Emergency department status boards: user-evolved artefacts for inter- and intra-group coordination

Large, easily viewed status boards are commonly used in some healthcare settings such as emergency departments, operating theaters, intensive care units, and inpatient wards. Because these artefacts were developed by front-line users, and have little to no supervisory or regulatory control, they offer valuable insights into the theories of work and hazard held by those users. Although the status boards case were locally developed over many years for within-group coordination, they have also become useful for between-group coordination across organizational boundaries. In this paper, we compare and contrast the use of such status boards in two disparate settings: a US emergency department, and a UK pediatric ward, and note striking similarities in their form and usage, despite the large differences in setting.     

Underground adaptations: case studies from health care

Clinical work is accomplished by complex, highly distributed, joint cognitive systems, and involves high levels of uncertainty and ambiguity. Hospital emergency departments (EDs) in particular must adapt to uncertainty, ambiguity and change on a variety of different temporal scales. Many of these adaptations are unofficial, in part because they cannot be specified in advance and because the official models of healthcare work do not include or acknowledge them. This paper presents two case studies of reactive adaptation within the ED setting and uses these to explore their implications for cognitive engineering and design.     

Phenolics of Vaccinium berries and other fruit crops

The concentrations and profiles of phenolics of selected fruit crops common in the Western diet, including several Vaccinium species, were examined to better understand how these crops may be useful sources of phenolic phytochemicals. Vaccinium fruit had a high phenolic concentration compared to non‐Vaccinium fruit. Some Vaccinium fruit were particularly rich in certain phenolic subgroups, especially anthocyanins and pro‐anthocyanidins. Among the pro‐anthocyanidin oligomers measured using fluorometric and mass spectroscopic detection, the trimers and tetramers were most abundant, while pro‐anthocyanidins with a degree of polymerization greater than 8 were least abundant. As biomedical studies determine which phenolic structures are associated with particular bioactivities, information on the phenolic concentration and profile of selected species will be useful in developing specific uses for fruit crops in human health. Methods were compared to assess the usefulness of simpler versus more sophisticated means of phenolic analysis. The phenolic components of fruit extracts were purified approximately 20‐fold, and not qualitatively altered, by C18 solid‐phase extraction. However, fruit extracts obtained from C18 solid‐phase extraction differed in their relative abundance of phenolic components. Colorimetric and HPLC‐DAD measures of phenolic concentration were correlated (R² = 0.79), as was pro‐anthocyanidin concentration detected fluorometrically and by mass spectrometry (R² = 0.44). Copyright © 2007 Crown in the right of Canada and Society of Chemical Industry     

Predicting change in depression following renal transplantation: Effect of patient coping preferences.

Improvement in patient quality of life is a central goal of renal transplantation. This study examined the hypothesis that change in depression following transplantation would vary as a function of patient coping preferences. Sixty patients were assessed with the Krantz Health Opinion Survey and the Beck Depression Inventory while on the waiting list for a cadaveric renal transplant. Patients were reassessed approximately 12 months later. Among the 33 patients receiving a transplant during the follow-up period, those with a high preference for health-related information exhibited a substantial reduction in depression. In contrast, patients low in preference for information showed a slight increase in depression. Among the 27 patients who were not transplanted during the follow-up period, preference for information had no effect on depression. Patient differences in preference for behavioral involvement did not exert a significant effect on depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of a behavioral self-regulation intervention on patient adherence in hemodialysis.

The present study examined the efficacy of a behavioral intervention designed to increase adherence to fluid-intake restrictions among hemodialysis patients. Twenty intervention-group patients were compared with 20 matched control patients on an indicator of fluid-intake adherence at 3 time points. The Group X Time interaction was significant, indicating that patients in the 2 groups exhibited a differential pattern of change in fluid-intake adherence across the follow-up period. The intervention and control groups did not differ significantly in terms of adherence at the initial postintervention period but did differ at the 8-week follow-up. The observed group differences were, in part, due to a trend toward increasingly better adherence in the intervention group and poorer adherence in the control group across the follow-up period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of family relationship quality and testosterone levels in adolescents' peer experiences: A biosocial analysis.

Grounded in a biosocial model, this study examines the interaction between adolescents' testosterone levels and qualities of the parent-adolescent and sibling-adolescent relationship in adolescents' peer experiences and contributes to empirical research on the role of biological factors and family socialization processes in adolescents' peer competence and involvement. Participants included 331 adolescents (M=14.68 years of age, SD=1.53) and their mothers and fathers in 173 families. During home visits, data were collected from family members regarding adolescents' family relationships, peer relationships, and psychosocial adjustment; daily time-use data were gathered during a series of 7 nightly phone interviews; and testosterone levels were assessed through saliva samples. Hierarchical regression results revealed that when boys had close relationships with mothers and sisters, testosterone was positively associated with their peer competence and involvement. Discussion focuses on the value of exploring biosocial interactions and highlights the particular importance of boys' relationships with opposite-sex family members in efforts to understand their peer experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dihydroxyacetone levels in electronic cigarettes: Wick temperature and toxin formation

Recently, we reported the presence of dihydroxyacetone (DHA), the active ingredient in sunless tanners, in the aerosol of an electronic cigarette. DHA has been shown to react with DNA in vitro. The FDA restricts the use of DHA to external application only. It states that it should not be inhaled, ingested, or come into contact with any areas containing mucous membranes, due to unknown risk. Herein, the quantification of DHA in the aerosols of three brands of e-cigarettes has been carried out. These included two devices with horizontal heating coil configurations as well as one with a sub-ohm resistance vertical heating coil. In order to understand and begin to address the origin of DHA and related aerosol products, the wicking properties of the three e-cigarettes were compared. DHA levels were analyzed by a combination of GS/MS and ¹H NMR. DHA was found in all three e-cigarettes, with substantially less in the sub-ohm, vertical coil device as compared to the horizontal coil devices (e.g., 0.088 µg/puff vs. 2.29 µg/puff, respectively). Correspondingly, the temperature of the wet layer of the wick for the vertical coil was relatively stable, compared to the wicks for the horizontal coils, upon increasing battery power output. This result is in agreement with prior studies of e-cigarette wicking efficiency and aerosol toxin formation. The temperature measurements reported are a simple means for comparing devices with different design properties during operation.

Copyright © 2018 American Association for Aerosol Research     

High-performance elastomeric nanocomposites via solvent-exchange processing

The incorporation of nanoparticles into engineering thermoplastics affords engineers an opportunity to synthesize polymer nanocomposites that potentially rival the most advanced materials in nature. Development of these materials is difficult because thermodynamic and kinetic barriers inhibit the dispersal of inorganic, often hydrophilic nanoparticles in hydrophobic polymer matrices. Using a new solvent-exchange approach, we preferentially reinforce the hard microdomains of thermoplastic elastomers with smectic clay of similar characteristic dimensions. The strong adhesion between the clay and the hard microdomains coupled with the formation of a percolative network not only stiffens and toughens, but increases the heat distortion temperature of the material and induces reversible thermotropic liquid-crystalline transitions. The discotic clay platelets induce morphological ordering over a range of length scales, which results in significant thermomechanical enhancement and expands high-temperature applications. Merging block-copolymer processing techniques with this method for preferential ordering of nanoparticle facilitates the development of new, hierarchically ordered materials.     

Dietitians' opinions and experiences of client-centred nutrition counselling.

PURPOSE: The concept of "client-centredness" was explored within a nutrition counselling relationship. METHODS: A two-round reactive Delphi survey was used. The first survey was sent to 65 Dietitians of Canada members who indicated in the member database that they had advanced counselling skills. Following analysis of the data, the second-round questionnaire was developed and sent to participants with a report of the first-round results. Analysis of the second-round survey indicated that participants' responses had remained stable, and the Delphi survey was terminated. RESULTS: Participants agreed that most of the issues identified in the Delphi questionnaire should be included in a client-centred approach to practice; however, when participants were asked about their experience in these areas, median responses and/ or the interquartile ranges changed, indicating some difficulty in implementing the client-centred approach. Comments also indicated that the reality of their workplaces did not allow participants to be as client-centred as they thought they should be, and suggested that the concept of "client-centredness" is not universally understood by dietitians. CONCLUSION: If a client-centred approach to practice is truly important, we need to start a dialogue within the profession to gain a deeper understanding of what this means and how it can be implemented.     

Quantitative measurement of urinary excretion of 3-hydroxyisovaleryl carnitine by LC-MS/MS as an indicator of biotin status in humans

Abnormally increased urinary excretion of 3-hydroxyisovaleryl carnitine (3HIA-carnitine) results from impairment in leucine catabolism caused by reduced activity of the biotin-dependent enzyme 3-methylcrotonyl-CoA carboxylase. Accordingly, urinary 3HIA-carnitine might reflect biotin status. Here, we describe an LC-MS/MS method for accurately quantitating the urinary concentration of 3HIA-carnitine at concentrations that are typical for excretion rates that are normal or only modestly increased. This method allows for high sample throughput and does not require solid-phase extraction. We used this method to provide evidence validating urinary 3HIA-carnitine as a biomarker of biotin deficiency in humans. Four healthy adult subjects were successfully made marginally biotin deficient by feeding a 30% egg white diet for 28 days. From study day 0 to 28, the mean urinary excretion of 3HIA-carnitine increased 3.5-fold (p = 0.026). These preliminary results indicate that urinary excretion of 3HIA-carnitine increases with marginal biotin deficiency. If these results are confirmed in studies involving larger numbers of subjects, urinary excretion of 3HIA-carnitine may potentially be a clinically useful indicator of biotin status.