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11.
OBJECTIVE: To evaluate what nursing home medical directors actually do, what they and other nursing home personnel believe would be desirable to do, and what problems and deficiencies are perceived. DESIGN: Mail survey with follow-up telephone interview when necessary. SETTING: Forty-five nursing facilities in upstate New York. PARTICIPANTS: The medical directors, administrators, and directors of nursing of the 45 facilities. MEASUREMENTS: Inventory of what medical directors reported as to their actual activities and time spent, and of what they, the administrators, and the directors of nursing felt should be their responsibilities and activities under ideal circumstances. RESULTS: For part-time medical directors, self-reported time spent on medical directorship activities averaged 12 hours per month; of all directors, 45% spent 8 hours or less per month. Proportion of time spent on various specific activities varied widely. There was general agreement that substantially more time should be spent, in particular, on evaluating and addressing problems of adequacy and quality of care, communicating with attending physicians about problems, and assisting with inservice training programs. CONCLUSIONS: To fill the role adequately, more time should be spent by many part-time medical directors, which will require greater financial commitment by facilities and reimbursement systems. Efforts need to made to better coordinate the expectations of medical directors and facility staff. 相似文献
12.
13.
Masami Ikeda Susumu Fukumoto Hiroshi Takao Shinya Ohtsuka Eiichi Haginomori Masayuki Hikita 《Electrical Engineering in Japan》2002,141(4):16-24
This paper describes the dielectric breakdown characteristics of oil and oil‐impregnated paper for very fast transient (VFT) voltages. Blumlein circuits generate VFT voltages of 60 and 300 ns in a pulse width that simulates disconnecting switching surges in gas‐insulated switch gears. We measured the breakdown voltages of needle‐to‐plane, plane‐to‐plane oil gaps and several pieces of paper between plane electrodes for VFT and lightning impulse voltages. The measured data were formulated in V‐t characteristics and Weibull probability distributions. The inclination n of V‐t characteristics of insulating paper is 150, which is less than n = 13.7 of the plane‐to‐plane oil gap in the VFT time range. The shape parameters of Weibull distribution obtained in this study show that the scattering of breakdown voltages of paper is much less than that of oil. © 2002 Wiley Periodicals, Inc. Electr Eng Jpn, 141(4): 16–24, 2002; Published online in Wiley InterScience ( www.interscience.wiley.com ). DOI 10.1002/eej.10043 相似文献
14.
Hideo Sawada Hiroshi Kakehi Masashi Koizumi Yoshihiro Katoh Masashi Miura 《Journal of Materials Science》2007,42(17):7147-7153
Fluoroalkyl end-capped N-(1,1-dimethyl-3-oxobutyl)acrylamide oligomer [RF-(DOBAA)
n
-RF] reacted with tetraethoxysilane (TEOS) and silica nanoparticles in the presence of low-molecular weight biocides such as
hibitane, hinokitiol, and hinokioil under alkaline conditions to afford RF-(DOBAA)
n
-RF/silica nanocomposites-encapsulated these biocides in excellent to moderate isolated yields. Fluoroalkyl end-capped N,N-dimethylacrylamide oligomer [RF-(DMAA)
n
-RF] and acrylic acid oligomer [RF-(ACA)
n
-RF]/silica nanocomposites-encapsulated hibitane were obtained under similar conditions. Dynamic light scattering measurements
showed that the size of these fluorinated nanocomposites-encapsulated biocides thus obtained is nanometer size-controlled.
Additionally, these fluorinated nanocomposites were shown to have a good dispersibility and stability in methanol and water.
Of particular interest, these fluorinated nanocomposites-encapsulated biocides were found to have a good antibacterial activity
against Staphylococcus aureus, and these nanocomposites were applied to the surface modification of traditional organic polymers such as poly(methyl methacrylate). 相似文献
15.
Tsukada T. Hashimoto Y. Sakata K. Okada H. Ishibashi K. 《Solid-State Circuits, IEEE Journal of》2005,40(1):67-79
A decoupling circuit using an operational amplifier is proposed to suppress substrate crosstalk in mixed-signal system-on-chip (SoC) devices. It overcomes the parasitic inductance problem of on-chip capacitor decoupling. The effect of the proposed decoupling circuit is not limited by parasitic fine impedance. A 0.13-/spl mu/m CMOS test chip showed that substrate noise at frequencies from 40 MHz to 1 GHz was incrementally suppressed by sequentially activating three of the proposed circuits in parallel. The power dissipation of each circuit was 3.3 mW at a 1.0-V power supply. The test chip measurement showed that the proposed decoupling reduced crosstalk by 31% at 200 MHz, whereas it was reduced by 4.4% with capacitor decoupling. This 7:1 ratio, or 17 dB, corresponds to the gain of the opamp. Design of the opamp and its feedback loop for active decoupling is simple, making the opamp useful for SoC applications. 相似文献
16.
This paper describes an effective analysis of magnetic shielding based on homogenization. The analyses become time‐consuming if the problems include the magnetic substances having fine structure. The homogenization of the structure makes it possible to analyze effectively the magnetic fields. The authors introduce a method to estimate the effective permeability of the homogenized substance. This method can be applied to any periodic structure made of magnetic substance. The magnetic shielding effects by the structures against direct‐current (DC) fields generated by electric railways are analyzed by using the present method. As a result, it is found that the overhead way and the protective fence near the railway work as a magnetic shield, whose effects can be improved by appropriate arrangement of those constructions. © 2007 Wiley Periodicals, Inc. Electr Eng Jpn, 160(4): 7–15, 2007; Published online in Wiley InterScience ( www.interscience.wiley.com ). DOI 10.1002/eej.20310 相似文献
17.
PURPOSE: To report a patient with acute retinal pigment epitheliitis examined less than 24 hours after onset of symptoms. METHOD: One day after the onset of blurred vision in her left eye, a 33-year-old woman had a best-corrected visual acuity of LE, 20/60 -2. The left eye had classic uniform golden-colored nodules in a honeycomb pattern in the foveal retinal pigment epithelium. Intravenous fundus fluorescein angiography disclosed staining of the foveal pigment epithelium. RESULTS: One month after initial examination, visual acuity was LE, 20/20, and fine subfoveal pigmentary clumping was present. CONCLUSION: The pigmentary maculopathy of acute retinal pigment epitheliitis may be nonspecific, resulting from more than one type of primary foveal inflammation. 相似文献
18.
Hashimoto J. Yoshida I. Murata M. Katsuyama T. 《Quantum Electronics, IEEE Journal of》1997,33(1):66-70
In this paper, we studied the aging time dependence of the catastrophic optical damage (COD) failure of an Al-free uncoated 0.98-μm GaInAs-GaInP strained quantum-well laser with an injection current as a parameter. Based on the stress-strength model, we first investigated experimentally the dependence of the critical power level (CPL) at which COD would take place upon the aging time. Then applying a statistical treatment to this result, we found for the first time that CPL data at each aging time could be considered to distribute according to the Weibull statistics, and the decrease rate of the CPL with the aging time depended very strongly on the injection current. Finally, using the relationship between the decrease rate of the CPL with the aging time and the current, we predicted roughly the time of a COD failure occurrence for both large and small current cases. As a result, we clarified that for our Al-free uncoated 0.98-μm laser, a COD failure became a fatal problem in the case of a large-current (high-power) operation 相似文献
19.
I Ezaki M Shingu M Hashimoto T Isayama J Tohmatsu H Kanda M Nobunaga T Watanabe 《Canadian Metallurgical Quarterly》1994,21(11):2005-2010
OBJECTIVE: To better understand the immunoglobulin variable (V) region repertoire of rheumatoid factors (RF). METHODS: We characterized the heavy (H) and light (L) chain gene segments utilized in a monospecific IgG RF secreting hybridoma (AEE111F) which were derived from a patient with rheumatoid arthritis (RA). The hybridoma was established by fusion of a mouse myeloma cell line with bone marrow derived mononuclear cells from a patient with RA. First strand complementary DNA (cDNA) was generated and used for a polymerase chain reaction amplification of the H and L chain V domains. The amplified V domains were sequenced and compared with an extensive database of germline and cDNA V gene segments. RESULTS: The VH sequence was found to be 96% homologous to a previously described fetal VH3 cDNA (60P2). The VL sequence was also highly homologous to the previously described V lambda II gene (96%) derived from a patient with systemic lupus erythematosus which correlated with an 8.12 idiotype (Id), and to an antibacterial antibody against the Haemophilus influenzae type b capsular polysaccharide (94.7%). CONCLUSION: The overlap among this RF VL gene and the 2 reported V lambda sequences of antibodies that expressed anti-DNA related Id and an environmental pathogen specificity suggests that a part of the IgG RF isolated from patients with RA may thus be derived from the physiological natural antibody repertoire during an abnormal immune response and then develop high affinity, monospecific RF by the selection of an antigen driven mechanism. 相似文献
20.
Cell death was analyzed in neurulating mouse embryos after in vivo doses of 2-methoxyethanol (2-ME) that produce anterior neural tube defects. Characterization of 2-ME-induced cell death was performed by evaluating: (1) vital fluorochrome staining in whole embryos applying confocal laser scanning microscopy; (2) characteristics of cell debris in conventional histological sections revealed by light microscopy; and (3) Apoptag in situ immunohistochemical staining for apoptosis using light microscopy. Methods for quantification of cell death identified by these three techniques were explored using computerized image analysis. Physiological cell death in control embryos primarily occurred in the neural crest region during neural fold elevation. Embryos exposed to 2-ME had expanded areas of cell death in the neural crest and also new areas of cell death in medial regions of the anterior neural tube. Both physiological and 2-ME-induced embryonic cell death had morphological, immunohistochemical, and fluorochrome staining characteristics of apoptosis. When fluorescence data from confocal microscopic analysis of vital fluorochrome-stained embryos were analyzed, a dose-dependent increase was found in embryos exposed to 2-ME. Similar results were obtained when cell death was analyzed in either conventional histological sections or sections prepared for immunohistochemical detection of apoptosis. The cell death data obtained in this study correlate with previously observed near-term malformation rates, suggesting that a quantitative relationship exists between 2-ME-induced embryonic cell death and neural tube defects. 相似文献