Biomedical subjects
Publications and source records attributed to P Nardone.
W. Edwards Deming's seven-step quality improvement process provided a sequential pathway to facilitate problem-solving allowing the pharmacy and nursing departments to formulate a systems perspective rather than an individual point of view. Both departments identified problems with the Medication Administration Record and defined three key outcomes needed to signify process improvement.
Increasing use of home care services in the past decade has led to concern about the nature and number of services provided to clients. Because third party payers have used case mix measures to develop reimbursement systems for acute and long-term care facilities, it seems likely that similar measures will be developed for home care. Three types of home care agencies were studied to test the usefulness of routinely gathered clinical and financial data for predicting resources provided. The findings suggest that current data sources may be inadequate for predicting the actual delivery of services.
The dependency at discharge instrument, developed to evaluate the needs for care of hospitalized patients on the day of discharge, was tested for its usefulness in measuring resource consumption in home health care. The instrument evaluates dependency in relation to bathing/hygiene, activity, technical procedures, and monitoring signs and symptoms. The sample used in this study consisted of 150 subjects admitted to one of three types of home health care agencies. Interrater reliability and internal consistency of the instrument were high. Factor analysis produced results similar to those of the developers for three of the four scale items. The item concerning need for assistance with procedures had a much lower loading, indicating that it had little in common with the other items. Criterion-based validity was measured by testing the instrument's ability to predict the number of registered nurse and home health aide visits, and length of enrollment. Findings indicated that the instrument had a modest level of criterion-based validity in predicting the use of registered nurse and home health aide services for the hospital-affiliated agency, but was relatively ineffective for public health and for-profit agencies.
Peroxidases have been detected in the membrane of the ejaculated normal spermatozoon; their distribution on the different zones of the gamete has been determined. This distribution is similar to that of the N-linked glycoprotein-containing oligosaccharides. Their resemblance and similarity to the plant peroxidases, which are glycoproteins with N-type oligosaccharides, suggest that the sperm peroxidases might be, at least partially, identical to concanavalin A (Con A) and wheat germ lectin glycoprotein-containing receptors.
A type of cosmological history that includes large-scale entropy production is proposed. These cosmologies are based on reinterpretation of the matter-energy stress tensor in Einstein's equations. This modifies the usual adiabatic energy conservation laws, thereby including irreversible matter creation. This creation corresponds to an irreversible energy flow from the gravitational field to the created matter constituents. This point of view results from consideration of the thermodynamics of open systems in the framework of cosmology. It is shown that the second law of thermodynamics requires that space-time transforms into matter, while the inverse transformation is forbidden. It appears that the usual initial singularity associated with the big bang is structurally unstable with respect to irreversible matter creation. The corresponding cosmological history therefore starts from an instability of the vacuum rather than from a singularity. This is exemplified in the framework of a simple phenomenological model that leads to a three-stage cosmology: the first drives the cosmological system from the initial instability to a de Sitter regime, and the last connects with the usual matter-radiation Robertson-Walker universe. Matter as well as entropy creation occurs during the first two stages, while the third involves the traditional cosmological evolution. A remarkable fact is that the de Sitter stage appears to be an attractor independent of the initial fluctuation. This is also the case for all the physical predictions involving the present Robertson-Walker universe. Most results obtained previously, in the framework of quantum field theory, can now be obtained on a macroscopic basis. It is shown that this description leads quite naturally to the introduction of primeval black holes as the intermediate stage between the Minkowski vacuum and the present matter-radiation universe. The instability at the origin of the universe is the result of fluctuations of the vacuum in which black holes act as membranes that stabilize these fluctuations. In short, black holes will be produced by and "inverse" Hawking radiation process and, once formed, will decompose into "real" matter through the usual Hawking radiation. In this way, the irreversible transformation of space-time into matter can be described as a phase separation between matter and gravitation in which black holes play the role of "critical nuclei."
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Similar locations of the Con A and wheat germ lectin receptors were obtained by using fluorescent lectins, in nonfixed spermatozoa and in spermatozoa fixed with formaldehyde and methanol, showing that in samples with the same previous treatment, worked out by the same operator, in which enough determinations have been performed to eliminate individual variations, the different procedures of fixation produced similar results. The locatizations obtained with fluorescent lectins confirm previous results, produced with the peroxidase technique, indicating that the lectins interact with oligomannosidic oligosaccharide receptors situated mainly in the equatorial segment of the acrosome and postnuclear cap. They also indicate the presence of similar receptors that were not detected previously on the neck and intermediate segment. The larger size of the lectin-peroxidase-diaminebenzidine reagent compared to that of the fluorescent lectins suggests that the new receptors are semicriptic and were not detected by steric effects in the first case, but were able to interact with lower volume, fluorescent probes. It is suggested that these oligomannosidic chains could be recognition signals for the elimination of incompetent sperm during their passage through the female reproductive track. Also these oligosaccharides and its possible metabolic variations could be involved in the interaction between the acrosome-reacted spermatozoa with the zone pellucida.
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