Deactivation of copper-ion-exchanged hydrogen-mordenite-type zeolite catalyst by SO₂ for NO reduction by NH₃ was examined in a fixed-bed flow reactor. The deactivation of the catalyst was strongly dependent on reaction temperature. At high reaction temperatures over 300°C, the catalyst did not lose its initial activity up to 50 h of operation, regardless of SO₂ feed concentration from 500 to 20,000 ppm. However, at low reaction temperatures near 250°C, apparent deactivation did occur. Changes in the physicochemical properties such as surface area and sulfur content of deactivated catalyst well correlated with catalyst activity, depending upon reaction temperatures. The deactivation was due to pore blocking and/or filling by deactivating agents, which plugged and/or filled the pores of catalyst. The deactivating agents deposited on the catalyst surface were presumed to be (NH₄)₂SO₄ and/or (NH₄)HSO₄ from the results of TGA and ion-chromatography measurement.