The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs). Data were collected from fall 2016 to spring 2017 from 11 NHs in 9 cities in Iowa. Binary logistic regression with generalized estimated equations was used to measure the association between ADE incidence and resident and facility characteristics. We extracted data from 755 medical charts and conducted 33 staff surveys. There were 6.13 ADEs per 100 residents per month. More than half were fall‐related (51.1%), and half of those were due to hypotension. Regression analysis revealed significant associations between ADEs and opioid analgesics, psychotropic medications, warfarin, skilled care, consultant pharmacist accessibility, nurse‐physician collaboration, CNA vital sign assessment skills, number of physician visits, nurse workload, and use of electronic health records. Five resident characteristics (skilled care, dementia, use of opioids, warfarin, psychotropics) and variables from 5 domains of the facility work system (organization, task, environment, person, technology) had significant associations with ADE incidence. The SEIPS model successfully identified work system factors influencing ADEs in NHs.
The removal of heavy metal ions from wastewater by sorptive flotation using Amberlite IR120 as a resin, and flotation column, was investigated. A combined two-stage process is proposed as an alternative of the heavy metals removal from aqueous solutions. The first stage is the sorption of heavy metals onto Amberlite IR120 followed by dispersed-air flotation. The sorption of metal ions on the resin, depending on contact time, pH, resin dosage, and initial metal concentration was studied in batch method .Various parameters such as pH, air flow rate, and surfactant concentration were investigated in the flotation stage. Sodium lauryl sulfate (SLS) and Hexadecyltrimethyl ammonium bromide (HTAB) were used as anionic and cationic surfactant re
... Show MoreThe response of the combustor’s liner to the air-flow that passes through it is the key reason for the combustion chambers noise, hence the instabilities of those chambers that decreases the mechanical efficiency of such sections, by increased its mechanical vibrations, which increases the failure rate created during originating of the cracks spreading by the shakes producing by the series of high-level frequencies. Accordingly, any work debating the impact of the context of liners in the combustion chamber can provide grasping for the combustion noise generated by the undesirable vibrations, and benefits the industrial firms to design an ideal production procedure which increases the lifespan of the combustor. The goal of this wo
... Show MoreIn this study, successive electrocoagulation (EC) and electro-oxidation (EO) processes were used to minimize some of the major pollutants in real wastewater, such as organics (detected by chemical oxygen demand (COD)), and turbidity. The wastewater utilized in the present study was collected from the Midland Refinery Company in Baghdad-Iraq. The performance of the successive batch EC-EO processes was studied by utilizing Graphite and Aluminum (Al) as monopolar anode electrodes and stainless steel (st.st.) as the cathode. The Taguchi experimental design approach was used to attain the best experimental conditions for COD reduction as a major response. Starting from chemical oxygen demand COD of (600 ppm), the effects of current densi
... Show MoreThe increasing drinking water demand in many countries leads to an increase in the use of desalination plants, which are considered a great solution for water treatment processes. Reverse osmosis (RO) and electro-dialysis (ED) systems are the most popular membrane processes used to desalinate water at high salinity. Both systems work by separating the ionic contaminates and disposing of them as a brine solution, but ED uses electrical current as a driving force while RO uses osmotic pressure. A direct comparison of reverse osmosis and electro-dialysis systems is needed to highlight process development similarities and variances. This work aims to provide an overview of previous studies on reverse osmosis and electro-dial
... Show MoreThis article proposes a new strategy based on a hybrid method that combines the gravitational search algorithm (GSA) with the bat algorithm (BAT) to solve a single-objective optimization problem. It first runs GSA, followed by BAT as the second step. The proposed approach relies on a parameter between 0 and 1 to address the problem of falling into local research because the lack of a local search mechanism increases intensity search, whereas diversity remains high and easily falls into the local optimum. The improvement is equivalent to the speed of the original BAT. Access speed is increased for the best solution. All solutions in the population are updated before the end of the operation of the proposed algorithm. The diversification f
... Show MoreThe purpose of this interview study was to explore teachers’ perceptions of Response to Intervention (RtI) implementation in their school. Particularly, the study explored teachers’ knowledge of RtI, teachers’ perceptions of RtI their intervention/instruction in school, and teachers’ suggestions of RtI implementation in their school. The study design was a qualitative interview in nature and data were collected from face-to-face interviews with four teachers in one school. The findings revealed that RtI means to identify students’ problems; the positive teachers’ perceptions of their implementation included: (a) students who demonstrate progress through RtI are those who receive private education services, (b) progress monito
... Show MoreThe issue of the development of Qur'anic studies for the tasks, and the first thought of minds and multiple understandings, and the most precious ideas, and the alternatives were floated, and varied visions, especially as we live in an era exploding knowledge, and complicate secretions, and scramble his ideas, and to devise intellectual approaches To achieve the witnesses of civilization in the words of the Almighty (to be martyrs on the people) Surat Al - Baqarah / 143 attendance and participation in the achievement and a positive interaction with the participants of humanity and civilization in the light of the meaning (to know) rooms / 13.
Therefore, we must emerge from the one-dimensional view of the Koran to the complex mindset t
Let R be a commutative ring with non-zero identity element. For two fixed positive integers m and n. A right R-module M is called fully (m,n) -stable relative to ideal A of , if for each n-generated submodule of Mm and R-homomorphism . In this paper we give some characterization theorems and properties of fully (m,n) -stable modules relative to an ideal A of . which generalize the results of fully stable modules relative to an ideal A of R.