Post Setup Research Articles

Delirium Assessment And Documentation As Part Of An Acute Medical Admission

Abstract Background Delirium is a prevalent issue affecting older patients in acute hospitals. National guidelines mandate that all patients >65 years old admitted to an acute hospital setting are screened for delirium. Prompt assessment and management of delirium is vital in delivering optimal care to the older patient. In our institution, delirium can be under recognised and not assessed routinely as part of the medical admission. Our aim was to assess delirium documentation rates and utilising the 4AT as part of the acute medical admission in a service development project. Methods A retrospective assessment of patient demographics and documentation of delirium and 4AT in the medical admission was carried out for January, February and March 2023 and compared to the same 3-month period in 2024 post set up of a new specialist geriatric ward (SGW) as part of a service development project. This was in tandem to targeted interventions for improving delirium education and management. Results Mean age was 83 years in both groups. 11% (18/157) in the cohort pre SGW and 30% (40/134) post setup of the SGW had a diagnosis of dementia. 13% (20/157) in the pre SGW cohort had delirium documented in the admission note and 23% (31/134) post. 24% (32/134) had a 4AT documented in the admission note post SGW setup compared with 6% (10/157) previously. Conclusion There was suboptimal documentation of the 4AT and delirium in the acute medical admission note. An acute medical admission proforma is being developed and implemented in our institution which will include a 4AT delirium screening tool. We will reassess this in 6 months’ time to ascertain whether there is an improvement in delirium and 4AT documentation. We will also give education to the medical NCHD group carrying out the admissions to emphasise the importance of utilising the 4AT and delirium documentation.

The Analysis of the Influence of Post Appointment System on the Performance of Faculty Members in Higher Learning Institutions

The development of higher learning institutions is inseparable from the support given by the teams of professional faculty members. In the time of knowledge explosion, for the purpose of realizing their leap-forward development, higher learning institutions should take the post appointment system as the approach to a breakthrough and make an in-depth analysis of the composite influence of the post appointment on faculty members' output performance, behavior performance as well as their ability and quality by discussing the deficiencies and problems in aspects including post setup, appointment process and assessment from the perspective of system before building the competitive and incentive mechanism of posts featuring the survival of the fittest. All of these are expected to able to promote the overall upgrading of the level of the faculty members on the part of higher learning institutions and facilitate their leap-forward development.

Standardization-based research on fiscal compensation measurement for communities in Shanghai

Objective To determine the standardized workload first of all. Then based on such workload, to establish the government′s resource input and allocation mechanism, and build the post setup, a fiscal compensation system, and the salary distribution mechanism of community medical staff. Methods This study selected 65 community health centers in Shanghai′s downtown area, suburban area and outer suburbs as sample units to investigate with questionnaires such indicators as community medical and health expenditure, standardized workload among others.With the measured workload as basis, item costs of health services at Shanghai′s communities were calculated. Results That of downtown, suburban and suburban areas accounted for 71.60%, 72.13% and 73.14% respectively of the total expenditure on health care.The unit cost of standardized workload varies with areas, while that in suburban and suburban areas was significantly higher than that downtown.The actual fiscal compensation was 20% lower than the target compensation as designed in the reform. Conclusions The ideal investment of basic public health services based on standardized workload can effectively realize the equalization of services among areas and promote effective allocation of resources.At the same time, estimates of the total standardized workload from the perspective of the demand side, and determination of an ideal investment ceiling for the investment of areas′ services budgets, can effectively minimize the waste of resources. Key words: Community health; Cost accounting; Standardized workload; Fiscal input; Shanghai

Validation of frame-based positioning accuracy with cone-beam computed tomography in Gamma Knife Icon radiosurgery

BackgroundFrame based positioning accuracy in Gamma Knife (GK) stereotactic radiosurgery (SRS) is extremely high but removal of a post may be necessary to enable the treatment in selected patients. ObjectiveTo verify the positioning accuracy in clinical scenarios with 4 and 3 posts in patients and phantoms using cone-beam CT (CBCT) of Gamma Knife Icon™. MethodsWe analyzed positioning accuracy for 12 patients with standard 4 post setup using pretreatment CBCT (pre-CBCT) on GK Icon™ and report 4 patients with different clinical scenarios (removal of a post). We performed phantom measurements to verify the frame accuracy via CBCT in different clinical scenarios without the influence of the human patient. ResultsMean frame accuracy for 12 patients with 4 posts was 0.35 mm/0.34 degree. Mean motion during treatment was 0.11 mm/0.04 degree. For two of the clinical scenarios where a post was removed, we found acceptable deviations within 0.66 mm/0.61 degree. For 2 patients, a deviation of 2.94 mm/−3.47 degree and 1.85 mm/−0.74 degree was found and replanning was necessary. Phantom measurements showed good agreement when planning MR/CT was performed with 4 or 3 post. Larger deviations of 0.86 mm/0.88 degree were detected when a post was removed after planning MR/CT. ConclusionThe frame accuracy with 4 posts before and during GK treatments is as high as expected. For clinical situations, where a post is removed after planning-CT/MR, pre-treatment position verification is strongly suggested using stereotactic CBCT or the P-CT/MR should be repeated to avoid possible mistreatments.

Practice and insight in the post setup of telemedicine assistants at a hospital

The paper presented the concept of telemedicine assistants, and analyzed their professional attributes, training modality and job description.Such scenarios as emergency telemedicine consultation, electronic ICU building, and international remote pathology consultation were taken as an example, to further elaborate the role of such assistants, for the purpose of providing patients with telemedicine services of higher quality, efficiency and convenience. Key words: Telemedicine; Remote consultation; Assistant; Responsibility; Professionalization

An integrated setup planning and fixture design system for prismatic parts

This paper reports a knowledge–based system for conceptual and layout modular fixture design developed on an intelligent CAD system, ICAD. The integration of setup planning and fixture design is achieved through conceptual fixture design which includes two stages: the pre–setup and post–setup conceptual design. In the pre–setup stage, the system takes feature–based part models as input and generates feasible fixturing features for each possible setup based on static constraints only. This information is then used by a setup planning system developed separately. Post–setup conceptual fixture design takes place when the setup plan is available. For each setup with its intermediate workpiece state, the surface candidates for each fixturing datum are identified and ranked according to various geometric and technological constraints. The best ranked surface for each fixturing datum is selected. The system then performs layout design by generating all the supporting, locating and clamping points for each setup, taking into account various constraints including part geometry, stability, modular fixture elements, and interference. The series of setups are simulated graphically on the computer screen. Output from this system can be used for detailed fixture design. In this paper, the development of the system is described in detail and a case study is presented to highlight its performance.

A dual compartment diffusion chamber for studying axonal chemotaxis in 3D collagen

During nervous system development growing axons are often guided by diffusible chemical gradients. An important contribution to our understanding of the mechanisms involved in this process has been made by in vitro assays. However, an inexpensive and simple assay which allows the establishment of stable and reproducible gradients in a 3D collagen environment has been lacking. Here we present a simple two-compartment diffusion chamber for this purpose. We show that gradient steepnesses of up to 2% are achieved within 1h post setup, and a gradient persists for at least 2 days. We demonstrate the assay by showing robust chemoattraction of dorsal root ganglion neurites by gradients of nerve growth factor (NGF), and chemorepulsion of olfactory bulb neurites by gradients of Slit2.

Methods and experiences of nursing post management of the hospital

The paper presented the methods and experiences of managing nursing posts in Beijing Friendship Hospital.As introduced in the paper,such measures as conversion of organizational structure,innovative nursing post setup,new training model,dynamic allocation of nursing manpower,and effective performance incentive mechanism,promoted better nursing quality and stabilized nursing team,achieving sustainable development of quality nursing service. Key words: Nursing post management; Post setup; Talent training; Dynamic allocation

Estimation of population size for wolverinesGulo guloat Daring Lake, Northwest Territories, Using DNA based mark-recapture methods

Abstract This paper presents the results of the first substantive DNA mark-recapture sampling effort for wolverines Gulo gulo using hair-snag sampling. In the spring of 2004, 284 bait posts were sampled in 3 × 3 km cells for four sessions in the Daring Lake area of the Northwest Territories, Canada. Bait posts were baited with caribou and scent lures. As well, a fish lure was dragged around by snowmobiles during bait post setup. One hair sample was genotyped from each post for each session. Results suggested a high degree of attraction to bait posts by wolverines with capture probabilities of > 0.5 for both sexes and very precise estimates for females. Males displayed substantial closure violation whereas females did not. Investigation of reduced effort designs suggests that a 2-session sampling design with moderate densities of bait posts is adequate for estimation of population size for wolverines due to high capture probabilities. A longer-term monitoring effort is recommended to allow better understan...

Marketless Set-up vs Trading Posts: A Comparative Analysis

This paper studies the efficiency properties with respect to transactions cost, of a trading post set-up vis-a-vis a marketless trading arrangement under the well-known frame-work of OSTROY and STARR (1974). It is revealed from this exercise that the social institute of money works better when coupled with the social institution of markets and further shows the extent of inefficiency that can be potentially associated with mar- ketless trade in large economies. This gives some insight into why, histori- cally speaking, a market set-up has evolved over time replacing a market- less set-up.