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This article reports an evidence-based practice project using the Iowa Model of Evidence-Based Practice to Promote Quality Care for a common nursing procedure, nasogastric tube placement verification in children. Little research exists regarding the care of nasogastric tubes in children, and traditional verification methods prevail. Auscultation of air insufflation over the abdomen is still used to check placement in many settings, despite research dating back to the 1980s questioning this approach. X-ray remains the only certain way to verify placement, but getting an X-ray before each feeding would be costly and impractical. Additional bedside methods are needed. Project results demonstrate a decrease (93.3% to 46.2%) in the use of auscultation and improved use of other, more reliable methods to determine nasogastric tube placement. Changing practice can be challenging. However, with persistence and re-infusion, this project provides an important example of how the evidence-based ...

1. ABSTRACT The JPL-led CSP Consortium of enterprises representing government agencies and private companies has joined together to pool in-kind resources for developing the quality and reliability of chip scale packages (CSPs) for a variety of projects. Since last year, more than 150 test vehicles, single- and double-sided, have been assembled and are presently being subjected to various environmental tests.

The preparation of three new examples of water insoluble host/guest assemblies of the general composition:[(R4N)(Me3Sn) 2M (CN) 6· zH2O](R= n-propyl or n-pentyl, M= Fe or Co, 0≤ z≤ 2) from likewise polymeric super-Prussian-blue derivatives [(Me3Sn) 3M (CN) ...

The Faint Object Spectrograph (FOS) aboard Hubble Space Telescope (HST) has been used in the UV to observe the prototypical X-ray pulsar Her X-1 and its companion HZ Her. Optical spectra were also obtained contemporaneously at the Kitt Peak National Observatory (KPNO) 2.1 m. The FOS spectra encompass the 1150-3300 A range near binary orbital phases 0.5 (X-ray maximum) and

Macrocyclic complexes of Mn(II) were synthesized by template condensation using 2,6-diaminopyridine and diethylenetriamine with malonic, succinic, glutaric and adipic acids. The reaction proceeded smoothly to completion. These 16- to 24-membered N(6), but behaving as tetradentate, macrocyclic complexes were characterized by elemental analyses, molecular weight determinations, infrared, electronic, mass and X-ray spectral analyses. The elemental analyses are consistent with the formation of complexes [Mn(N(6)L(n))Cl(2)]. All the complexes are stable and monomeric in nature, as indicated by the molecular weight determinations. The spectral studies confirmed the proposed framework of the new macrocyclic complexes and indicated an octahedral geometry around the central metal atom. The complexes were screened in vitro against a number of pathogenic fungi and bacteria to assess their growth-inhibiting potential. The testicular sperm density, sperm morphology, sperm motility, density of ca...

Pharyngeal perforations are uncommon in children and are usually secondary to instrumentation or external penetrating injuries. A delay in management can lead to life-threatening complications such as ret-ropharyngeal abscess, mediastinitis, and airway com-promise. We report ...

Titanium-zirconium based alloys containing a small amount of niobium were investigated in order to evaluate their possible use as biomedical materials. Zirconium, which belongs to the IVa group, is known to have good corrosion resistance and biocompatibility similar to titanium. As the titanium-zirconium system shows a complete solid solution, a wide variation of alloy design is available and large quantities of solid-solution hardening must be possible. Niobium, having a beta-phase stabilizing effect, was chosen as a ternary element in order to control desirably the microstructure. There have been no reports which suggest its harm to a living body. The alloys containing 2% or 3% niobium showed the highest hardness value after aging heat treatment at 773 K. In contrast to this, no alteration of hardness was seen in specimens aged at 1073 K. Through conventional X-ray diffractometry and in situ X-ray analysis using a hot stage, beta-phase precipitation in the A matrix was identified....

The melting behavior of restrained isotactic polypropylene fibers is examined quantitatively in terms of the influence the anisotropic structural state of the polymer has on the observed properties. Two endotherm peaks are observed to occur in some of the samples. The formation and location of the multiple peaks are determined by the orientation of the noncrystalline chains, and is independent of the fabrication path used to achieve that orientation. Above a certain minimum orientation of the noncrystalline chains, multiple endotherm peak formation occurs. The high-temperature endotherm (T2M) extrapolates to an ultimate melting point for fully oriented noncrystalline chains of 220°C, while the lower-temperature endotherm (T1M) extrapolates to an ultimate melting point of 185°C. Noncrystalline chain orientation influences the endotherm temperature through its changing configurational entropy. It is shown quantitatively that the noncrystalline polymer must be considered as plastically deformed, since rubber elasticity theory is not followed as predicted. The melting behavior of isothermally crystallized samples are also reported to further elucidate the nature of the observed endotherms.

The possibility of developing a photochemical setup on the basis of an optically pumped ammonia laser with an intracavity photoreactor is proved. The obtained values of the cavity 'implication' factor γ are comparable with those of intracavity systems based on a CO2 laser. The conditions for achieving the maximum energy in the focusing cavity are determined and the ways to control the shape of its caustic are indicated.

... 5. Tavani M., Barbiellini G., Caraveo P., Di Pippo S., Longo F., Mereghetti S., Morselli A., Pellizzoni A., Picozza P., Severoni S., Tavecchio F., Vercellone S., 1998, AGILE Phase A Report 6. Tavani M., et al., 2000, Proceedings of the 5th Compton Symposium, AIP Conf. ...

The objective of this study was to investigate the outcome of revision total knee arthroplasty (TKA) in relation to the cause of index failure, the characteristics of the index procedure, and the elapsed time between index TKA and revision. A retrospective review based on a prospective database was performed on 146 consecutive revision TKA's. Variables tested were the cause of index failure; the elapsed time between the index and revision procedure; patient age at time of revision; partial or total revision of the implants; the performance of a tibial tubercle osteotomy; the presence of radiolucent lines; postoperative patellar tracking; and coronal plane alignment. Outcomes were measured with the Knee Society Knee Score (KS), Function Score (FS), and X-ray evaluation. Mean KS improved from 27.6 (SD 21.6) to 71.5 (SD 24.2) after revision (P < 0.0001), mean FS from 27.5 (SD 22.7) to 53.3 (SD27.7), P < 0.0001. Overall survival rate was 90% at 5 years and 85% at 10 and 14 years. The cause of index failure had no significant influence on any of the outcome parameters. Significantly, better outcomes were noted for partial revisions and for revisions in older patients. Early revisions (<2 years) were mostly performed for infection and instability, whereas late revisions (>2 years) were mostly performed for polyethylene wear and loosening. The survival rate for late revisions was significantly better than for early revisions (P = 0.002). Revision TKA leads to a significant reduction in symptoms and improvement in function. The worst results can be expected for early revisions in young patients. Revision TKA is a demanding procedure with variable results and should therefore be performed by experienced surgeons. Therapeutic study-Level IV.