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Health 400 | OB-GYN

National Center for Health Statistics: Birth Data Files

Jordan Peterson: Accidental Childlessness, The Epidemic That Dare Not Speak Its Name

Today we break down regulations, codes, standards and open-source literature governing the safety and sustainability of university-affiliated medical research and healthcare delivery facilities.  Because of the complexity of the topic we break down our coverage:

Health 200.   Survey of all relevant codes, standards, guidelines and recommended practices for healthcare settings.

Health 400.  All of the above with special consideration needed for obstetrics, gynecological and neonatal clinical practice and research.

Today we confine our interest to systems — water, power, telecommunication and security; for example — that are unique to campus-configured, city-within-city risk aggregations.  Electrotechnologies (voltage stability, static electricity control, radio-interference, etc.) in these enterprises are subtle, complex and high risk.  Sample titles from legacy best practice literature in this domain are listed below:

American College of Obstetricians and Gynecologists: Levels of Maternal Care

Provision of Care, Treatment, and Services standards for maternal safety

Since our interest lies in the habitable spaces for these enterprises we usually start with a scan of the following titles:

International Building Code Section 407 (Institutional Group I-2) identifies requirements specific to healthcare settings, covering aspects such as fire safety, means of egress, and smoke compartments. Maternity and obstetric facilities within hospitals fall under this classification.

K-TAG Matrix for Healthcare Facilities

NFPA 70 National Electrical Code Article 517

NFPA 99 Healthcare Facilities Code

NFPA 101 Life Safety Code Chapters 18 & 19

ASHRAE 170 Ventilation of Healthcare Facilities

ASHRAE 189.3: Design, Construction and Operation of Sustainable High Performance Health Care Facilities

Relevant Institute of Electrical and Electronic Engineers research

Towards Deeper Neural Networks for Neonatal Seizure Detection

A System to Provide Primary Maternity Healthcare Services in Developing Countries

Deep Learning for Continuous Electronic Fetal Monitoring in Labor

Reorganizing of University Hospital of Oran’s operating theatre: Simulation approach

Finally, we collaborate with the IEEE E&H Committee on the following IEC committee projects from IEC/TC 62 Electrical equipment in medical practice:

– Common aspects of electrical equipment used in diagnostic imaging equipment

– Equipment for radiotherapy, nuclear medicine and radiation dosimetry

– Electromedical equipment for neonatal care

 

More

Doula International

A relatively new publisher of related standards is the Facility Guidelines Institute.  We are monitoring its catalog and its processes.  The healthcare facility industry is likely large enough for another non-profit but we have yet to see meaningful leading practice discovery and promulgation that is unrelated to the literature that is already out there.

Journal of Healthcare Management Standards: Operational Resilience of Hospital Power Systems in the Digital Age

Health Insurance Portability and Accountability Act (HIPAA)

Health care cost as percentage of Gross Domestic Product for six representative nations.

Association of Academic Health Centers

International Conference on Harmonization: The ICH guidelines provide guidance on the development of pharmaceuticals and related substances, including clinical trials, drug safety, and efficacy.

Animal Welfare Act and the Institutional Animal Care and Use Committee

Good Laboratory Practice: GLP is a set of principles that ensure the quality and integrity of non-clinical laboratory studies. It ensures that data generated from non-clinical laboratory studies are reliable, valid, and accurate.

International Code Council Representation of Interests

University of Chicago

Neonatal Care Units

Children’s Hospital Neonatal Intensive Care

Some of the common electro-technologies used in a neonatal care unit include:

  • Incubators: These temperature-controlled units create a controlled environment to keep premature or sick infants warm and protected.
  • Ventilators: Mechanical ventilators assist newborns with respiratory distress by delivering oxygen and helping them breathe.
  • Monitors: These devices track vital signs such as heart rate, oxygen levels, blood pressure, and temperature to ensure the baby’s health and detect any abnormalities.
  • Phototherapy Lights: Special lights are used to treat jaundice in newborns, helping to break down excess bilirubin in the blood.
  • Intravenous Pumps: These pumps are used to deliver medications, fluids, and nutrients directly into the baby’s bloodstream.
  • Feeding Tubes: For infants who are unable to feed orally, feeding tubes are used to deliver breast milk or formula directly into their stomach.
  • Blood Gas Analyzers: These machines measure the levels of oxygen, carbon dioxide, and other gases in a baby’s blood to monitor respiratory status and acid-base balance.
  • Infusion Pumps: Used to administer controlled amounts of fluids, medications, or nutrients to newborns.
  • CPAP/BiPAP Machines: Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP) machines help newborns with breathing difficulties by providing a continuous flow of air pressure.
  • Neonatal Resuscitation Equipment: This includes equipment such as resuscitation bags, endotracheal tubes, laryngoscopes, and suction devices used during emergency situations to assist with newborn resuscitation.

It’s important to note that specific tools and equipment may vary depending on the level of neonatal care provided by the unit, the needs of the infants, and the policies of the healthcare facility.

Neonatal care, as a specialized field, has been shaped by the contributions of several pioneers in medicine. Here are a few notable figures who have made significant advancements in neonatal care:

  • Dr. Virginia Apgar was an American obstetrical anesthesiologist who developed the Apgar score in 1952. The Apgar score is a quick assessment tool used to evaluate the overall health of newborns immediately after birth. It assesses the baby’s heart rate, respiratory effort, muscle tone, reflex irritability, and color, providing valuable information for prompt intervention and monitoring.
  • Dr. Martin Couney, a pioneering physician, established incubator exhibits at world fairs and amusement parks in the early 20th century. He promoted the use of incubators to care for premature infants and played a significant role in popularizing the concept of neonatal intensive care.
  • Dr. Virginia A. Apgar, an American pediatrician and neonatologist, made significant contributions to the field of neonatology. She specialized in the care of premature infants and conducted extensive research on neonatal resuscitation and newborn health. She also developed the Apgar scoring system, although unrelated to Dr. Virginia Apgar mentioned earlier.
  • Dr. Lula O. Lubchenco was an influential researcher and neonatologist who made important contributions to the understanding of newborn growth and development. She developed the Lubchenco Growth Chart, which provides a standardized assessment of a newborn’s size and gestational age, aiding in the identification and monitoring of growth abnormalities.
  • Dr. Mary Ellen Avery was a renowned American pediatrician and researcher whose work focused on understanding and treating respiratory distress syndrome (RDS) in premature infants. She identified the importance of surfactant deficiency in RDS and contributed to the development of surfactant replacement therapy, revolutionizing the care of preterm infants.

These individuals, among many others, have played pivotal roles in advancing the field of neonatal care, improving the understanding, diagnosis, treatment, and overall outcomes for newborn infants.

Healthcare Facilities Code

IEEE  Education & Healthcare Facility Electrotechnology

 

Design & Operation of Health Care Facilities

The pandemic provides background for the importance of ventilation systems in healthcare settings and reminder that there is plenty of work to do.  The scope of ASHRAE 189.3 – Design, Construction and Operation of Sustainable High Performance Health Care Facilities — lies in this domain:

Purpose.  The purpose of this standard is to prescribe the procedures, methods and documentation requirements for the design, construction and operation of high-performance sustainable health care facilities.

Scope.This standard applies to patient care areas and related support areas within health care facilities, including hospitals, nursing facilities, outpatient facilities, and their site.  It applies to new buildings, additions to existing buildings, and those alterations to existing buildings that are identified within the standard.  It provides procedures for the integration of sustainable principles into the health care facility design, construction and operation process including:

    1. integrated design
    2. conservation of water
    3. conservation of energy
    4. indoor environmental quality
    5. construction practices
    6. commissioning
    7. operations and maintenance

Noteworthy: Related title ASHRAE/ASHE Standard 170 Ventilation of Healthcare Facilities

Public consultation on Addendum m regarding definition of “room units” and the heating and cooling of such units closes January 27th

Public consultation on Standard 189.3-2021, Design, Construction, and Operation of Sustainable High-Performance Health Care Facilities closes November 11.

We maintain this title on the standing agenda of our periodic Health, Energy and Mechanical colloquia.  See our CALENDAR for the online meeting; open to everyone.


October 9 Update

As of the date of this post, two redlines have been released for public consultation

Proposed Addendum L to Standard 170-2021, Ventilation of Health Care Facilities

Proposed Addendum i to Standard 170-2021, Ventilation of Health Care Facilities

The consultation closes October 29th.

Other redlines are released and posted at the link below:

Public Review Draft Standards / Online Comment Database

Because this title is administered on ASHRAE’s continuous maintenance platform, public consultations run 30 to 45 days.   You may also submit an original idea to the ASHRAE standards development enterprise.  CLICK HERE to get started.

We maintain this title on the standing agenda of our periodic Health, Energy and Mechanical colloquia.  See our CALENDAR for the online meeting; open to everyone.

"The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest" - William Osler"While we try to teach our children all about life, our children teach us what life is all about" - Angela Schwindt "The true art of pediatrics lies not only in curing diseases but also in preventing them" - Abraham JacobiGermany

 

Issue: [Various]

Category: Mechanical, Electrical, Energy, Facility Asset Management

Colleagues:  David Conrad, Richard Robben, Larry Spielvogel

Workspace / ASHRAE

Healthcare Occupancies


Safety and sustainability for any facility, not just university-affiliated healthcare facilities, usually begin with an understanding of who, and how, shall occupy the built environment.  University settings, with mixed-use occupancy arising spontaneously and temporarily, often present challenges and they are generally well managed.

First principles regarding occupancy classifications for healthcare facilities appear in Section 308 of the International Building Code, Institutional Group I; linked below:

2021 International Building Code Section 308 Institutional Group I

There are thousands of healthcare code compliance functionaries and instructors; most of them supported by trade associations and most of them authoritative.   Hewing to our market discipline to track only the concepts that will affect university-affiliated healthcare enterprises only.  There are a few noteworthy differences between corporate healthcare businesses and university affiliated healthcare enterprises (usually combined with teaching and research activity) that we identify on this collaboration platform.

We collaborate closely with the IEEE Education & Healthcare Facilities Committee which takes a far more global view of the healthcare industry.  That committee meets online 4 times monthly in European and American time zones.

Finally, we encourage our colleagues to participate directly in the ICC Code Development process.  Contact Kimberly Paarlberg ([email protected]) for more information about its healthcare committees and how to participate in the ICC code development process generally.  Tranches of ICC titles are developed according to the schedule below:

2024/2025/2026 ICC CODE DEVELOPMENT SCHEDULE

LIVE: I-Code Group B Public Comment Hearings

 

Issue: [18-166]

Category: Architectural, Healthcare Facilities, Facility Asset Management

Colleagues: Mike Anthony, Jim Harvey, Richard Robben


More

The ICC Code Development Process

K-TAG Matrix for Healthcare Facilities

American Society of Healthcare Engineers

“Tea, Earl Grey, Hot”

The command issued by the character Captain Jean-Luc Picard in the television series “Star Trek: The Next Generation” finds its way into the archive of photographs of Nobel Laureates consorting with politicians at the University of Michigan and elsewhere.

Attendees of the Theoretical Physics Colloquium at the University of Michigan in 1929.

American Institute of Physics Archive

 

Ex Libris Universum

…”There’s not good math explaining forget the physics of it.  Math explaining the behavior of complex systems yeah and that to me is both exciting and paralyzing like we’re at very early days of understanding you know how complicated and fascinating things emerge from simple rules…” — Peter Woit [1:16:00]

Coffee & Tea Standards


Since 1936 the Brown Jug has been the ancestral trough of generations of University of Michigan students and faculty — notably. Donald Glaser (inventor of the bubble chamber) and Samuel C. C. Ting (Nobel Laureate) whose offices at Randall Laboratory were a 2-minute walk around the corner from The Brown Jug.  As the lore goes, the inspiration happened whilst watching beer bubbles one ordinary TGIF Friday.

The Brown Jug is named after the Michigan vs Minnesota football trophy, which is the oldest in college football.

VIU: FM 98.3 Pamplona

CLICK IMAGE TO ACCESS LIVESTREAM

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History of Radio Regulations

The Year Ahead 2025

“Chance favors the prepared mind.”
— Louis Pasteur

Today at 16:00 UTC

Agenda

Technical:

Respond to client queries and retainers

Recap of activity in the ISO and IEC catalogs.  We are members of Healthcare Management.  We coordinate our responses to IEC CDV’s with IEEE Education & Healthcare Facilities Committee.

2024 “Wins” and “Losses”

“Wins”: All of the references to IEEE research and recommended practices that appear in electrical related titles in the NFPA catalog are the result of Standards Michigan advocacy in collaboration with the IEEE

“Losses”: Persist in getting Article 210 (Soon to be in Chapter 1) 180 VA per outlet requirement down to 150 VA instead of 120 VA in the ASHRAE suite from an energy conservation perspective.  This will be the most meaningful and transformative code “win” since our 2014 code “win” in 2014 NEC Section 220.12.

Expansion of user-interest advocacy for the 2028 IEEE National Electrical Safety Code.

Follow up driving electrical safety concepts into the ASHRAE and ICC catalog that cannot, or will not, be incorporated into the NFPA catalog

Continue driving IEEE best practice literature into the NFPA, ASHRAE and IEEE catalog

Electric service reliability data gathering for point of common coupling of merchant utilities and schools, colleges, universities with emphasis on large health care systems.  (Bob Arno’s IEEE 493 Gold Book update)

Break out coverage of ASHRAE 90.1 in its entirety in a dedicated content management system now that its scope includes outside/between buildings.

Break out coverage of Chapter 27 (Electrical) of the International Building Code as a “pivot” or “anchor” post for other relevant titles in the ICC catalog.

10-year retrospective on the IEEE Education & Healthcare Facilities Committee at the May Technical Conference in Montreal

Administrative:

Expansion of our unaccredited for-profit educational mission to Michigan school districts, colleges, universities, trade schools.  In the normal course of business we present educational opportunities to faculty and students administered by ANSI, ASME, AWS, ACI, ICC, IEC, IEEE, IEEE, NIST, SAE and others.  List of Faculty & Student Standards Education Resources

New signage at our State Street office

Rollout the platform to at least two more states — we have only one now.

Re-organize web pages to track IEEE, NFPA, ASHRAE, ICC, CSA Group and TIA catalog action more effectively.  ASTM and UL catalogs remain “problematic” because their titles are so deeply embedded in products and less so in systems.

List of ANSI Accredited Standards Developers

List of US TAGS to the ISO

USNA IEC

Other:

Our thanks for the collegiality and wisdom of Larry Spielvogel as he enters retirement

Continued mentorship of electrical engineering students in the IEEE Southeastern Michigan Section.  Introduction to mentorship partner Nathan from private industry.

Social Page Rollout: Engagements, Weddings & Births

A few of the University’s Electrical Engineers

Looking Ahead: 2024

Accreditation 200

“I have no special talent.
I am only passionately curious”
— Albert Einstein

Early 20th-century fresco depicting guilds in the 13th-century New Tower of Sélestat

Standards are the seed corn for compliance revenue; hence the hegemony of conformance and enforcement enterprises that dominate the global standards system.

Accreditation is a relatively recent breakout topic so we approach it gently; respectful of the business models of the hundreds of education community charitable associations involved in the safety and sustainability of the physical spaces of education communities.

Accreditation 100 tracks facility management credentialing:

Ferris State University | Certificate Program in Facility Management

University of San Diego | Facilities Management Program

Arizona State University | Facility Management Certificate Program

Later in 2024 we will sort through other issues in the credentialing domain:

Accreditation 200: Recent innovations in credentialing

Q. There are about 150 hospitals in the USA with the word “university” in their name.  Are they tax-exempt?  Should they be?  A.  Whether a hospital with “university” in its name is tax-exempt depends on various factors, including its ownership, structure, and purpose. Non-profit hospitals, including those affiliated with universities, may qualify for tax-exempt status under certain conditions. However, the mere presence of “university” in the name does not automatically confer tax-exempt status.  Tax-exempt status, the hospital’s activities, such as providing charity care, medical education, and research, are typically considered.

Accreditation 300: Requirements for baccalaureate, masters and doctoral degrees

Accreditation 400: Advanced Topics

Open to everyone.  Use the login credentials at the top of our home page.

Syllabus: Accreditation 100

Readings:

“Student Retention at the Community College: Meeting Students’ Needs” | University of Delware Fall 2006 | Jill Jacobs-Biden

“Princeton-Educated Black and the Black Community” | Princeton University | Michelle LaVaughn Robinson

“Employment, Output and Capital Accumulation in an Open Economy: A Disequilibrium Approach” | Yale University | Janet Louise Yellen

 

Intelligence is quickness in seeing things as they are. - George Santayana

Fellows Coffee Shop

“I have found that it is the small everyday deeds of ordinary folk

that keep the darkness at bay.”

— J.R. R. Tolkein

 

 

 

 

 

 

 

 

 

 

 

 

 

Tolkien, author of “The Lord of the Rings” and “The Hobbit,” completed his studies at the University of Birmingham in 1915. He graduated with first-class honors in English Language and Literature. After graduation, Tolkien went on to serve in World War I before embarking on his distinguished career as a writer and academic.

Old Joe Clocktower | Fixing Old Joe

Roger Scruton “Why Intellectuals are Mostly Left”


Coffee

How Coffee Loves Us Back

The Perfect Cup of Coffee

Best Coffee Spots Near Campus

Social Experiment: Giving College Students Coffee

Bruin Café

 

College students create the ultimate hangover cure

Two Yale University seniors have created a product they believe will cure what ails their peers — and many others: hangovers.

Margaret Morse and Liam McClintock wanted a supplement that would allow them to have fun on a night out, but would not impede on being able to work the next morning.

What causes hangovers to begin with? Morse, a molecular cellular and developmental biology major, told local news outlet WTNH, “There’s an acetaldehyde build up. There is a vitamin and electrolyte loss. There is a glutamine rebound and there are immunological disturbances.”

Their proposed solution is SunUp, a powdered citrus-flavored supplement filled with vitamins and nutrients.

“This is a powder that you take before you start drinking and it helps your liver deal with the stress you’re putting it under when you drink,” McClintock told WTNH. According to the New Haven Register, one would drink SunUp in a glass of water around an hour before they start drinking.  While one might believe dehydration is the cause of hangovers, SunUp’s website explains that it is actually a symptom. “These two phenomena are concurrent because of the diuretic effects of alcohol, but dehydration does not cause the actual hangover feeling,” says the site’s FAQ.  SunUp instead focuses on combating four root causes of a hangover: acetaldehyde building, vitamin and electrolyte loss, glutamine rebound and immunological disturbances.

“It’s intended for productive workers,” McClintock told WTNH. “Like ourselves who like to have a social life, like to go out and have a couple of drinks but also need to be productive the next day and get up and have work to do.”

Morse and McClintock have received positive feedback from fellow students and the Yale community. They’ve brought it to a pharmaceutical company, and it could be available in April. SunUp will retail for $5; if you want to pre-order, you can purchase through the company’s Indiegogo page.

Yale University Office of Facilities

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