Objectives: The objective of this thesis is to explore the association between delayed rapid response team activation and patient mortality and morbidity in adult in-patients. Methods: Study 1 presents a protocol for a systematic review of literature regarding the association of delayed activation of rapid response teams and patient outcomes. Study 2 contains the results of the conducted systematic review, performing a search of the literature to critically appraise, aggregate, and present a narrative synthesis of included studies. The final study examines the association between delayed rapid response team activation and hospital mortality, ICU transfer, and cardiopulmonary arrest risk in a retrospective observational cohort study conducted as part of the “Hospital without Code Blues” initiative at Hamilton Health Sciences. Results: Studies included in the systematic review report an association between delayed activation and patient mortality and ICU transfer odds. Results of study three find that these delays may not be associated with patient mortality, but are significantly associated with ICU transfer events and a composite outcome of patient in-hospital mortality, ICU transfer, and cardiopulmonary arrest. Overall, patients experiencing a delayed rapid response team activation were at greater odds of experiencing a negative event during their course of stay in hospital. Conclusions: This thesis presents findings that suggest delayed activation of rapid response teams is associated with an increase in patient mortality and ICU transfers. Increased durations of delay are associated with increased odds of experiencing the above events. / Thesis / Master of Science (MSc)

No / Modelling of wastewater temperatures along a sewer pipe using energy balance equations and assuming steady-state conditions was achieved. Modelling error was calculated, by comparing the predicted temperature drop to measured ones in three combined sewers, and was found to have an overall root mean squared error of 0.37 K. Downstream measured wastewater temperature was plotted against modelled values; their line gradients were found to be within the range of 0.9995-1.0012. The ultimate aim of the modelling is to assess the viability of recovering heat from sewer pipes. This is done by evaluating an appropriate location for a heat exchanger within a sewer network that can recover heat without impacting negatively on the downstream wastewater treatment plant (WWTP). Long sewers may prove to be more viable for heat recovery, as heat lost can be reclaimed before wastewater reaching the WWTP.

Time, the one educational resource educators desire most, is so often in short supply in America 's schools. The ability of the school administrator to schedule teachers' and students' time so that both groups can maximize opportunities for teaching and learning each day has become an essential skill. Changing the structure of the school day to extend learning opportunities requires that administrators, teachers, and students have a firm commitment and clear understanding of the educational resources and processes of time. Successful practices regarding the use of time include: (a) careful planning and design, (b) adequate staff preparation and training, (c) effective use of extended time, and (d) a focus on equal access for students to multiple learning opportunities. Schools are under enormous pressure to show, through improved test scores, that they are providing every student with a thorough and efficient education. A review of the literature on alternative scheduling practices that use specified and structured blocks of learning time, focuses, overwhelmingly, on high school alternative scheduling models. However, there is a paucity of current research on the effects of alternative scheduling practices on elementary school cultures even though the elements of one particular method, parallel block scheduling, have been employed for over 30 years in elementary schools. This lack of research points to the necessity of exploring the benefits of alternative scheduling practices for delivery of instruction as well as changes in elementary school scheduling since the implementation of the No Child Left Behind mandate. / Ed. D.

Nos últimos anos, em função dos resultados negativos do HEMO Study e da elevada mortalidade na população dialítica, observou-se crescente interesse nosregimes de hemodiálise diária. A dose de diálise persiste como um dos elementos fundamentais na adequação do tratamento dialítico. Comparamos as doses de diálise em hemodiálise diária (90 minutos, 6 vezes / semana), com as doses em hemodiálise convencional (240 minutos, 3 vezes / semana), através da quantificação direta da diálise, do modelo de cinética de uréia e pelo Standard Kt/V de Gotch. A comparação foi feita para diferentes solutos (uréia, creatinina, fósforo, ácido úrico e ß2-microglobulina) e diferentes taxas de ultrafiltração / The recent efforts to improve dialysis outcome and the negative results from the HEMO Study have created great interest on alternative hemodialysis (HD) regimens. Dialysis dose persist fundamental to HD adequacy. However, parameters of adequacy have not been validated to Daily HD. We compared the dialysis dose of daily, high efficiency and flux HD (90 minutes, 6 times a week) with Conventional high flux HD (240 minutes, 3 times a week) by direct dialysis quantification, urea kinetics model and Gotch's stdKt/V. The comparison was made with urea, creatinine, phosphate, uric acid and ß2-microglobulin. We, also, analyzed the effect of different ultrafiltration rates on solute removal on Daily HD

Introduktion: Både tiden då patienten är sövd eller bedövad och tiden då det kirurgiska ingreppet utförs innebär risker för patienten. Bland annat ökar risken för trycksår och hypotermi med längden på anestesitiden och därmed är det viktigt att anestesitiden inte blir längre än nödvändigt. För att minska riskerna bör patientens anestesitid överensstämma med kirurgitiden i så stor utsträckning som möjligt och därför är det av vikt att få ta del av och sammanställa perioperativa sjuksköterskors erfarenheter kring detta. Syfte: Syftet med studien var att beskriva perioperativa sjuksköterskors erfarenheter av överensstämmelse mellan anestesitid och kirurgitid. Metod: En kvalitativ intervjumetod med semistrukturerade frågor användes. Deltagarna kom från två sjukhus i Mellansverige och valdes med bekvämlighetsurval. Åtta anestesisjuksköterskor och åtta operationssjuksköterskor deltog. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Innehållsanalysen resulterade i fyra kategorier: Svårigheten att förutse anestesiläkemedlens effekt på individuella patienter påverkar bedömning av tidsåtgång, Kommunikationens betydelse för överensstämmelsen mellan anestesitid och kirurgitid, Teamarbetets betydelse för överensstämmelsen mellan anestesitid och kirurgitid samt Oförutsedda händelser kan förlänga anestesitiden. Konklusion: Denna studie ger en ökad förståelse för hur patientens anestesitid överensstämmer med kirurgitiden utifrån perioperativa sjuksköterskors erfarenheter. / Introduction: Being under general or regional anesthesia and the surgical procedure itself involves risks for the patient. Since length of anesthesia increases the risk for pressure ulcers and hypothermia, anesthesia should as far as possible correspond to surgical time. It is therefore important to take part of the experience of perioperative nurses about this subject. Aim: The aim of the study was to describe perioperative nurses’ experience of correspondence between duration of anesthesia and surgery. Method: A qualitative interview method with semistructured questions were used to collect data. Participants were chosen by convenience sampling from two hospitals in central Sweden. Eight certified registered nurse anesthetists and eight theatre nurses participated. The interviews were analysed using qualitative content analysis. Result: The content analysis resulted in four categories: Difficulty in predicting the effect of anesthetics on individual patients affects the assessment of time consumption, The importance of communication for the correspondence between anesthesia and surgery time, The importance of teamwork for the correspondence between anesthesia and surgery time, Unforeseen events can prolong duration of anesthesia. Conclusion: This study contributes to understanding the correspondence between duration of anesthesia and surgery from the perspective of the perioperative nurses.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

Thesis (Ph.D. in Biostatistics) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 117-119). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Thesis (Ph.D. in Biostatistics) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 53-56). Online version available via ProQuest Digital Dissertations.

Thesis--University of Oklahoma. / Bibliography: leaves 70-75.

Nos últimos anos, em função dos resultados negativos do HEMO Study e da elevada mortalidade na população dialítica, observou-se crescente interesse nosregimes de hemodiálise diária. A dose de diálise persiste como um dos elementos fundamentais na adequação do tratamento dialítico. Comparamos as doses de diálise em hemodiálise diária (90 minutos, 6 vezes / semana), com as doses em hemodiálise convencional (240 minutos, 3 vezes / semana), através da quantificação direta da diálise, do modelo de cinética de uréia e pelo Standard Kt/V de Gotch. A comparação foi feita para diferentes solutos (uréia, creatinina, fósforo, ácido úrico e ß2-microglobulina) e diferentes taxas de ultrafiltração / The recent efforts to improve dialysis outcome and the negative results from the HEMO Study have created great interest on alternative hemodialysis (HD) regimens. Dialysis dose persist fundamental to HD adequacy. However, parameters of adequacy have not been validated to Daily HD. We compared the dialysis dose of daily, high efficiency and flux HD (90 minutes, 6 times a week) with Conventional high flux HD (240 minutes, 3 times a week) by direct dialysis quantification, urea kinetics model and Gotch's stdKt/V. The comparison was made with urea, creatinine, phosphate, uric acid and ß2-microglobulin. We, also, analyzed the effect of different ultrafiltration rates on solute removal on Daily HD