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1.
The thermal responses of neonates during a cool acclimation period were studied with regard to sleep stages. Sleep stages, body temperatures and metabolic rate (VO2) were studied for seven neonates nursed in incubators and exposed to a cool temperature (thermoneutrality minus 2 degrees C) for 75 h. Each recording session lasted 3 h in the morning: firstly under thermoneutral baseline conditions, then during the first and last 3-h periods of the cool acclimation and finally during the last 3 h of a 24-h recovery period. Sleep structure was modified during the initial hours of cool exposure: the percentage of active sleep increased (AS: +13%, P = 0.028) at the expense of quiet sleep (QS: -11%, P = 0.043). This alteration in sleep structure persisted at the end of the acclimation period. Metabolic heat production only increased in the later period of cool acclimation. Throughout the cool exposure, VO2 increased more (P = 0.040) in QS (+33%) than in AS (+20%) so that by the end of the cool period, VO2 levels were similar in both sleep stages. During cool acclimation, the maintenance of homeothermy is related not only to a change in sleep organization but also to modifications in the thermoregulatory processes in both sleep stages. Considering the importance of AS/QS patterns in the neurobehavioral development of neonates, the present results could have clinical implications for the thermal management of neonates. 相似文献
2.
N. Pallua H. G. Machens A. Berger R. Gieseke H. -G. Sobottka 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1996,381(3):155-159
Zusammenfassung Ausgehend von Überlegungen für ein angemessenes Qualitätssicherungssystem im intensiv-medizinischen Bereich werden die Voraussetzungen für ein ganzheitliches Qualitätsmanagementsystem im Krankenhaus entworfen. Die Grundlage für ein dynamisches Qualitätssicherungssystem ist auf der dokumentatorischen Ebene eine umfassende Datenbasis, die auf einer zeitlich und datentechnisch unbegrenzten Patientenakte basiert. Die notwendige Hard- und Softwarestruktur wird durch die konsequente Anwendung einer Client-Server-Architektur gewährleistet. Die ständige Überprüfung der bestehenden Qualitätsziele in einem ökonomischen Regelkreis benötigt ein System mit flexiblen Abfragemechanismen. Dieser informatorische Datenzugriff auf jeder Hierarchieebene der Krankenhausstruktur wird durch das Konzept des Data-Warehouse ermöglicht, das als Datenbanksystem mit subjektorientierten, integrierten, zeitvariablen und beständigen Informationen konzipiert ist.
A computer-assisted quality-assurance model for burn intensive care applications
The prerequisites for an integrated quality management system for hospitals were developed as a result of considerations regarding the necessity of an appropriate quality-assurance system for the intensive care sector. The basis for a dynamic quality-assurance system on the documentational level is a comprehensive data base containing patient files unlimited in terms of time and data technology. The necessary hardware and software structure will be provided by consistent application of a client-server architecture. Permanent surveillance of existing quality objectives within the scope of an economic close-loop system requires a system with flexible query mechanisms. Informational data access from all hierarchical level within the hospital organization is facilitated by the data warehouse concept, a data base system with subject-oriented, integrated, time-variable, and persistent data.相似文献
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数据仓库在军字一号工程药品信息管理分析中应用研究 总被引:1,自引:0,他引:1
目的探讨如何应用数据仓库技术构建军字一号工程药品信息统计资源库。方法运用Oracle9.2和OWB9.0数据仓库生成软件,构建药品信息统计资源库,并利用Oracle9iDiscoverer工具进行数据挖掘。结果从药品信息统计资源库中挖掘出大量的管理信息,并生成了相应的报表和视图。结论应用数据仓库技术构建医院药品信息统计资源库,可从中得到丰富的辅助决策信息,拓展了HIS信息资源利用空间。 相似文献
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Background: There are a variety of challenges to developing strategies to improve access to health care, but access to data is critical for effective evidence-based decision-making. Many agencies and organizations throughout Mississippi have been collecting quality health data for many years. However, those data have historically resided in data silos and have not been readily shared. A strategy was developed to build and coordinate infrastructure, capacity, tools, and resources to facilitate health workforce and population health planning throughout the state. Objective: Realizing data as the foundation upon which to build, the primary objective was to develop the capacity to collect, store, maintain, visualize, and analyze data from a variety of disparate sources -- with the ultimate goal of improving access to health care. Specific aims were to: 1) build a centralized data repository and scalable informatics platform, 2) develop a data management solution for this platform and then, 3) derive value from this platform by facilitating data visualization and analysis. Methods: A managed data lake was designed and constructed for health data from disparate sources throughout the state of Mississippi. A data management application was developed to log and track all data sources, maps and geographies, and data marts. With this informatics platform as a foundation, a variety of tools are used to visualize and analyze data. To illustrate, a web mapping application was developed to examine the health workforce geographically and attractive data visualizations and dynamic dashboards were created to facilitate health planning and research.
Results: Samples of data visualizations that aim to inform health planners and policymakers are presented. Many agencies and organizations throughout the state benefit from this platform.
Conclusion: The overarching goal is that by providing timely, reliable information to stakeholders, Mississippians in general will experience improved access to quality care. 相似文献
7.
目的:确定酸枣仁适合的贮藏条件、包装材料和包装方式,为保障酸枣仁质量提供参考。方法:选用同一批酸枣仁样品,分别采取塑料编织袋包装、塑料袋包装、塑料袋真空包装、铝塑复合袋包装、铝塑复合袋真空包装和牛皮淋膜纸袋包装,贮藏在阴凉库(温度≤20℃、相对湿度为45%~75%)和药品稳定性试验箱[温度为(40±2)℃、相对湿度为(75±5)%]中,以性状及水分、黄曲霉毒素、酸枣仁皂苷A、斯皮诺素含量为考察指标,开展为期6个月的阴凉长期稳定性试验和加速稳定性试验研究。结果:6个月阴凉长期稳定性试验结果显示,不同包装条件下酸枣仁样品的性状以及水分、黄曲霉毒素、酸枣仁皂苷A含量均符合2015年版《中国药典》(一部)(后文简称"药典")酸枣仁项下规定;斯皮诺素含量均不符合药典的规定(不低于0.080%),但其中铝塑复合袋真空包装样品中斯皮诺素含量(0.079%)与药典要求接近。6个月加速稳定性试验结果显示,牛皮淋膜纸袋包装、塑料编织袋包装样品发霉严重,塑料袋包装、塑料袋真空包装样品表面颜色变暗,铝塑复合袋包装样品颜色稍变暗,但铝塑复合袋真空包装样品外观基本无变化;塑料编织袋包装、牛皮淋膜纸袋包装样品中水分含量超过了药典要求最高值(9.0%);仅在贮藏2个月时,编织塑料袋包装样品被检出黄曲霉毒素B1含量为8.64μg/kg,超出药典规定;各包装样品中酸枣仁皂苷A含量虽有下降,但均满足药典要求;仅塑料袋真空包装样品中斯皮诺素含量(0.084%)满足药典要求,其次属铝塑复合袋真空包装样品中含量(0.071%)相对较高。结论:酸枣仁以铝塑复合袋真空包装后置于阴凉干燥处为宜。 相似文献
8.
Jennifer VanderWeele Teresa Pollack Diana Johnson Oakes Colleen Smyrniotis Vidhya Illuri Priyathama Vellanki Kevin OLeary Jane Holl Grazia Aleppo Mark E. Molitch Amisha Wallia 《Journal of diabetes and its complications》2018,32(7):650-654
Aims
This study validated enterprise data warehouse (EDW) data for a cohort of hospitalized patients with a primary diagnosis of diabetic ketoacidosis (DKA).Methods
247 patients with 319 admissions for DKA (ICD-9 code 250.12, 250.13, or 250.xx with biochemical criteria for DKA) were admitted to Northwestern Memorial Hospital from 1/1/2010 to 9/1/2013. Validation was performed by electronic medical record (EMR) review of 10% of admissions (N?=?32). Classification of diabetes type (Type 1 vs. Type 2) and DKA clinical status were compared between the EMR review and EDW data.Results
Key findings included incorrect classification of diabetes type in 5 of 32 (16%) admissions and indeterminable classification in 5 admissions. DKA was not present, based on the review, in 11 of 32 (34%) admissions. DKA was not present, based on biochemical criteria, in 15 of 32 (47%) admissions.Conclusions
This study found that EDW data have substantial errors. Some discrepancies can be addressed by refining the EDW query code, while others, related to diabetes classification and DKA diagnosis, cannot be corrected without improving clinical coding accuracy, consistency of medical record documentation, or EMR design. These results support the need for comprehensive validation of data for complex clinical populations obtained through data repositories such as the EDW. 相似文献9.
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目的 探讨智能垂直仓储管理系统应用于无菌包从消毒供应中心转运至手术中心的效果。方法 将2018年10月152例首台手术用无菌包作为对照组,由工勤人员采用传统密闭车转运无菌包至手术中心;2018年11月174例首台手术无菌包作为观察组,通过智能垂直仓储管理系统转运无菌包。比较两组无菌包转运和取用时间和无菌包不良事件发生率。结果 观察组无菌包转运和取用时间显著短于对照组,无菌包在转运和取用过程中漏取包发生率显著低于对照组(均P<0.01)。结论 智能垂直仓储管理系统在无菌包的效期管理、定位查找以及出入库把控方面有着明显优势,可提升手术无菌包的质量管理,优化工作流程,满足手术需求。 相似文献