168 research outputs found
Dementia and risk of adverse warfarin-related events in the nursing home setting
No full textBACKGROUND: Little attention has been focused on the safety of medications administered to treat non illnesses in nursing home residents with dementia. It is unclear whether this population is at increased risk of adverse drug events. OBJECTIVES: To test the hypotheses that in nursing home residents with dementia prescribed warfarin have less time in therapeutic range and a higher incidence of nonpreventable and preventable adverse warfarin events compared to nursing home residents without dementia after controlling for facility and patient characteristics. METHODS: A prospective cohort embedded in a clinical trial of nursing home residents prescribed warfarin in 26 nursing homes in Connecticut was observed for up to 12 months. The primary outcome measures included adverse warfarin events (AWEs) (injuries resulting from warfarin use), potential AWEs (INR [international normalized ratio] >4.5 and management error), and AWE preventability based on physician reviews of medical record abstractions. Potential confounders included nursing home structural characteristics (eg, number of beds and for-profit status), nursing staff time, and nursing home regulatory deficiencies (pharmacy, administrative, quality of care, and all other deficiencies). Multivariable Poisson regression analysis was used to determine the independent association of dementia with potential and preventable AWEs using generalized estimating equations to account for clustering within nursing homes. RESULTS: Residents with dementia had no difference in the number of INR monitoring tests or percentage of days in the therapeutic range, but did have an increased risk of AWEs (adjusted incidence rate ratio [IRR], 1.47; 95% confidence interval [CI], 1.20-1.82), and preventable or potential AWEs (adjusted IRR, 1.36; 95% CI, 1.06-1.76) after adjustment for patient characteristics, nursing home quality, and case mix. Greater nursing staff time was protective for preventable and potential AWEs (adjusted IRR, 0.66; 95% CI, 0.48-0.90) but not for nonpreventable AWEs. CONCLUSION: A diagnosis of dementia was associated with increased risk of nonpreventable and preventable or potential AWEs. Greater nursing staff time was associated with lower risk of preventable AWEs. These findings have implications for quality-of-care reporting and patient safety
Single Skin Kite Airfoil Optimization for AWES
No full textAirborne Wind Energy is a technology where wind energy is harvested with tethered flying devices. Kitepower uses flexible leading edge inflatable kites, but these have a scaling disadvantage in that they become heavier with size. A single skin kite has the potential of negating this disadvantage while at the same time being more aerodynamically efficient. An airfoil of this type is therefore investigated using Computational Fluid Dynamics and optimized using Surrogate Modelling techniques. A hybrid mesh was generated with hyperbolic extrusion and triangulation. The RANS solver that was used produced good results.The results of the optimization were unsatisfactory. The parametrization did not provide enough local control and unique airfoil shapes. The surrogate modelling approach is promising due to the computationally expensive CFD analyses.Aerospace Engineerin
Airborne Wind Energy Resource Analysis: From Wind Potential to Power Output
No full textAirborne Wind Energy Systems (AWES) have different power generation characteristics than conventional wind turbines, which can not be accurately captured in the traditional power curve. One important aspect is that it can harvest wind energy in a much wider range of altitudes than conventional wind turbines. Theoretically also High Altitude Winds (HAW) can be harnessed and the systems can be placed at a larger variety of sites.Wind Energ
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