Structural and Electrical Characterization of Highly Tetrahedral-Coordinated Diamond-Like Carbon Films Grown by Pulsed-Laser Deposition

Highly tetrahedral-coordinated-amorphous-carbon (a-tC) films deposited by pulsed-laser deposition (PLD) on silicon substrates are studied. These films are grown at room-temperatures in a high-vacuum ambient. a-tC films grown in this manner have demonstrated stability to temperatures in excess of T = 1000°C, more than sufficient for any post-processing treatment or application. Film surfaces are optically smooth as determined both visually and by atomic-force microscopy. PLD growth parameters can be controlled to produce films with a range of sp2 - sp3 carbon-carbon bond ratios. Films with the highest yield of sp3 C-C bonds have high resistivity, with a dielectric permittivity constant s σ 4, measured capacitively at low frequencies (1 – 100 kHz). These a-tC films are p-type semiconductors as grown. Schottky barrier diode structures have been fabricated.

What to do before disaster strikes

The key to averting disaster or minimizing its effects is a solid data security plan. Learn the types of data risks that exist, how to develop a plan to counteract them, and your role in ensuring the safety of health and patient data.

Nurses--yes, nurses--improve physician order entry

Automated physician order entry systems can reduce medication errors and improve patient outcomes. But there are a variety of barriers--psychological, behavioral and technological--to physician adoption. Nursing not only has a stake in this issue, but plays a valuable role in resolving it.

In our hands? The future of health care technology

Use improvements in data accuracy and nursing productivity to enhance your quality of care.

There is no "I" in team, but there is one in meeting

Increasingly, emotional intelligence (EI) and one's emotional quotient, or EQ, have become critical workforce success factors. This article examines the often overlooked issue of EI and EQ in group situations. It will delineate the three types of groups that show the most variance in emotional dynamics, and explore the application of EI and EQ to these group settings.

"Techno-marvels" just around the corner

In the next 18 months, cutting-edge information technology will likely become commonplace in hospitals.

Government cracks down on billing fraud

As the largest professional caregiving group, nurses have a stake in preventing misuse of the reimbursement system. Technology also plays a crucial role, as automated billing systems can both prevent and enable billing fraud.

Using lower eyelid fascial slings for recalcitrant burn ectropion

Burns of the lower eyelid represent a difficult management problem. Even with skin grafting, scarring and contraction can result in ectropion. This condition creates a marked aesthetic deformity, poses a risk of corneal exposure, and jeopardizes the patient's vision. Historically, full-thickness skin grafts and tarsorrhaphies have been described to manage recurrent ectropion. The lower eyelid fascial sling (LEFS) uses a temporalis fascial strip to create a suspension sling for the lower eyelid. In a series of 7 patients, the LEFS procedure resolved the symptoms permanently in all patients. Because the LEFS procedure counteracts the natural scar contraction forces of lower eyelid burns, it can resolve recalcitrant ectropion successfully while preserving the function and aesthetics of the lower eyelid.

How can we keep private data private?

While technology increases the accessibility of patient data, it also compromises its confidentiality. Here, review the federal government's solutions.

Size up the big three

Before we can tackle the complexities of solid nursing IT, we need a set of standards on which to base our efforts. Learn how three groups--HIPAA, JCAHO, and the Workgroup--are building nursing a firm foundation.

Mapping an IT career: the future of nursing

In today's health care environment, nurses are finding themselves working in nontraditional roles and settings. Some fear technology will all but replace them. In some cases--given the speed at which technology has and continues to advance--that fear is well placed. For nursing to remain viable as a profession, it must incorporate information technology (IT) not only into today's practices, but also into tomorrow's unfolding roles, from advancing practice with new technology-based delivery models to moving away from direct patient care to become informaticians. Nursing administrators and managers must also embrace technology, for their ability to direct IT policy will directly influence their chances for career advancement. But what is required to map an IT career? How is the value of experience balanced against the need for education? Will nursing's core competencies remain constant over time?

Compassion meets the computer age

Computers get smarter and smarter, but they'll never replace human caring. View the nature of compassion and its unique role in nursing, as well as our challenge to measure the abstract quality. The surprising revelation: Computers are our best bet.

Stop the rise in nursing errors—systematically

The number of reported nursing errors in hospitals has increased in each of the past 5 years. Information technology can help nurses make better care decisions in today's harried hospital environment.

Burn injury in kitchen workers: a cause for prevention

Preventable thermal injuries in professional kitchen workers have been identified, and we have introduced a protective garment. Because of the nature of their occupation, kitchen workers are prone to thermal injuries. It has been our experience that the majority of these injuries are scald injuries on the ankles and dorsum of the feet. We propose that a protective garment, such as a waterproof shoe and garter, could reduce the incidence of these injuries.

The role of IT in caring for the chronically ill

This article provides a brief overview of the problem of chronic disease, presents some of the emerging models of care delivery for the chronically ill, and discusses information technology's (IT) role in supporting those models and assisting in the search for cures.

XML: Health careʼs killer application?

XML promises to be the next big thing in health care information.

Medical Errors, Airplanes, and Information Technology

The IOM says tens of thousands die each year from medical errors. Learn lessons from the aviation industry and how we can build a culture of safety with information technology and clinical information systems.

Toward a new millennium: outlook and obligations for 21st century health care technology

This article will discuss key trends--from globalization to the culture of change and the rise of the information age--fueling development and deployment of 21st century IT. It will describe some of the new technologies, their applications, and implications for nursing.

Minding the store: how IT impacts outcomes measurement

Today, the question is not whether organizations should measure outcomes, but how. Right now, there are several initiatives, but no single, collaborative effort to tie them all together. This article will discuss the rise and early history of outcomes assessment in health care and highlight some key current initiatives (for example, OASIS [home health], QISMC [managed care organizations], HCQIP [inpatient care], ACQIP [ambulatory care], Joint Commission's ORYX accreditation initiative [hospitals, long-term care, home care, behavioral health care, and networks]). It will also delineate some of the problems with measuring outcomes and discuss where more work is needed. It will go on to discuss the role of IT in outcomes measurement, including its contributions, goals, effects, categories of IT support, infrastructure solutions, and analysis.

Nursing information systems: who needs them?

This article examines some of the reasons why--both financial and perceptual--organizations are becoming skeptical of nursing information systems. Then it delineates some key benefits and explains how nursing can and should be prepared to head off such skepticism.

Developing IT relief for chronic illness

Read about emerging models of care delivery for the chronically ill and how information technology supports them and the search for cures.

Need to know: essential survival skills for the information age

Twenty-five years ago, health care information technology was dramatically different from what it is today. Twenty-five years from now, it promises to be worlds away from what it is today. How good a job has nursing done at keeping up with this exponential change? This article addresses the evolution of technology in health care and nursing's track record of technology expertise. It also discusses the price nursing will pay if it does not keep up with technology and the benefits it can gain if it does.

R&D in the mergers and acquisitions age

Learn about an emerging shift in the way research and development (R&D) is funded and the implications of that shift for health care information technology, product innovation, and delivery.

Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia

BACKGROUND

Losartan, an angiotensin II receptor antagonist, has been shown to decrease serum uric acid and to increase urinary excretion of uric acid.

METHODS

To determine if this effect can increase the risk of acute urate nephropathy, 63 hypertensive patients with thiazide-induced asymptomatic hyperuricemia (serum uric acid 7.0 to 12.0 mg/dl) were randomized double-blind to losartan 50 mg every day (q.d.), losartan 50 mg plus hydrochlorothiazide (HCTZ) 50 mg q.d., HCTZ 50 mg q.d., or placebo for three weeks. To potentiate the risk of crystal formation, patients received a 2 g/kg protein diet one day prior to each clinic visit on days 0 (baseline), 1, 7, and 21.

RESULTS

Adverse events typically associated with acute urate nephropathy, for example, flank pain, hematuria, or increased blood urea nitrogen/creatinine, were not reported. Uric acid excretion and urine pH increased four and six hours after losartan on day 1 compared with day 0. Dihydrogen urate, the primary risk factor for crystal formation, decreased at four and six hours on day 1 compared with day 0 associated with the concurrent rise in urine pH. Day 7 and 21 changes, compared with day 0, in uric acid excretion rate, urine pH, and dihydrogen urate with losartan were comparable to day 1 results but were not statistically significant. Serum uric acid was significantly reduced after 21 days of therapy with losartan.

CONCLUSION

Losartan decreased serum uric acid and increased uric acid excretion without increasing urinary dihydrogen urate, the primary risk factor for acute urate nephropathy, during 21 days of dosing in hypertensive patients with thiazide-induced hyperuricemia.

What does IT have in store for nursing?

Globalization, our culture of change, and the information age shape 21st-century information technology. Find out the applications and implications for nursing.

Nursing's role in Y2K planning

Why have more nurses not fulfilled their role in planning for the year 2000? Nurses need to apply their skills and expertise to solving often overlooked problems such as point-of-service applications, transactions with business partners, and contingency planning.

IT takes lead role in outcomes measurement

To succeed in outcomes measurement, leaders need to understand key current initiatives, barriers, and the role of information technology.

High touch vs. high tech: rediscover the human element

Communication technology makes efficiencies possible, but it can cause major personal and organizational problems when it replaces human contact.

Nursing's role in Y2K planning

Why haven't more nurses fulfilled their role in Y2K planning? Nurses need to apply their skills and expertise to solving often overlooked problems such as point-of-service applications, transactions with business partners, and contingency planning.

Let's talk telemetry

As telemetry becomes more prevalent, the lines between medical device and clinical information system begins to blur. The author explains why telemetry is growing and merging with traditional information systems and the issues this creates.

Changing world, changing systems: why managed health care demands information technology

In an industry in which the only constant is change, information technology is increasingly becoming the means by which health care organizations manage the constant volatility they face. This article discusses the emerging managed care trends that are driving the move to open systems and increased technological flexibility. In addition, it explains how changing models of care are fueling the evolution of a new breed of clinical information systems that are interdisciplinary, interoperable, and outcomes focused.

Tech talk on multistate licensure

Professional nursing associations, unions, state regulatory boards, and even Congress are hotly debating the topic of multistate licensure. This article discusses several hurdles to implementing a multistate licensure model and explains how technology can help to overcome them.