717 research outputs found
A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic
Full text linkBackground: Survivors of acute kidney injury (AKI) are at risk of adverse outcomes. Post-discharge nephrology care may improve patients’ AKI knowledge and prevent post-AKI complications. Objective: The purpose of this study was to examine patients’ awareness about their AKI diagnosis and self-rated knowledge and severity of AKI before and after their first post-discharge AKI Clinic encounter. Design: We conducted a pre- and post-survey study among AKI survivors who attended a post-discharge AKI Clinic. Setting: AKI Clinic at the University of Kentucky Medical Center (October 2016 to December 2017). Education about AKI was based on transformative learning theory and provided through printed materials and interdisciplinary interactions between patients/caregivers and nurses, pharmacists, and nephrologists. Patients: A total of 104 patients completed the survey and were included in the analysis. Measurements: Three survey questions were administered before and after the first AKI Clinic encounter: Question 1 (yes-no) for awareness, and questions 2 and 3 (Likert scale, 1 = lowest to 5 = highest) for self-rated knowledge and severity of AKI. Methods: Two mixed-model analysis of variance (ANOVA) was used for between-group (AKI severity) and within-group (pre- and post-encounter) comparisons. Logistic regression was used to examine parameters associated with the within-group change in self-perceived knowledge. Results: Twenty-two out of 104 (21%) patients were not aware of their AKI diagnosis before the clinic encounter. Patients’ self-ratings of their AKI knowledge significantly increased after the first AKI Clinic encounter (mean ± SEM: pre-visit = 1.94 ± 0.12 to post-visit = 3.88 ± 0.09, P = .001), even after adjustment for age, gender, Kidney Disease Improving Global Outcomes (KDIGO) severity stage, or poverty level. Patients with AKI stage 3 self-rated their AKI as more severe than patients with AKI stage 1 or 2. Limitations: Our study population may not be representative of the general AKI survivor population. Administered surveys are subject to response-shift bias. Conclusions: Patients’ self-perceived knowledge about AKI significantly increased following the first post-discharge AKI Clinic encounter that included interdisciplinary education. This is the first survey study examining self-perceived AKI knowledge in AKI survivors. Further examination of AKI literacy in survivors of AKI and its effect on post-AKI outcomes is needed. Trial registration: Not applicable
AHOB/AKI module voor de spoorbaan te Madurodam: Taakverslag
No full textIn het kader van de "Modernisering Spoorbaan Madurodam" is een AHOB/AKI module ontwikkeld. Deze vormt de schakel tussen de baan-hardware en de centrale besturingscomputer. Dit verslag geeft een volledige beschrijving van deze overwegbeveiligingsmodule, zowel hardware als software. De documentatie van de hardware-realisatie van de ontwikkelde printkaart is hierbij opgenomen.Applied SciencesElectrotechniekAutomatische Verkeerssysteme
Stress corrosion crack growth rate measurement in high temperature water using small precracked bend specimens
Full text linkThe applicability of elastic-plastic fracture mechanics to stress corrosion crack growth rate measurements was studied. Several test series were performed on small elastic-plastically loaded SEN(B) specimens in high temperature water. One test was performed on a 25 mm C(T) specimen under linear-elastic loading. The tests on the SEN(B) specimens were performed using either rising displacement or a combination of rising and constant displacement loading. The test on the 25 mm C(T) specimen was performed using a combination of constant load and constant displacement.
The studied materials were AISI 304 steel in sensitized, mill-annealed and irradiated conditions, AISI 316 in cold-worked condition, Inconel 82 and 182 weld metals in as-welded and thermally aged conditions and ferritic low activation steel F82H in tempered condition. The crack growth rate tests were performed in simulated pure BWR water and simulated BWR water with 10-100 ppb SO42- at 230-290°C.
It was shown that intergranular stress corrosion cracking susceptibility can be determined using an elastic-plastic fracture mechanics approach. Fracture surface morphology in sensitized AISI 304 and welded AISI 321 steels depends on the applied loading rate in BWR water. The fracture surface morphology changes from transgranular to intergranular, when J-integral increase rate is decreased. However, extremely slow displacement rate is needed for the fracture surface morphology to be fully intergranular. Rising J results in transgranular stress corrosion cracking (or strain-induced corrosion cracking) also in the mill-annealed AISI 304 and 321 steels.
Tests on irradiated AISI 304 steel showed that welding together with exposure to low neutron fluence in the BWR operating conditions results in a higher susceptibility to stress corrosion cracking than welding or irradiation alone.
Ferritic low activation steel F82H (in tempered condition) is not susceptible to stress corrosion cracking under static loading conditions in high temperature water. However, its fracture resistance is clearly lower in water than in inert environment.
Even as low an amount as 10 ppb SO42- in the otherwise pure BWR water results in one order of magnitude higher stress corrosion crack growth rate than the crack growth rate is in the pure water. Higher sulphate concentrations do not increase the crack growth rate further. Inconel 82 weld metal is much more resistant to stress corrosion cracking than Inconel 182 weld metal. No relevant crack growth rates could be measured for Inconel 82 weld metal in this work.
Cold-worked (20%) AISI 316 steel is susceptible to intergranular stress corrosion cracking in BWR water. Sulphate in BWR water increases the crack growth rate also for AISI 316 steel. However, the observed effect was not as pronounced as for Inconel 182 weld metal.
The results indicate that the same crack growth rates can be obtained using small SEN(B) specimens under elastic-plastic loading conditions and large specimens predominantly under linear-elastic loading conditions. The crack growth rates of the studied IGSCC susceptible materials were independent of the stress intensity factor level, KJ or KI, in the studied stress intensity ranges. At very low J-integral increase rates, the crack growth rate is linearly dependent on the loading rate.
Loading rate may be a better parameter to correlate with the crack growth rate than the load, e.g., stress intensity factor. The observed dependence between crack growth rate and dJ/dt implicates that the specimen size has an effect on the crack growth rate in constant load tests. In constant load tests the specimen size, dJ/dt and crack growth rate are interconnected.reviewe
The Role of Risk Prediction Models in Prevention and Management of AKI.
No full textAuthor(s) pre or post print version onlyAcute kidney injury is a major health care problem. Improving recognition of those at risk and highlighting those who have developed AKI at an earlier stage remains a priority for research and clinical practice. Prediction models to risk-stratify patients and electronic alerts for AKI are two approaches that could address previously highlighted shortcomings in management and facilitate timely intervention. We describe and critique available prediction models and the effects of the use of AKI alerts on patient outcomes are reviewed. Finally, the potential for prediction models to enrich population subsets for other diagnostic approaches and potential research, including biomarkers of AKI, are discussed
Incidence and Risk Factors of in-hospital mortality from AKI after non-cardiovascular operation: A nationwide Survey in China
No full textThis study aimed to describe the mortality and risk factors of in-hospital mortality from acute kidney injury (AKI) after non-cardiovascular operation in China based on a nationwide survey about AKI. The study sample was drawn from ISN AKF 0by25 China Consortiums, which is a nationwide, cross-sectional survey from 22 provinces in mainland China. AKI after non-cardiovascular operation was identified according to the 2012 KDIGO AKI creatinine criteria or expanded criteria. In total, 3468 cases were identified as hospital-acquired AKI (HA-AKI). Of these, 1059 cases were defined as AKI after major non-cardiovascular surgery. Post-operative AKI and non-operative AKI were similar in aetiology and in the need for RRT intervention. The all-cause in-hospital mortality was 17.0% (180 of 1059) among patients with AKI after a major surgery. Older age (OR = 1.14, p = 0.046), more severe comorbidities (OR = 9.29, p < 0.001), a history of CVD (OR = 1.85, p = 0.007), more severe peak AKI stage, and being located in the northwest region of China (OR = 2.47, p = 0.012) were all significantly associated with increased in-hospital mortality risk in AKI patients who underwent an operation. AKI after a non-cardiovascular operation has become a huge medical burden in China. The features of operative AKI varied substantially in different regions of China. Increased attention must be paid to the occurrence of potential intrinsic renal AKI when patients are exposed to nephrotoxic factors or comorbidities.National 985 Project of China; National Natural Science Foundation of China [81625004, 81270777]; Beijing Training Program for Talents; ISN Research CommitteeSCI(E)ARTICLE
Targeting Endogenous Repair Pathways after AKI
No full textContains fulltext :
171621.pdf (Publisher’s version ) (Open Access)AKI remains a highly prevalent disease associated with poor short- and long-term outcomes and high costs. Although significant advances in our understanding of repair after AKI have been made over the last 5 years, this knowledge has not yet been translated into new AKI therapies. A consensus conference held by the Acute Dialysis Quality Initiative was convened in April of 2014 and reviewed new evidence on successful kidney repair to identify the most promising pathways that could be translated into new treatments. In this paper, we provide a summary of current knowledge regarding successful kidney repair and offer a framework for conceptualizing the therapeutic targeting that may facilitate this process. We outline gaps in knowledge and suggest a research agenda to more efficiently bring new discoveries regarding repair after AKI to the clinic
Avaumanmittausmenetelmän kehittäminen murtumisvastuskäyrän määrittämiseen ydinreaktorin primääripiirin simuloiduissa vesiolosuhteissa
No full textA Matter of Taste – Consumer Appropriation of the Craft Beer Taste Regime in Finland
No full textThe consumption of craft beer is becoming increasingly popular in Finland. This is evinced by the rapid rise in the number of microbreweries and their market share. Consequently, also the way beer is consumed takes different forms that are culturally dictated.
This study focuses on the construct that orchestrates these practices – taste regime. It is a discursively mediated system that orchestrates the aesthetic practice of taste. The concept of taste regime relies on practice theory that sees practice being the overarching and essential dimension of social life. This is also the theoretical framework of this study.
Consumer identity is another focal concept in the study. While the historic roots of consumer identity lie in the rather one-sided view of consumption as a means of displaying economic aptitude and therefore status, its theorizations have evolved to understand the consumer as a socially and culturally driven being. In this respect, it has become a central stream of cultural research.
This study taps into the research gap that lies in connecting the practice-driven exercise of taste and the consumer’s need of individual sense-making and a more or less coherent identity. Its purpose is understand how hegemonic taste regimes influence the way consumers negotiate different identities. The research problem is divided into three subquestions: 1. How is taste practiced within the taste regime? 2. How are these practices shaped by the consumer’s identity? 3. How does this appropriation affect the configuration of practice?
Due to its explorative nature, the study takes a qualitative approach, often employed in cultural research. The research paradigm is constructivism, evoking a socially constructed view of the world. The study’s epistemological approach is subjectivist, focusing on a interpretative outlook on the production of knowledge. The circuit of practice – a practice-theoretical concept that structures practice as a triad between objects, doings, and meanings – is used as the analytical framework. Data for the study has been gathered in semi-structured interviews, through the ethnographic methods of participant observation and introspection, and in the form of complementing online data.
In line with previous research on the craft beer taste regime in US, the study’s findings present the craft beer taste regime as a consumption context that problematizes mass-production, ritualizes particular sequences of tasting, and instrumentalizes objects and doings to achieve a sense of exploration, pleasure, and quality. Consumers are found to appropriate the taste regime based on their subjective sense-making by embracing particular meanings and reconfiguring the objects and doings accordingly
Isuzu-huollon markkinointi : Pirkanmaan Autotaito Oy
Full text linkTässä opinnäytetyössä luotiin markkinointisuunnitelma Pirkanmaan Autotaito Oy:lle Isuzu-merkkihuollon osalta. Isuzujen huolto aloitettiin yrityksessä kevään 2014 aikana. Työ oli siis erittäin ajankohtainen. Työssä keskityttiin vertaamaan erilaisia mainonta- ja markkinointiratkaisuja. Työn alussa keskityttiin selvittämään markkinointia, segmentointia ja mainontaa. Työn keskivaiheilla pohditaan eri mainontaratkaisuja, joita Pirkanmaan Autotaito voisi käyttää. Työn lopussa esitetään markkinointiratkaisu.
Isuzun asiakaskunta Pirkanmaalla on todella pieni. Mainontaratkaisuja pohdittiin ja lopulta päädyttiin suoramarkkinointikirjeen luomiseen. Se osoittautui kaikista parhaim-maksi vaihtoehdoksi, koska sillä tavoittaa asiakkaat helpoiten ja edullisimmin. Suoramarkkinointikirjeen teko onnistui hyvin ja Pirkanmaan Autotaidon johto oli samaa mieltä. Suoramarkkinointikirjeessä keskityttiin tiedottamaan asiakkaita uudesta merkkihuollosta, joka on samalla Tampereen ainoa.
Opinnäytetyö eli markkinoinnin käsittely ja markkinointisuunnitelman luominen oli haastavaa, mutta erittäin opettavaista. Työssä huomattiin, että varsinkin pienemmässä korjaamossa on hyvä osata myös markkinointiin liittyviä asioita. Markkinoinnin onnistumista voi tulevaisuudessa seurata suoraan Isuzu asiakkaiden kävijämäärissä.The objective of the thesis is creating a marketing plan for Isuzu car service of Pirkanmaan Autotaito Oy. Isuzu service was started in the company during spring of 2014. Therefore the objective of the thesis was very topical. The thesis concentrates in comparing different marketing and advertising solutions. Marketing, segmenting and advertising are presented in the first part of the thesis. Potential advertising solutions for Pirkanmaan Autotaito are being compared in the middle part of the thesis. Marketing method is presented in the final part of the thesis.
Direct marketing letter was chosen as the best advertising solution for Pirkanmaan Autotaito. The biggest reason for choosing direct marketing letter as an advertising solution is the fact that the clientele for Isuzu car service is very small in the Pirkanmaa region. The chosen advertising solution proved to be the best one because it reaches the clientele most effectively and with the lowest costs. The management of Pirkanmaan Autotaito thought the creating process of the direct marketing letter went well. The main point in the letter was informing the potential clientele about the new Isuzu car service, which is the only one in Tampere.
The whole process of the thesis, reading about marketing and creating an advertising plan, was challenging but educational at the same time. One of the lessons learned in the process was that it’s important to know about car service marketing, especially in small garages. In the future the success of marketing can be seen directly in the number of Isuzu clients
Adding a new dimension to the weekend effect: an analysis of a national data set of electronic AKI alerts
Full text link© The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. Background: Increased mortality related to differences in delivery of weekend clinical care is the subject of much debate. Aim: We compared mortality following detection of acute kidney injury (AKI) on week and weekend days across community and hospital settings. Design: A prospective national cohort study, with AKI identified using the Welsh National electronic AKI reporting system. Methods: Data were collected on outcome for all cases of adult AKI in Wales between 1 November 2013 and 31 January 2017. Results: There were a total of 107 298 episodes. Weekday detection of AKI was associated with 28.8% (26 439); 90-day mortality compared to 90-day mortality of 31.9% (4551) for AKI detected on weekdays (RR: 1.11, 95% CI: 1.08-1.14, P<0.001, HR: 1.16 95% CI: 1.12-1.20, P<0.001). There was no 'weekend effect' for mortality associated with hospital-acquired AKI. Weekday detection of community-acquired AKI (CA-AKI) was associated with a 22.6% (10 356) mortality compared with weekend detection of CA-AKI, which was associated with a 28.6% (1619) mortality (RR: 1.26, 95% CI: 1.21-1.32, P<0.001, HR: 1.34, 95%CI: 1.28-1.42, P<0.001). The excess mortality in weekend CA-AKI was driven by CA-AKI detected at the weekend that was not admitted to hospital compared with CA-AKI detected on weekdays which was admitted to hospital (34.5% vs. 19.1%, RR: 1.8, 95% CI: 1.69-1.91, P<0.001, HR: 2.03, 95% CI: 1.88-2.19, P<0.001). Conclusion: 'Weekend effect' in AKI relates to access to in-patient care for patients presenting predominantly to hospital emergency departments with AKI at the weekend.link_to_OA_fulltex
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