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Time Requirements (time + requirement)
Selected AbstractsNursing Time Devoted to Medication Administration in Long-Term Care: Clinical, Safety, and Resource ImplicationsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2009Mary S. Thomson PhD OBJECTIVES: To quantify the time required for nurses to complete the medication administration process in long-term care (LTC). DESIGN: Time-motion methods were used to time all steps in the medication administration process. SETTING: LTC units that differed according to case mix (physical support, behavioral care, dementia care, and continuing care) in a single facility in Ontario, Canada. PARTICIPANTS: Regular and temporary nurses who agreed to be observed. MEASUREMENTS: Seven predefined steps, interruptions, and total time required for the medication administration process were timed using a personal digital assistant. RESULTS: One hundred forty-one medication rounds were observed. Total time estimates were standardized to 20 beds to facilitate comparisons. For a single medication administration process, the average total time was 62.0±4.9 minutes per 20 residents on physical support units, 84.0±4.5 minutes per 20 residents on behavioral care units, and 70.0±4.9 minutes per 20 residents on dementia care units. Regular nurses took an average of 68.0±4.9 minutes per 20 residents to complete the medication administration process, and temporary nurses took an average of 90.0±5.4 minutes per 20 residents. On continuing care units, which are organized differently because of the greater severity of residents' needs, the medication administration process took 9.6±3.2 minutes per resident. Interruptions occurred in 79% of observations and accounted for 11.5% of the medication administration process. CONCLUSION: Time requirements for the medication administration process are substantial in LTC and are compounded when nurses are unfamiliar with residents. Interruptions are a major problem, potentially affecting the efficiency, quality, and safety of this process. [source] Quantitative analysis of total mitochondrial DNA: Competitive polymerase chain reaction versus real-time polymerase chain reactionJOURNAL OF BIOCHEMICAL AND MOLECULAR TOXICOLOGY, Issue 4 2004Hari K. Bhat Abstract An efficient and effective method for quantification of small amounts of nucleic acids contained within a sample specimen would be an important diagnostic tool for determining the content of mitochondrial DNA (mtDNA) in situations where the depletion thereof may be a contributing factor to the exhibited pathology phenotype. This study compares two quantification assays for calculating the total mtDNA molecule number per nanogram of total genomic DNA isolated from human blood, through the amplification of a 613-bp region on the mtDNA molecule. In one case, the mtDNA copy number was calculated by standard competitive polymerase chain reaction (PCR) technique that involves co-amplification of target DNA with various dilutions of a nonhomologous internal competitor that has the same primer binding sites as the target sequence, and subsequent determination of an equivalence point of target and competitor concentrations. In the second method, the calculation of copy number involved extrapolation from the fluorescence versus copy number standard curve generated by real-time PCR using various dilutions of the target amplicon sequence. While the mtDNA copy number was comparable using the two methods (4.92 ± 1.01 × 104 molecules/ng total genomic DNA using competitive PCR vs 4.90 ± 0.84 × 104 molecules/ng total genomic DNA using real-time PCR), both inter- and intraexperimental variance were significantly lower using the real-time PCR analysis. On the basis of reproducibility, assay complexity, and overall efficiency, including the time requirement and number of PCR reactions necessary for the analysis of a single sample, we recommend the real-time PCR quantification method described here, as its versatility and effectiveness will undoubtedly be of great use in various kinds of research related to mitochondrial DNA damage- and depletion-associated disorders. © 2004 Wiley Periodicals, Inc. J Biochem Mol Toxicol 18:180,186, 2004 Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/jbt.20024 [source] A Method for Improving Arrival-to-electrocardiogram Time in Emergency Department Chest Pain Patients and the Effect on Door-to-balloon Time for ST-segment Elevation Myocardial InfarctionACADEMIC EMERGENCY MEDICINE, Issue 10 2009Kevin M. Takakuwa MD Abstract Objectives:, The objectives were to determine if an emergency department (ED) could improve the adherence to a door-to-electrocardiogram (ECG) time goal of 10 minutes or less for patients who presented to an ED with chest pain and the effect of this adherence on door-to-balloon (DTB) time for ST-segment elevation myocardial infarction (STEMI) cardiac catheterization (cath) alert patients. Methods:, This was a planned 1-month before-and-after interventional study design for implementing a new process for obtaining ECGs in patients presenting to the study ED with chest pain. Prior to the change, patients were registered and triaged before an ECG was obtained. The new procedure required registration clerks to identify those with chest pain and directly overhead page or call a designated ECG technician. This technician had other ED duties, but prioritized performing ECGs and delivering them to attending physicians. A full registration process occurred after the clinical staff performed their initial assessment. The primary outcome was the total percentage of patients with chest pain who received an ECG within 10 minutes of ED arrival. The secondary outcome was DTB time for patients with STEMI who were emergently cath alerted. Data were analyzed using mean differences, 95% confidence intervals (CIs), and relative risk (RR) regression to adjust for possible confounders. Results:, A total of 719 patients were studied: 313 before and 405 after the intervention. The mean (±standard deviation [SD]) age was 50 (±16) years, 54% were women, 57% were African American, and 36% were white. Patients walked in 89% of the time; 11% arrived by ambulance. Thirty-nine percent were triaged as emergent and 61% as nonemergent. Patients presented during daytime 68% of the time, and 32% presented during the night. Before the intervention, 16% received an ECG at 10 minutes or less. After the intervention, 64% met the time requirement, for a mean difference of 47.3% (95% CI = 40.8% to 53.3%, p < 0.0001). Results were not affected by age, sex, race, mode of arrival, triage classification, or time of arrival. For patients with STEMI cath alerts, four were seen before and seven after the intervention. No patients before the intervention had ECG time within 10 minutes, and one of four had DTB time of <90 minutes. After the intervention, all seven patients had ECG time within 10 minutes; the three arriving during weekday hours when the cath team was on site had DTB times of <90 minutes, but the four arriving at night and on weekends when the cath team was off site had DTB times of >90 minutes. Conclusions:, The overall percentage of patients with a door-to-ECG time within 10 minutes improved without increasing staffing. An ECG was performed within 10 minutes of arrival for all patients who were STEMI cath alerted, but DTB time under 90 minutes was achieved only when the cath team was on site. [source] A dynamic admission control scheme to manage contention on shared computing resourcesCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 2 2009Percival Xavier Abstract A virtual organization is established when physical organizations collaborate to share their computing resources with the aim of serving each other when there is a likelihood of insufficient local resources during peak resource usage periods at any organization. Contention becomes a potential problem when a large number of requests, which can overwhelm the aggregate capacity of shared resources, are submitted from the participating organizations coincidentally at the same period. In particular, when a small number of requests that require large amounts of computing resources are admitted in place of a large number of requests that require less computing resources, the overall system performance, in terms of admission ratio, can deteriorate significantly. Hence, admission control is necessary to reduce resource oversubscription. Because domain-shared computing resources are likely to be combined to form a large-scale system, it is not possible to define a fixed admission policy solely based on the request's CPU and execution time requirements. In this paper, we introduce an admission control framework, based on a pricing model, for a multi-domain-shared computing infrastructure. The performance of the admission control framework is evaluated under different scenarios that contribute to the overall degree of competition for shared resources. The results are presented and analyzed in this paper. Copyright © 2008 John Wiley & Sons, Ltd. [source] Conspecifics and Their Posture Influence Site Choice and Oviposition in the Damselfly Argia moestaETHOLOGY, Issue 8 2009Catherine J. Byers Finding a suitable oviposition site can be costly because of energy and time requirements, and ovipositioning can be dangerous because of the risk of predation and harassment by males. The damselfly Argia moesta oviposits, contact-guarded by her mate, on vegetation in streams. Oviposition aggregations are commonly observed in this species, despite their territorial nature during other behaviors. We conducted experiments in the field to test the hypothesis that aggregations are the result of conspecific attraction. In the first experiment, two oviposition sites (sycamore leaves) were provided, one with models of ovipositing pairs, and one without. In the second experiment, one leaf again had ovipositing models, while the other had models of uncoupled males and females in a resting posture. In both experiments, damselfly pairs preferred the site with ovipositing models. In general, they visited the ovipositing models first more often than expected by chance, stayed longer there, were more likely to oviposit there, and laid a greater total number of eggs there. These results support the hypothesis that conspecific attraction is responsible for ovipositing aggregations in A. moesta and that posture is an important cue for attraction. Using conspecific cues could be a beneficial strategy to save in search costs while taking advantage of the presence of ovipositing conspecifics to dilute the effects of harassment and predation. [source] Sex Differences in Feeding Activity Results in Sexual Segregation of Feral GoatsETHOLOGY, Issue 5 2008Robin I. M. Dunbar Sexual segregation is common in ungulates. We show, in a high latitude population of feral goats where behavioural synchrony and fission rates have been shown to be the best explanation for segregation, that it is differences explicitly in the feeding time requirements of the two sexes (but not those for other activities) that best explains the variations in monthly frequencies of segregation. However, this effect is less marked during winter months when short day length forces the time budgets of the two sexes to converge. We argue that the various explanations for segregation can best be interpreted as separate factors in a multivariate model in which species- and habitat-specific weightings influence the relative importance of these variables, and thus the likelihood that segregation will occur. [source] Temporal Elements in the Spatial Extension of Production NetworksGROWTH AND CHANGE, Issue 4 2006JOHAN WOXENIUS ABSTRACT The spatial extension of production networks presents a significant challenge to managers accustomed to reducing lead times by geographically contracting supply chains. This paper extends the theory on time in transportation by defining the elements of transport time, order time, timing, punctuality, and frequency and elaborating on their characteristics. Structured along these elements, it analyses the consequences of extending production networks from within a mature economic region, mainly the EU-15, U.S., and Japan, first to adjacent and then to nearby and finally distant low-cost regions. Distance obviously affects the transport quality in all time dimensions. Except for air parcel services that globally match what road transport offers within an economic region, the longer the distance, the lower the time-related performance. Distant, low-cost regions, meaning China and India, also imply a polarisation between air and sea transport at opposite ends of the time, cost, and capacity scales. This supply gap restricts the types of products traded. The conceptual framework is illustrated in the setting of a global vehicle manufacturer spatially extending its sourcing. It demands that sequenced sub-assemblies and small, cheap, and generic components are delivered from the vicinity of each assembly plant. Batched components can be sourced from adjacent regions, but deliveries from longer distances imply storage at pick-up points to fulfil their time requirements. Hence, the suppliers must offer the manufacturing firm deliveries as if they produce relatively close to the assembly plants. [source] Investing time in health: do socioeconomically disadvantaged patients spend more or less extra time on diabetes self-care?HEALTH ECONOMICS, Issue 6 2009Susan L. Ettner Abstract Background: Research on self-care for chronic disease has not examined time requirements. Translating Research into Action for Diabetes (TRIAD), a multi-site study of managed care patients with diabetes, is among the first to assess self-care time. Objective: To examine associations between socioeconomic position and extra time patients spend on foot care, shopping/cooking, and exercise due to diabetes. Data: Eleven thousand nine hundred and twenty-seven patient surveys from 2000 to 2001. Methods: Bayesian two-part models were used to estimate associations of self-reported extra time spent on self-care with race/ethnicity, education, and income, controlling for demographic and clinical characteristics. Results: Proportions of patients spending no extra time on foot care, shopping/cooking, and exercise were, respectively, 37, 52, and 31%. Extra time spent on foot care and shopping/cooking was greater among racial/ethnic minorities, less-educated and lower-income patients. For example, African-Americans were about 10 percentage points more likely to report spending extra time on foot care than whites and extra time spent was about 3,min more per day. Discussion: Extra time spent on self-care was greater for socioeconomically disadvantaged patients than for advantaged patients, perhaps because their perceived opportunity cost of time is lower or they cannot afford substitutes. Our findings suggest that poorly controlled diabetes risk factors among disadvantaged populations may not be attributable to self-care practices. Copyright © 2008 John Wiley & Sons, Ltd. [source] A segregated method for compressible flow computation Part I: isothermal compressible flowsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 4 2005Guillermo Hauke Abstract Traditionally, coupled methods have been employed for the computation of compressible flows, whereas segregated methods have been preferred for the computation of incompressible flows. Compared to coupled methods, segregated solvers present the advantage of reduced computer memory and CPU time requirements, although at the cost of an inferior robustness. Therefore, in a series of papers we present unified computational techniques to compute compressible and incompressible flows with segregated stabilized methods. The proposed algorithms have an increased robustness compared to existing techniques, while possessing additional benefits such as employing standard pressure boundary conditions. In this first part, the thermodynamics of isothermal, thermally perfect compressible flows is set up in the framework of symmetric systems and the corresponding segregated algorithms are introduced. Copyright © 2005 John Wiley & Sons, Ltd. [source] Efficient MILP formulations for the simultaneous optimal peptide tag design and downstream processing synthesisAICHE JOURNAL, Issue 9 2009Joćo M. Natali Abstract Novel and efficient linear formulations are developed for the problem of simultaneously performing an optimal synthesis of chromatographic protein purification processes, and the concomitant selection of peptide purification tags, that result in a maximal process improvement. To this end, two formulations are developed for the solution of this problem: (1) a model that minimizes both the number of chromatographic steps in the final purification process flow sheet and the composition of the tag, by use of weighted objectives, while satisfying minimal purity requirements for the final product; and (2) a model that attempts to find the maximal attainable purity under constraints on the maximum number of separation techniques and tag size. Both models are linearized using a previously developed strategy for obtaining optimal piecewise linear approximations of nonlinear functions. Proposed are models to two case studies based on protein mixtures with different numbers of proteins. Results show that the models are capable of solving to optimality all the implemented cases with computational time requirements of under 1 s, on average. The results obtained are further compared with previous nonlinear and linear models attempting to solve the same problem, and, thus, show that the approach represents significant gains in robustness and efficiency. © 2009 American Institute of Chemical Engineers AIChE J, 2009 [source] Calculation of densities from cubic equations of stateAICHE JOURNAL, Issue 4 2002Ulrich K. Deiters Some cubic equations of state can eventually have unphysical solutions for the molar volume. The conditions for this phenomenon are discussed. The computational accuracy and computing time requirements of the analytical root finding method (Cardano's formula) are investigated. A new, faster iterative root finder for cubic polynomials is proposed. [source] User perspectives on relevance criteria: A comparison among relevant, partially relevant, and not-relevant judgmentsJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 5 2002Kelly L. Maglaughlin This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant, partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance. These criteria can be grouped into six categories: abstract (e.g., citability, informativeness), author (e.g., novelty, discipline, affiliation, perceived status), content (e.g., accuracy/validity, background, novelty, contrast, depth/scope, domain, citations, links, relevant to other interests, rarity, subject matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially relevant, and not-relevant judgments, and that most criteria can have either a positive or negative contribution to the relevance of a document. The criteria most frequently mentioned by study participants were content, followed by criteria characterizing the full text document. These findings may have implications for relevance feedback in information retrieval systems, suggesting that systems accept and utilize multiple positive and negative relevance criteria from users. Systems designers may want to focus on supporting content criteria followed by full text criteria as these may provide the greatest cost benefit. [source] Magnetic resonance angiography of collateral vessels in a murine femoral artery ligation modelNMR IN BIOMEDICINE, Issue 1 2004Shawn Wagner Abstract The in vivo detection of growing collateral vessels following arterial occlusion is difficult in small animals. We have addressed the feasibility of performing high resolution time-of-flight angiograms to monitor the growth of collateral vessels after femoral artery occlusion in mice. We will also present a low-pass quadrature birdcage coil construction with a sufficient signal-to-noise ratio to produce high resolution. After a 4-month recovery period a C57BL/6 mouse with a surgical occlusion of the right femoral artery was used to assess the image quality and time requirements to produce magnetic resonance angiograms sufficient to assess collateral artery development using a two-dimensional gradient echo sequence. At a resolution of 100,×,100,×,100,,m and a matrix size of 256,×,128,×,256 for a 2.56,cm isometric volume, three scans were performed with one, two and four repetitions resulting in signal-to-noise ratios for the femoral artery proximal to the ligation site of 58, 126 and 194, respectively. Five C57BL/6 mice were additionally measured 4 weeks after occlusion using two repetitions and the visual collateral vessels were assessed for number and location: 2.0,±,1.2 in quadriceps muscle, 0.6,±,0.5 in adductor (deep adductor vessel), 0.0,±,0.0 in adductor (surface adductor vessels). The results showed a significant difference, two-sided t -test, p,<,0.05, in number of vessels in all the locations. We have shown that this method can be utilized to elucidate the contribution of collateral vessels to arterial flow. Copyright © 2004 John Wiley & Sons, Ltd. [source] Emergency Medicine Resident Attitudes and Perceptions of HIV Testing Before and After a Focused Training Program and Testing ImplementationACADEMIC EMERGENCY MEDICINE, Issue 11 2009Yu-Hsiang Hsieh MSc Abstract Objectives:, The objectives were to determine attitudes and perceptions (A&P) of emergency medicine (EM) residents toward emergency department (ED) routine provider-driven rapid HIV testing services and the impact of both a focused training program (FTP) and implementation of HIV testing on A&P. Methods:, A three-phase, consecutive, anonymous, identity-unlinked survey was conducted pre-FTP, post-FTP, and 6 months postimplementation. The survey was designed to assess residents' A&P using a five-point Likert scale. A preimplementation FTP provided both the rationale for the HIV testing program and the planned operational details of the intervention. The HIV testing program used only indigenous ED staff to deliver HIV testing as part of standard-of-care in an academic ED. The impact of the FTP and implementation on A&P were analyzed by multivariate regression analysis using generalized estimating equations to control for repeated measurements in the same individuals. A "favorable" A&P was operationally defined as a mean score of >3.5, "neutral" as mean score of 2.5 to 3.5, and "unfavorable" as mean score of <2.5. Results:, Thirty of 36 residents (83.3%) participated in all three phases. Areas of favorable A&P found in phase I and sustained through phases II and III included "ED serving as a testing venue" (score range = 3.7,4.1) and "emergency medicine physicians offering the test" (score range = 3.9,4.1). Areas of unfavorable and neutral A&P identified in phase I were all operational barriers and included required paperwork (score = 3.2), inadequate staff support (score = 2.2), counseling and referral requirements (score range = 2.2,3.1), and time requirements (score = 2.9). Following the FTP, significant increases in favorable A&P were observed with regard to impact of the intervention on modification of patient risk behaviors, decrease in rates of HIV transmission, availability of support staff, and self-confidence in counseling and referral (p < 0.05). At 6 months postimplementation, all A&P except for time requirements and lack of support staff scored favorably or neutral. During the study period, 388 patients were consented for and received HIV testing; six (1.5%) were newly confirmed HIV positive. Conclusions:, Emergency medicine residents conceptually supported HIV testing services. Most A&P were favorably influenced by both the FTP and the implementation. All areas of negative A&P involved operational requirements, which may have influenced the low overall uptake of HIV testing during the study period. [source] | ||||||||||||||||