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
A birefringence of siliceous glass, which is coexisting with mullite crystals, was studied by an optical polarizing microscope. The cause of the birefringence was assumed to be the residual stress induced by a large contraction difference between the mullite and glass on cooling. The stress has been evaluated to be as high as—0.3 GPa, and to correspond to the elastic one which began to develop at the glass transition point. 相似文献
Summary: Polyacrylonitrile (PAN) particles with micro‐size ranges (0.15–2 μm) were prepared by emulsion and dispersion polymerizationa and in supercritical carbon dioxide media. The PAN particles were blended with Nylon 6 (PA6) at 220 °C by using a miniature mixer; it was found that melt‐mixing was possible for PAN‐rich compositions as high as 70 wt.‐%. Blends were characterized by scanning electron microscopy, IR, viscosity measurements, differential scanning calorimetry, and dynamic mechanical thermal analysis (DMTA). The size and shape of original PAN particles were retained in PAN/PA6 blends. The useful range to blend PAN particles size was less than 1 μm in terms of shape retention of the PAN particles in blends. Blends with 40 wt.‐% PAN content were found to be melt‐processable. The elastic modulus was higher for PAN/PA6 blends than pure PA6.
SEM photograph of PAN‐SC/PA6 blend with a 40/60 weight ratio. 相似文献
Nylon-6,6 — a typical polyamide — was annealed in the swollen state in glycerol to promote the partial melting of the polymer crystal. The recrystallization or lamellar thickening of nylon-6,6 crystal following partial melting was easily induced by this annealing, and the lamellar thickness of the crystal increased stepwise by monomer unit length with increasing annealing temperature or annealing time. In addition, another distinct layer-thickening mechanism was observed which led to approximately doubling (and frequently quadrupling) the straight stem length of the lamellar crystal for all samples annealed under adequate conditions. New melting endotherms corresponding to these layer thicknesses (range of long spacings 140–180Å) were obtained by differential scanning calorimetry (d.s.c.) at temperatures ranging from 270° to 282°C. The mechanism of lamellar thickening is discussed with reference to the experimental results. 相似文献
A dry developable negative working resist composition comprised of poly(methyl isopropenyl ketone) (PMIPK) and 4-methyl-2,6-di(4′-azido-benzylidene) cyclohexanone-1 was examined. The main photochemical product formed in the resist pattern was found to be a secondary amine which crosslinks PMIPK. Post-annealing forms a hydrogen-bonded product which shows a powerful electronic excitation energy quenching effect. The quencher is more powerful than the aromatic compound arising from the azide by post-annealing only. The residual resist thickness of the negative pattern is about 80 percent of the initial thickness of the coating in spite of all the azide compound remaining in the resist coating. The obtained dry developed resist pattern has a high dry etch resistance. Etchings of Si and SiO2 were performed by plasma and reactive ion etching, respectively. 相似文献
Three samples of LaCoO3 were prepared by two different methods and calcined at 800 or 1000 °C. They had BET areas of 1, 12, and 16 m2/g and all of them showed pure perovskite X-ray diffraction patterns with identical unit cell dimensions. In a series of experiments the oxide, having larger surface area, was stepwise reduced in hydrogen at temperatures between 60 and 500 °C. The XPS spectra, taken at room temperature after evacuation at 400 °C at each reduction level, showed that the surface concentration of Co° was very low up to 300 °C but increased sharply between 300 and 350 °C (9–75%). This concentration further increased to 100% after 10 min reduction at 450 °C, but upon heating in hydrogen for an additional 10 min at 500 °C it decreased again to 75%. In another series of experiments the mixed oxide was reoxidized after each reduction. A fresh sample was reduced to 350 and 400 °C by contacting with hydrogen for 1 hr and evacuated at temperatures between 400 and 500 °C. Both high evacuation temperatures and reduction at 400 °C during 1 hr produced a sharp decrease in Co° surface concentration. These results are consistent with the catalytic behavior of this perovskite reported earlier by E. A. Lombardo et al. (4–7). A model is proposed to interpret the reduction of LaCoO3. 相似文献
The effects of Cu addition on the β phase formation rate and the thermoelectric power in various FeSi2 and Fe2Si5 based alloys was examined. The peritectoid reaction (a+→β) in FeSi2 alloys was initially enhanced by the addition of Cu but it became slower for longer annealing times. The retained metallic ε was harmful for the thermoelectric power. The inherent thermoelectric properties of (FeSi2)99−XMn1CuX (X=0–1.O at.%), (FeSi2)99−X Co1CuX (X=0–1.0 at.%) alloys were attained after the elimination of ε. In the case of eutectoid reaction (→β+Si). Differential thermal analysis, X-ray diffraction and microscopic observation clearly confirmed that the eutectoid reaction rate was drastically enhanced by the addition of a small amount of Cu and its rate decreased with decreasing Cu content. The rate also depends on the annealing temperature and reached a maximum at about 1073 K for most alloys. The addition of only 0.1 at.% Cu was still very effective even in Mn or Co doped alloys. The thermoelectric power of these alloys increased very quickly with annealing time. Their final values decreased with Cu content and saturated at 0.2 at.% Cu. The value of the 0.1 at.% Cu added alloy was higher than that of both the conventional p- and a-type FeSi2 based alloys. These results suggest that the Fe2Si5 alloys with a small amount of Cu may be attractive as new thermoelectric materials. 相似文献
OBJECTIVE: For resuscitation of hemorrhagic hypovolemia, we compared the effectiveness of (1) isotonic lactated Ringer's solution (LRS), (2) 2400 mOsm of 7.5% NaCl:6% dextran 70 (HSD), and (3) 2400 mOsm of 7.9% sodium acetate:1.9% NaCl:6% dextran 70 (HAD). DESIGN: In six randomized, blinded experiments for each solution, conscious instrumented adult sheep were hemorrhaged by removing approximately 1.8 L (42 +/- 3 mL/kg) of blood, while maintaining the mean arterial pressure (MAP) at 50 mm Hg for 2 hours. METHODS: Test solutions were infused as needed to restore the cardiac index to baseline. RESULTS: Volume requirements with HAD (236 +/- 29 mL) and HSD (244 +/- 39 mL) were significantly less (p < 0.05) than LRS (3463 +/- 234 mL). Mean arterial pressure was normalized with HSD and LRS, but not with HAD, which resulted in MAPs of 20 to 25 mm Hg less than baseline resulting from a reduced peripheral resistance. Oxygen delivery, however, was significantly higher with HAD during the resuscitation period. Acid-base balance (pH) and oxygen consumption were normalized within 5 minutes of infusion only with HAD. CONCLUSIONS: Small-volume infusion with HAD resulting in "high-flow-low-pressure" resuscitation may offer unique hemodynamic and metabolic advantages for the initial treatment of hemorrhage from trauma. 相似文献
Crystallite size distributions and lattice distortions have been analysed for highly-irradiated linear polyethylene in the direction normal to 1 1 0 and 0 0 1 lattice planes through X-ray line profile analysis. It has been found that the lateral crystallite size is little affected irradiation greater than 1000 Mrad, whereas that in the chain direction decreases almost linearly with the dose of irradiation. A minor difference in the crystallite size between irradiation atmospheres, i.e. irradiation in air or in vacuum, has been disclosed at a very high dose of irradiation. The above degradation behaviour of crystallites and the change in lattice distortions have proved that radiation cross-links are mainly formed in the amorphous region near the lamellar surface of polyethylene. 相似文献