Nurses as writers

In 1996 the total in-hospital charges for the primary treatment of breast cancer with a modified radical mastectomy averaged $10,000 throughout the United States. The total charge (hospital plus physician's fees) varied by 95 percent between the high charge reported in New York ($12,690) and the low charge in Michigan ($6,510). The hospital portion of the bill averaged 65 percent of the total and ranged from 51 percent in New York to 74 percent in Virginia. The average length of stay for these women was 2.39 days and ranged from 3.18 days in New York to 1.69 and 1.66 days in Washington and Arizona, respectively. The average charge for a partial mastectomy was $8,760 with notable variations between states. The Texas total charge was the highest ($12,890, some 47 percent above the U.S. norm) and more than twice the low charge in Ohio ($6,080, 31 percent below the U.S. average). The physicians' charges averaged $3,330 for the country as a whole and accounted for 38 percent of the bill. This proportion ranged from 46 percent of the total in New York to 70 percent in Indiana and Colorado. The average length of hospitalization for a partial mastectomy was 1.84 days. On average, women remained in the hospital for the longest time in New Jersey (2.78 days) and for the shortest time in Oregon and Massachusetts (1.40 days and 1.45 days, respectively).     

Hospital practices influence the pattern of infective endocarditis

OBJECTIVE: To identify factors contributing to infective endocarditis at a major teaching hospital. METHODS: Retrospective review of clinical records of patients diagnosed with endocarditis by standard case definitions with respect to causative organisms, clinical features and outcome. RESULTS: One hundred and ninety-three episodes of endocarditis seen between 1979 and 1992 at Westmead Hospital, Sydney, were reviewed. In the 174 cases where the causative organism was isolated, 75 (43%) were Staphylococcus aureus and 50 (29%) were viridans streptococci. Nosocomial acquisition and/or inter-hospital transfer accounted for 83 episodes; 48 (58%) S. aureus (P < 0.001) and nine (11%) viridans streptococci (P < 0.001). In cases from the local community, viridans streptococci were more common than S. aureus (37% versus 25%); these included 18 episodes (14 S. aureus) in intravenous drug users. CONCLUSION: We conclude that, compared with community-acquired infections, the aetiology of endocarditis in a large teaching hospital is influenced strongly by the prevalence of nosocomial endocarditis and the need for interhospital transfer of complicated cases.     

Colour control in fly ash as a combined function of particle size and chemical composition

This paper presents the results of an investigation on the combined effect of particle size and chemical composition on the colour of fly ash - a property that determines whether fly ash polymer composites can be engineered to have very light appearance satisfying the need for a wide range of commodity applications, particularly in the building material and computer housing industry. Four fly ash samples were collected from Tarong power plant Queensland, Australia, namely fly ash from first hopper (T59), classified fly ash from first hopper (T60), grinded and then classified fly ash from first hopper (T63) and fly ash from fourth hopper (T64). It was found that the particle size of T64 is smaller but still in the same order as T63. Colour measurement and chemical composition analysis of the different FA samples showed that there is a correlation between the particle size, chemical composition and colour of the fly ash. This information could be effectively used in fly ash recycling industry.     

Mo-doped,Cr-Doped,and Mo–Cr codoped TiO2 thin-film photocatalysts by comparative sol-gel spin coating and ion implantation

Uniformly codoped anatase TiO₂ thin films of varying (equal) Mo and Cr concentrations (≤1.00 mol% for each dopant) were fabricated using sol-gel spin coating and deposited on fused silica substrates. All films were annealed at 450 °C for 2 h to recrystallise anatase. Undoped anatase films have been subjected to dual ion implantation for the first time, using Mo, Cr, and sequential Mo + Cr at 1 × 10¹⁴ atoms/cm². The films were characterised by GAXRD, AFM, SIMS, XPS, and UV–Vis and the performance was assessed by dye degradation. Despite the volumetric doping by sol-gel and the directional doping by ion implantation, neither method resulted in homogeneous dopant distributions. Both methods caused decreasing crystallinities and associated partial amorphisation. The XPS signal of the uniformly codoped films is dominated by undissolved dopant ions, which is not the case for the ion-implanted films. Increasing Ti valences are attributed to the fully oxidised condition of the Ti⁴⁺ ions that diffuse to the surface from Ti vacancy formation compared to the Ti valence of the bulk lattice, which contains Ti³⁺. Increasing O valence is attributed to the electronegativity of O^2?, which is higher than that of Ti⁴⁺. Detailed structural mechanisms for the solubility and energetics mechanisms involve the initial formation of Mo and Cr interstitials that fill the two voids adjacent to the central Ti ion in the TiO₆ octahedron, followed by integrated solid solubility (ISS) and intervalence/multivalence charge transfer (IVCT/MVCT). The sequential order of the last two is reversed for the two different doping methods. These two effects are likely to be the source of synergy, if any, between the two dopant ions. The photocatalytic performances of the uniformly codoped films are relatively poor and correlate well with the band gap (E_g). The performances of the ion-implanted films do not correlate with the E_g, where TiO₂–Mo performs poorly but TiO₂–Cr and TiO₂–Mo–Cr outperform the undoped film. These results are interpreted in terms of the competition between the effects of Mo doping, which causes partial amorphisation and/or blockage of active sites, and Cr doping, which may cause Mo–Cr synergism, Cr-based heterojunction formation, and/or improved charge-carrier separation owing to the surface-deposition nature of ion implantation.     

Growth and characterization of Bi2Sr2Ca1Cu2O8+x single crystals

High-quality single crystals are well suited to the investigation of some intrinsic material properties. A modified Bridgman method using a sharp temperature gradient (～300°C/cm) was used to grow Bi₂Sr₂Ca₁Cu₂O_8+x single crystals. Although the samples were contained in alumina ampoules, no aluminium contamination of the samples was detected. Blade-shaped crystals up to ～7–8 mm length and 3–4 mm width could be grown by this method, although extraction from the matrix was difficult. Electron diffraction patterns of the [001] zone axis revealed a high degree of crystallinity. The narrowness of the superconducting transition temperature, as determined by ac susceptibility, also suggests the existence of well-formed crystalline domains. In order to determine the relative orientation of the crystalline domains, electron channeling patterns were recorded from several consecutive growth steps from a fracture surface. The poor contrast of these and Kikuchi patterns suggests the presence of a stacking structure. The results showed a [100] growth direction and (001) cleavage plane. Reversible oxygen loss at the peritectic decomposition temperature of 863°C was observed. Knoop indentation measurements showed that the crystals were quite soft, having a microhardness of 0.44 GPa.     

Effects of Different Boron Compounds on the Corrosion Resistance of Andalusite-Based Low-Cement Castables in Contact with Molten Al Alloy

Interfacial reactions between Al alloy and andalusite low-cement castables (LCCs) containing 5 wt pct B₂O₃, B₄C, and BN were analyzed at 1123 K and 1433 K (850 °C and 1160 °C) using the Alcoa cup test. The results showed that the addition of boron-containing materials led to the formation of aluminoborate (9Al₂O₃.2B₂O₃) and glassy phase containing boron in the prefiring temperature (1373 K [1100 °C]), which consequently improved the corrosion resistance of the refractories. The high heat of formation of the aluminoborate phase (which increased its stability to reactions with molten Al alloy) and the low solubility of boron in molten Al were the major factors that contributed to the improvement in the corrosion resistance of B-doped samples.     

Equilibration kinetics of (La,Sr)MnO3

The present work reports isothermal changes of oxygen non-stoichiometry for the perovskite-type electrode material (La_0.8Sr_0.2)MnO₃ in the temperature range 945–1255 K. A thermogravimetric method was used to monitor the rate of the gas/solid equilibration. For equilibration degrees larger than 0.5, the equilibration kinetic data can be described by a diffusion equation. The determined chemical diffusion coefficient depends essentially on the oxygen partial pressure. Its temperature dependence can be expressed by the following expressions at low and high p(O₂), respectively: