Change In Overall Volume Research Articles

Effects of a Labor Dispute on a Hospital-Based Helicopter Air Ambulance Service's Volume and Destinations

ObjectiveIn the United States, there are few unionized hospitals with air medical transport agencies. When labor disputes and strikes occur, information about the effect on helicopter air ambulances and critical care ground transport services is limited. For this study, a helicopter air ambulance and critical care ground transport agency's volume of transports was examined before, during, and after a strike and compared with volumes from the prior year. MethodsThis was a retrospective, descriptive comparative review of a unionized hospital's air ambulance and critical care mobile ground transport service records from March 28 to July 22, 2018 (control year, 872 transports) and March 28 to July 22, 2019 (strike year, 863 transports). ResultsCompared with the prior year, during the strike period alone, the volume of flight transports remained stable; however, there was a significant 31% loss in transports for time-critical diseases including trauma, stroke, and myocardial infarction. ConclusionThe unionized helicopter air ambulance experienced little change in overall volume, but there was a statistically and financially significant decline in flight transports for patients with time-critical diseases. When preparing for labor disputes, potential declines in the transportation of this population type should be considered, and future studies should look at patient and requesting agency preferences during strikes.

Promoting physical activity with self-management support for those with multimorbidity: a randomised controlled trial.

BackgroundTargeted self-management programmes may improve health and increase physical activity (PA) in people with multimorbidity.AimTo investigate the impact of a structured, theoretically driven, self-management group education programme on habitual PA levels in people with multimorbidity.Design and settingIndividually randomised controlled trial with 12-month follow-up, involving nine primary care practices in Leicestershire, UK.MethodIn total, 353 adults with multimorbidity (age 67.8 years [±9 years], 161 male sex) were randomised to intervention (n = 180) or control (n = 173) groups. Intervention participants were invited to attend four group-based self-management sessions, centred primarily on increasing PA, and received motivational text-message support. The primary outcome measure was change in overall volume (time and intensity) of daily PA at 12 months, as measured by the GENEActiv wrist-worn accelerometer device.ResultsAt baseline, the total sample achieved 22 min of moderate–vigorous intensity PA per day (mean/participant). At 12 months, in the complete-case analysis, a reduction in daily mean PA volume was seen in the intervention group relative to control (−0.80 milligravity [m g]; 95% confidence interval [CI] = −1.57 to −0.03; P = 0.04). Reductions were also seen in the intervention group in time spent in moderate–vigorous PA (−3.86 min per day; 95% CI= −6.70 to −1.03; P = 0.008) and time spent at an intensity equivalent to a slow walk (−4.66 min per day; 95% CI = −8.82 to −0.51; P = 0.028). However, the per-protocol analysis (excluding participants who did not attend at least one education session) found no between-group differences in overall daily PA at 12 months (−0.65 mg; 95% CI = −1.46 to 0.15; P = 0.11).ConclusionThe self-management programme elicited a slight reduction in PA levels in people with multimorbidity. Future research should identify and target subgroups of those with multimorbidity in greatest need of PA promotion in order to maximise potential capacity for benefit, and also focus on refining the intervention in order to increase efficacy in increasing PA.

RETRACTED: Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: controlled interrupted time series analysis

ObjectiveTo determine changes in household purchases of drinks and confectionery one year after implementation of the UK soft drinks industry levy (SDIL).DesignControlled interrupted time series analysis.ParticipantsMembers of a panel of...

Underutilization of the Emergency Department During the COVID-19 Pandemic.

IntroductionThe novel coronavirus 2019 (COVID-19) pandemic in the United States (US) prompted widespread containment measures such as shelter-in-place (SIP) orders. The goal of our study was to determine whether there was a significant change in overall volume and proportion of emergency department (ED) encounters since SIP measures began.MethodsThis was a retrospective, observational, cross-sectional study using billing data from January 1, 2017–April 20, 2020. We received data from 141 EDs across 16 states, encompassing a convenience sample of 26,223,438 ED encounters. We used a generalized least squares regression approach to ascertain changes for overall ED encounters, hospital admissions, and New York University ED visit algorithm categories.ResultsED encounters decreased significantly in the post-SIP period. Overall, there was a 39.6% decrease in ED encounters compared to expected volume in the pre-SIP period. Emergent encounters decreased by 35.8%, while non-emergent encounters decreased by 52.1%. Psychiatric encounters decreased by 30.2%. Encounters related to drugs and alcohol decreased the least, by 9.3% and 27.5%, respectively.ConclusionThere was a significant overall reduction in ED utilization in the post-SIP period. There was a greater reduction in lower acuity encounters than higher acuity encounters. Of all subtypes of ED encounters, substance abuse- and alcohol-related encounters reduced the least, and injury-related encounters reduced the most.

The Effect of Therapeutic Whirlpool and Hot Packs on Hand Volume During Rehabilitation After Distal Radius Fracture: A Blinded Randomized Controlled Trial.

Edema is a possibility with all heating modalities due to the increase in local blood flow caused by vasodilation. Despite the frequent application of superficial heat modalities, their relative effect on hand volume has not been determined for the upper extremity. The objective of this study was to compare the immediate effects of hot packs and whirlpool on hand volume for patients with distal radius fracture (DRF) and to determine whether any changes in volume between these modalities were still present 30 minutes after heat application. Finally, to determine whether there were any differences in volume change between groups after 3 repeated therapy visits. Sixty patients with clinically healed DRFs were divided into 2 groups. Half received therapeutic whirlpool at each therapy visit, and the other half received a moist hot pack treatment for 3 consecutive visits. Hand volume was measured before heat, after heat, and at the end of each 30-minute therapy session. There was a significant difference between groups immediately after heat application, as patients in the whirlpool group experienced an initial volume increase greater than those who received a hot pack. When remeasured after a hand therapy session approximately 30 minutes later, this group difference in volume change was no longer significant. The overall change in volume from enrollment in the study to completion of the study 3 weeks later was not statistically different between groups. Whirlpool is a potential consideration when selecting a heat modality for patients with DRF.

Polarity of Water Transport across Epidermal Cell Membranes in Tradescantia virginiana

Using the automated cell pressure probe, small and highly reproducible hydrostatic pressure clamp (PC) and pressure relaxation (PR) tests (typically, applied step change in pressure = 0.02 MPa and overall change in volume = 30 pL, respectively) were applied to individual Tradescantia virginiana epidermal cells to determine both exosmotic and endosmotic hydraulic conductivity (L(p)(OUT) and L(p)(IN), respectively). Within-cell reproducibility of measured hydraulic parameters depended on the method used, with the PR method giving a lower average coefficient of variation (15.2%, 5.8%, and 19.0% for half-time, cell volume [V(o)], and hydraulic conductivity [L(p)], respectively) than the PC method (25.4%, 22.0%, and 24.2%, respectively). V(o) as determined from PC and PR tests was 1.1 to 2.7 nL and in the range of optically estimated V(o) values of 1.5 to 4.9 nL. For the same cell, V(o) and L(p) estimates were significantly lower (about 15% and 30%, respectively) when determined by PC compared with PR. Both methods, however, showed significantly higher L(p)(OUT) than L(p)(IN) (L(p)(OUT)/L(p)(IN) ≅ 1.20). Because these results were obtained using small and reversible hydrostatically driven flows in the same cell, the 20% outward biased polarity of water transport is most likely not due to artifacts associated with unstirred layers or to direct effects of externally applied osmotica on the membrane, as has been suggested in previous studies. The rapid reversibility of applied flow direction, particularly for the PR method, and the lack of a clear increase in L(p)(OUT)/L(p)(IN) over a wide range of L(p) values suggest that the observed polarity is an intrinsic biophysical property of the intact membrane/protein complex.

CFD Simulation and Experiment of Scroll Expander for Organic Rankine Systems

Organic Rankine cycles (ORCs) could recover low-grade heat to useful energy. The expander is a key element in ORC systems. The expander efficiency is about 35% to 40% in the experiment. This research investigates the transient thermal-hydraulic behavior of 2-D scroll expander using computational fluid dynamics (CFD) approach. The working fluid was assumed to behave like ideal gas. The verification has been compared by mass flow rate between experiment data and CFD simulation. Finally, pitch of the scroll geometry has been selected as the parameter for sensitivity study based on the condition of no change in overall volume. The pressure-volume (P-V) behavior and volumetric efficiency with rotating speed diagram have been discussed on various scroll geometry.

Statut socio-économique et utilisation des services de santé à Montréal

National health insurance was implemented in Quebec in late 1970. Previously reported surveys carried out in Montreal in 1969-70 and 1971-72 showed that while there was no change in overall volume of services, there was a redistribution, with increases among the poor and decreases among the wealthy. We conducted a survey in late 1974 to determine the "steady-state" impact of l’assurance-maladie on social class differences in health care utilization. In a socially heterogeneous area of Montreal 1,559 households were surveyed. When reported morbidity status was taken into account, physician visit rates in the past two weeks were 21.6 per cent, 20.2 per cent, and 20.4 per cent in low, middle and high economic classes respectively, confirming the disparity of access has been reduced. However, relative to the non-poor, the poor still made considerable use of hospital clinics and emergency rooms for primary care and more of their visits entailed prescriptions and physician-initiated requests to return. The latter may indicate that the poor still consult the doctor for more advanced conditions than the non-poor. There is no evidence of abuse of "free" medical care by the poor. In contrast to the equalization in use of physician services, dental services are still unequally distributed, although compared with the 1969-70 and 1971-72 surveys, utilization rates were higher in 1974 in all social classes. The overall increase in per capita physician visits was confirmed by statistics of the Régie de l’assurance-maladie du Québec. A parallel increase in the supply of physicians kept the workload of the average physician at a constant level.

Deformations in Extreme Matter

Most materials become narrower in cross section when stretched, but some materials, such as foams, have the counterintuitive property of becoming fatter when stretched (they have a negative Poisson's ratio). In this Perspective, Lakes discusses how his unusual property may arise in isotropic and anisotropic materials. He highlights the study by Baughman et al., who show that anisotropic materials with a negative Poisson's ratio in one direction can be incompressible, i.e., without an overall change in volume upon stretching. This behavior is predicted for materials with very high density, such as neutron star crusts, or very low density, such as ion plasmas, and the validity of the prediction is demonstrated with experimental data for ion plasmas.

Artifact-free application of drugs into the avian endolymphatic space

A push-pull system is described that allows artifact-free application of drugs into very small volumes such as, e.g., the endolymphatic space of the inner ear. The system consists of two syringes, the pistons of which are fixed together and driven by an Oriel motordrive. The syringes are connected to the pipette holders and microcapillaries by PVC tubes. One capillary is used to expel a certain volume, whilst the other one aspirates the same volume. A balanced exchange of fluids within a given space without an overall change in volume is therefore possible.

In situ strain measurements during the formation of palladium silicide films

The evolution of strain in the Pd–Si system during the growth of Pd2Si thin films on Si (100) substrate has been followed in situ using a double optical beam technique. As was observed for the Pt–Si system, the reaction to form Pd2Si yields a compressive intrinsic surface film stress as well as for the silicon-rich silicides as proposed by Angilello et al. [Thin Film Interfaces and Interactions, edited by J. Baglin and J. Poate (The Electrochemical Society, Pennington, NJ, 1980)]. A transmission electron microscopy analysis has revealed grain growth during the formation of Pd2Si which cannot account for the compressive film stresses. The formation of silicide at the interfaces rather than the overall change in volume agrees with the sign of the stresses formed.

Macaque anteroventral cochlear nucleus: developmental anatomy

The development of the anteroventral cochlear nucleus (AVCN) in fetal and infant monkeys ( Macaca nemestrina) was analyzed for gross morphologic changes together with growth-related modifications in constituent cell size and cell distribution. Rapid and extensive prenatal volumetric changes were followed by slow and limited postnatal volumetric changes. The time course of packing density and cell size changes paralleled the volumetric changes. At each age the packing density along the rostrocaudal axis of the AVCN was constant except in the youngest specimens (mid- to late-fetal), where local variations occurred. Similarly, the size of AVCN cells along the rostrocaudal axis remained approximately constant at any given age. In comparison with the human and mouse, the macaque exhibits relatively less pronounced postnatal change in overall volume and cellular growth features.