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.     

Porphyromonas (Bacteroides) endodontalis: its role in endodontal infections

Porphyromonas endodontalis (formerly Bacteroides endodontalis) is a black-pigmented anaerobic Gram-negative rod which is associated with endodontal infections. It has been isolated from infected dental root canals and submucous abscesses of endodontal origin. The presence of P. endodontalis in infected dental root canals has been correlated with symptoms of an acute infection. It is occasionally found on oral mucous membranes and periodontal pockets. P. endodontalis has shown relatively low virulence in experimental monoinfections. In anaerobic mixed infections it can play an essential role. Differences in virulence between strains have been related to capsular material. On the basis of different types of capsules, three serotypes have been described. P. endodontalis is sensitive to a wide range of antibiotics, including the penicillins, the tetracyclines, and metronidazole.     

A three-dimensional iterative scheme for an electromagneticinductive applicator

An efficient iterative method for solving quasi-static electromagnetic field problems is presented. The electromagnetic field is generated by an inductive applicator and is represented as a superposition of two constituents, viz. a primary field in absence of the tissue configuration and a secondary field generated by the presence of the tissue. Then, for the secondary field a quasi-static approximation is employed. In the quasi-static field equations a relaxation function is introduced, such that the resulting equations can be solved iteratively. For a realistic three-dimensional model of a human hand numerical results are presented.     

A Genetic Dissociation of Learning and Recall in Caenorhabditis elegans.

A learning event can be dissociated into 3 components: acquisition, storage, and recall. When the laboratory wild-type strain of Caenorhabditis elegans (N2 strain) is exposed to benzaldehyde in the absence of food, the worms display a reduction of their attractive response to this volatile odorant. This results from the association between benzaldehyde and a nutrient-deficient environment. Another wild-type isolate, the CB4856 strain, fails to display this decreased response to benzaldehyde after exposure to benzaldehyde in the absence of food. However, like the N2 strain, when tested to isoamyl alcohol after benzaldehyde conditioning, the CB4856 strain displays a decreased isoamyl alcohol response. Therefore, the CB4856 strain does not have an acquisition deficit, but it suffers from a recall deficit specific to benzaldehyde. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Non-point sources and the waste discharge charge system.

The development of a waste discharge charge system (WDCS) in South Africa has been proposed to promote waste reduction and water conservation. The WDCS is based on the polluter pays principle and is designed such that the management of waste discharges achieves resource quality objectives (RQOs) at the minimum total cost to the catchment. Two charges are distinguished: first a charge for optimising use of the resource (incentive charge); and secondly, a charge for development and operation of mitigation measures in the resource (mitigation charge). The WDCS is applied to both point sources and non-point sources (NPS) of contamination. In the inclusion of NPS, the charge system distinguishes between registered and non-registered NPS, with the charge applied to the former group only, in the first instance. This paper introduces the WDCS by describing the principles and the theoretical basis of the WDCS, highlighting the link to RQOs as the benchmark of acceptable externalities. The paper explores the inclusion of NPS in the WDCS, describing: first, the principles of NPS inclusion in the WDCS; secondly, the types of NPS included in the present version of the WDCS; thirdly, the methodology for charge estimation; and finally, non-registered NPS and their potential inclusion in future editions of the WDCS. The paper concludes with remarks and challenges facing the first edition of the WDCS.     

Investigation of bounds on particle packing in pebble-bed high temperature reactors

Models and methods are presented for determining practical limits of the packing density of TRISO particles in fuel pebbles for a pebble-bed reactor (PBR). These models are devised for designing and interpreting fuel testing experiments. Two processes for particle failure are accounted for: failure of touching particles at the pressing stage in the pebble manufacturing process and failure due to inner pressure buildup during irradiation. The second process gains importance with increasing fuel temperature, which limits the particle packing density and the corresponding fuel enrichment. Suggestions for improvements to the models are presented.