Different Types Of Units Research Articles

Epidemiology of Vancomycin-Resistant Enterococci in Various Medical Wards

Background. Vancomycin-resistant enterococci (VRE) have become one of the leading cause of health care-associated infections. Data on occurrence and spread of these pathogens in different types of hospital units are needed to develop effective surveillance and control measures to prevent dissemination of VRE. Aim. The aim of this study was to define hospital units with high risk of VRE dissemination in health care facilities of St. Petersburg. Materials and Methods. Point-prevalence study of colonisation and infection in patients and contamination of the environment was conducted during 2013 - 2014 in 8 hospital units of different types: neonatal intensive care, newborn pathology, general paediatric surgery, bone marrow transplantation (BMT for adolescents), cancer surgery of the gastrointestinal (GI) tract and breast cancer, haemodialysis (three units). In each unit microbiological testing of clinical (N=857) and environmental (N=508) samples was conducted three times a months during the study period. Verification of vancomycin resistance in enterococci was conducted by amplification of vanA and vanB cassettes according to the technique developed by S. Dutka-Malen et al. Molecular genetic typing of enterococci by random amplification of polymorphic DNA (RAPD-PCR) was performed with universal primer R5 (5’-AACGCGCAAC-3’) in the concentration of 50 pmol/^L, according to the protocol proposed by B. Martin et al. VNTR analysis was performed according to the technique published by J. Top et al. Results. Colonization of patients and contamination of environment by VRE were detected only in haemato-oncologyunits (21,6 per 100 patients, 2,6 per 100 environmental swabs), neonatal intensive care (16,7 per 100 patients, 8,5 per 100 environmental swabs), and newborn pathology (34,6 per 100 patients, 3,3 per 100 environmental swabs). VRE were detected on the related to patient care environmental objects in common use for all patients (scales, changing tables, procedure tables, sink faucets) in the neonatal intensive care units and non-medical objects shared by all patients (tables in patient rooms, microwave oven and refrigerators shelves) in the haemato-oncology unit. The molecular genetic typing showed that strains of VRE isolated from patients and the environment were identical. Vancomycin resistance due to presence of vanA was dominating. Conclusion. Neonatal and haemato-oncology departments were identified as high risk hospital units. The most common mode of transmission of VRE is contact transmission via hands of health care workers in neonatal units and via environmental objects in haemato-oncology. To contain dissemination of VRE in the high risk units, development of microbiological monitoring of VRE and measures to control their transmission is needed.

On the identifiability of start-up demonstration mixture models

In start-up demonstration testing, the performance of the unit on successive start-ups is taken into account and several different types of decision criteria (most of them are inspired by the theory of runs and scans) for accepting or rejecting the unit have been introduced. Although the use of a start-up demonstration test assumes the existence of units of lower quality, when the estimation of the respective probability comes up, there is still much work to be done. Therefore, in this paper, we study binary start-up demonstration tests, assuming that we have at hand two different types of units with potentially different probabilities of successful start-up. In this case, the waiting time distributions are expressed as two-component mixture models and their identifiability is discussed. Finally, an estimation method based on the EM algorithm for the model parameters is described and some numerical examples are presented to illustrate the methods developed here.

Predikatski apozitiv u pripovetkama Ive Andrića

In this paper we examined usage of predicate appositive in Ivo Andrić's book 'Children and other narratives' from syntactic and semantic aspect. In the introductory part we pointed to problem of designation this sentence constituent and it's significant characteristics. After that we ascertained criterions for separating predicate appositive and related constituents. Considering it's ability to be expressed by different types of units, concrete task of research was stating and describing various units in function of predicate appositive. Those are 1) adjectives and adjective pronouns, 2) nouns and personal pronouns, and 3) construction with comparative particle kao.

Hope VI Data Compilation and Analysis

This report relies on performance measurement data that HOPE VI grantees report to HUD. Those performance measurement data summarize activities of HOPE VI grantees, with particular emphasis on demolition and production of housing units, and also supportive services provided to residents. The Case Western University research team has analyzed those performance measurement data to create an overall assessment of the HOPE VI program. Their report reinforces many well-understood aspects of the HOPE VI program: that it resulted in a net loss of public housing units; that a low proportion of baseline residents returned to completed developments; but that the program produced new units of different types, including other forms of affordable housing, market rate housing, and both rental and homeownership units. Research on HOPE VI trailed off substantially after 2004, so this report is perhaps the most comprehensive accounting of the program’s outputs.

Memory Stacking in Hierarchical Networks.

Robust representations of sounds with a complex spectrotemporal structure are thought to emerge in hierarchically organized auditory cortex, but the computational advantage of this hierarchy remains unknown. Here, we used computational models to study how such hierarchical structures affect temporal binding in neural networks. We equipped individual units in different types of feedforward networks with local memory mechanisms storing recent inputs and observed how this affected the ability of the networks to process stimuli context dependently. Our findings illustrate that these local memories stack up in hierarchical structures and hence allow network units to exhibit selectivity to spectral sequences longer than the time spans of the local memories. We also illustrate that short-term synaptic plasticity is a potential local memory mechanism within the auditory cortex, and we show that it can bring robustness to context dependence against variation in the temporal rate of stimuli, while introducing nonlinearities to response profiles that are not well captured by standard linear spectrotemporal receptive field models. The results therefore indicate that short-term synaptic plasticity might provide hierarchically structured auditory cortex with computational capabilities important for robust representations of spectrotemporal patterns.

Experimental substantiation of selection of fuel channel imitator for hydrodynamic model of nuclear reactor

Description is given of the methodology for experimental substantiation of hydrodynamic characteristics of imitators of fuel channels in the model of reactor unit with two-loop configuration. It is known from the experience of development of reactor units of different types that it is practically not feasible to select the channel to serve as the imitator with simple geometry for which the dependence of pressure drop due to hydraulic losses would be the same as the dependence for full-scale operating fuel channel containing fuel assemblies. Therefore, only approximate modeling of hydraulic losses in operational fuel channels with fuel assemblies and imitating channels within the limited range of Reynolds numbers can be discussed as well as inclusion of all coolant flow regimes within the reactor vessel predicted by design calculations.Selection of final geometry of imitating channels was made based on the following several basic assumptions of approximate modeling of flow path in the full-scale fuel channel with fuel assembly under nominal operational mode of the nuclear reactor using the channel with simplified geometry: (1) range of variation of coolant flow rates in the operational fuel channel with fuel assembly in nominal operational mode of the reactor is known from physical and from preliminary thermal physics calculation studies; (2) equality of Euler numbers for nominal coolant flow regimes in the reactor and for coolant flow in imitating channels. Experiments were conducted with three types of imitators and the most suitable among them was chosen as the result. The finally selected design of imitating channel included a pipe with high-quality of manufacturing, two diaphragms and a nozzle with configured using the method suggested by Vitoshinsky.

Nurse work environment and quality of care by unit types: A cross-sectional study

BackgroundNursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. ObjectivesTo examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. MethodsThis is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. ResultsOn average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical–surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. ConclusionsUnit type differences exist in the overall quality of care as well as achievement in improving quality of care. The low rates of nurses reporting improvement in the quality of nursing care to patients suggest that further interventions focusing at the unit-level are needed for achieving high care quality. Findings from our study also suggest that improving nurse work environments can be an effective strategy to improve quality of care.

Type of unit and population served matters when implementing a smoke-free policy in mental health settings: Perceptions of unit managers across England.

Globally, smoking remains a significant issue for mental health populations. Many mental health trusts in England are facing challenges of implementing the National Institute for Health and Care Excellence guidance according to which all mental health settings, no matter the type, should be entirely smoke-free and provide comprehensive smoking cessation support. The aim of this paper was to determine if unit type and unit manager smoking status influence mental health smoke-free policy implementation. This paper reports on the secondary analysis of data from a cross-sectional survey of 147 mental health inpatient settings in England, in 2010. The original study's main aim was to understand unit managers' perceived reasons for success or failure of smoke-free policy. Unit managers (n = 131) held a positive stance towards supporting smoke-free policy and most perceived that the policy was successful. Non-smoker unit managers were more likely to adopt complete bans than smoker unit managers, whereas smoker unit managers were more likely than non-smoker unit managers to think that stopping smoking aggravated patients' mental illness. Smoking rates for staff and patients remain high, as perceived by unit managers, regardless of unit type. Proportion of units offering nicotine replacement therapy and peer support to patients was significantly higher in locked units compared to semi-locked or residential rehabilitation. Applied strategies significantly vary by type of unit, whereas unit managers' knowledge, attitude and practices vary by their smoking status. There are nuanced differences in how smoke-free policy is enacted which vary by unit type. These variations recognise the differing contexts of care provision in different types of units serving different patient groups. Addressing staff smoking rates, promoting consistency of staff response to patients' smoking and providing staff education and support continue to be key strategies to successful smoke-free policy. Our results demonstrate the importance of taking into account the type of unit and acuity of patients when enacting smoke-free policy and addressing staff smoking.

Methods of inspection supervision of the Serbian Armed Forces' operational capabilities

The paper describes methods and techniques of inspection supervision of the Serbian Armed Forces' operational capabilities. Realistic assessment of operational capabilities is a key element for successful planning of employment of the Serbian Armed Forces' units in different types of operations. The requirement for realistic identification of operational capabilities is a choice of methods for collecting the relevant data in order to obtain an objective assessment of current operational capabilities. With applying certain methods, the focus is on designing a tool that can measure the manifestations of operational capabilities' elements. To evaluate the operational capabilities, it is necessary to apply different methods and techniques, whereby a realistic picture of the operational capabilities of the Serbian Armed Forces' units and commands is obtained.

A New Multilayer Perceptron Pruning Algorithm for Classification and Regression Applications

Optimizing the structure of neural networks remains a hard task. If too small, the architecture does not allow for proper learning from the data, whereas if the structure is too large, learning leads to the well-known overfitting problem. This paper considers this issue, and proposes a new pruning approach to determine the optimal structure. Our algorithm is based on variance sensitivity analysis, and prunes the different types of unit (hidden neurons, inputs, and weights) sequentially. The stop criterion is based on a performance evaluation of the network results from both the learning and validation datasets. Four variants of this algorithm are proposed. These variants use two different estimators of the variance. They are tested and compared with four classical algorithms on three classification and three regression problems. The results show that the proposed algorithms outperform the classical approaches in terms of both computational time and accuracy.

Estimates of the Need for Palliative Care Consultation across United States Intensive Care Units Using a Trigger-based Model

Use of triggers for palliative care consultation has been advocated in intensive care units (ICUs) to ensure appropriate specialist involvement for patients at high risk of unmet palliative care needs. The volume of patients meeting these triggers, and thus the potential workload for providers, is unknown. To estimate the prevalence of ICU admissions who met criteria for palliative care consultation using different sets of triggers. Retrospective cohort study of ICU admissions from Project IMPACT for 2001-2008. We assessed the prevalence of ICU admissions meeting one or more primary palliative care triggers, and prevalence meeting any of multiple sets of triggers. Overall, 53,124 (13.8%) ICU admissions met one or more primary triggers for palliative care consultation. Variation in prevalence was minimal across different types of units (mean 13.3% in medical ICUs to 15.8% in trauma/burn ICUs; P = 0.41) and individual units (mean 13.8%, median 13.0%, interquartile range, 10.2-16.5%). A comprehensive model combining multiple sets of triggers identified a total of 75,923 (19.7%) ICU admissions requiring palliative care consultation; of them, 85.4% were captured by five triggers: (1) ICU admission after hospital stay greater than or equal to 10 days, (2) multisystem organ failure greater than or equal to three systems, (3) stage IV malignancy, (4) status post cardiac arrest, and (5) intracerebral hemorrhage requiring mechanical ventilation. Approximately one in seven ICU admissions met triggers for palliative care consultation using a single set of triggers, with an upper estimate of one in five patients using multiple sets of triggers; these estimates were consistent across different types of ICUs and individual units. These results may inform staffing requirements for providers to ensure delivery of specialized palliative care to ICU patients nationally.

Anterior lateral line nerve encoding to tones and play back vocalisations in free swimming oyster toadfish, Opsanus tau

In the underwater environment, sound propagates both as a pressure wave and as particle motion, with particle motion dominating close to the source. At the receptor level, the fish ear and the neuromast hair cells act as displacement detectors, and both are potentially stimulated by the particle motion component of sound. The encoding of the anterior lateral line nerve to acoustic stimuli in freely behaving oyster toadfish, Opsanus tau, was examined. Nerve sensitivity and directional responses were determined using spike rate and vector strength analysis, a measure of phase-locking of spike times to the stimulus waveform. All units showed greatest sensitivity to 100 Hz stimulus. While sensitivity was independent of stimuli orientation, the neuron's ability to phase-lock was correlated with stimuli origin. Two different types of units were classified, type 1 (tonic), and type 2 (phasic). The type 1 fibres were further classified into two sub-types based on their frequency response (type 1-1 and type 1-2), which was hypothesised to be related to canal (type 1-1) and superficial (type 1-2) neuromast innervation. Lateral line units also exhibited sensitivity and phase locking to boatwhistle vocalisations, with greatest spike rates exhibited at the onset of the call. These results provide direct evidence that oyster toadfish can use their lateral line to detect behaviourally relevant acoustic stimuli, which could provide a sensory pathway to aid in sound source localisation.

Communication practices among nurses in the acute care setting

AimTo describe and quantify nursing communication practices in the in-patient setting.BackgroundStrategies aimed at improving communication among the healthcare team have resulted in marginal improvements, which may in part be due to the limited time the team communicates with one another.MethodNurses (n = 12) on three different types of units were observed to determine time spent in synchronous communication with the healthcare team.ResultsTotal communication time, on average, was 2.85 hours (23.8%) of a 12-hour shift, with nurse–physician communication (11.3 minutes) and nurse-assistive personnel (8.5 minutes) accounting for a small part of time. Differences in time communicating with physicians were noted between the intensive care unit and the pediatric unit. Time spent in communication with unlicensed assistive personnel was 9.6 minutes in the intensive care unit, 14.1 minutes in the adult unit, and only 1.8 minutes in the pediatric unit.ConclusionStrategies must be identified that will either maximize time spent in communication or provide more opportunities for communication to occur. Administrators must reinforce the need for communication and initiate opportunities for engagement among the team. They must role model the importance of communicating with all members of the healthcare team, as well as instill the importance of time spent in communication.

Quantifying the Potential Bias when Directly Comparing Standardised Mortality Ratios for In-Unit Neonatal Mortality

IntroductionThe Standardised Mortality Ratio (SMR) is increasingly used to compare the performance of different healthcare providers. However, it has long been known that differences in the populations of the providers can cause biased results when directly comparing two SMRs. This is potentially a particular problem in neonatal medicine where units provide different levels of care.MethodsUsing data from The Neonatal Survey (TNS), babies born at 24 to 31 weeks gestational age from 2002 to 2011 and admitted to one of 11 UK neonatal units were identified. Risk-adjusted SMRs were calculated for each unit using a previously published model to estimate the expected number of deaths. The model parameters were then re-estimated based on data from each individual neonatal unit (“reference” unit) and these then applied to each of the other units to estimate the number of deaths each unit would have observed if they had the same underlying mortality rates as each of the “reference” hospitals. The ratios of the SMRs were then calculated under the assumption of identical risk-specific probabilities of death.Results7243 babies were included in all analyses. When comparing between Network Neonatal Units (Level 3) the ratio of SMRs ranged from 0.92 to 1.00 and for the comparisons within Local Neonatal Units (Level 2) ranged from 0.79 to 1.56. However when comparing between neonatal units providing different levels of care ratios up to 1.68 were observed.ConclusionsIf the populations of healthcare providers differ considerably then it is likely that bias will be an issue when directly comparing SMRs. In neonatal care, the comparison of Network Neonatal Units is likely to be useful but caution is required when comparing Local Neonatal Units or between units of different types. Tools to quantify the likely bias are required.

Phraseological Units Used in the Functional Styles in English and Albanian Language

Phraseological phrases are present everywhere and we see a fast growing role of phraseology in a wide range of linguistic disciplines .Scholarly attention has been focused on the semantic and syntactic properties of phraseological units, on various approaches , pragmatic function and cultural peculiarities. However this paper focuses on the stylistic properties of phraseological units and the textual environment and if we do really find phraseological units in different types of genre . Phraseological units are used by the speaker or writer who intends a particular stylistic effect and they are used in accordance to certain genres which are considered as different functional styles. By comparing ,contrasting and providing examples of phraseological units in different kind of functional style we aim to have a clear picture and actually see that they are present not only in colloquial level of discourse but they also stretch from fiction to non-fiction. The stylistic potential of the phraseological units is enormous .”Since phraseological units may be relevant stylistic devices, they are strong evidence of a level inside the stylistic system which has been termed ‘phraseo-stylistic’ (Glaser 1986b) and which combines the systemic and communicative aspects of linguo-stylistic analysis. DOI: 10.5901/mjss.2013.v4n2p453

Entrepreneurial land developers: Joint production, local externalities, and mixed housing developments

Housing developments (condos and suburban developments) are not necessarily homogeneous. Developers provide different types of units of various sizes and other characteristics catering to different types of customers. In this paper, we allow joint production and local consumption externalities within each development, and show that land developers who seek a profit-maximizing set of units in developments may provide mixed developments. We show that there exists an equilibrium, and that every equilibrium is Pareto efficient. We provide examples in which mixed developments arise in a long-run equilibrium. We relate this work to a widely used hedonic pricing model by Rosen (1974), and to an equilibrium concept under asymmetric information by Rothschild and Stiglitz (1976).

The Application of ANSYS Multipoint Constraint on the Combination Modeling of SOLID-SHELL

The problem of the modeling connection of different units is encountered in engineering practice. Its reasonable proposals are that the modeling is discrete into the respective discrete three-dimensional solid elements for calculation. But different types of units’ degrees of freedom are not discontinuity，it will lead to significant deviation of calculated results and the actual. In the paper, the methods and characteristics of SOLID-SHELL unit with the application of ANSYS constraint equations method and the MPC law are discussed, and compared the shell - solid element with the whole solid element modeling combined the results, it draw a conclusion that MPC law is advantage in modeling of three-dimensional solid element and shell element.

Mobile Decontamination Units—Room for Improvement?

Mobile decontamination units are intended to be used at the accident site to decontaminate persons contaminated by toxic substances. A test program was carried out to evaluate the efficacy of mobile decontamination units. The tests included functionality, methodology, inside environment, effects of wind direction, and decontamination efficacy. Three different types of units were tested during summer and winter conditions. Up to 15 test-persons per trial were contaminated with the imitation substances Purasolve ethyl lactate (PEL) and methyl salicylate (MES). Decontamination was carried out according to standardized procedures. During the decontamination trials, the concentrations of the substances inside the units were measured. After decontamination, substances evaporating from test-persons and blankets as well as remaining amounts in the units were measured. The air concentrations of PEL and MES inside the units during decontamination in some cases exceeded short-term exposure limits for most toxic industrial chemicals. This was a problem, especially during harmful wind conditions, i.e., wind blowing in the same direction as persons moving through the decontamination units. Although decontamination removed a greater part of the substances from the skin, the concentrations evaporating from some test-persons occasionally were high and potentially harmful if the substances had been toxic. The study also showed that blankets placed in the units absorbed chemicals and that the units still were contaminated five hours after the end of operations. After decontamination, the imitation substances still were present and evaporating from the contaminated persons, blankets, and units. These results indicate a need for improvements in technical solutions, procedures, and training.

Getting a sense of the client: Working methods in the personal social services in Sweden

• Summary: This article presents a study of working methods used by social workers within the personal social services (PSS), in their work with clients. The study is part of a larger research project with the aim of describing and analysing how specialized respectively integrated forms of organizations in the PSS condition social workers’ interventions and client effects (outcomes). The study was carried out in three Swedish municipalities with different organizational models. Two of those represent ‘extremes’ as they have pure specialized (divided in different types of units) respectively integrated (generic) organizations. The third municipality has chosen a middle way with an organization that combines aspects of the two other models. All social workers within the PSS in those three municipalities were included in the study. • Findings: Our findings among other things show 1) that the use of unspecific methods dominates, 2) that several methods that are reported as specific are definitely not specific, 3) that specific methods often are used in free and unspecific ways, 4) that there seems to be a compensating movement (regarding use of methods) with the aim of evening out limitations in the formal PSS organizations, 5) that there are two relatively large groups of method users: ‘improvisers’ and ‘eclecticists’. • Applications: One can neither understand the use of working methods in social work with clients by studying the methods as such nor by studying the evidence base of different methods. Social workers consider their relationships to clients and the clients’ trust as much more important (in order to achieve results) than any particular method. The use of methods is mirroring the social workers’ readiness before, and planned adaptation to, different types of situations.

RTS game strategy evaluation using extreme learning machine

The fundamental game of real-time strategy (RTS) is collecting resources to build an army with military units to kill and destroy enemy units. In this research, an extreme learning machine (ELM) model is proposed for RTS game strategy evaluation. Due to the complicated game rules and numerous playable items, the commonly used tree-based decision models become complex, sometimes even unmanageable. Since complex interactions exist among unit types, the weighted average model usually cannot be well used to compute the combined power of unit groups, which results in misleading unit generation strategy. Fuzzy measures and integrals are often used to handle interactions among attributes, but they cannot handle the predefined unit production sequence which is strictly required in RTS games. In this paper, an ELM model is trained based on real data to obtain the combined power of units in different types. Both the unit interactions and the production sequence can be implicitly and simultaneously handled by this model. Warcraft III battle data from real players are collected and used in our experiments. Experimental results show that ELM is fast and effective in evaluating the unit generation strategies.