Large numbers of individuals utilize the ER each year for mental health reasons. The health home agency in this study was designed under the Affordable Care Act with the intention of increasing patient self-management thus decreasing high-cost service utilization. The effectiveness of health homes in reducing mental health-related ER visits has remained unexplored. In this study, the relationship between participation in this program and ER utilization was examined, using the theoretical framework of the Health Belief Model. The sample of 128 health home participants with documented mental health conditions was selected using systematic random sampling. A one-way, repeated-measures t-test and a one-way, repeated-measures ANCOVA were used to analyze hospital records for ER visits with a primary or secondary mental health diagnosis. The results indicated that health home participation did not have a statistically significant impact on ER utilization when comparing overall 12-month means or at quarterly anniversary dates when controlling for age, race, and gender. These findings suggested opportunities for improvement in professional practice, identified areas that require further research, and will be used to initiate discussion into the existing and potential value that health homes offer to the mental health clientele being served. Those discussions have the potential to create social change through infrastructure changes that lead to improved service coordination, increased resources for improving access and quality of care, and overall enhancement of outcomes for individuals with mental health conditions.

La catalyse de polycondensation des silicones, et notamment des élastomères vulcanisables à froid bicomposants, constitue un enjeu scientifique, environnemental et économique. Le dilaurate de dibutyl étain (DLDBE), classé CMR2, très largement utilisé dans l'industrie du silicone sera prochainement interdit par la nouvelle réglementation REACH. L'objectif de cette étude est donc d'étudier de nouveaux systèmes catalytiques des réactions de polycondensation. L'effet des différents constituants de la formulation (masse molaire du PDMS réactif, concentration en réticulant, concentration en catalyseur) sur la cinétique de réticulation et sur les propriétés finales a été étudié par combinaison des techniques de rhéologie, RMN et taux de gonflement. Principalement, ce travail consiste en l'étude approfondie de deux catalyseurs : une guanidine et un complexe de zinc et les résultats montrent que la construction des réseaux est plus ou moins différente selon la catalyse. En effet, un dérivé de l'étain conduit à une construction en deux étapes d'hydrolyse et de condensation, dont l'hydrolyse est d'abord favorisée. En comparaison, les complexes de zinc tendent à se comporter d'une façon très similaire, bien que l'hydrolyse des alcoxysilanes soit plus importante. Au contraire, une catalyse basique favorise très largement la condensation par rapport à l'hydrolyse. La guanidine réagit très rapidement avec les fonctions silanols. Ensuite, l'hydrolyse des alcoxysilanes se produisant dans une moindre proportion, le réseau tridimensionnel se construit. Ces travaux ont donc montré que le complexe de zinc étudié est un bon remplaçant du DLDBE / Silicones condensation catalysis, and more especially room temperature vulcanizable compounds, is a very important scientific, environmental and economic issue. The catalysis species, derivated from tin dilaurate, which are now classified as a CMR2 compound (toxic for reproduction), have been widely used in the silicone industry. The new REACH regulation is going to forbid its use very soon. This study aims to work on new catalytic systems. The influence of the components of the formulation on the kinetics and mechanical properties has been study by different methods: rheology, NMR and swelling measurements. More precisely, this work focuses on two catalysts: one guanidine and zinc complexes. Results have shown that the network construction depends on the catalysis. In fact, while using a tin compound, the construction occurs in two steps, in which hydrolysis is the most important. As a comparison, zinc complexes present the same behaviour as tin compounds even though the hydrolysis step is much more important. On the contrary, it’s known that basic catalysis enhances the condensation step. Then, the guanidine quickly reacts with the silanol functions. Then, in a second step, the alkoxysilanes hydrolysis occurs in a smaller proportion. The tridimensional network is getting built. This work mainly showed that zinc complexes can easily replace tin compounds

The master's thesis deals with the project of the new building of the Sports Hall in the Staré Město at the stage of project documentation for the construction on plots 2420/1, 2420/41, 2420/42, 2420/43, 2420/44, 4568/38, 6277/2, 6277/3 , 2517/4. The plots on which the construction is proposed are flat or slightly sloping. The building has no basement, has two floors. The perimeter structures in the locker rooms are designed from ceramic blocks of the POROTHERM system, including the thermal insulation system according to the principles of ETICS, and in the gym from the curtain walling of the KINGSPAN system. Horizontal structures are folded prestressed ceiling panels SPIROLL. The cloakroom building is covered by a warm flat roof, and the gymnasium by barrel roof made of glued laminated girder. In the sports hall, 5 changing rooms are designed, including sanitary facilities, then facilities for the operation of the hall and refreshments for spectators.

The main purpose of this master's thesis is to create electronic mail room of The BUT. First of all I described problems concerning a digital signature, its use and safety, and as well as sphere of qualified certificates and method of their issuing by certification authority. The next part of the thesis deals with systems enabling electronic submission (so-called "Electronic Mail Room"). I have focused on available applications providing electronic submission service to civil offices, and subsequently analyzed functions that individual applications offer to the Mail Room clients as well as to authority staff. On the basis of gained knowledge and according CVIS requirements I created project of electronic submission for needs of the Brno University of Technology. Result of this thesis is the application of electronic mail room, implemented in BUT portal.

The diploma thesis is the project of the hotel in Gbely. The Hotel is project as a four–storeyed house with one basement. The building is designed as object with twelve flats. The house has flat roof. The above grade masonry is created by Ytong system. The bearing walls in basement is created by Prefa BTB system, interior grade masonry is created by Ytong system. The partitions are created by Ytong system too. The main building entrance is situated to north–east side. In the basement, there are boiler room, alternative energy source, facilities for employees, laundry room, ironing room, air conditioning engine room and storage units. The first elevated floor is content of main entrance to the object, stairway, shop, reception, restaurant and bar, kitchen and elevators. On the second floor, there are eight guest rooms, background for cleaner, multimedia room. On the third there are ten guest rooms and multimedia room. On the fourth floor there are eight guest rooms, multimedia room and terrace with access to the roof. The foreside of exterior walls will be white with colored stripes. General architectonical and structural solution created harmony with neighbourhood. The project contains technical, thermal and acoustic appraisal forms. Parking is located in the hotel area.

No description available.

Dieser Beitrag gibt, basierend auf einem BMBF-Verbundvorhaben, Einblicke in die umfassende Bewertung von OPTextilien. Ziel des Vorhabens ist es, Entscheidern in Krankenhäusern Anregungen und Know-how für ihren Berufsalltag und Produzenten von OP-Textilien Impulse für die Gestaltung ihrer Produkte zu geben. Es werden die hygienischen Anforderungen zur Vermeidung nosokomialer Infektionen, die die Schutzwirkung der Textilien garantierenden textiltechnologischen Voraussetzungen sowie die zur Erfüllung der Wirtschaftlichkeit und Umweltfreundlichkeit notwendigen Anforderungen an OP-Textilien dargestellt. Der Beitrag verdeutlicht, dass die Beachtung all dieser Kriterien und deren Zusammenführung für eine bewusste Entscheidung zum Einsatz von OP-Textilien notwendig ist. / This article describes a holistic assessment approach for operating room (OR) textiles, based on a joint research project funded by the German Ministry of Education and Research. The objective of the project is to ease decision processes for decision makers in hospitals and OR textile manufacturers. The hygienic demands for protection against nosocominal infections, the technological requirements to guarantee textiles their protective properties, as well as the bases for an economically and environmentally optimum decision, are discussed. To permit a holistic procurement decision regarding OR textiles, it is necessary to consider all these criteria and their integration, as proposed in this article.

Bakgrund: På operationssalar samarbetar flera olika kompetenser mot ett gemensamt mål, att ge patienten god och säker vård och omvårdnad. Forskning har visat att det krävs ett gott teamarbete bland personalen för att patientsäkerheten ska kunna säkerställas.  Syfte: Syftet var att beskriva operationsteamets erfarenheter av vilka faktorer som påverkar teamarbetet på operationssal. Metod: Studien har genomförts med kvalitativ metod och induktiv ansats. Ett strategiskt urval användes som urvalsmetod. Två personer från varje yrkeskategori i teamet; anestesisjuksköterskor, anestesiologer, operationssjuksköterskor, operationsundersköterskor och operatörer handplockades till kvalitativa semistrukturerade intervjuer. Data har analyserats med kvalitativ innehållsanalys.  Resultat: Studien resulterade i sex huvudkategorier: Att samarbeta och ha en personlig relation till kompetenta kollegor, Att ha en god stämning där alla är inkluderade och känner sig trygga, Att vara väl förberedd, ha ett gemensamt mål och uttalade roller, Att vara fokuserad, engagerad och visa respekt även under stress, Att lyssna på varandra och kommunicera högt och tydligt med closed loop och Att arbeta strukturerat och använda de hjälpmedel och verktyg som finns.  Slutsats: Teamarbetet är viktigt för patientsäkerheten och för en god omvårdnad. Faktorer som samarbete, personliga relationer, en god stämning, gemensamma mål, respekt och kommunikation upplever operationsteamet påverkar teamarbetet. Faktorerna kan kännas självklara, samtidigt påtalar deltagarna den förbättringspotential som finns, vilket belyser det komplexa med teamarbetet.

Utifrån de teoretiska begreppen handlingsutrymme och paternalism undersöker studien handläggares hantering av gravida kvinnor med missbruksproblematik med fokus på samverkan och hänsyn till graviditet. Urvalet består av sex handläggare med erfarenhet av gravida klienter med missbruk. Hälften av intervjupersonerna arbetar i stadsdelsförvaltningar och kommuner i Stockholm medan den andra hälften arbetar i andra kommuner. Det empiriska materialet insamlades genom semi-strukturerade intervjuer med utgångspunkt i en vinjett. Därefter analyserades materialet utifrån en tematisk analys. Resultatet visar att handläggarnas hantering av klientgruppen varierar i stor utsträckning. Vissa handläggare anpassar insatserna på grund av klientens graviditet medan andra inte låter sig påverkas av det. Dessutom skiljer sig handläggarnas uppfattning kring vad som krävs för att tillämpa LVM när det gäller en gravid klient. Tidigare forskning visar att det är framgångsrikt att samla insatser för att tillgodose klientgruppens behov. Samtidigt visar studiens resultat att detta inte går att uppnå om det inte finns en god samverkan mellan kommun och region. Handläggarnas fokus på samverkan varierar vilket också påverkar klientgruppens möjlighet att få heltäckande behandling. / Based on the theoretical concepts of room for action and paternalism, the study examines caseworkers' handling of pregnant women with substance abuse problems with a focus on collaboration and consideration of pregnancy. The selection consists of six caseworkers with experience of pregnant clients with addiction. Half of the interviewees work in district administrations and municipalities in Stockholm, while the other half work in other municipalities. The empirical material was collected through semi-structured interviews based on a vignette. The material was then analyzed based on a thematic analysis. The results show that the case managers' handling of the client group varies to a large extent. Some caseworkers adapt the interventions due to the client's pregnancy, while others are not affected by it. In addition, case managers differ in their views on what is required to apply compulsory care when it comes to a pregnant client. Previous research shows that it is successful to gather efforts to meet the needs of the client group, the results of the study show that this cannot be achieved if there is no good cooperation between municipality and county council. The case managers' focus on collaboration varies, which also affects the client group's ability to receive comprehensive treatment.

No description available.