A Time and Motion Analysis of Nursing Workload and Electronic Health Record Use in the Emergency Department.

Introduction: The use of an electronic health record may create unanticipated consequences for emergency care delivery. We sought to describe emergency department nursing task distribution and the use of the electronic health record.

Methods: This was a prospective observational study of nurses in the emergency department using a time-and-motion methodology.

A model for rapid emergency department expansion for the COVID-19 pandemic.

COVID-19 has caused global dramatic change in medical practices including the introduction of temporary screening and assessment areas outside the footprint of the main hospital structures. Following the initial surge of patients with novel coronavirus (2019-nCoV) in the United States, our medical center rapidly designed and constructed an alternative assessment and treatment site in a converted parking garage deck for emergency department patients with suspected or confirmed 2019-nCoV. During the first month after opening, 651 patients were treated in this alternative assessment area including 54 patients who tested positive for 2019-nCoV.

Children's daily exposure to polychlorinated biphenyls from dietary supplements containing fish oils.

In children, omega-3 polyunsaturated fatty acids (PUFAs) may elicit a suite of health benefits including enhancement of cognitive development. Subsequently, dietary supplements containing omega-3 PUFAs have become increasingly popular. Often, the largest source of beneficial PUFAs in these supplements is fish oil, which may contain significant levels of contaminants such as polychlorinated biphenyls (PCBs).

Using principal component analysis to aid bayesian network development for prediction of critical care patient outcomes.

Background: Predicting an intensive care unit patient's outcome is highly desirable. An end goal is for computational techniques to provide updated, accurate predictions about changing patient condition using a manageable number of physiologic parameters.

Methods: Principal component analysis was used to select input parameters for critical care patient outcome models.

Bacterial community profiles from sediments of the Anacostia River using metabolic and molecular analyses.

Unlabelled: BACKGROUND AIM AND SCOPE: Though the tidal Anacostia River, a highly polluted riverine system, has been well characterized with regard to contaminants, its overall resident bacterial populations have remained largely unknown. Improving the health of this system will rely upon enhanced understanding of the diversity and functions of these communities. Bacterial DNA was extracted from archived (AR, year 2000) and fresh sediments (RE, year 2006) collected from various locations within the Anacostia River.

Historical contamination of the Anacostia River, Washington, D.C.

The tidal Anacostia River in Washington DC has long been impacted by various sources of chemical pollution over the past 200 years. To explore more recent inputs of various chemicals, six sediment cores were collected for dating and chemical analysis in the downstream section of the tidal Anacostia River. Profiles of contaminants in sediment cores can be useful in determining management direction and effectiveness of pollution controls over time.

Implementing a unit-level intervention to reduce the probability of ventilator-associated pneumonia.

Background: Ventilator-associated pneumonia (VAP) is the second most common hospital-acquired infection and is associated with high morbidity and mortality rates for mechanically ventilated patients in the intensive care unit. Routine nursing interventions have been shown to reduce VAP rates.

Objectives: The purpose of this study was to evaluate the effectiveness of a unit-specific education intervention that emphasized hand hygiene, head-of-the-bed elevation, and oral care.

Using the Sediment Quality Triad to characterize baseline conditions in the Anacostia River, Washington, DC, USA.

The Sediment Quality Triad (SQT) consists of complementary measures of sediment chemistry, benthic community structure, and sediment toxicity. We applied the SQT at 20 stations in the tidal portion of the Anacostia River from Bladensburg, MD to Washington, DC to establish a baseline of conditions to evaluate the effects of management actions. Sediment toxicity was assessed using 10-day survival and growth tests with the freshwater amphipod, Hyalella azteca and the midge, Chironomus dilutus.

Poverty reduction and Millennium Development Goals: recognizing population, health, and environment linkages in rural Madagascar.

The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty. Madagascar is one such example, although some gains are being made.

Outcomes of adoption: measuring evidence uptake by individuals and organizations.

Background: The translation and diffusion of findings into health care validate the potential of evidence-based innovation to improve clinical practice and affirm the benefits of society's investment in advancing science.

Aims: This article briefly reviews key concepts in the knowledge use process, considers theoretical implications for measuring outcomes and uptake of innovation, discusses issues to consider in planning for measurement of adoption, and provides an example of confronting those challenges from a project now in progress. THEORETICAL PERSPECTIVES AND TRANSLATION OUTCOMES: Four principal conceptual frameworks related to translational science, Lewin, Rogers, Havelock, and Promoting Action on Research Implementation in Health Services (PARIHS), explicate a process that catalyzes new knowledge adoption and use by individuals and systems to solve problems.

Contaminants in fish of the Hackensack Meadowlands, New Jersey: size, sex, and seasonal relationships as related to health risks.

The trace metal content and related safety (health risk) of Hackensack River fish were assessed within the Hackensack Meadowlands of New Jersey, USA. Eight elements were analyzed in the edible portion (i.e.

The effects of small dam removal on the distribution of sedimentary contaminants.

With increasing concern over degradation of aquatic resources, issues of liability, and maintenance costs, removal of small dams has become increasing popular. Although the benefits of removal seem to outweigh the drawbacks, there is a relative paucity of studies documenting the extent and magnitude of biological and chemical changes associated with dam removal, especially those evaluating potential changes in contaminant inventories. In August and November of 2000, a run-of-the-river dam on Manatawny Creek (southeast Pennsylvania) was removed in a two-stage process.

A 34-year-old man with Darier-White disease: a case report and review of the literature.

Darier-White disease is an uncommon genodermatosis that is commonly under-recognized and is characteristically refractory to treatment. It is most frequently due to an autosomal dominant mutation in an intracellular calcium pump. It can be associated with severe cutaneous infections requiring hospitalization as well as neurologic and psychiatric comorbid disease.

A comparison of congeneric PCB patterns in American eels and striped bass from the Hudson and Delaware River estuaries.

The Hudson River estuary has enormous spatial variation in polychlorinated biphenyl (PCB) contamination due in large part to historical point source discharges above Troy Dam. The Delaware River estuary has accumulated significant levels of PCBs through decades of industrial, municipal, and non-point source inputs. The overall goal of this research was to use existing data sets to compare and contrast the patterns of accumulated PCB congeners in sub-populations of American eels and striped bass inhabiting these two estuaries and surrounding coastal waters.