Implementing Interconception Care in a Dyadic Adolescent Mother-Child Clinic.

Introduction: The birth of a second child to an adolescent woman worsens the adverse medical, socioeconomic, educational, and parenting outcomes for the woman and her children. Despite the known high efficacy of long-acting reversible contraception (LARC), many postpartum adolescents use less effective or no contraception. Interconception care (ICC) focuses on modifying maternal risks between pregnancies and promoting healthy birth spacing to improve outcomes for women and children.

Application of motional Stark effect in situ background correction to a superconducting tokamak.

A polychrometer-type motional Stark effect (MSE) diagnostic technique, originally developed for the Alcator C-Mod tokamak, has been extended and applied to the Korea Superconducting Advanced Tokamak Research (KSTAR) device, the long-pulse superconducting tokamak, for the first time. It demonstrates a successful in situ subtraction of the polarized reflections off the vacuum vessel wall, sometimes up to half the total signal in some sightlines. To avoid the secondary neutral beam emission that may contaminate conventional beam-into-gas calibrations, a new approach, where the beam-into-gas measurements are made at various torus pressures with fixed vacuum fields, has been devised, which is possible with the stable superconducting coil systems of KSTAR.

Influence of electronic triage decision-support on hospital admission, left without being seen and time to physician initial assessment in the emergency department.

Objective: To explore the impact of the implementation of eCTAS, a real-time electronic decision-support tool, on hospital admission, rate of left without being seen, and time from triage to physician initial assessment.

Methods: We conducted a cohort study using population-based administrative data from all Ontario emergency departments (EDs) that had implemented eCTAS for 9 months. We compared 6 months post-eCTAS data to the same 6 months the previous year (pre-eCTAS).

Consistency of triage scores by presenting complaint pre- and post-implementation of a real-time electronic triage decision support tool.

Objective: eCTAS is a real-time electronic decision-support tool designed to standardize the application of the Canadian Triage and Acuity Scale (CTAS). This study addresses the variability of CTAS score distributions across institutions pre- and post-eCTAS implementation.

Methods: We used population-based administrative data from 2016-2018 from all emergency departments (EDs) that had implemented eCTAS for 9 months.

Interrater Reliability, Accuracy, and Triage Time Pre- and Post-implementation of a Real-Time Electronic Triage Decision-Support Tool.

Study Objective: The electronic Canadian Triage and Acuity Scale (eCTAS) is a real-time electronic triage decision-support tool designed to improve patient safety and quality of care by standardizing the application of the Canadian Triage and Acuity Scale (CTAS). The objective of this study is to determine interrater agreement of triage scores pre- and post-implementation of eCTAS.

Methods: This was a prospective, observational study conducted in 7 emergency departments (EDs), selected to represent a mix of triage documentation practices, hospital types, and patient volumes.

Unique Features of the US Department of Defense Multidisciplinary Concussion Clinics.

The US Department of Defense (DoD) and the Department of Veterans Affairs (VA) actively address care needs for a subset of service members (SMs) who experience prolonged symptoms and adverse sequelae interfering with their usual level of function after sustaining mild traumatic brain injury. The development of multidisciplinary concussion clinics and implementation of several reinforcing policies within the DoD and the VA address this unique patient population. A network known as the National Intrepid Center of Excellence and Intrepid Spirit Centers and the VA, primarily support these patients through intensive outpatient programs.

Development of the Diabetes Technology Society Blood Glucose Monitor System Surveillance Protocol.

Background: Inaccurate blood glucsoe monitoring systems (BGMSs) can lead to adverse health effects. The Diabetes Technology Society (DTS) Surveillance Program for cleared BGMSs is intended to protect people with diabetes from inaccurate, unreliable BGMS products that are currently on the market in the United States. The Surveillance Program will provide an independent assessment of the analytical performance of cleared BGMSs.

Lesson of the month. (1). What lies beneath the surface? Diagnosis. Churg-Strauss syndrome.

This reports describes the development of a rash in a 43-year-old man with asthma, who was admitted to the respiratory clinic with dyspnoea, leucocytosis and a productive cough. His symptoms progressed and he was admitted to the high-dependency unit for respiratory support. The incisional biopsy taken from his rash was paramount in the diagnosis of systemic vasculitis.

A robust microfluidic in vitro cell perifusion system.

We present here a robust microfluidic cell perifusion device for in vitro primary tissue cell secretion studies. This system increases the sample concentration to perifusion volume ratio by an order of magnitude compared with standard multi-well plate static incubation assays. Further, this device achieves physiologically relevant flow rates, pressures, and temperature.

Intrashot motional Stark effect calibration technique for lower hybrid current drive experiments.

The spurious drift in pitch angle of order several degrees measured by the motional Stark effect (MSE) diagnostic in the Alcator C-Mod tokamak over the course of an experimental run day has precluded direct utilization of independent absolute calibrations. Recently, the underlying cause of the drift has been identified as thermal stress-induced birefringence in a set of in-vessel lenses. The shot-to-shot drift can be avoided by using MSE to measure only the change in pitch angle between a reference phase and a phase of physical interest within a single plasma discharge.

International partnerships to foster growth in emergency medicine in Romania.

Emergency medicine (EM) is a growing specialty internationally, but has yet to be cultivated in countries with otherwise advanced health care systems. To promote the growth of EM, emergency physicians from countries where EM is a mature specialty can assist with knowledge transfer and development of emergency medical systems to make a lasting impact on the community served. We present our experience in assisting the development of emergency medicine in a university-affiliated regional hospital in Romania.

The influence of reaction temperature on the oscillatory behaviour in the palladium-catalysed phenylacetylene oxidative carbonylation reaction.

This paper reports the influence of reaction temperature on the occurrence and characteristics of pH oscillations that are observed during the palladium-catalysed phenylacetylene oxidative carbonylation reaction in a catalytic system (PdI2, KI, air, NaOAc) in methanol. Isothermal experiments were performed over the temperature range 10-50 degrees C. The experiments demonstrate that oscillations occur in the range 10-40 degrees C and that a decrease in reaction temperature results in an increase in the period and amplitude of the pH oscillations.

Rehabilitation needs of combat-injured service members admitted to the VA Polytrauma Rehabilitation Centers: the role of PM&R in the care of wounded warriors.

Objective: To describe the rehabilitation course of combat-injured service members who sustained polytraumatic injuries during the current wars in and around Iraq and Afghanistan.

Design: Retrospective descriptive analysis.

Setting: Department of Veterans Administration Polytrauma Rehabilitation Centers (PRCs).

Design of a new optical system for Alcator C-Mod motional Stark effect diagnostic.

The motional Stark effect (MSE) diagnostic on Alcator C-Mod uses an in-vessel optical system (five lenses and three mirrors) to relay polarized light to an external polarimeter because port access limitations on Alcator C-Mod preclude a direct view of the diagnostic beam. The system experiences unacceptable, spurious drifts of order several degrees in measured pitch angle over the course of a run day. Recent experiments illuminated the MSE diagnostic with polarized light of fixed orientation as heat was applied to various optical elements.