Clinician Education Program: Promoting the Use of Care Bundles in Reducing the Hospital Length of Stay and Readmission Rates of Adult COPD Patients

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing$7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care. Internal records indicated that the study hospital has an average of 66 COPD-related, 19 of which are readmissions 30 days post-discharge in a month. A wide range of empirical data confirmed that using care bundles reduced COPD patients’ hospital LOS and RAR by two days and up to 87$3,760 (Hegwer, 2018). With a substantial reduction in LOS and RAR, the organization can save $304,742 for the first month or$3,656,904 for the first fiscal year. Other advantages are improved patient outcomes, better patient satisfaction ratings, efficient resource allocation, and improved quality care (Atwood et al., 2022)

Internações e óbitos e sua relação com a poluição atmosférica em São Paulo, 1993 a 1997

OBJETIVO: Investigar efeitos de curto prazo da poluição atmosférica na morbidade respiratória de menores de 15 anos e na mortalidade de idosos. MÉTODOS: O estudo foi realizado na cidade de São Paulo, Brasil. Foram analisadas as contagens diárias de admissões hospitalares, de menores de 15 anos e de mortes de idosos (>64 anos) no período de 1993 a 1997, em relação às variações diárias de poluentes atmosféricos (PM10, CO, O3). Foi utilizada para análise a regressão de Poisson em modelos aditivos generalizados. Os modelos foram ajustados para efeitos da tendência temporal, sazonalidade, dias da semana, fatores meteorológicos e autocorrelação. RESULTADOS: Variações do 10° ao 90° percentil dos poluentes foi significativamente associada com o aumento de admissões por doenças respiratórias em menores de 15 anos para PM10 (%RR=10,0), CO (%RR=6,1) e O3 (%RR=2,5). Associação similar foi encontrada para mortalidade em idosos e PM10 (%RR=8,1) e CO (%RR=7,9). CONCLUSÕES: Os resultados encontrados são coerentes com os estudos que apontam associação entre variações de curto prazo dos poluentes atmosféricos e incremento na morbidade e mortalidade nos grandes centros urbanos

Evaporation and explosion of liquid drops on a heated surface

The literature pertinent to various aspects of drop evaporation on a heated surface is reviewed. Both the laser shadowgraphic and direct photographic methods are employed to study thermal stability and flow structures in evaporating drops in all heating regimes. It is revealed that four flow regions exist in stable and unstable type drops at low liquid-film type vaporization regime. As the surface temperature is raised, the flow regions reduce to two. In the nucleate-boiling type vaporization regime, the interfacial flow structure changes due to a reduction in the Marangoni number as well as the dielectric constant of the liquid. An evidence of bubble growth in the drops is disclosed. The micro explosion of drops is found to occur in the transition-boiling type heating range. No drop explosion takes place in the spheriodal vaporization regime except when the drop rolls on to a microscratch on the heating surface. It is concluded that the mechanisms for triggering drop explosion include the spontaneous nucleation and growth phenomena and the destabilization of film boiling.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47061/1/348_2004_Article_BF00266263.pd

Constructing connections between theory and practice. Analysis of teacher’s assistance to favour reflection and knowledge construction

La gran mayoría de programas de formación de profesorado incluyen la reflexión como estrategia para la construcción de conocimiento. Sin embargo, en la literatura existen desacuerdos en la dirección y en el modo en que debería promoverse esta reflexión. Algunos autores (Korthagen, 2010) postulan que la reflexión debería estar basada en establecer conexiones entre el conocimiento teórico y práctico. Otros (Yoon & Kim, 2010; Pareja Roblin & Margalef, 2013) proponen que en todos los contextos educativos subyacen dilemas internos sobre los que los profesores deben reflexionar. Además, también existe debate entre el tipo de intervenciones que el docente debería realizar y el papel de las ayudas para suscitar niveles complejos de reflexión (Moore-Russo & Wilsey, 2014; Gelfuso & Dennis, 2014). Por tanto, ante esta realidad, la investigación que se presenta pretende contribuir a una mejor comprensión sobre los elementos que facilitan las competencias de reflexión en el alumnado y la conexión entre el conocimiento situacional y el conocimiento práctico (Clarà & Mauri, 2009, 2010). Se han estudiado 8 casos, ocho grupos de estudiantes de magisterio con su correspondiente tutor (112 alumnas/os y 8 tutoras/es). Los grupos proceden de 3 Universidades diferentes: Universidad de Barcelona, Universidad de Sevilla y Mondragon Unibertsitatea. El objetivo de dichos grupos es reflexionar sobre situaciones vividas durante sus prácticas, partiendo de situaciones elegidas y descritas por ellas/os. Se ha grabado el proceso reflexivo (5 sesiones por grupo) y analizado posteriormente mediante el método denominado análisis de contenido, poniendo el foco en la forma de organización de la reflexión conjunta y su concreción en diferentes segmentos de interactividad y tipos de ayudas que se proporcionan. Se han identificado diferentes patrones de interacción y ayudas específicas de las tutoras para abordar la reflexión conjunta. Los resultados nos permiten profundizar en la influencia de estos patrones en los procesos de reflexión.Most teacher training programs include reflection as strategy for the construction of knowledge. Nevertheless, there is discrepancy in literature in regard to the way reflection should be directed and fostered. Some experts (Korthagen, 2010) argue that reflection should be based on establishing links between theoretical and practical knowledge. Others (Yoon & Kim, 2010; Pareja Roblin & Margalef, 2013) claim that internal dilemmas underlie every educational context, on which teachers must reflect. Besides, there is debate between the teacher’s type of intervention and the role of assistance so as to foster more complex reflection levels (Moore-Russo & Wilsey, 2014; Gelfuso & Dennis, 2014). Therefore, this being the reality, the research we present aims at contributing a better understanding of the elements that facilitate students’ reflecting competences and the link between situational knowledge and practical knowledge (Clarà & Mauri, 2009, 2010). 8 cases have been analyzed, eight teacher students with their corresponding tutors (112 students and 8 tutors). Groups are from 3 different Universities: Universidad de Barcelona, Universidad de Sevilla and Mondragon Unibertsitatea. The aim of these groups is to reflect on the situations experienced during their teaching practice placements, based on the situations chosen and described by them. The reflective process (5 sessions per group) have been recorded and subsequently analyzed using the method called content analysis, placing the focus on how joint reflection is organized and its realization in different interaction sections and the types of assistance provided. Different interaction patterns and specific assistance from the tutors to deal with joint reflection have been identified. The results allow us for deepening in the influence of those patterns in reflection processes

Hypoglycemic effect of Musa acuminata aqueous leaf extract on alloxan-induced diabetic ICR mice (Mus musculus)

Diabetes mellitus is a metabolic disease characterized by abnormally high glucose level in blood. Plant-based compounds are now being studied as alternatives for diabetes. Due to limited information on the pharmacologic activity of Musa acuminata, also known as “lakatan”, this study was carried out to determine the effect of Musa acuminata aqueous leaf extract on blood glucose level of alloxan-induced diabetes mice and to assess its safety in vivo. Thirty male ICR mice (Mus musculus) were divided into six groups (n=5) and were administered intraperitoneally with alloxan monohydrate (75 mg/kg) (5 groups), or normal saline solution (sham control group). Treatment groups were given distilled water (both sham and negative control groups), glimepiride (17.6 μg/kg, positive control), or one of the three doses of M. acuminata leaf aqueous extract tested (250, 500 and 1000 mg/kg) concomitantly via oral gavage for 28 days. The blood glucose levels of the mice were measured at baseline and at 0th, 14th and 28th. Phytochemicals present as well as signs of general toxicity were also determined. Results showed that M. acuminata (1000 mg/kg) significantly decreased blood glucose level (