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recent study conducted in a rural hematology-oncology clinic focused on infection. A port infection can present as local tenderness, pain, erythema, induration or edema at the insertion or exit site |
or over the port pocket. Patients may also have purulent or serous drainage, fever and chills. To prevent infection, aseptic technique should be utilized for dressing changes. In addition, clinicians |
should follow accessing and deaccessing procedures and keep the exit clear of potential sources of infection. The 62 patients included in the study were receiving a minimum of two complete |
cycles of chemotherapy after port insertion. Ports were accessed and deaccessed following outlined protocol. *Steps for Accessing Ports: - Wash hands. Assess the port site for erythema, warmth or drainage. |
- Palpate the outline of the portal body. - Wash hands. - Apply nonsterile gloves. Cleanse port site with chlorohexidine swab in a circular motion for 30 seconds. Allow to |
dry for 30 seconds. - Spray ethyl chloride. - Stabilize portal body with one hand. Insert Huber needle (link to EZ Huber product page) into septum with other hand. Ensure |
patency by blood return. If no blood return, use interventions to assess port's patency. - Stabilize port with gauze and tape or apply transparent dressing. *Steps for Deaccessing Ports: - |
Wash hands. Apply nonsterile gloves. - Inspect exit site. - Flush device with 20 ml normal saline followed by 5 ml heparin flush (100 units/ml). During final flush, clamp tubing |
to port. - Stabilize port and remove needle. - Apply bandage. Six of the 62 patients in the study experienced a port infection, with four of the six ports requiring |
removal. The total number of catheter days for the implanted ports was 7,277. Patient catheter days ranged from 32-288. The study concluded that consistent, routine care is the best preventative |
measure against port complications. The entire study can be found in the October 2009 issue of the Clinical Journal of Oncology Nursing. *The port access and de-access protocols are those |
that were used by the authors for this study. Please follow institutional policies and procedures regarding port access and de-access. Although many infection headlines are related to hospitals, individual doctor's |
offices are facing similar challenges. Almost 30 cases of hepatitis B were recently tied to one doctor's office in New Jersey. When health inspectors visited the office they found blood |
on the floor of a room where chemotherapy was administered, blood in a bin where blood vials were stored, unsterile saline and gauze as well as open medication vials. Inspectors |
also noticed cross-contamination of pens, refrigerators and countertops, use of contaminated gloves and misuse of antiseptics. Patients were sent a letter from state epidemiologist Dr. Christina Chan urging testing for |
hepatitis B. "Evidence gathered at this time suggests that since 2002, some clinic staff provided care in a manner that puts patients at risk for infection caused by bloodborne viruses, |
including hepatitis B," the letter told patients. "The investigation to date suggests that hepatitis B infections identified may be associated with the method by which medications were administered and procedures |
performed at the practice." Numerous checklists and recommendations have been published around infection control. The American Academy of Pediatrics Committee on Infectious Diseases and Committee on Practice and Ambulatory Medicine |
offers these infection control musts: - Hand washing - Barrier precautions to prevent skin and mucous membrane exposure - Proper handling of sharps and contaminated waste - Appropriate cleaning and |
disinfecting of surfaces and equipment - Aseptic technique for invasive procedures For the full recommendation on infection control in physician's offices, click here. To read more about the hepatitis B |
outbreak in New Jersey, continue reading here. Photo Credit: Hollywood Pimp The Joint Commission Center for Transforming Healthcare is working on its first improvement venture: The Hand Hygiene Project. According |
to the Centers for Disease Control and Prevention, an estimated 2 million patients get a hospital-related infection every year and 90,000 die from their infection. Causes of Failure to Clean |
Hands - Ineffective placement of dispensers or sinks - Hand hygiene compliance data are not collected or reported accurately or frequently - Lack of accountability and just-in-time coaching - Safety |
culture does not stress hand hygiene at all levels - Ineffective or insufficient education - Hands full - Wearing gloves interferes with process - Perception that hand hygiene is not |
needed if wearing gloves - Healthcare workers forget Early results of the program found on average that caregivers washed their hands less than 50 percent of the time. "Demanding that |
healthcare workers try harder is not the answer. These healthcare organizations have the courage to step forward to tackle the problem of hand washing by digging deep to find out |
where the breakdowns take place so we can create targeted solutions that will work now and keep working in the future," said Mark R. Chassin, M.D., M.P.P, M.P.H., president, The |
Joint Commission. By January, 2010, the Joint Commission Center for Transforming Healthcare plans to have data to demonstrate whether the proposed hand hygiene solutions can be sustained to achieve a |
90+ percent compliance rate. Eight hospitals are participating in this project: - Cedars-Sinai Health System, Los Angeles, California - Exempla Lutheran Medical Center, Wheat Ridge, Colorado - Froedtert Hospital, Milwaukee, |
Wisconsin - The Johns Hopkins Hospital and Health System, Baltimore, Maryland - Memorial Hermann Health Care System, Houston, Texas - Trinity Health, Novi, Michigan - Virtua, Marlton, New Jersey - |
Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina To read the full release from the Joint Commission for Transforming Healthcare, click here. Photo Credit: Mag3737 Healthcare providers are on |
alert due to an increase in a new strain of hospital-acquired infections. A recent study released by Arlington Medical Resources (AMR) and Decision Resources, found that recurrent Clostridium difficile is |
difficult to treat in a hospital setting. Clostridium difficile is a bacterium that can cause symptoms as minor as diarrhea and as life threatening as severe inflammation of the colon. |
The elderly are most at risk and the Centers for Medicare and Medicaid services is considering adding Clostridium difficile to its list of "never events" or preventable hospital-acquired infections. Hospitals |
will receive reduced or no Medicare payments for infections on the "never events" list. Read more about how the study was conducted as well as more information on Clostridium difficile |
here. Photo Credit: Big Grey Mare Jeanne Hahne was working as a nurse in a burn ward when inspiration struck. Because the patients were so vulnerable to infection, Hahne and |
other healthcare providers had to wear full protective gear including a cap to cover her hair and a mask that covered the majority of her face. Even though she worked |
with many of the burn patients every day, most couldn't recognize her. Flash forward almost 30 years and Hahne has designed a face mask made of clear plastic so patients |
can see her smile. Hahne believes she can reassure patients with a smile and help decrease their anxiety. The masks also have utility for patients and healthcare providers with hearing |
loss since they allow for lip reading. In addition, the masks have helped improve communication between healthcare workers which can help decrease the chance for mistakes or misunderstanding. To read |
There are many aspects to learning the creation of interactive fiction. Here we mostly undertake to explain approaches to using Inform, and leave the larger questions of craft and design for elsewhere. The two manuals There are two interlinked manuals built into every copy of the Inform application: if you've downloaded Inform, you already have them. But they are also available to read or |
download separately from this website. Writing with Inform is an overview of the language, beginning with the simplest kinds of construction (such as building a map of rooms, objects, and doors) and working its way up to more advanced tasks. It is meant to be read more or less sequentially, since later chapters build on the ideas in earlier ones; though some of the |
late chapters (such as those covering numbers, activities, or advanced text) might reasonably be read out of order. The Recipe Book approaches the problem of authorship from a different perspective. Instead of trying to teach the language from start to finish, it is organized for the author who wants to accomplish something specific, such as asking the player's name at the start of play |
or implementing a system of measured liquids. It shares the same set of examples that are keyed to Writing with Inform, but organizes them into a new order and accompanies them with text about design problems in creating interactive fiction, rather than explanation of language features. Following requests from partially sighted Inform users, we've also made two plain vanilla versions of the manual available |
- they have as little decoration or web design as possible, which means less clutter for screen-reading software to cope with. We offer a choice of: Minimally tagged HTML provides an archive containing the pages of the manuals and examples as vanilla-flavoured HTML files. Writing with Inform in plain text format is just what it claims to be - one single file containing only |
text, with no marking-up of any kind. This contains all of the examples, following the text in numerical order, but not the Recipe Book. (The whole idea of two interleaved manuals can't really be achieved in one flat text file.) We receive occasional questions about publishing a printed form of the manuals. The answer is that we intend to do exactly that, in due |
course, but that we expect the current text will be revised wholesale once the system is more mature. (The same thing happened with Inform 6, with the appearance of the printed Designer's Manual in 2001 essentially marking the end of its design cycle.) |
Flickr as a Paintbrush [cartogrammar.com] reveals the recorded colors of our surrounding landscape, both in a physical and cultural sense. In short, Andy Woodruff created a set of geographic heatmaps |
that represent the average colors of images taken on locations surrounding a specific landmark. In other words, the resulting maps reveal the colors that people on the ground should be |
looking at. Technically, these maps are based on the most recent 2,000 photos uploaded to Flickr that were geotagged within a specified bounding box. These were then averaged by hue. |
As an emergent result, the color red reveals the dominance of brick, while green/yellow colors naturally denote grass and trees. However, some unexpected patterns appear as well, such as blue/purple |
This is an old lecture by linguist and political activist Noam Chomsky (professor at MIT) given at UC Berkeley in 2003. For that evening in the Charles M. and Martha Hitchcock Lecture series, Chomsky examined biolinguistics - the study of relations between physiology and speech. A second video of Chomsky is featured below, which is the second half of this |
talk. Fair warning - this is not easy material - Chomsky is speaking to people who are well-versed in this field. Chomsky has been one the most influential scholars over the last three or four decades - between 1980 and 1992, he was cited as a source more than any other living scholar, and ranked eighth overall. As background for |
this lecture, Wikipedia offers a good summary of his influence in linguistics (below the video). Chomskyan LinguisticsChomskyan linguistics, beginning with his Syntactic Structures, a distillation of his Logical Structure of Linguistic Theory (1955, 75), challenges structural linguistics and introduces transformational grammar. This approach takes utterances (sequences of words) to have a syntax characterized by a formal grammar; in particular, a |
context-free grammar extended with transformational rules. Perhaps his most influential and time-tested contribution to the field, is the claim that modeling knowledge of language using a formal grammar accounts for the "productivity" or "creativity" of language. In other words, a formal grammar of a language can explain the ability of a hearer-speaker to produce and interpret an infinite number of |
utterances, including novel ones, with a limited set of grammatical rules and a finite set of terms. He has always acknowledged his debt to Pāṇini for his modern notion of an explicit generative grammar although it is also related to rationalist ideas of a priori knowledge. It is a popular misconception that Chomsky proved that language is entirely innate and |
discovered a "universal grammar" (UG). In fact, Chomsky simply observed that while a human baby and a kitten are both capable of inductive reasoning, if they are exposed to exactly the same linguistic data, the human child will always acquire the ability to understand and produce language, while the kitten will never acquire either ability. Chomsky labeled whatever the relevant |
capacity the human has which the cat lacks the "language acquisition device" (LAD) and suggested that one of the tasks for linguistics should be to figure out what the LAD is and what constraints it puts on the range of possible human languages. The universal features that would result from these constraints are often termed "universal grammar" or UG. The |
Principles and Parameters approach (P&P)—developed in his Pisa 1979 Lectures, later published as Lectures on Government and Binding (LGB)—makes strong claims regarding universal grammar: that the grammatical principles underlying languages are innate and fixed, and the differences among the world's languages can be characterized in terms of parameter settings in the brain (such as the pro-drop parameter, which indicates whether |
an explicit subject is always required, as in English, or can be optionally dropped, as in Spanish), which are often likened to switches. (Hence the term principles and parameters, often given to this approach.) In this view, a child learning a language need only acquire the necessary lexical items (words, grammatical morphemes, and idioms), and determine the appropriate parameter settings, |
which can be done based on a few key examples. Proponents of this view argue that the pace at which children learn languages is inexplicably rapid, unless children have an innate ability to learn languages. The similar steps followed by children all across the world when learning languages, and the fact that children make certain characteristic errors as they learn |
their first language, whereas other seemingly logical kinds of errors never occur (and, according to Chomsky, should be attested if a purely general, rather than language-specific, learning mechanism were being employed), are also pointed to as motivation for innateness. More recently, in his Minimalist Program (1995), while retaining the core concept of "principles and parameters," Chomsky attempts a major overhaul |
of the linguistic machinery involved in the LGB model, stripping from it all but the barest necessary elements, while advocating a general approach to the architecture of the human language faculty that emphasizes principles of economy and optimal design, reverting to a derivational approach to generation, in contrast with the largely representational approach of classic P&P. Chomsky's ideas have had |
a strong influence on researchers of the language acquisition in children, though many researchers in this area such as Elizabeth Bates and Michael Tomasello argue very strongly against Chomsky's theories, and instead advocate emergentist or connectionist theories, explaining language with a number of general processing mechanisms in the brain that interact with the extensive and complex social environment in which |
language is used and learned. His best-known work in phonology is The Sound Pattern of English (1968), written with Morris Halle (and often known as simply SPE). This work has had a great significance for the development in the field. While phonological theory has since moved beyond "SPE phonology" in many important respects, the SPE system is considered the precursor |
Chinese researchers have turned to the light absorbing properties of butterfly wings to significantly increase the efficiency of solar hydrogen cells, using biomimetics to copy the nanostructure that allows for incredible light and heat absorption. Butterflies are known to use heat from the sun to warm themselves beyond what their bodies can provide, and this new research takes a page |
from their evolution to improve hydrogen fuel generation. Analyzing the wings of Papilio helenus, the researchers found scales that are described as having: [...] Ridges running the length of the scale with very small holes on either side that opened up onto an underlying layer. The steep walls of the ridges help funnel light into the holes. The walls absorb |
longer wavelengths of light while allowing shorter wavelengths to reach a membrane below the scales. Using the images of the scales, the researchers created computer models to confirm this filtering effect. The nano-hole arrays change from wave guides for short wavelengths to barriers and absorbers for longer wavelengths, which act just like a high-pass filtering layer. So, what does this |
have to do with fuel cells? Splitting water into hydrogen and oxygen takes energy, and is a drain on the amount you can get out of a cell. To split the water, the process uses a catalyst, and certain catalysts — say, titanium dioxide — function by exposure to light. The researchers synthesized a titanium dioxide catalyst using the pattern |
from the butterfly's wings, and paired it with platinum nanoparticles to make it more efficient at splitting water. The result? A 230% uptick in the amount of hydrogen produced. The structure of the butterfly's wing means that it's better at absorbing light — so who knows, you might also see the same technique on solar panels, too. |
4 Dice Helps Students Learn to Add, Subtract, Multiply, and Divide Fractions 4 Dice is an iPad app designed to help students learn to add, subtract, multiply, and divide fractions. The app was developed by the same people that built the popular 5 Dice app that helps students learn the order of operations. In 4 Dice students are shown a fraction and they have |
to drag four dice into position to complete the arithmetic that will result in the fraction that they were shown. It’s kind of like the Jeopardy concept applied to fractions mathematics. There are five modes in 4 Dice. There are the addition, subtraction, multiplication, and division modes as well as a challenge mode that randomized the problems. At any point in a series of |
problems students can pause and use the whiteboard to work out possible solutions to a problem. 4 Dice does ask for an email address, but doesn’t ask users to confirm that email address. If your students don’t have email addresses you can use the Gmail+1 trick to create dummy addresses for them that you can monitor. 4 Dice costs $0.99. This app is appropriate |
Early Childhood Education - The American Academy of Pediatrics is dedicated to the health of all children and committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents, and - The Center for Early Childhood Leadership is dedicated to enhancing the management skills, professional orientation and leadership capacity of early - The |
Child & Family WebGuide describes and evaluates web sites that contain research-based information about child development. - An organization of regional Child Care Resource and Referral (CCR&R) agencies serving communities throughout the state of Illinois. - The Children's Book Council is dedicated to encouraging literacy and the use and enjoyment of children's books. - Children's Literature offers information on authors |
and illustrators, recommended books by theme, book award winners, etc. - The Circle of Inclusion web site is for early childhood service providers and families of young children. This web site offers demonstrations of and information about the effective practices of inclusive educational programs for children from birth through age eight. - Civitas is a national not-for-profit communication group that |
works to provide educational tools to all adults who live and work with young children. - The CLAS Early Childhood Research Institute collects and describes early childhood/early intervention resources that have been developed across the United States for children with disabilities and their families and the service providers who work with them. The materials and resources available on this site |
reflect the intersection of culture and language, disabilities and child development. - The Division of Early Childhood (DEC) of the Council for Exceptional Children (CEC) is a nonprofit organization advocating for individuals who work with or on behalf of children with special needs, birth through age eight, and their families. There is also an Illinois Subdivision for the Division of |
Early Childhood (IDEC). - The Early Childhood Educators' and Family Web Corner contains articles, teacher pages, family pages, etc. - EdWorld.Resources covers a variety of areas of Early Childhood. - ERIC provides research-based information and articles in the field of early childhood. - I Am Your Child is a national public awareness and engagement campaign to make early childhood development |
a top priority of our nation. - The Illinois Department of Children and Family Services web site for information on day care licensing, etc. - The Illinois Department of Human Services Early Intervention site contains information for parents and service providers, including Child and Family Connections contacts. . - The Illinois Early Learning Web site provides evidence-based, reliable information for |
parents, caregivers, and teachers of young children in the State of Illinois. - Illinois Head Start Association information. - Lists of recommended children's books for birth to five and Early Childhood Block Grant professional development opportunities are available on the Early Childhood portion of the Illinois Resource Center's web site. - The Illinois Secretary of State's literacy program site includes |
grant applications and literacy resources. - Meld offers education and support for parents, trains family service providers to apply best practices in their work with families and publishes a broad range of resource materials for parents and the people who work with them. - The National Association for the Education of Young Children has for its purpose, “leading and consolidating |
the efforts of individuals and groups working to achieve healthy development and constructive education for all young children.” - The National Clearinghouse on Child Abuse and Neglect is a resource for professionals and others seeking information on abuse and neglect and child welfare. - The National Early Childhood Technical Assistance Center supports the implementation of the early childhood provisions of |
the Individuals with Disabilities Education Act (IDEA). Their mission is to strengthen service systems to ensure that children with disabilities (birth through five) and their families receive and benefit from high quality, culturally appropriate, and family-centered supports and services. - The National Head Start Association is a private not-for-profit membership organization that provides a national forum for the continued enhancement |
of Head Start services for children ages 0 to 5 and their families. - The National Institute for Early Education Research supports early childhood education initiatives by providing objective, nonpartisan information based on research. - Ongoing update about the National Institute of Child Health and Human Development (NICHID) study of Early Child Care and Youth Development. - The Ounce of |
Prevention was established to promote the well-being of children and adolescents by working with families, communities, and policy-makers. - The Parents as Teachers National Center is committed to seeing that “all children will learn, grow, and develop to realize their full potential." The information is geared to parents but helpful to all programs in early childhood. - The Partnership for |
Reading continually creates resources and shares information about how scientifically based research can inform the acquisition of reading skills across the lifespan, from birth to adulthood. Visit the Early - Prevent Child Abuse America provides leadership to promote the prevention of child abuse and neglect at both the national and local levels. Information is also available in Spanish. - Reading |
Rockets, "launching young readers", contains resources, book lists, and tips on early reading. - The Society for Research in Child Development at the University of Michigan is a multidisciplinary, not-for-profit, professional association of approximately 5,000 researchers, practitioners, and human development professionals. - The U.S. Department of Education's Early Reading First site contains information on the status of Early Reading First |
grants. - The U.S. Department of Education main site includes information on No Child - Voices for Illinois Children works with families, communities, and policy-makers to ensure that all children grow up healthy, nurtured, safe, and well educated. - Zero to Three is a leading resource on the first three years of life. Its goal is to strengthen and support |
World’s poorest on front line in climate change fight 24 July 2008 | News story Climate change is already happening – and it hits poor people most. The effect of more frequent hurricanes, floods and droughts on developing countries is |
devastating, as this year’s cyclone Nagris proved again in southern Myanmar, leaving over 130,000 people dead or missing. To protect the world’s poor against today’s more frequent extreme weather events, some US$ 2 billion is required according to the Internacional |
relief agency Oxfam. However, commitments so far only total US$173. The need for innovative means to mitigate climate change impacts and help poor countries adapt is high on the agenda of the World Conservation Congress, held by IUCN, the International |
Union for Conservation of Nature from 5-14 October in Barcelona. - In 2007, there were 950 natural catastrophes in 2007 compared with 850 in 2006, according to Munich Re, one of the world’s largest insurance companies. This is the highest |
number recorded since the company started compiling annual disaster reports in 1974. - The burden of the disasters fall on the poor who are least to blame for climate change. Benin, and Bangladesh, for example, are at particularly high risk |
from rising sea-levels and storm surges, yet their per capita contribution to greenhouse gas output is one eightieth that of the United States, according to the British Institute of Development Studies. - “What worries us the most is the impact |
on the poorest countries which have the least capacity to respond to the challenge,” said Yvo de Boer, secretary of the Convention on Climate Change. - A healthy environment can help people survive. Healthy mangrove forests and coral reefs, for |
example, can serve as barriers and prevent coastal erosion; a solid forest cover prevents flooding in times of heavy rainfall. - “There are positive examples of local level adaptation to the impacts of climate change, such as replanting mangrove forests |
that can serve as buffers against more frequent storms. But to implement these solutions on a larger scale, substantial financial support is required,” says Ninni Ikkala, Climate Change Officer at IUCN. Upcoming media products: 6 August – International Press Release |
sustainable development in 2008. Over ten days they debate the best ways to tackle environmental and development challenges. They share pragmatic solutions to pressing issues. And they commit to collaborative action. |
Link back to index.html The Death and Dying Process Death and Dying As caregivers, one either becomes a better person through compassion, patience, and humor, or they become embittered and angry. Wendy Lustbader is an author who has written a moving book entitled " Counting on Kindness: The Dilemmas of |
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