Sample records for army surgical hospital

  1. The Falklands war: Army field surgical experience.

    PubMed Central

    Jackson, D. S.; Batty, C. G.; Ryan, J. M.; McGregor, W. S.

    1983-01-01

    In the recent Falklands campaign four Army Field Surgical Teams were deployed in the two phases of the war. They functioned as Advanced Surgical Centres and operated on 233 casualties. There were 3 deaths. The patterns of wounding and the methods of casualty management are discussed and compared with other recent campaigns. Images Fig. 1 PMID:6614760

  2. [The army nurse, from hospital to overseas operations].

    PubMed

    Guérot, Françoise; Saliou, Henri; Lefort, Hugues; De Rudnickl, Stéphane

    2014-09-01

    Assigned to French army teaching hospitals, the army nurse can be deployed on overseas operations in support of the armed forces. Experience in the treatment of casualties in life-threatening emergencies is essential, as is the ability to adapt and react. Designated on a voluntary basis, after some two years of working in an army teaching hospital, the hospital nurse receives training in the specificities of the theatre of deployment. PMID:25464633

  3. Does Competition from Ambulatory Surgical Centers Affect Hospital Surgical Output and Hospital Profit?

    Microsoft Academic Search

    Michael Plotzke; Charles Courtemanche

    2009-01-01

    Hospital administrators have expressed concern that ambulatory surgical centers (ASCs) lower the profitability of hospitals' outpatient departments by reducing their volume and cherry picking their most profitable patients. This could lead to welfare losses by causing hospitals to reduce their provision of less profitable services such as uncompensated care. This paper estimates the effects of ASC prevalence on hospital surgical

  4. The Surgical Clerkship in the Community Hospital

    ERIC Educational Resources Information Center

    Dean, Richard E.; Johnson, Tom M.

    1977-01-01

    Since 1972 Michigan State University College of Human Medicine has participated with community hospitals and practicing physicians in a number of cities to provide surgical clerkship experiences for its students. The new role of a full-time community-based university surgeon to facilitate this program is described. (Author/LBH)

  5. Costs of surgical procedures in Indian hospitals

    PubMed Central

    Chatterjee, Susmita; Laxminarayan, Ramanan

    2013-01-01

    Objective Despite a growing volume of surgical procedures in low-income and middle-income countries, the costs of these procedures are not well understood. We estimated the costs of 12 surgical procedures commonly conducted in five different types of hospitals in India from the provider perspective, using a microcosting method. Design Cost and utilisation data were collected retrospectively from April 2010 to March 2011 to avoid seasonal variability. Setting For this study, we chose five hospitals of different types: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed district hospital, a 655-bed private teaching hospital and a 778-bed tertiary care teaching hospital based on their willingness to cooperate and data accessibility. The hospitals were from four states in India. The private, charitable and tertiary care hospitals serve urban populations, the district hospital serves a semiurban area and the private teaching hospital serves a rural population. Results Costs of conducting lower section caesarean section ranged from rupees 2469 to 41?087; hysterectomy rupees 4124 to 57?622 and appendectomy rupees 2421 to 3616 (US$1=rupees 52). We computed the costs of conducting lap and open cholecystectomy (rupees 27?732 and 44?142, respectively); hernia repair (rupees 13?204); external fixation (rupees 8406); intestinal obstruction (rupees 6406); amputation (rupees 5158); coronary artery bypass graft (rupees 177?141); craniotomy (rupees 75?982) and functional endoscopic sinus surgery (rupees 53?398). Conclusions Estimated costs are roughly comparable with rates of reimbursement provided by the Rashtriya Swasthya Bima Yojana (RSBY)—India's government-financed health insurance scheme that covers 32.4 million poor families. Results from this type of study can be used to set and revise the reimbursement rates. PMID:23794591

  6. The epidemiology of varicella hospitalizations in the U.S. Army.

    PubMed

    Lee, T; Nang, R N

    2000-10-01

    Varicella infections affect the U.S. Army, but the extent has not been quantified recently. We obtained 1990 to 1997 hospitalization data from the U.S. Army Medical Command and calculated rates using data from the Army Medical Surveillance Activity and the U.S. Army Training Command. There was a decline in the number and incidence of varicella hospitalizations for U.S. Army active duty soldiers from 1990 to 1997. Varicella incidence rates for active duty soldiers are significantly higher for females, blacks, those younger than 20 years, and those whose home of record were tropical island regions. Army initial entry training hospitalizations constitute 11.8% of active duty Army hospitalizations and have also declined. Varicella continues to affect the training and health of the U.S. Army; however, the impact has diminished over the years. A feasible approach to limit varicella in the U.S. Army is to target trainees for screening or vaccination. Refinement of this strategy should be determined from a follow-up cost-effectiveness analysis. PMID:11050878

  7. 77 FR 24409 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-24

    ...Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical Center...Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical Center...Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

  8. CPAP Use in a Hospital or Surgical Setting

    MedlinePLUS

    ... org * 888.293.3650 CPAP USE IN A HOSPITAL OR SURGICAL SETTING This Patient Education Bulletin specifically ... Also, refer to the ASAA Patient Education Bulletin “HOSPITAL CHECKLIST FOR OBSTRUCTIVE SLEEP APNEA PATIENTS”. We suggest ...

  9. The surgical value of community hospitals: a closer look.

    PubMed

    Sanger, R; Clyne, C A

    1991-07-01

    To assess and compare the safety and efficiency of a surgical unit at a District General Hospital and a Community Hospital for elective cold surgery. A retrospective survey was made using regional computer Hospital Activity Analysis data and monthly audit meeting records of all inpatients having selected elective general surgical operations on one consultant's firm over a period of one year, at Torbay Hospital, Torquay, (DGH) and Newton Abbot Hospital, Newton Abbot (CH). All inpatients and day cases admitted under CACC from April 1, 1987, until March 31, 1988, were studied comparing mortality, morbidity and efficiency for comparable elective surgical procedures. A postal questionnaire to assess patient satisfaction with surgical care at both hospitals was included in the study. 350 patients underwent elective surgical procedures at the DGH and 380 patients underwent similar procedures at the CH. There was no significant increase in mortality and morbidity at the CH, which was preferred by most patients for routine surgical operations. The Community Hospital unit was found to be satisfactory and more efficient for routine elective surgery as determined from the above parameters and the patients themselves. PMID:1863060

  10. Surgical wound infections diagnosed after discharge from hospital: epidemiologic differences with in-hospital infections

    Microsoft Academic Search

    Marcelino Medina-Cuadros; María Sillero-Arenas; Gabriel Martínez-Gallego; Miguel Delgado-Rodríguez

    1996-01-01

    Bacground: The purpose of this study was to study postoperative infections detected in hospital and after discharge and to identify risk factors for such infections.Methods: A prospective cohort study was used, with a follow-up of 30 days after hospital discharge, on 1483 patients admitted to the general surgery service of a tertiary care hospital. The main outcome measure was surgical

  11. District nursing sister attached to hospital surgical department.

    PubMed

    Hockey, L

    1970-04-18

    An experiment of attaching a district nursing sister to the surgical department of a general hospital was designed to show the use of the district nursing service for the after-care of patients discharged from hospital after surgical treatment. In a 15-week period about 590 bed days were saved, and only six out of 126 patients discharged early had to be readmitted. Most of the patients and the general practitioners who replied to questionaries about the scheme were in favour of it. PMID:4314877

  12. District Nursing Sister Attached to Hospital Surgical Department

    PubMed Central

    Hockey, Lisbeth

    1970-01-01

    An experiment of attaching a district nursing sister to the surgical department of a general hospital was designed to show the use of the district nursing service for the after-care of patients discharged from hospital after surgical treatment. In a 15-week period about 590 bed days were saved, and only six out of 126 patients discharged early had to be readmitted. Most of the patients and the general practitioners who replied to questionaries about the scheme were in favour of it. PMID:4314877

  13. Re-engineering surgical services in a community teaching hospital.

    PubMed

    Cohen, M M; Wreford, M; Barnes, M; Voight, P

    1997-04-01

    The Grace Hospital Surgical Services redesign project began in December 1995 and concluded in November 1996. It was led by the Chief of Surgery, the Surgical/Anesthesia Services Director, and the Associate Director of Critical Care/Trauma. The project was undertaken in order to radically redesign the delivery of surgical services in the Detroit Medical Center (DMC) Northwest Region. It encompassed the Grace Hospital Main Operating Room (10 operating theatres) and Post-Anesthesia Recovery Unit, and a satellite Ambulatory Surgery Center in Southfield, Michigan. The four areas of focus were materials management, case scheduling, patient flow/staffing, and business planning. The guiding objectives of the project were to improve upon the quality of surgical services for patients and physicians, to substantially reduce costs, and to increase case volume. Because the Grace Surgical Services redesign project was conducted in a markedly open communicative, and inclusive fashion and drew participation from a broad range of medical professionals, support staff, and management, it created positive ripple effects across the institution by raising staff cost-consciousness, satisfaction, and morale. Other important accomplishments of the project included: Introduction of block scheduling in the ORs, which improved room utilization and turnaround efficiencies, and greatly smoothed the boarding process for physicians. Centralization of all surgical boarding, upgrading of computer equipment to implement "one call" surgery scheduling, and enlarging the capacity for archiving, managing and retrieving OR data. Installation of a 23-hour, overnight recovery unit and provision of physician assistants at the Ambulatory Surgery Center, opening the doors to an expanded number of surgical procedures, and enabling higher quality care for patients. Reduction of FTE positions by 27 percent at the Ambulatory Surgery Center. This yielded a total cost reduction of +1.5 million per annum in the annual budget of +10.3 million; Recruited 10 new podiatrists and increased the volume of cases brought to Northwest Region facilities by surgical specialists. This added 100 cases in 1996, and is projected to add 500 cases in 1997. A 14.5 percent reduction in the cost of operating the Surgical Services was achieved. This was accompanied by enhanced staff morale, physician satisfaction and a higher quality of patient care. PMID:10172985

  14. Spinal injury hospitalizations among u.s. Army soldiers deployed to iraq and afghanistan.

    PubMed

    Wojcik, Barbara E; Curley, Kenneth C; Szeszel-Fedorowicz, Wioletta; Stein, Catherine R; Humphrey, Rebecca J

    2015-02-01

    This retrospective study examined spinal-related hospitalizations of U.S. Army soldiers deployed to Afghanistan and Iraq. Spinal cord injuries (SCI) and vertebral column injuries (VCI) were identified using International Classification of Disease, 9th Revision, Clinical Modification diagnosis codes. In our study, spinal hospitalizations represented 8.2% of total injury admissions. Risk factors for SCI and VCI incidences were determined using Poisson regression. Lack of previous deployment experience increased risk of having SCI by 33% and VCI by 24% in Iraq (similar increases, but not statistically significant in Afghanistan). Male soldiers had 4.85 times higher risk for SCI in Iraq and 69% higher risk in Afghanistan than female soldiers. In Afghanistan, almost 60% of spinal episodes included traumatic brain injury (TBI), compared to about 40% in Iraq. In both theaters, mild TBI accounted for more than 50% of all TBI-spinal episodes. Sixteen percent of SCI inpatient episodes in Afghanistan and 13% in Iraq were associated with paralysis, with median bed days of 46 and 33 days compared to a median of 6 days in both theaters for nonparalysis spinal injuries. The mortality rate was 2.5 times lower in Afghanistan than in Iraq. PMID:25643390

  15. Surgical caseload in army general surgery programs: A 10-year retrospective 1 1 The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense

    Microsoft Academic Search

    Rebecca Marier McGuigan; Alan L Beitler

    2002-01-01

    PURPOSE: Over the past decade, the Army Medical Department (AMEDD) has been affected by a military-wide drawdown. The volume and acuity of patients appears to be declining, raising questions regarding quantity and quality in Army surgical training programs. The purpose of this study is to examine the caseloads of Army general surgery programs compared with national averages, and to compare

  16. Energy Engineering Analysis Program, Fort McClellan, Alabama, energy audit of Noble Army Hospital. Executive summary. Final report

    SciTech Connect

    NONE

    1985-06-01

    This report is the executive summary of an Energy Engineering Analysis Program (EEAP) Study that was conducted at the Noble Army Hospital, Fort McClellan, Alabama by the firm of BENATECH, INC. Work was begun on the hospital energy audit during November, 1983. The facilities investigated in this EEAP Study include the main hospital (building 292) and certain support facilities (buildings 1789, 1929, 2290 and 3211). The study was a special EEAP Hospital Energy Audit and indentified I ECIP Project, 3 non-ECiP Projects and 13 Energy Conservation Measures (ECMs). The Scope of Work for the hospital study required the performance of a comprehensive energy audit and analysis. If all of the 17 recommended projects and measures are implemented, a 2.3 percent reduction in basewide energy consumption would be realized. A four volume report has been prepared that describes in detail the work accomplished during the study.

  17. [The key function of the military hospital at Versaille to the army responsible for winning back Paris during the insurrection of the commune (March-May 1871)].

    PubMed

    Delahaye, R P

    1994-01-01

    The military Hospital of Versailles standing near the seat of the Government and the Assemblies played an important role in the organization of the sanitary services of the Versailles army. Hippolyte Larrey, chief physician of the army decided in agreement with Thiers, head of the government that the military hospital will primarily receive all the wounded soldiers evacuated from the front lines and all the patients from the various regiments of the Versailles army. To satisfy the numerous hospitalisations, annexes were opened in Versailles, the hospital capacity being extended to 2600 beds. In proportion of the troops progression towards Paris, the evacuation plan of the wounded soldiers will be modified the delays of evacuation towards Versailles becoming too long, by the creation of campaign hospitals and by sending wounded soldiers to the military hospitals of Paris (Val-de-Grâce and Gros Caillou) and to some ambulances established during the siege of Paris. PMID:11640279

  18. A Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the Congo

    PubMed Central

    Sion, Melanie; Rajan, Dheepa; Kalambay, Hyppolite; Lokonga, Jean-Pierre; Bulakali, Joseph; Mossoko, Mathias; Kwete, Dieudonne; Schmets, Gerard; Kelley, Edward; Elongo, Tarcisse; Sambo, Luis; Cherian, Meena

    2015-01-01

    Abstract Background: The impact of surgical conditions on global health, particularly on vulnerable populations, is gaining recognition. However, only 3.5% of the 234.2 million cases per year of major surgery are performed in countries where the world's poorest third reside, such as the Democratic Republic of the Congo (DRC). Methods: Data on the availability of anesthesia and surgical services were gathered from 12 DRC district hospitals using the World Health Organization's (WHO's) Emergency and Essential Surgical Care Situation Analysis Tool. We complemented these data with an analysis of the costs of surgical services in a Congolese norms-based district hospital as well as in 2 of the 12 hospitals in which we conducted the situational analysis (Demba and Kabare District Hospitals). For the cost analysis, we used WHO's integrated Healthcare Technology Package tool. Results: Of the 32 surgical interventions surveyed, only 2 of the 12 hospitals provided all essential services. The deficits in procedures varied from no deficits to 17 services that could not be provided, with an average of 7 essential procedures unavailable. Many of the hospitals did not have basic infrastructure such as running water and electricity; 9 of 12 had no or interrupted water and 7 of 12 had no or interrupted electricity. On average, 21% of lifesaving surgical interventions were absent from the facilities, compared with the model normative hospital. According to the normative hospital, all surgical services would cost US$2.17 per inhabitant per year, representing 33.3% of the total patient caseload but only 18.3% of the total district hospital operating budget. At Demba Hospital, the operating budget required for surgical interventions was US$0.08 per inhabitant per year, and at Kabare Hospital, US$0.69 per inhabitant per year. Conclusion: A significant portion of the health problems addressed at Congolese district hospitals is surgical in nature, but there is a current inability to meet this surgical need. The deficient services and substandard capacity in the surveyed district hospitals are systemic in nature, representing infrastructure, supply, equipment, and human resource constraints. Yet surgical services are affordable and represent a minor portion of the total operating budget. Greater emphasis should be made to appropriately fund district hospitals to meet the need for lifesaving surgical services. PMID:25745120

  19. Assessment of protocols for surgical-site preparation in a regional network of hospitals.

    PubMed

    Peñalver-Mompeán, Maria Dolores; Saturno-Hernández, Pedro Jesus; Fonseca-Miranda, Yadira; Gama, Zenewton André da Silva

    2012-01-01

    Surgical-site infection is a preventable adverse event. Implementation of good practices for correct surgical-site preparation can contribute to lessen this safety problem. The objective of this study was to describe the presence and quality of protocols on surgical-site preparation in the Murcia (Spain) regional network of public hospitals. The indicator "existence of protocol for surgical-site preparation" was assessed, as well as the formal quality (expected attributes) and contents (compared to current evidence-based recommendations) of existing documents. Seven of the nine hospitals have a protocol for surgical-site preparation. Opportunities to improve have been identified in relation to the protocols' formal quality and contents. Recommendations related to skin asepsis are incomplete and those related to hair removal contradict existing evidence. Most hospitals have protocols for surgical-site preparation; however, there is great room for improvement, in relation to their expected attributes and to the inclusion of evidence-based recommendations. PMID:22699732

  20. 38 CFR 3.358 - Compensation for disability or death from hospitalization, medical or surgical treatment...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...hospitalization, medical or surgical treatment, examinations or vocational rehabilitation training (§ 3.800). 3.358 Section 3.358 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION...

  1. How Does Degree of Rurality Impact the Provision of Surgical Services at Rural Hospitals?

    ERIC Educational Resources Information Center

    Doty, Brit; Zuckerman, Randall; Finlayson, Samuel; Jenkins, Paul; Rieb, Nathaniel; Heneghan, Steven

    2008-01-01

    Context: Rural residents frequently have decreased access to surgical services. Consequences of this situation include increased travel time and financial costs for patients. There are also economic implications for hospitals as they may lose revenue when patients leave the area in order to obtain surgical services. Rural communities vary in size…

  2. From Pergamon to Army Base Hospital No. 5: the history and significance of the galea aponeurotica in the evolution of neurosurgery.

    PubMed

    Connor, David E; Chittiboina, Prashant; Nanda, Anil

    2014-08-01

    The authors trace the etymology and historical significance of galea or epicranial aponeurosis. In ancient Greece, galea referred to a helmet worn by soldiers, typically made of animal hide or leather. Throughout antiquity, physicians referred to all soft tissue between the skin and the skull as panniculus, a standard established by Galen of Pergamon. A manual of surgery in the Middle Ages referred to the entire scalp as a "great panicle that is called pericranium." During the early Renaissance, Leonardo da Vinci famously and stylistically analogized the dissection of the cranium with the peeling of an onion. Not until 1724 would the tendinous sheath connecting the frontalis and occipitalis muscles be defined as "Galea tendinosa cranii." By 1741, the convention of referring to the galea as an aponeurosis was well established. Harvey Cushing's wartime experiences at Army Base Hospital No. 5 reinforced the surgical significance of the galea. Operative mortality was significantly diminished due to "closure of the wounds with buried sutures in the galea." This operative nuance was then passed from teacher to pupil and has now become one of the tenets of modern neurosurgical practice. PMID:24926652

  3. 78 FR 54842 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    This document corrects technical errors that appeared in the proposed rule published in the Federal Register on July 19, 2013, entitled ``Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Hospital Value-Based Purchasing Program; Organ Procurement Organizations; Quality Improvement Organizations;......

  4. Are hospitals “keeping up with the Joneses”?: Assessing the spatial and temporal diffusion of the surgical robot

    PubMed Central

    Li, Huilin; Gail, Mitchell H.; Braithwaite, R. Scott; Gold, Heather T.; Walter, Dawn; Liu, Mengling; Gross, Cary P.; Makarov, Danil V.

    2015-01-01

    Background The surgical robot has been widely adopted in the United States in spite of its high cost and controversy surrounding its benefit. Some have suggested that a “medical arms race” influences technology adoption. We wanted to determine whether a hospital would acquire a surgical robot if its nearest neighboring hospital already owned one. Methods We identified 554 hospitals performing radical prostatectomy from the Healthcare Cost and Utilization Project Statewide Inpatient Databases for seven states. We used publicly available data from the website of the surgical robot’s sole manufacturer (Intuitive Surgical, Sunnyvale, CA) combined with data collected from the hospitals to ascertain the timing of robot acquisition during year 2001 to 2008. One hundred thirty four hospitals (24%) had acquired a surgical robot by the end of 2008. We geocoded the address of each hospital and determined a hospital’s likelihood to acquire a surgical robot based on whether its nearest neighbor owned a surgical robot. We developed a Markov chain method to model the acquisition process spatially and temporally and quantified the “neighborhood effect” on the acquisition of the surgical robot while adjusting simultaneously for known confounders. Results After adjusting for hospital teaching status, surgical volume, urban status and number of hospital beds, the Markov chain analysis demonstrated that a hospital whose nearest neighbor had acquired a surgical robot had a higher likelihood itself acquiring a surgical robot. (OR=1.71, 95% CI: 1.07–2.72, p=0.02). Conclusion There is a significant spatial and temporal association for hospitals acquiring surgical robots during the study period. Hospitals were more likely to acquire a surgical robot during the robot’s early adoption phase if their nearest neighbor had already done so.

  5. Does the Entry of an Ambulatory Surgery Center Affect Hospital Surgical Output and Hospital Profit?

    Microsoft Academic Search

    Michael Plotzke; Charles Courtemanche

    2010-01-01

    Ambulatory Surgery Centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients who require those services. Since ASCs perform a limited range of services in comparison to a hospital, it is unclear how large an impact an ASC entering into a hospital’s market would have on that hospital.

  6. Adjunctive use of monthly physician questionnaires for surveillance of surgical site infections after hospital discharge and in ambulatory surgical patients: Report of a seven-year experience

    Microsoft Academic Search

    Farrin A. Manian; Lynn Meyer

    1997-01-01

    We report our experience with the use of monthly physician questionnaires, in conjunction with traditional in-house monitoring, for surveillance of surgical site infections (SSIs) in inpatients after hospital discharge and in ambulatory surgical patients (i.e., those not requiring perioperative hospitalization) over a 7-year period (July 1988 to June 1995) involving 156,977 surgical procedures. The mean annual response rate was 73%

  7. Lived experiences and challenges of older surgical patients during hospitalization for cancer: An ethnographic fieldwork

    PubMed Central

    Høybye, Mette Terp

    2014-01-01

    This paper explores the lived experiences of older surgical patients’ (aged 74 years and older) experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n = 9, aged 74 years and older) were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of participant observation and interviews, each patient was followed through the course of 1 day during their stay at the hospital. Interviews were carried out with all patients during this time. Three areas of concern were identified as prominent in the patients’ experiences and challenges during their short hospital stay: teeth and oral cavity, eating in a hospital setting, and medication during hospitalization. Short-term hospitalization requires focused collaboration between staff and patient concerning individual challenges from their teeth and oral cavity as support of nutritional needs during surgical treatment for cancer. PMID:24559546

  8. Reliability of Superficial Surgical Site Infections as a Hospital Quality Measure

    PubMed Central

    Kao, Lillian S.; Ghaferi, Amir A.; Ko, Clifford Y.; Dimick, Justin B.

    2011-01-01

    Background Although rates of superficial surgical site infection (SSI) are increasingly used as measures of hospital quality, the statistical reliability of using SSI rates in this context is uncertain. We used the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) data to determine the reliability of SSI rates as a measure of hospital performance and to evaluate the effect of hospital caseload on reliability. Study Design We examined all patients who underwent colon resection in hospitals participating in ACS NSQIP in 2007 (n=18,455 patients, n= 181 hospitals). We first calculated the number of cases and the risk-adjusted rate of SSI at each hospital. We then used hierarchical modeling to estimate the reliability of this quality measure for each hospital. Finally, we quantified the proportion of hospital-level variation in SSI rates due to patient characteristics and measurement noise. Results The average number of colon resections per hospital was 102 (standard deviation, 65). The risk-adjusted rate of superficial SSI was 10.5%, but varied from 0 to 30% across hospitals. Approximately 35% of the variation in SSI rates was explained by noise, 7% could be attributed to patient characteristics, and the remaining 58% represented true differences in SSI rates. Just over half of the hospitals (54%) had a reliability greater 0.70, which is considered a minimum acceptable level. To achieve this level of reliability, 94 cases were required. Conclusions SSIs rates are a reliable measure of hospital quality when an adequate number of cases have been reported. For hospitals with inadequate caseloads, the NSQIP sampling strategy could be altered to provide enough cases to ensure reliability. PMID:21622011

  9. [Importance of medical treatment in second echelon during war in Croatia, example--war surgical hospital in Garesnica].

    PubMed

    Gveri?, Tugomir; Huljev, Dubravko; Zdilar, Boris; Kolak, Toni; Barisic, Jadranko; Ahmetasovic, Snjezana Gveric; Trajbar, Dubravka; Lojo, Nermin; Sever, Marko

    2009-05-01

    At beginning of 1991, the increasing necessity of emergency surgical treatment of wounded persons in Croatia led to the formation of mobile surgical teams. However, this system was abandoned due to many problems and echelon health division was formed. One of the war surgical hospitals (second echelon) was the War Surgical Hospital Garesnica. In this study, materials of the Croatian War Veterans Ministry, Ministry of Defense, Garesnica War Surgical Hospital and Garesnica Defense Office archive were used. We analyzed the number and localization of wounds, and describe the organization, work and results of the War Surgical Hospital in Garesnica. During the work of the War Surgical Hospital in Garesnica, 909 surgical examinations were performed, 521 wounded were surgically treated (45% civilians and 55% soldiers), 331 wounded were operated on, 5 lethal outcomes were recorded, 68% of wounds were localized on the extremities, 19% on the thorax and abdomen, and 13% on the head end neck. In this article the organization and work of the War Surgical Hospital in Garesnica is described, which had a major role in providing emergency medical care to people wounded in west Slavonia. PMID:19580229

  10. Hospital type- and volume-outcome relationships in esophageal cancer patients receiving non-surgical treatments

    PubMed Central

    Hsu, Po-Kuei; Chen, Hui-Shan; Wang, Bing-Yen; Wu, Shiao-Chi; Liu, Chao-Yu; Shih, Chih-Hsun; Liu, Chia-Chuan

    2015-01-01

    AIM: To study the “hospital type-outcome” and “volume-outcome” relationships in patients with esophageal cancer who receive non-surgical treatments. METHODS: A total of 6106 patients with esophageal cancer diagnosed between 2008 and 2011 were identified from a national population-based cancer registry in Taiwan. The hospital types were defined as medical center and non-medical center. The threshold for high-volume hospitals was based on a median volume of 225 cases between 2008 and 2011 (annual volume, > 56 cases) or an upper quartile (> 75%) volume of 377 cases (annual volume > 94 cases). Cox regression analyses were used to determine the effects of hospital type and volume outcome on patient survival. RESULTS: A total of 3955 non-surgically treated patients were included in the survival analysis. In the unadjusted analysis, the significant prognostic factors included cT, cN, cM stage, hospital type and hospital volume (annual volume, > 94 vs ? 94). The 1- and 3-year overall survival rates in the non-medical centers (36.2% and 13.2%, respectively) were significantly higher than those in the medical centers (33.5% and 11.3%, respectively; P = 0.027). The 1- and 3-year overall survival rates in hospitals with an annual volume of ? 94 (35.3% and 12.6%, respectively) were significantly higher than those with an annual volume of > 94 (31.1% and 9.4%, respectively; P = 0.001). However, in the multivariate analysis, the hospital type was not statistically significant. Only cT, cN, and cM stages and hospital volume (annual volume > 94 vs ? 94) were independent prognostic factors. CONCLUSION: Whether the treatment occurs in medical centers is not a significant prognostic factor. High-volume hospitals were not associated with better survival rates compared with low-volume hospitals. PMID:25632197

  11. Surgical therapies for corneal perforations: 10 years of cases in a tertiary referral hospital

    PubMed Central

    Yokogawa, Hideaki; Kobayashi, Akira; Yamazaki, Natsuko; Masaki, Toshinori; Sugiyama, Kazuhisa

    2014-01-01

    Purpose To report surgical therapies for corneal perforations in a tertiary referral hospital. Methods Thirty-one eyes of 31 patients (aged 62.4±18.3 years) with surgically treated corneal perforations from January 2002 to July 2013 were included in this study. Demographic data such as cause of corneal perforation, surgical procedures, and visual outcomes were retrospectively analyzed. Results The causes of corneal perforation (n=31) were divided into infectious (n=8, 26%) and noninfectious (n=23, 74%) categories. Infectious causes included fungal ulcer, herpetic stromal necrotizing keratitis, and bacterial ulcer. The causes of noninfectious keratopathy included corneal melting after removal of a metal foreign body, severe dry eye, lagophthalmos, canaliculitis, the oral anticancer drug S-1, keratoconus, rheumatoid arthritis, neurotrophic ulcer, atopic keratoconjunctivitis, and unknown causes. Initial surgical procedures included central large corneal graft (n=17), small corneal graft (n=7), and amniotic membrane transplantation (n=7). In two cases the perforation could not be sealed during the first surgical treatment and required subsequent procedures. All infectious keratitis required central large penetrating keratoplasty to obtain anatomical cure. In contrast, several surgical options were used for the treatment of noninfectious keratitis. After surgical treatment, anatomical cure was obtained in all cases. Mean postoperative best corrected visual acuity was better at 6 months (logMAR 1.3) than preoperatively (logMAR 1.8). Conclusion Surgical therapies for corneal perforations in our hospital included central large lamellar/penetrating keratoplasty, small peripheral patch graft, and amniotic membrane transplantation. All treatments were effective. Corneal perforation due to the oral anticancer drug S-1 is newly reported. PMID:25378903

  12. Energy savings opportunity survey; Dewitt Army Hospital, Fort Belvoir, Virginia: Volume I, executive summary and engineering study

    SciTech Connect

    NONE

    1991-05-01

    Energy Savings Opportunity Survey (ESOS) at Dewitt Army Hospital is a project to improve its energy utilization and includes analysis of applicable energy conservation opportunities (ECOs). This study was originally initiated by NUS Corporation under Contract No. DACA31-84-C-0185 in 1985. In 1989, a pre-final report was submitted by NUS and reviewed by the Corps of Engineers, Baltimore District. At the end of 1989, after terminating NUS contract, the Corps of Engineers requested Engineering Applications Consultants, P.C. to make recommendations for editing the report. After a Scope of Work was developed, EAC was awarded a contract to review and edit this report. In the process of reviewing the NUS report, the following items were noted: The field survey was performed in 1985 and the pre-final report was submitted four years later in 1989. Comparison of 1989 baseline electrical consumption was made with 1982-84 metered data. Calculations for electrical savings used 11,600 btu/kWh for purchased electrical energy. (ECIP guidelines have a conversion factor of 3,413 btu/kWh for purchased power.) The baseline energy consumption indicated in NUS report is twice that calculated by EAC.

  13. Predictors of Medical or Surgical and Psychiatric Hospitalizations Among a Population-Based Cohort of Homeless Adults

    PubMed Central

    Chambers, Catharine; Katic, Marko; Chiu, Shirley; Redelmeier, Donald A.; Levinson, Wendy; Kiss, Alex

    2013-01-01

    Objectives. We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Methods. We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005–2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. Results. Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. Conclusions. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services. PMID:24148040

  14. Predictors of hip fracture mortality at a general hospital in South Brazil: an unacceptable surgical delay

    PubMed Central

    Ribeiro, Tiango Aguiar; Premaor, Melissa Orlandin; Larangeira, João Alberto; Brito, Luiz Giulian; Luft, Michel; Guterres, Leonardo Waihrich; Monticielo, Odirlei André

    2014-01-01

    OBJECTIVE: Hip fractures have been associated with increased mortality in the elderly. Several risk factors such as the time between the insult and the surgical repair have been associated with hip fracture mortality. Nevertheless, the risk of delayed surgical repair remains controversial. Few studies have examined this issue in Brazil. The aim of this study was to study the risk factors for death one year after hip fracture and in-hospital stay at a tertiary hospital in South Brazil. METHODS: A prospective cohort study was carried out from April 2005 to April 2011 at a tertiary university hospital at Santa Maria, Brazil. Subjects admitted for hip fracture who were 65 years of age or older were followed for one year. Information about fracture type, age, gender, clinical comorbidities, time to surgery, discharge, and American Society of Anesthesiologists score were recorded. Death was evaluated during the hospital stay and at one year. RESULTS: Four hundred and eighteen subjects were included in the final analysis. Of these, 4.3% died in-hospital and 15.3% were dead at one year. Time to surgery, American Society of Anesthesiologists score, Ischemic Heart Disease, and in-hospital stay were associated with death at one year in the univariate analysis. The American Society of Anesthesiologists score and time to surgery were one-year mortality predictors in the final regression model. In-hospital death was associated with American Society of Anesthesiologists score and age. CONCLUSION: Time to surgery is worryingly high at the South Brazil tertiary public health center studied here. Surgical delay is a risk factor that has the potential to be modified to improve mortality. PMID:24714833

  15. A prospective study of surgical site infections in a teaching hospital in Goa

    Microsoft Academic Search

    Umesh S. Kamat; A. M. A. Fereirra; M. S. Kulkarni; D. D. Motghare

    2008-01-01

    Introduction  Surgical Site Infections contribute significantly to increased health care costs in terms of prolonged hospital stay and lost\\u000a work days. The problem was largely unexplored in an apex medical institute in Goa.\\u000a \\u000a \\u000a \\u000a Aims and Objectives  To estimate the incidence, and study the bacteriology and the factors associated with SSI in the study setting.\\u000a \\u000a \\u000a \\u000a Settings and Design  Prospective study in the surgical wards

  16. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...basis, that are related to covered ASC surgical...hospital's reasonable cost or customary charges...hospital's reasonable cost or customary charges...For the period of time beginning with the...of a hospital's cost reporting period...classified in diagnosis related groups 36...

  17. Epidemiology of paediatric surgical admissions to a government referral hospital in the Gambia.

    PubMed Central

    Bickler, S. W.; Sanno-Duanda, B.

    2000-01-01

    INTRODUCTION: There is a paucity of published data on the type of conditions that require surgery among children in sub-Saharan Africa. Such information is necessary for assessing the impact of such conditions on child health and for setting priorities to improve paediatric surgical care. METHODS: Described in the article is a 29-month prospective study of all children aged < 15 years who were admitted to a government referral hospital in the Gambia from January 1996 to May 1998. RESULTS: A total of 1726 children were admitted with surgical problems. Surgical patients accounted for 11.3% of paediatric admissions and 34,625 total inpatient days. The most common admission diagnoses were injuries (46.9%), congenital anomalies (24.3%), and infections requiring surgery (14.5%). The diagnoses that accounted for the greatest number of inpatient days were burns (18.8%), osteomyelitis (15.4%), fractures (12.7%), soft tissue injuries (3.9%), and head injuries (3.4%). Gambian children were rarely admitted for appendicitis and never admitted for hypertrophic pyloric stenosis. The leading causes of surgical deaths were burns, congenital anomalies, and injuries other than burns. DISCUSSION: Prevention of childhood injuries and better trauma management, especially at the primary and secondary health care levels, should be the priorities for improving paediatric surgical care in sub-Saharan Africa. Surgical care of children should be considered an essential component of child health programmes in developing countries. PMID:11143193

  18. Waiting times for surgical and diagnostic procedures in public hospitals in Mexico.

    PubMed

    Contreras-Loya, David; Gómez-Dantés, Octavio; Puentes, Esteban; Garrido-Latorre, Francisco; Castro-Tinoco, Manuel; Fajardo-Dolci, Germán

    2015-02-01

    Objective. A retrospective evaluation of waiting times for elective procedures was conducted in a sample of Mexican public hospitals from the following institutions: the Mexican Institute for Social Security (IMSS), the Institute for Social Security and Social Services for Civil Servants (ISSSTE) and the Ministry of Health (MoH). Our aim was to describe current waiting times and identify opportunities to redistribute service demand among public institutions. Materials and methods. We examined current waiting times and productivity for seven elective surgical and four diagnostic imaging procedures, selected on the basis of their relative frequency and comparability with other national health systems. Results. Mean waiting time for the seven surgical procedures in the three institutions was 14 weeks. IMSS and ISSSTE hospitals showed better performance (12 and 13 weeks) than the MoH hospitals (15 weeks). Mean waiting time for the four diagnostic procedures was 11 weeks. IMSS hospitals (10 weeks) showed better average waiting times than ISSSTE (12 weeks) and MoH hospitals (11 weeks). Conclusion. Substantial variations were revealed, not only among institutions but also within the same institution. These variations need to be addressed in order to improve patient satisfaction. PMID:25629277

  19. Variations in surgical rates in Quebec: does access to teaching hospitals make a difference?

    PubMed Central

    Blais, R

    1993-01-01

    OBJECTIVE: To document the geographic variations in the rates of 10 common surgical procedures in Quebec and to examine the relation between surgical rates and level of access to teaching hospitals. DESIGN: Population-based rates standardized for age and sex were calculated from 1985-88 data from MED-ECHO (the provincial hospital discharge database) for each of the 32 community health districts (départements de santé communautaire [DSCs]) in Quebec. Variation across DSCs was analysed with the use of the ratio of the highest to the lowest rate, the coefficient of variation and the systematic component of variation. On the basis of an urbanization index designed by Statistics Canada, DSCs were classified as having a low, medium, high or very high level of access to teaching hospitals. PATIENTS: All Quebec residents except those whose DSC of residence could not be traced (accounting for no more than 1.7% of patients for any study procedure) and aboriginal people from northern Quebec. SURGICAL PROCEDURES STUDIED: Appendectomy, cesarean section, cholecystectomy, coronary artery bypass grafting (CABG), hysterectomy, inguinal hernia repair, prostatectomy, tonsillectomy with or without adenoidectomy, total hip replacement and varicose vein stripping. RESULTS: There was considerable systematic variation in the surgical rates for all 10 procedures. Cesarean section, the rates of which varied the least, still exhibited almost a twofold variation between the highest and lowest rates. The rates of tonsillectomy varied the most, by a factor of more than five. With a few exceptions there was relatively little relation between the rates of the procedures within the DSCs. The rates of appendectomy, cholecystectomy, hysterectomy and tonsillectomy tended to be lower in the DSCs containing teaching hospitals, whereas the reverse was true for CABG. For the other procedures the relation between the rates and the level of access to teaching hospitals was nonsignificant. CONCLUSIONS: The overall consistency of the observed variations with those of previous studies invites a closer look at the practice patterns and the scientific basis of the clinical decisions associated with procedures showing high variations in rates. The lack of a systematic relation between the surgical rates and the level of access to teaching hospitals challenges the belief that remote regions are underserved with respect to the procedures studied. PMID:8485676

  20. Antibiotics Use Patterns for Surgical Prophylaxis Site Infection in Different Surgical Wards of a Teaching Hospital in Ahvaz, Iran

    PubMed Central

    Alavi, Seyed Mohammad; Roozbeh, Fatemeh; Behmanesh, Farzaneh; Alavi, Leila

    2014-01-01

    Background: Despite the effectiveness of prophylactic antimicrobials to prevent surgical site infection the use of antibiotic prophylaxis is often inappropriate. Objectives: The current study aimed to determine the pattern of prophylactic antibiotic use in a teaching hospital affiliated to Jundishapur University of Medical Sciences, Ahvaz, Iran. Patients and Methods: The current descriptive study included 8586 patients who received prophylactic antibiotics before surgery from April 2011 to March 2012, in Razi Hospital affiliated to Jundishapur University of Medical Sciences. Indications for antibiotic use, proper or inappropriate antibiotics, an antibiotic or combination of antibiotics, dosage and length of treatment for each patient based on the infectious disease textbook (Mandel's Principle and practice of infectious diseases) definitions were administrated. Results: Of the total 8586 patients who took antibiotics for preventive purposes, 4815 (56%) required antimicrobial prophylaxis, and 3771 (44%) patients did not. Of the 4815 patients who received prophylaxis, 86.9% received it appropriately, 13.1% received it inappropriately; 8.2% received inappropriate dosage, and 9.5% received antibiotic longer than 24 hours. Conclusions: The current study revealed that 44% of those who received prophylaxis did not need it. In the patients who received antibiotics, the most common mistakes were antibiotic selection followed by prolonged prophylaxis (> 24 hours) and excess dose. PMID:25774270

  1. Immediate versus delayed hysterectomy for endometrial carcinoma: surgical morbidity and hospital stay

    SciTech Connect

    Chambers, J.T.; Kapp, D.S.; Lawrence, R.; Kohorn, E.I.; Schwartz, P.E.

    1985-02-01

    A retrospective review presented is of the intraoperative complications, postoperative morbidity, and length of hospitalization in 138 patients with stage I endometrial carcinoma treated at Yale-New Haven Hospital from January 1, 1977 to December 31, 1981. One group (stage IA, grade 1) was treated with surgery alone; two groups were treated with preoperative intracavitary radium, followed with either an immediate or a delayed hysterectomy. The three groups were comparable in age, weight, and major preoperative medical problems. The mean estimated blood loss during surgery and transfusion requirements during hospitalization were similar for all three groups. The duration of the surgery in the immediate group was longer than the other two groups. The occurrence of febrile morbidity and major postoperative complications in the three groups was similar, except for bacteriuria, which was significantly more common in the immediate group. The length of the postoperative hospitalization was the same for each group; however, the delayed group as compared with the immediate group had a total hospitalization of two days longer. Hence, in the current study, immediate hysterectomy did not significantly increase the surgical or postoperative morbidity rate, compared with delayed hysterectomy. The single hospital stay in the former treatment group represented cost containment.

  2. Psychiatric disorders in gynaecological, surgical and medical departments of general hospitals in an urban and a rural area of Austria

    Microsoft Academic Search

    J. Wancata; N. Benda; M. Hajji; O. M. Lesch; C. Müller

    1996-01-01

    A total of 728 patients admitted to the medical, gynaecological and surgical departments of one urban and one rural general hospital in Austria were investigated for psychiatric morbidity. Using the Clinical Interview Schedule and its case criteria, the prevalence of psychiatric morbidity was found to be highest in medical departments (38.2%), followed by surgical departments (32.5%), and lowest in gynaecological

  3. Hospital Acquired Infections Among Patients Admitted in the Medical and Surgical Wards of a Non-Teaching Secondary Care Hospital in Northern India

    PubMed Central

    Ginawi, I.; Saleem, Mohd; Sigh, Mastan; Vaish, A.K.; Ahmad, I.; Srivastava, V.K.; Abdullah, A. Fahad M.

    2014-01-01

    Objective: To investigate the incidence of Nosocomial Infection (NI) and type of bacteriological isolates among the patients admitted in the medical and surgical wards of a non-teaching secondary care hospital in north India. Materials and Methods: This was a cross-sectional hospital based study conducted in the Wards of General Medicine, General Surgery and Orthopaedic of the hospital. The patient were admitted in the department for various surgical procedures, without evidence of initial infection, were included in the study. Results: A total of 176 patients were included in the study of which 82 were from Medical and 94 from Surgical ward. Overall incidence of NI was found to be 26.1% (Medical ward=28%, Surgical ward=24.5%., p=0.58). The isolation rate of Acinetobacter baumanii was (p=0.15) higher among the patients of medical ward (95.7%) than surgical ward (82.6). Escherichia coli was isolated in 89.1% and no significant difference was observed between medical and surgical wards. Klebsiella pneumoniae was isolated in 50% patients and was almost similar (p=0.37) in medical surgical wards. The isolation rate of Pseudomonos aeruginosa, Enterococcus faecalis, Staphylococcus aureus and Coagulase negative staphylococci were 43.5%, 73.9%, 34.8% and 17.4% respectively. A significant difference was observed in the isolation rate of Enterococcus faecalis (p=0.007) and Coagulase negative staphylococci (p=0.002) between medical and surgical wards. Overall, among the patients who developed NI, 27.2% patient’s bacterial isolates were Gram positive (Surgical=64.1, Medical=80%). Conclusion: The incidence of NI is increasing in the hospitals, so extensive that more care has to be taken in cleaning the wards of the hospitals. PMID:24701489

  4. Determinants of Malnutrition and Post-operative Complications in Hospitalized Surgical Patients

    PubMed Central

    de Aquino, José Luiz Braga

    2014-01-01

    ABSTRACT The study aimed to determine the nutritional status (NS) of hospitalized surgical patients and investigate a possible association between NS and type of disease, type of surgery and post-operative complications. The gender, age, disease, surgery, complications, length of hospital stay, number of medications, laboratory test results, and energy intake of 388 hospitalized surgical patients were recorded. NS was determined by classical anthropometry. The inclusion criteria were: nutritional status assessment done within the first 24 hours of admission, age ?20 years, and complete medical history. Univariate and multiple Cox's regression analyses were employed to determine which variables were possible risk factors of malnutrition and complications. Malnutrition was more common in males (p=0.017), individuals aged 70 to 79 years (p=0.000), and individuals with neoplasms and digestive tract diseases (p=0.000). Malnourished individuals had longer hospital stays (p=0.013) and required more medications (p=0.001). The risk of malnutrition was associated with age and disease. Individuals aged 70 years or more had a two-fold increased risk of malnutrition (p=0.014; RR=2.207; 95% CI 1.169-4.165); those with neoplasms (p=0.008; RR=14.950; 95% CI 2.011-111.151) and those having digestive tract diseases (p=0.009; RR=14.826; 95% CI 1.939-113.362) had a 14-fold increased risk of malnutrition. Complications prevailed in older individuals (p=0.016), individuals with longer hospital stays (p=0.007), and individuals who died (p=0.002). The risk of complications was associated with age and BMI. In the present study, the risk of malnutrition was associated with age and type of disease; old age and low BMI may increase complications. PMID:25395903

  5. Vacuum-based preservation of surgical specimens: An environmentally-safe step towards a formalin-free hospital

    Microsoft Academic Search

    Cinzia Di Novi; Davide Minniti; Silvana Barbaro; Maria Gabriella Zampirolo; Antonio Cimino; Gianni Bussolati

    2010-01-01

    Formalin as a fixative has no practical substitutes, but is toxic and potentially carcinogenic, so caution of its use in hospitals and elsewhere is mandatory. In our hospital, preservation of surgical specimens into formalin to be transferred to pathology labs was replaced by under-vacuum sealing (UVS) tissues into plastic bags and preservation at 4°C until transfer. Data analysis showed UVS

  6. Cost differences between academic and nonacademic hospitals: a case study of surgical procedures.

    PubMed

    Williams, Joe R; Matthews, Michael C; Hassan, Mahmud

    2007-01-01

    Decreased public funding, a competitive healthcare market, and higher patient care costs have been blamed for the present financial challenges that confront academic health centers. The authors examined the costs associated with graduate medical education, particularly, indirect medical education expenses in the operating room. The results indicate that it is more costly for teaching hospitals to provide surgical care to patients in the operating room. The academic health center's indirect graduate medical expenses only covered a portion of the increased costs. If the missions of academic health centers are perceived as a public good, policy makers must design a system that more appropriately compensates academic health centers for the additional costs associated with surgical procedures in graduate medical education. PMID:17405419

  7. LED Surgical Task Lighting Scoping Study: A Hospital Energy Alliance Project

    SciTech Connect

    Tuenge, Jason R.

    2011-01-17

    Tungsten-halogen (halogen) lamps have traditionally been used to light surgical tasks in hospitals, even though they are in many respects ill-suited to the application due to the large percentage of radiant energy outside the visible spectrum and issues with color rendering/quality. Light-emitting diode (LED) technology offers potential for adjustable color and improved color rendition/quality, while simultaneously reducing side-effects from non-visible radiant energy. It also has the potential for significant energy savings, although this is a fairly narrow application in the larger commercial building energy use sector. Based on analysis of available products and Hospital Energy Alliance member interest, it is recommended that a product specification and field measurement procedure be developed for implementation in demonstration projects.

  8. Incidence of healthcare associated infection in the surgical ICU of a tertiary care hospital

    PubMed Central

    Singh, Shivinder; Chaturvedi, R.; Garg, S.M.; Datta, Rashmi; Kumar, Ambikesh

    2012-01-01

    Background Healthcare associated infections (HAI) have taken on a new dimension with outbreaks of increasingly resistant organisms becoming common. Protocol-based infection control practices in the intensive care unit (ICU) are extremely important. Moreover, baseline information of the incidence of HAI helps in planning-specific interventions at infection control. Methods This hospital-based observational study was carried out from Dec 2009 to May 2010 in the 10-bedded surgical intensive care unit of a tertiary care hospital. CDC HAI definitions were used to diagnose HAI. Results A total of 293 patients were admitted in the ICU. 204 of these were included in the study. 36 of these patients developed HAI with a frequency of 17.6%. The incidence rate (IR) of catheter-related blood stream infections (CRBSI) was 16/1000 Central Venous Catheter (CVC) days [95% C.I. 9–26]. Catheter-associated urinary tract infections (CAUTI) 9/1000 urinary catheter days [95% C.I. 4–18] and ventilator-associated pneumonias (VAP) 32/1000 ventilator days [95% confidence interval 22–45]. Conclusion The HAI rates in our ICU are less than other hospitals in developing countries. The incidence of VAP is comparable to other studies. Institution of an independent formal infection control monitoring and surveillance team to monitor & undertake infection control practices is an inescapable need in service hospitals. PMID:24600084

  9. Planning and design of a surgical intensive care unit in a new regional hospital.

    PubMed

    Koay, C K; Fock, K M

    1998-05-01

    Critical care unit design has profound effect on work efficiency, infection control and psychology of patients and staff working in the area. A multidisciplinary team was involved in the design and planning of a surgical intensive care unit (SICU) in a new regional hospital. A workgroup consisting of clinicians, nurses, engineers and hospital administrators were involved in its planning. The Hospital Planning Committee oversaw the activities of the workgroup to ensure co-ordination and integration of the unit plan with the hospital plan. The issue on "single room" versus "open unit" patient room design was much debated. "Single room" concept was adopted and the cubicles were arranged radially facing a central station. Access of patients from the operating theatres and wards to the SICU was an important consideration. The design and facilities of various rooms in the SICU are described. New technology such as the automated guided vehicle, pneumatic tube system, floor mounted power column and closed circuit television were some of the useful assets available in the unit. PMID:9777097

  10. Adjunctive use of monthly physician questionnaires for surveillance of surgical site infections after hospital discharge and in ambulatory surgical patients: report of a seven-year experience.

    PubMed

    Manian, F A; Meyer, L

    1997-10-01

    We report our experience with the use of monthly physician questionnaires, in conjunction with traditional in-house monitoring, for surveillance of surgical site infections (SSIs) in inpatients after hospital discharge and in ambulatory surgical patients (i.e., those not requiring perioperative hospitalization) over a 7-year period (July 1988 to June 1995) involving 156,977 surgical procedures. The mean annual response rate was 73% and did not change significantly from year to year (range, 71% to 75%), but the proportion of surgical procedures covered by returned surveys increased during the study period from 75% to 81% in inpatients and from 78% to 86% in ambulatory surgical patients (p < 0.0001 for both comparisons). Of 1051 SSIs identified, 231 (22%) were identified solely by the survey: 16% of SSIs in inpatients after discharge and 66% of SSIs in ambulatory surgical patients. Of 787 cases meeting the criteria for SSI on the basis of in-house surveillance and listed on returned questionnaires, 366 (47%) were not marked as SSIs by the responding surgeons. We conclude that since its implementation in 1988, monthly physician surveys at our medical center continue to contribute significantly to identification of otherwise undetected SSIs. However, monthly questionnaires should only complement, not replace, traditional in-house surveillance. PMID:9343622

  11. Hospital variation in medical and surgical treatment of patent ductus arteriosus.

    PubMed

    Lee, Henry C; Durand, David J; Danielsen, Beate; Dueñas, Grace Villarin; Powers, Richard J

    2015-03-01

    Objective?This study aims to characterize population risks for diagnosis, medical treatment, and surgical ligation of patent ductus arteriosus (PDA) in very low-birth-weight infants. Study Design?Maternal and neonatal data were collected in 40 hospitals in California during 2011 for infants with birth weight???1,500?g without any congenital malformation, with a diagnosis of PDA. Multivariable logistic regression was used to determine independent risks for PDA diagnosis and for surgical ligation. Results?There were 770/1,902 (40.4%) infants diagnosed with PDA. Low birth weight, gestational age, respiratory distress syndrome, and surfactant administration were associated with PDA diagnosis. Ligation occurred in 43% of patients with birth weight???750?g, in 24% of patients weighing between 715 and 1,000?g, and in 12% of patients weighing from 1,001 to 1,500 g. Older gestational age (1?week, odds ratio 0.55, 95% confidence interval 0.48-0.63) and absence of respiratory distress syndrome (odds ratio 0.14, 95% confidence interval 0.03-0.59) were associated with lower ligation risk. The median hospital ligation rate was 14% (interquartile range 0-38%). Conclusion?Most patients with PDA receive treatment for closure. Practice variation may set the stage for further exploration of experimental trials. PMID:25241108

  12. Compliance with Surgical Care Improvement Project Measures and Hospital-Associated Infections Following Hip Arthroplasty

    PubMed Central

    Wang, Zhong; Chen, Foster; Ward, Michael; Bhattacharyya, Timothy

    2012-01-01

    Background: Hospital compliance with the Surgical Care Improvement Project (SCIP) measures has increased recently for patients undergoing hip arthroplasty. However, reductions in postoperative infections were less than expected, and concern remains about complications associated with prophylaxis against venous thromboembolism (VTE). We sought to examine the association between hospital adherence to SCIP measures and postoperative infections. Methods: We conducted an observational study of 17,714 patients who underwent hip replacement in 2008 at 128 New York state hospitals. These hospitals were divided into less compliant and highly compliant groups, on the basis of their levels of compliance compared with the median value of compliance with SCIP measures. From the New York State Department of Health annual report, we collected the confirmed postoperative infections at the facility level. From the Healthcare Cost and Utilization Project state inpatient database, we identified incidences of postoperative infections at the patient level, using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Results: During 2008, mean hospital compliance increased from 93.5% to 96.0% for the infection prevention measure and from 91.4% to 97.5% for the VTE prevention measure. Higher adherence to infection prevention measures was not associated with a significant reduction in infection (p ? 0.09 for all). Hospitals that were at least 97% compliant with the SCIP VTE-2 measure (patients receiving VTE prophylaxis around the time of surgery) reported significantly higher infection rates compared with less compliant hospitals (1.60% versus 0.93%; p < 0.001). Similarly, patients from highly compliant hospitals (for the VTE-2 measure) were at significant risk of postoperative infection (adjusted odds ratio, 1.50; 95% confidence interval, 1.07 to 2.12; p = 0.02). Conclusions: Targeting complete compliance with SCIP infection prevention measures was not associated with additional reductions in infection outcomes following hip replacement. Furthermore, significant risk of postoperative infections may result from increased perioperative use of VTE prophylactics. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. PMID:22740029

  13. Evaluation of surveillance for surgical site infections in Thika Hospital, Kenya

    PubMed Central

    Aiken, A.M.; Wanyoro, A.K.; Mwangi, J.; Mulingwa, P.; Wanjohi, J.; Njoroge, J.; Juma, F.; Mugoya, I.K.; Scott, J.A.G.; Hall, A.J.

    2013-01-01

    Summary Background In low-income countries, surgical site infections (SSIs) are a very frequent form of hospital-acquired infection. Surveillance is an important method for controlling SSI but it is unclear how this can best be performed in low-income settings. Aim To examine the epidemiological characteristics of various components of an SSI surveillance programme in a single Kenyan hospital. Methods The study assessed the inter-observer consistency of the surgical wound class (SWC) and American Society of Anesthesiologists (ASA) scores using the kappa statistic. Post-discharge telephone calls were evaluated against an outpatient clinician review ‘gold standard’. The predictive value of components of the Centers for Disease Control and Prevention – National Healthcare Safety Network (CDC-NHNS) risk index was examined in patients having major obstetric or gynaecological surgery (O&G) between August 2010 and February 2011. Findings After appropriate training, surgeons and anaesthetists were found to be consistent in their use of the SWC and ASA scores respectively. Telephone calls were found to have a sensitivity of 70% [95% confidence interval (CI): 47–87] and a specificity of 100% (95% CI: 95–100) for detection of post-discharge SSI in this setting. In 954 patients undergoing major O&G operations, the SWC score was the only parameter in the CDC-NHNS risk index model associated with the risk of SSI (odds ratio: 4.00; 95% CI: 1.21–13.2; P = 0.02). Conclusions Surveillance for SSI can be conducted in a low-income hospital setting, although dedicated staff, intensive training and local modifications to surveillance methods are necessary. Surveillance for post-discharge SSI using telephone calls is imperfect but provides a practical alternative to clinic-based diagnosis. The SWC score was the only predictor of SSI risk in O&G surgery in this context. PMID:23332563

  14. Incidence of adverse events in an integrated US healthcare system: a retrospective observational study of 82,784 surgical hospitalizations

    PubMed Central

    2014-01-01

    Background Many health care facilities have developed electronic reporting systems for identifying and reporting adverse events (AEs), so that measures can be taken to improve patient safety. Although several studies have examined AEs in surgical settings, there has not previously been a systematic assessment of the variations in adverse event rates among different types of surgery, nor an identification of the particular types of AEs that are most common within each surgical category. Additionally, this study will identify the AE severity level associated with each of the AE category types. Methods This retrospective observational study was conducted at three Midwestern hospitals that are part of a large integrated healthcare system. Data from 2006 through 2009 were analyzed to determine the rates of reported adverse events (per 1,000 hospitalizations involving a surgical procedure) for 96 categories of surgery as classified according to the ICD-9-CM procedural coding system. Univariate and bivariate summary statistics were compiled for AEs by type, severity, and patient age. Results During the four-year study period, there was a total of 82,784 distinct hospitalizations involving at least one surgical procedure at these three hospitals. At least one adverse event was reported at 5,368 (6.5%) of those hospitalizations. The mean rate of AEs among all surgical procedure groups was 82.8 AEs per 1,000 hospitalizations. Adverse event rates varied widely among surgical categories with a high of 556.7 AEs per 1,000 hospitalizations for operations on the heart and pericardium. The most common type of adverse event involved care management, followed by medication events and events related to invasive procedures. Conclusions Detecting variations in AEs among surgical categories can be useful for surgeons and for hospital quality assurance personnel. Documenting the specific AE incidence rates among the most common types of surgical categories, and determining AE severity and age distributions within surgical categories will enable officials to better identify specific patient safety needs and develop appropriately targeted interventions for improvement. PMID:24932219

  15. Study of patient satisfaction in a surgical unit of a tertiary care teaching hospital

    PubMed Central

    Mishra, P.H.; Gupta, Shakti

    2012-01-01

    Background The hospitals have evolved from being an isolated sanatorium to a place with five star facilities. Patients and their relatives coming to the hospital not only expect world-class treatment, but also other facilities to make their stay comfortable in the hospital. This change in expectation has come due to tremendous growth of media and its exposure, as well as commercialization and improvement in facilities. The aim of this study was to evaluate the level of patient/relatives satisfaction at tertiary care teaching hospital and feedback from them for improvement of the same. Methods The study was conducted by 1. Review of available national and international literature on the subject. 2. Carrying out survey amongst 50 patients and their relatives at one of the surgical unit by using structured questionnaire. 3. By analyzing the data using appropriate statistical methods. Results Eighty two percent people were satisfied with the service at admission counter while 81% were satisfied with room preparation at the time of admission. The nursing services satisfied 80% of people while 92% were satisfied with explanation about disease and treatment by doctor. The behavior of nurses, doctors and orderlies satisfied 92, 92 and 83% of people. The cleanliness of toilets satisfied only 49% while diet services satisfied 78% of people. Conclusion The five major satisfiers were behavior of doctors, explanation about disease and treatment, courtesy of staff at admission counter, behavior and cooperation of nurses. The five major dissatisfiers were cleanliness of toilets, quality of food, explanation about rules and regulation, behavior of orderlies and sanitary attendant and room preparedness.

  16. Quality of surgical care in hospitals providing internship training in Kenya: a cross sectional survey.

    PubMed Central

    Mwinga, Stephen; Kulohoma, Colette; Mwaniki, Paul; Idowu, Rachel; Masasabi, John; English, Mike

    2015-01-01

    Objective To evaluate services in hospitals providing internship training to graduate doctors in Kenya. Methods A survey of 22 internship training hospitals was conducted. Availability of key resources spanning infrastructure, personnel, equipment and drugs was assessed by observation. Outcomes and process of care for pre-specified priority conditions (head injury, chest injury, fractures, burns and acute abdomen) were evaluated by auditing case records. Results Each hospital had at least one consultant surgeon. Scheduled surgical outpatient clinics, major ward rounds and elective (half day) theatre lists were provided once per week in 91%, 55% and 9%, respectively. In all other hospitals, these were conducted twice weekly. Basic drugs were not always available (e.g. gentamicin, morphine and pethidine in 50%, injectable antistaphylococcal penicillins in 5% hospitals). Fewer than half of hospitals had all resources needed to provide oxygen. One hundred and forty-five of 956 cases evaluated underwent operations under general or spinal anaesthesia. We found operation notes for 99% and anaesthetic records for 72%. Pre-operatively measured vital signs were recorded in 80% of cases, and evidence of consent to operation was found in 78%. Blood loss was documented in only one case and sponge and instrument counts in 7%. Conclusions Evaluation of surgical services would be improved by development and dissemination of clear standards of care. This survey suggests that internship hospitals may be poorly equipped and documented care suggests inadequacies in quality and training. Objectif Evaluer les services dans les hôpitaux offrant des stages de formation à des médecins diplômés au Kenya. Méthodes Enquête auprès de 22 hôpitaux offrant des stages de formation. La disponibilité des ressources clés incluant infrastructure, personnel, matériel et médicaments a été évaluée par observation. Les résultats et processus de soins pour des affections prioritaires prédéfinies (blessure à la tête, blessure à la poitrine, fractures, brûlures et maux d'estomac aigus) ont été évalués par l'audit des dossiers des cas. Résultats Chaque hôpital avait au moins un chirurgien consultant. Les cliniques chirurgicales ambulatoires planifiées, les principales tournées dans les chambres d'hospitalisation et des listes d'opérations choisies (demi-journée) ont été fournies une fois par semaine dans 91%, 55% et 9% des cas respectivement. Dans tous les autres hôpitaux, cela a été effectué deux fois par semaine. Les médicaments de base n’étaient pas toujours disponibles (par ex. la gentamicine, la morphine et la péthidine dans 50% des hôpitaux, les pénicillines anti-staphylococciques injectables dans 5%). Moins de la moitié des hôpitaux disposaient de toutes les ressources nécessaires pour fournir de l'oxygène. 145 sur 956 cas évalués ont subi des opérations sous anesthésie générale ou rachidienne. Nous avons retrouvé des notes d'opération pour 99% des cas et des dossiers d'anesthésie pour 72%. Les mesures préopératoires des signes vitaux ont été enregistrées dans 80% des cas et la preuve du consentement pour l'opération a été trouvée dans 78% des cas. La perte de sang a été documentée dans un seul cas et le comptage des éponges et instruments dans 7% des cas. Conclusions L’évaluation des services de chirurgie serait améliorée par le développement et la dissémination de normes de soins claires. Cette étude suggère que les hôpitaux offrant des stages peuvent être mal équipés et les soins enregistrés suggèrent des insuffisances dans la qualité et la formation. Objetivo Evaluar los servicios en hospitales que proveen entrenamiento a m

  17. Analysis of wounds incurred by U.S. Army Seventh Corps personnel treated in Corps hospitals during Operation Desert Storm, February 20 to March 10, 1991.

    PubMed

    Carey, M E

    1996-03-01

    One hundred and forty-three soldiers who received ballistic injury were actively treated at U.S. Army Seventh Corps hospitals during Operation Desert Storm. Ninety-five percent were wounded by fragments, 5% by bullets. Many had wounds of several body parts, including 17.3% who received a head wound; 4.3% a neck wound; 5.8% a chest wound; 9.3% an abdominal wound; and 90% who had extremity wounds. Three hospital deaths occurred--a 2.1% mortality rate. Only two soldiers sustained a brain wound; in both, the missile entered below the skull area protected by the Kevlar helmet. One brainwounded individual was treated and lived; the other died from hemorrhage and shock from concomitant traumatic lower-extremity amputations. The current U.S. helmet appears to provide significant protection from fragmenting ordnance as does the armored vest. Hemorrhage from proximal extremity wounds caused hospital deaths. Treatment of such wounds will have to be improved to reduce future combat mortality. PMID:8606402

  18. The increasing number of surgical procedures for female genital fistula in England: analysis of Hospital Episode Statistics (HES) data.

    PubMed

    Ismail, S I M F

    2015-01-01

    The aim of this study was to describe the number and trend of surgical procedures for female genital fistula in England. An online search of Hospital Episode Statistics (HES) data was carried out. Data were available for the 4-year period from 2002-03 until 2005-06. The total number of surgical procedures carried out for female genital fistula steadily increased by 28.7% from 616 in 2002-03 to 793 in 2005-06. The number of surgical procedures performed for rectovaginal fistula exceeded the total number of surgical procedures carried out for vesicovaginal and urethrovaginal fistula in each year of the study period. This pattern needs to be monitored and investigated further. PMID:25020114

  19. Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Uganda

    PubMed Central

    2013-01-01

    Background Surgical site infections (SSIs) are difficult to treat and are associated with substantially longer hospital stay, higher treatment cost, morbidity and mortality, particularly when the etiological agent is multidrug-resistant (MDR). To address the limited data in Uganda on SSIs, we present the spectrum of bacteria isolated from hospitalized patients, the magnitude and impact of MDR bacterial isolates among patients with SSIs. Methods A descriptive cross sectional study was conducted from September 2011 through April 2012 involving 314 patients with SSIs in the obstetrics & gynecology, general surgery and orthopedic wards at Mulago National Hospital in Kampala, Uganda. Wound swabs were taken and processed using standard microbiological methods. Clinico-demographic characteristics of patients were obtained using structured questionnaires and patients’ files. Results Of the 314 enrolled patients with SSIs (mean age 29.7 ±13.14 years), 239 (76.1%) were female. More than half of the patients were from obstetrics and gynecology (62.1%, 195/314). Of 314 wound swabs taken, 68.8% (216/314) were culture positive aerobically, yielding 304 bacterial isolates; of which 23.7% (72/304) were Escherichia coli and 21.1% (64/304) were Staphylococcus aureus. More than three quarters of Enterobacteriaceae were found to be extended spectrum beta lactamase (ESBL) producers and 37.5% of S. aureus were Methicillin resistant S. aureus (MRSA). MDR occurred in 78.3% (238/304) of the isolates; these were more among Gram-negative bacteria (78.6%, 187/238) compared to Gram-positive bacteria (21.4%, 51/238), (p-value?Hospital are due to MDR bacteria. Isolation of MRSA and ESBL-producing Enterobacteriaceae in higher proportions than previously reported calls for laboratory guided SSIs- therapy and strengthening of infection control surveillance in this setting. PMID:23890206

  20. The direct cost of care among surgical inpatients at a tertiary hospital in south west Nigeria

    PubMed Central

    Ilesanmi, Olayinka Stephen; Fatiregun, Akinola Ayoola

    2014-01-01

    Introduction This study was conducted to assess the direct cost of care and its determinants among surgical inpatients at university College Hospital, Ibadan. Methods A retrospective review of records of 404 inpatients that had surgery from January to December, 2010 was conducted. Information was extracted on socio-demographic variables, investigations, drugs, length of stay (LOS) and cost of carewith a semi-structured pro-forma. Mean cost of care were compared using t-test and Analysis of variance (ANOVA). Linear regression analysis was used to identify determinants of cost of care. Level of significance of 5% was used. In year 2010 $1 was equivalent to 150 naira ($1=? 150). Results The median age of patients was 30 years with inter-quartile range of 13-42 years. Males were 257(63. 6%). The mean overall cost of care was ?66,983 ± ?31,985. Cost of surgery is about 50% of total cost of care. Patient first seen at the Accident and Emergency had a significantly higher mean cost of care of ß = ?17,207(95% CI: ?4,003 to ?30,410). Neuro Surgery (ß=?36,210), and Orthopaedic Surgery versus General Surgery(ß=?10,258),and Blood transfusion (ß=?18,493) all contributed to cost of care significantly. Increase of one day in LOS significantly increased cost of care by ?2,372. 57. Conclusion The evidence evaluated here shows that costs and LOS are interrelated. Attempt at reducing LOS will reduce the costs of care of surgical inpatient. PMID:25360187

  1. Improvement of teamwork and safety climate following implementation of the WHO surgical safety checklist at a university hospital in Japan.

    PubMed

    Kawano, Takashi; Taniwaki, Miki; Ogata, Kimiyo; Sakamoto, Miwa; Yokoyama, Masataka

    2014-06-01

    With the aim to optimize surgical safety, the World Health Organization (WHO) introduced the Surgical Safety Checklist (SSCL) in 2008. The SSCL has been piloted in many countries worldwide and shown to improve both safety attitudes within surgical teams and patient outcomes. In the study reported here we investigated whether implementation of the SSCL improved the teamwork and safety climate at a single university hospital in Japan. All surgical teams at the hospital implemented the SSCL in all surgical procedures with strict adherence to the SSCL implementation manual developed by WHO. Changes in safety attitudes were evaluated using the modified operating-room version of the Safety Attitudes Questionnaire (SAQ). A before and after design was used, with the questionnaire administered before and 3 months after SSCL implementation. Our analysis revealed that the mean scores on the SAQ had significantly improved 3 months after implementation of the SSCL compared to those before implementation. This finding implies that effective implementation of the SSCL could improve patient outcomes in Japan, similar to the findings of the WHO pilot study. PMID:24170220

  2. Changing Use of Surgical Antibiotic Prophylaxis in Thika Hospital, Kenya: A Quality Improvement Intervention with an Interrupted Time Series Design

    PubMed Central

    Aiken, Alexander M.; Wanyoro, Anthony K.; Mwangi, Jonah; Juma, Francis; Mugoya, Isaac K.; Scott, J. Anthony G

    2013-01-01

    Introduction In low-income countries, Surgical Site Infection (SSI) is a common form of hospital-acquired infection. Antibiotic prophylaxis is an effective method of preventing these infections, if given immediately before the start of surgery. Although several studies in Africa have compared pre-operative versus post-operative prophylaxis, there are no studies describing the implementation of policies to improve prescribing of surgical antibiotic prophylaxis in African hospitals. Methods We conducted SSI surveillance at a typical Government hospital in Kenya over a 16 month period between August 2010 and December 2011, using standard definitions of SSI and the extent of contamination of surgical wounds. As an intervention, we developed a hospital policy that advised pre-operative antibiotic prophylaxis and discouraged extended post-operative antibiotics use. We measured process, outcome and balancing effects of this intervention in using an interrupted time series design. Results From a starting point of near-exclusive post-operative antibiotic use, after policy introduction in February 2011 there was rapid adoption of the use of pre-operative antibiotic prophylaxis (60% of operations at 1 week; 98% at 6 weeks) and a substantial decrease in the use of post-operative antibiotics (40% of operations at 1 week; 10% at 6 weeks) in Clean and Clean-Contaminated surgery. There was no immediate step-change in risk of SSI, but overall, there appeared to be a moderate reduction in the risk of superficial SSI across all levels of wound contamination. There were marked reductions in the costs associated with antibiotic use, the number of intravenous injections performed and nursing time spent administering these. Conclusion Implementation of a locally developed policy regarding surgical antibiotic prophylaxis is an achievable quality improvement target for hospitals in low-income countries, and can lead to substantial benefits for individual patients and the institution. PMID:24244390

  3. [Integrated medical records for surgical services: a new tool for a new hospital model].

    PubMed

    Terranova, Giuseppina; Cortesi, Elisabetta; Briani, Silvia; Giannini, Raffaella; Bartolomei, Marco; Corsale, Italo; Biscioni, Luca; Caffi, Tiziana; Paganelli, Ilaria; Frugoli, Patrizia; Ammazzini, Daniela

    2007-01-01

    According to a modern definition, the patient's medical record is a tool shared by health-care professionals whose purpose is to support the planning, providing and documenting of patient-centred care. The requirements and regulations of medical records, which date back to the sixties, need now be adapted to more recent organisational models based on different levels of care intensity and strongly integrated patient-oriented care approaches designed to create connectivity, alignment and collaboration within and between different professional fields. On this basis, the SS. Cosma and Damiano Hospital Chief Physician endorsed a multiprofessional project providing for the complete reorganisation of surgical activities according to the above-mentioned approach and, at the same time, for the elaboration of an "integrated" medical record, capable of overcoming the traditional separation between medical and nursing documents. This paper presents the results of a long period of complex teamwork consisting in revising and sharing a new medical record model based on principles of professional integration and patient-centredness in health-care provision. PMID:18360986

  4. [Ways to decrease postoperative mortality in acute surgical diseases of the abdominal organs in a city hospital].

    PubMed

    Guzeev, A I

    2000-01-01

    Under analysis there were 4227 case histories of patients operated upon in 1978-1987 for acute surgical diseases of the abdominal organs. It was found that diagnostic, tactical and technical medical errors had taken place in 24.8% of the cases at the hospital stage. In 113 dead patients errors responsible for the lethal outcome were found in 30% of the cases. For the period from 1987 to 1997 postoperative lethality from acute surgical diseases was substantially decreased due to the improvement of professional training of the surgeons, less amount of errors, using the present-day methods of treatment and surgery. PMID:10983334

  5. 78 FR 43533 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    ...facilities, under the Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP); Long-term care hospitals, under the Long-Term Care Hospital Quality Reporting (LTCHQR) Program; PPS-exempt cancer hospitals, under the...

  6. Radiation Therapy After Breast-Conserving Surgery: Does Hospital Surgical Volume Matter? A Population-Based Study in Taiwan

    SciTech Connect

    Chien, Chun-Ru [Section of Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Department of Radiation Oncology, China Medical University Hospital, and School of Medicine, China Medical University, Taichung, Taiwan (China); Pan, I-Wen [Section of Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Tsai, Yi-Wen [Center of Health Policy Research and Development, National Health Research Institutes, Miaoli County, Taiwan (China); Institute of Health and Welfare Policy, National Yang-Ming University Hospital, Taipei, Taiwan (China); Tsai, Teressa [Center of Health Policy Research and Development, National Health Research Institutes, Miaoli County, Taiwan (China); Liang, Ji-An [Department of Radiation Oncology, China Medical University Hospital, and School of Medicine, China Medical University, Taichung, Taiwan (China); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Shih, Ya-Chen Tina, E-mail: yashih@mdanderson.org [Section of Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2012-01-01

    Purpose: To examine the association between hospital surgical volume and the use of radiation therapy (RT) after breast-conserving surgery (BCS) in Taiwan. Methods and Materials: We used claims data from the National Health Insurance program in Taiwan (1997-2005) in this retrospective population-based study. We identified patients with breast cancer, receipt of BCS, use of radiation, and the factors that could potentially associated with the use of RT from enrollment records, and the ICD-9 and billing codes in claims. We conducted logistic regression to examine factors associated with RT use after BCS, and performed subgroup analyses to examine whether the association differs by medical center status or hospital volumes. Results: Among 5,094 patients with newly diagnosed invasive breast cancer who underwent BCS, the rate of RT was significantly lower in low-volume hospitals (74% vs. 82%, p < 0.01). Patients treated in low-volume hospitals were less likely to receive RT after BCS (odds ratio = 0.72, 95% confidence interval = 0.62-0.83). In addition, patients treated after the implementation of the voluntary pay-for-performance policy in 2001 were more likely to receive RT (odds ratio = 1.23; 95% confidence interval = 1.05-1.45). Subgroup analyses indicated that the high-volume effect was limited to hospitals accredited as non-medical centers, and that the effect of the pay-for-performance policy was most pronounced among low-volume hospitals. Conclusions: Using population-based data from Taiwan, our study concluded that hospital surgical volume and pay-for-performance policy are positively associated with RT use after BCS.

  7. Postoperative Pain Management among Surgically Treated Patients in an Ethiopian Hospital

    PubMed Central

    Woldehaimanot, Tewodros Eyob; Eshetie, Tesfahun Chanie; Kerie, Mirkuzie Woldie

    2014-01-01

    Background Incidence of postoperative pain has been reported to be between 47–100%. Ineffective postoperative pain management results in tangible and intangible costs. The purpose of this study was to assess the processes and outcomes of pain management in the surgical wards of Jimma University Specialized Hospital, Ethiopia. Methods and Findings A prospective cross sectional study was conducted among 252 postoperative patients during February 13 to April 30, 2012. A contextually modified and validated (Cronbach’s ? coefficient of 0.78) American Pain Society Patient Outcome Questionnaire was used to assess pain experience of patients. Patients’ charts were reviewed to assess the pattern of analgesic use. Incidence of postoperative pain was 91.4%, and remained high over 3 measurements (McNemar’s; p<0.05), and 80.1% of the patients were undertreated. The mean pain intensity, and pain interference on functional status were 6.72±1.44 and 5.61±1.13 on a 10 point Numerical rating scale respectively; both being strongly correlated(r?=?0.86: p<0.001). Pain intensity was varied by ethnicity, education and preoperative information (ANOVA; P<0.05). Only 50% of the patients were adequately satisfied with their pain management. As needed (prn), solo analgesic, null analgesic, and intramuscular orders were noted for 31.3%, 89.29%, 9.7% and 20.1% of the prescription orders respectively. Though under dose, diclofenac and tramadol were the top prescribed medications, and only 57% of their dose was administered. Linear regression model showed that the predictors of satisfaction were sex of an individual and pain interference with functional status. Conclusion Despite patients’ paradoxical high satisfaction with pain management, the majority of patients were inadequately and inappropriately treated. Thus, further research is needed to determine how best to break down current barriers to effective pain management. PMID:25033399

  8. Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting

    PubMed Central

    2014-01-01

    Background Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. Methods A cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients’ record files for informed consent documentation was done. Results A total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0–39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient’s disease. Conclusions Informed consent administration and documentation for surgical health care is still inadequate at University teaching hospitals in Uganda. PMID:24885609

  9. Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok

    PubMed Central

    Luksamijarulkul, Pipat; Aiempradit, Natkitta; Vatanasomboon, Pisit

    2014-01-01

    Objective To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards. Methods This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Gram’s stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearson’s correlation coefficient at the significant level of p<0.050. Results Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively). For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively. Conclusion High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards. PMID:25337311

  10. Evaluation of Prevalence and Risk Factors of Hepatitis G Virus Infection Among Hemodialysis Patients Referred to Iranian Army Hospitals in Tehran During 2012-2013

    PubMed Central

    Dadmanesh, Maryam; Hosseinzadeh, Mohammad; Keyvani, Hossein; Ghorban, Khodayar; Rahimi, Maryam; Hosseinzadeh, Mehdi; Ranjbar, Mohammad Mehdi

    2015-01-01

    Background: GB virus C (GBV-C) or hepatitis G virus (HGV) is a newly discovered and enveloped RNA positive-stranded flavivirus-like particle, which has not yet been proven to have major negative effects on liver. Objectives: Increasing the risk of blood-borne infections in hemodialysis patients is a main health care concern in different countries. Therefore, it is important to estimate the prevalence and risk factors of hepatitis G virus infection in Iranian hemodialysis patients to design standard prevention and treatment plans. Patients and Methods: In this multicenter observational or epidemiologic study, 138 patients who underwent hemodialysis in Iranian Army hospitals in Tehran were included. Serum HIV antibody (Ab), HCV antibody and HBS antigen (Ag) were assessed. Demographic data such as gender, age, blood group, cause of renal failure, dialysis onset and duration were collected from medical files. GBV-C/HGV was evaluated by nested reverse transcription polymerase chain reaction (RT-PCR) method. Then, all data were analyzed by SPSS ver. 13. Results: In total, 81 males and 57 females were included. The mean age of patients was 62.16 ± 14.86 years. Six (4.3%) had positive results for GBV-C/HGV by RT-PCR. Except gender (P = 0.045) and duration of dialysis in a week (P < 0.001), other demographic factors revealed no significant difference (P > 0.05). All patients had negative results for HIV Ab, HCV Ab and HBS Ag. Conclusions: Overall, 4.3% of patients had positive results for GBV-C/HGV and all negative for HIV, HCV and HBV. Further studies are needed to elucidate real prevalence, risk factors and characteristics of HGV infection in Iranian hemodialysis patients. PMID:25741370

  11. 76 FR 74121 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-30

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient......

  12. Risk-assessment models for predicting venous thromboembolism among hospitalized non-surgical patients: a systematic review.

    PubMed

    Huang, Wei; Anderson, Frederick A; Spencer, Frederick A; Gallus, Alexander; Goldberg, Robert J

    2013-01-01

    Venous thromboembolism (VTE) prophylaxis is suboptimal in American hospitals despite long-standing evidence-based recommendations. Data from observational studies indicate a lower uptake of effective prophylaxis in patients hospitalized with medical versus surgical conditions. Reluctance to use prophylaxis in medical patients has been attributed to difficulty in identifying at-risk patients and balancing risks of bleeding against occurrence of VTE. Several risk-assessment models (RAMs) have been proposed to assist physicians in identifying non-surgical patients who need prophylaxis. We conducted a systematic review of published RAMs, based on objective criteria, to determine whether any RAM is validated sufficiently to be employed in clinical practice. We identified 11 RAMs, six derived from primary data and five based on expert opinion. The number, types, and strength of association of VTE risk predictors were highly variable. The variability in methods and outcome measurement precluded pooled estimates of these different models. Published RAMs for VTE lack generalizability and adequate validation. As electronic health records become more ubiquitous, validated dynamic RAMs are needed to assess VTE risk at the point-of-care in real time. PMID:22826096

  13. [Head nurse at Kabul military hospital].

    PubMed

    Le Bec, Myriam; Serre, Vincent; Rondier, Philippe; De Montleau, Franck

    2014-09-01

    The French medical and surgical army hospital in Kabul supports coalition armed forces and delivers care to the local population. Technical and human managerial experience is essential for the position of head nurse whose role is central to the preparation of paramedical teams before deployment. Once deployed, working in an international environment, the head nurse has many missions to carry out, some routine while others, in a context of crisis are more out of the ordinary. PMID:25464634

  14. 77 FR 45061 - Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems and Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ...Healthcare-associated infection HCERA Health Care and Education Reconciliation...defibrillator ICU Intensive care unit IHS Indian Health Service...Rehabilitation Facility-Patient Assessment Instrument LDR Low dose rate LTCH Long-term care hospital MAC Medicare...

  15. Impact of a major hurricane on surgical services in a university hospital.

    PubMed

    Norcross, E D; Elliott, B M; Adams, D B; Crawford, F A

    1993-01-01

    Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on September 17, hurricane damage by high winds and an 8.7-foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigeration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of temperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include: 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support. PMID:8480928

  16. Is endovascular repair of ruptured abdominal aortic aneurysms associated with improved in-hospital mortality compared with surgical repair?

    PubMed

    Antoniou, George A; Ahmed, Naseer; Georgiadis, George S; Torella, Francesco

    2015-01-01

    A best evidence topic in vascular surgery was constructed according to a structured protocol. The question addressed was whether patients with ruptured abdominal aortic aneurysm (AAA) treated with endovascular aneurysm repair (EVAR) have improved in-hospital outcomes compared with conventional surgical repair. The reported search retrieved 1398 reports, of which 6 papers were thought to represent the best available evidence to answer the study question. Three randomized trials were identified. The first was a pilot trial conducted in a single centre in the UK, which recruited 32 patients and found similar 30-day mortality in the patient groups. The second trial, conducted in Netherlands, recruited 116 patients anatomically suitable for EVAR. This trial found no significant difference in the composite of death and severe complications within 30 days of intervention between patients subjected to EVAR and those undergoing open repair (42 vs 47%; absolute risk reduction 5.4%, 95% confidence interval: -13% to +23%). The IMPROVE trial, based on a pragmatic design, demonstrated similar 30-day mortality in the 613 patients randomized to endovascular strategy or open repair (35.4 vs 37.4%, P = 0.62). The average hospital costs within the first 30 days of randomization were similar between the randomized groups, with an incremental cost-saving for the endovascular strategy vs open repair of £1186. Meta-analysis of all three randomized trials in a Cochrane review found no difference in 30-day or in-hospital mortality between EVAR and open repair (odds ratio: 0.91, 95% confidence interval: 0.67-1.22; P = 0.52). In contrast, a systematic review and meta-analysis, mainly of observational, cohort studies, and another large, nationwide study demonstrated EVAR to be associated with improved in-hospital results compared with open repair, as expressed by mortality, severe complications, length of hospital stay and proportion of patients discharged home. Even though randomized trials demonstrate equivalent in-hospital mortality with EVAR and open repair, large-scale, nationwide, observational studies and meta-analyses have shown EVAR to confer improved in-hospital mortality and morbidity in patients with favourable aneurysm morphology stable enough to undergo imaging. Reconfiguration of acute aortic services and establishment of standardized institutional protocols might be advisable for improvements in the management of ruptured AAA. PMID:25281705

  17. Molecular Characterization of Staphylococcus aureus from Patients with Surgical Site Infections at Mulago Hospital in Kampala, Uganda

    PubMed Central

    Seni, Jeremiah; Bwanga, Freddie; Najjuka, Christine F.; Makobore, Patson; Okee, Moses; Mshana, Stephen E.; Kidenya, Benson R.; Joloba, Moses L.; Kateete, David P.

    2013-01-01

    Background The prevalence of Methicillin resistant Staphylococcus aureus (MRSA) is progressively increasing globally with significant regional variation. Understanding the Staphylococcus aureus lineages is crucial in controlling nosocomial infections. Recent studies on S. aureus in Uganda have revealed an escalating burden of MRSA. However, the S. aureus genotypes circulating among patients are not known. Here, we report S. aureus lineages circulating in patients with surgical site infections (SSI) at Mulago National hospital, Kampala, Uganda. Methods A cross-sectional study involving 314 patients with SSI at Mulago National Hospital was conducted from September 2011 to April 2012. Pus swabs from the patients’ SSI were processed using standard microbiological procedures. Methicillin sensitive Staphylococcus aureus (MSSA) and MRSA were identified using phenotypic tests and confirmed by PCR-detection of the nuc and mecA genes, respectively. SCCmec genotypes were determined among MRSA isolates using multiplex PCR. Furthermore, to determine lineages, spa sequence based-genotyping was performed on all S. aureus isolates. Results Of the 314 patients with SSI, S. aureus accounted for 20.4% (64/314), of which 37.5% (24/64) were MRSA. The predominant SCCmec types were type V (33.3%, 8/24) and type I (16.7%, 4/24). The predominant spa lineages were t645 (17.2%, 11/64) and t4353 (15.6%, 10/64), and these were found to be clonally circulating in all the surgical wards. On the other hand, lineages t064, t355, and t4609 were confined to the obstetrics and gynecology wards. A new spa type (t10277) was identified from MSSA isolate. On multivariate logistic regression analysis, cancer and inducible clindamycin resistance remained as independent predictors of MRSA-SSI. Conclusion SCCmec types I and V are the most prevalent MRSA mecA types from the patients’ SSI. The predominant spa lineages (t645 and t4353) are clonally circulating in all the surgical wards, calling for strengthening of infection control practices at Mulago National Hospital. PMID:23840416

  18. Surgical treatment of primary intracardiac myxoma: 20-year experience in "shahid modarres hospital"-a tertiary university hospital-tehran, iran.

    PubMed

    Ansari Aval, Zahra; Ghaderi, Hamid; Tatari, Hassan; Foroughi, Mahnoosh; Mirjafari, Seyedeh Adeleh; Forozeshfard, Mohammad; Fani, Kamal; Khaheshi, Isa

    2015-01-01

    Although cardiac tumors are not common they may vary in terms of race and surgical approach in different countries. Method. Patients data of 20 years was collected and evaluated in the "Shahid Modarres Hospital"-a tertiary university hospital-Tehran, Iran. Results. 42 patients with cardiac myxoma (all cases in 20 years) were included in study, 17 males and 25 females, age difference: 13 to 76 years (mean 50.6). Most of patients were in functional classes I, II. 35 patients complained of dyspnea and 3 patients had embolic events. 97.6% of tumors were primary (41 patients) and one tumor was recurrent (2.4%), 85.7% of tumors (36 cases) were located in LA, and 88.1% of tumors (37 cases) were pediculated. 40 patients (95%) had one tumor. In 22 patients (52.3%) after tumor resection septal defects were repaired primarily while in 18 patients (42.8%) the defects were repaired with pericardial patch and In one patient, tumor resected without any septal defect. Mean tumor size was about 5.22?cm (range of 2.2 to 8.2?cm). Postoperatively, 33 patients discharged from hospital without any complication. Discussion. The research reveals that patients' age and gender were similar to that of other studies in other countries while tumor's incidence seems to be higher. 3 patients were diagnosed after remote embolic event and one patient was diagnosed after MI reflecting relatively high tumor complications and late diagnosis. Conclusion. In our study mean time from diagnosis to operation was too long. The patients had more preoperative embolic events and complication. However, size of myxoma and location of that was as same as its rate in the other literature. As recommendation we suggested that in all patients with vague chest pain or remote embolic events cardiac myxomas should be ruled out. PMID:25688375

  19. Surgical Treatment of Primary Intracardiac Myxoma: 20-Year Experience in “Shahid Modarres Hospital”—A Tertiary University Hospital—Tehran, Iran

    PubMed Central

    Ansari Aval, Zahra; Ghaderi, Hamid; Tatari, Hassan; Foroughi, Mahnoosh; Mirjafari, Seyedeh Adeleh; Forozeshfard, Mohammad; Fani, Kamal; Khaheshi, Isa

    2015-01-01

    Although cardiac tumors are not common they may vary in terms of race and surgical approach in different countries. Method. Patients data of 20 years was collected and evaluated in the “Shahid Modarres Hospital”—a tertiary university hospital—Tehran, Iran. Results. 42 patients with cardiac myxoma (all cases in 20 years) were included in study, 17 males and 25 females, age difference: 13 to 76 years (mean 50.6). Most of patients were in functional classes I, II. 35 patients complained of dyspnea and 3 patients had embolic events. 97.6% of tumors were primary (41 patients) and one tumor was recurrent (2.4%), 85.7% of tumors (36 cases) were located in LA, and 88.1% of tumors (37 cases) were pediculated. 40 patients (95%) had one tumor. In 22 patients (52.3%) after tumor resection septal defects were repaired primarily while in 18 patients (42.8%) the defects were repaired with pericardial patch and In one patient, tumor resected without any septal defect. Mean tumor size was about 5.22?cm (range of 2.2 to 8.2?cm). Postoperatively, 33 patients discharged from hospital without any complication. Discussion. The research reveals that patients' age and gender were similar to that of other studies in other countries while tumor's incidence seems to be higher. 3 patients were diagnosed after remote embolic event and one patient was diagnosed after MI reflecting relatively high tumor complications and late diagnosis. Conclusion. In our study mean time from diagnosis to operation was too long. The patients had more preoperative embolic events and complication. However, size of myxoma and location of that was as same as its rate in the other literature. As recommendation we suggested that in all patients with vague chest pain or remote embolic events cardiac myxomas should be ruled out. PMID:25688375

  20. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia

    PubMed Central

    2014-01-01

    Background Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patients. Patients may perceive the day of surgery as the biggest and the most threatening day in their lives. There is paucity of information on predictors of anxiety in the current study area. The main objective of this study is to assess predictors of preoperative anxiety among patients scheduled for surgery in Jimma University Specialized Teaching Hospital. Methods A facility based cross-sectional study was conducted using quantitative data collection technique in Jimma University Specialized Teaching Hospital from February 13 to April 13, 2012 on 239 patients scheduled for surgery. The data were collected by five trained diploma nurses using structured interviewer administered questionnaires that were prepared based on state trait anxiety inventory measurement scale. The quantitative data were entered into SPSS for windows version 16. 0 and descriptive, simple and multiple linear regression analyses were performed. Results A total of 239 patients were enrolled in the study with a response rate of 93.0%. Their mean age was 42.7?±?1.8 years (range 16 to 85 years). Nearly over half 53.6% were females, while 48.1% illiterate, 72.4% Oromo and 56.5% were Muslim followers. Significant preoperative anxiety was seen in 70.3% patients. The most common factors that lead to anxiety were fear of death 38.1% and fear of unknown origin 24.3% and the most common strategy mentioned by patient in reducing anxiety were talking to other patient 79.8% and religious belief. Conclusions In the present study, two third 70.3% of preoperative patients had anxiety. Factors which were positively correlated with anxiety were trait anxiety, single and divorced, time of operation and income. Factors which were shown to reduce anxiety were preoperative anxiety related information provision and afternoon operation. Health professionals working in the hospital should provide anxiety related information for patients. PMID:25189274

  1. Surgical Revascularization for Acute Coronary Insufficiency: Analysis of Risk Factors for Hospital Mortality

    Microsoft Academic Search

    Biagio Tomasco; Antonino Cappiello; Rosario Fiorilli; Archimede Leccese; Raniero Lupino; Antonio Romiti; Ugo F Tesler

    1997-01-01

    Background. A retrospective study of 444 patients undergoing urgent and emergent coronary artery bypass grafting for acute coronary insufficiency was performed to identify the risk factors for hospital death specifically associated with the clinical severity of the acute coronary insufficiency syndrome.Methods. The patients were divided into three groups—urgent, emergent A, and emergent B—on the basis of the evolution of the

  2. Surgical Travellers: Tapestry to Bayeux

    PubMed Central

    Hedley-Whyte, John; Milamed, Debra R

    2014-01-01

    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant Surgeons was of great value to the Allies. PMID:25484466

  3. Surgical travellers: tapestry to Bayeux.

    PubMed

    Hedley-Whyte, John; Milamed, Debra R

    2014-09-01

    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant Surgeons was of great value to the Allies. PMID:25484466

  4. Surgical Technologists

    MedlinePLUS

    ... the average for all occupations. Advances in medical technology have made surgery safer, and more operations are ... universities and hospitals, have accredited programs in surgical technology. Programs range in length from several months to ...

  5. Environment US Army Corps

    E-print Network

    US Army Corps of Engineers

    Environment The Corps US Army Corps of Engineers ® April 2012 Vol. 13, No. 2 See Earth Day page 10 of the U.S. Army Corps of Engineers A s we approach Earth Day 2012, it affords us the opportunity to look The U.S. Army Earth Day poster. (Illustration by U.S. Army Environmental Command) and technical

  6. Patient safety in surgical environments: Cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety

    PubMed Central

    2010-01-01

    Background How hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS). Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway. Methods This survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report. Results The professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6) for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ? 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory. Conclusions The psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating theatre personnel perceived their hospital's patient safety climate far more negatively than the health care personnel in hospitals in the United States and with perceptions more comparable to those of health care personnel in hospitals in the Netherlands. In fact, the surgical personnel in our hospital may perceive that patient safety climate is less focused in our hospital, at least compared with the results from hospitals in the United States. PMID:20860787

  7. Pediatric Day Case Surgical Practice at a Tertiary Hospital in Lagos: How Have We Faired?

    PubMed Central

    Elebute, OA; Ademuyiwa, AO; Bode, CO; Idiodi-Thomas, HOI

    2014-01-01

    Background: There has been a gradual increase in the number of patients treated as a day case surgery in our center. This study has been conducted to audit pediatric day case surgery practice at the Lagos University Teaching Hospital. Aims: The aim of the following study is to determine the morbidity and mortality from day case surgery in our center. Subjects and Methods: The type of study was a prospective study over a 2½ year period at the Lagos University Teaching Hospital. The patients scheduled for surgeries were assessed in the pediatric outpatient clinic and information obtained for each of the patients included age, sex, diagnosis and operation planned. Additional information collected included the (1) type of anesthesia (2) post-operative complications and the cadre of the surgeon. The data was analyzed using SPSS version 19 (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp, USA). Result: A total of 381 patients were operated during the study period. The age range of patients was 2 weeks to 15 years and the mean age was 2.9 years (3.0). There were 338 male patients (88.7%;338/381) and 43 females (11.3%;43/381). Inguinal hernias and hydroceles constituted almost half of the cases treated while 16.0% of cases were undescended testis. There were four morbidities and no mortality. Conclusion: Day case surgery is associated with a low morbidity and no mortality in our center. PMID:25221704

  8. A Prospective Study on Malnutrition and Duration of Hospitalisation among Hospitalised Geriatric Patients Admitted to Surgical and Medical Wards of Hospital Universiti Kebangsaan Malaysia

    Microsoft Academic Search

    Suzana Shahar; Wong Sun Fun; Wan Chak; Pa' Wan Chik

    Elderly people are known to be at a greater risk of malnutrition, particularly those having diseases or illnesses. A prospective study was undertaken on 92 hospitalised geriatric patients (45.6% males), aged 60 to 89 years old, admitted to surgical and medical wards at Hospital Universiti Kebangsaan Malaysia (HUKM). The study aimed to assess malnutrition at admission, day 3 and day

  9. Surgical Management of Adenocarcinoma of the Pancreatic Uncinate Process in a Cancer Hospital in Egypt

    PubMed Central

    Roshdy, Sameh; Hussein, Osama; Abdallah, Ahmed; Abdel-Wahab, Khaled; Senbel, Ahmed

    2015-01-01

    INTRODUCTION Pancreatic carcinoma affecting the uncinate process is a challenging surgical condition. Several considerations affect the management plan, including the need for vascular resection and the ability to achieve a clear margin. METHODS The data of 19 patients who had curative resection for pancreatic adenocarcinoma of the uncinate process were reviewed. Operative mortality and morbidity, and disease-free survival (DFS) were calculated. RESULTS The study population included 13 male and 6 female patients with a mean age of 55 years. Nine patients (47.4%) had stage I disease, seven patients (36.8%) had stage II disease, and three patients (15.8%) had stage III disease. A total of 12 patients had Whipple procedure and 7 patients had total pancreatectomy. In total, there were 9 R0 and 10 R1 resections. Operative mortality rate was 10.5% (2/19), postoperative leakage rate was 21.1% (4/19), and wound sepsis rate was 21.1%. Median DFS was 19.2 months. Survival was superior in the Whipple procedure group than in the total pancreatectomy group (median survival 19 months vs 4 months, respectively). Vascular resection and retroperitoneal safety margin status did not affect disease relapse. CONCLUSION Non-metastatic pancreatic adenocarcinoma of the uncinate process should be offered R0 or R1 resection whenever technically feasible. PMID:25635169

  10. Official U.S. Army Internet Sources Army Home page: www.army.mil

    E-print Network

    US Army Corps of Engineers

    page (www.army. mil) provides official Army news and information and links to Army social media sites://www.army.mil/news/ Early Bird: http://ebird.osd.mil/ebird2/index.html Information: http://www.army.mil/info/ Benefits: https://myarmybenefits.us.army.mil Audio/video: http://www.army.mil/media/amp/ Mobile phone apps: http

  11. Benchmarking the Use of a Rapid Response Team by Surgical Services at a Tertiary Care Hospital

    PubMed Central

    Barocas, Daniel A; Kulahalli, Chirag S; Ehrenfeld, Jesse M; Kapu, April N; Penson, David F; You, Chaochen (Chad); Weavind, Lisa; Dmochowski, Roger

    2015-01-01

    BACKGROUND Rapid response teams (RRT) are used to prevent adverse events in patients with acute clinical deterioration, and to save costs of unnecessary transfer in patients with lower-acuity problems. However, determining the optimal use of RRT services is challenging. One method of benchmarking performance is to determine whether a department's event rate is commensurate with its volume and acuity. STUDY DESIGN Using admissions between 2009 and 2011 to 18 distinct surgical services at a tertiary care center, we developed logistic regression models to predict RRT activation, accounting for days at-risk for RRT and patient acuity, using claims modifiers for risk of mortality (ROM) and severity of illness (SOI). The model was used to compute observed-to-expected (O/E) RRT use by service. RESULTS Of 45,651 admissions, 728 (1.6%, or 3.2 per 1,000 inpatient days) resulted in 1 or more RRT activations. Use varied widely across services (0.4% to 6.2% of admissions; 1.39 to 8.73 per 1,000 inpatient days, unadjusted). In the multivariable model, the greatest contributors to the likelihood of RRT were days at risk, SOI, and ROM. The O/E RRT use ranged from 0.32 to 2.82 across services, with 8 services having an observed value that was significantly higher or lower than predicted by the model. CONCLUSIONS We developed a tool for identifying outlying use of an important institutional medical resource. The O/E computation provides a starting point for further investigation into the reasons for variability among services, and a benchmark for quality and process improvement efforts in patient safety. PMID:24275072

  12. Bacterial Contamination of Hospital Bed-Control Handsets in a Surgical Setting: A Potential Marker of Contamination of the Healthcare Environment

    PubMed Central

    Brady, RRW; Kalima, P; Damani, NN; Wilson, RG; Dunlop, MG

    2007-01-01

    INTRODUCTION Patients undergoing colorectal surgical resections have a high incidence of surgical site infection (SSI). Many patient-specific risk factors have been recognised in association with SSI in such patients, but environmental contamination is increasingly recognised as a contributor to hospital-acquired infection (HAI). This study set out to describe the bacterial contamination of the patient environment, using hospital bed-control handsets, as they are frequently handled by both staff and patients and represent a marker of environmental contamination. PATIENTS AND METHODS On two unannounced sampling events, 1 week apart, 140 bacteriological assessments were made of 70 hospital bed control handsets within a specialist colorectal surgical unit. RESULTS Of the handsets examined, 67 (95.7%) demonstrated at least one bacterial species (52.9% grew 1, 30% grew 2 and 12.9% grew 3 or more bacterial species). Of these, 29 (41.4%) bed-control handsets grew bacteria known to cause nosocomial infection, including 22 (31.4%) handsets which grew Enterococcus spp., 9 (12.9%) which grew MRSA, 2 (2.9%) which grew MSSA, 2 (2.9%) which grew coliforms, and 1 (1.4%) handset which grew anaerobes. At 1-week follow-up, 31 bed-control handsets showed evidence of contamination by the same bacterial species. CONCLUSIONS This study revealed high levels of bacteria known to cause HAI, contaminating hospital bed-control handsets in a surgical setting. Further study is now required to confirm whether hospital environmental contamination is causally involved in SSI. PMID:17959000

  13. Validation of a whole slide imaging system for primary diagnosis in surgical pathology: A community hospital experience

    PubMed Central

    Buck, Thomas P.; Dilorio, Rebecca; Havrilla, Lauren; O’Neill, Dennis G.

    2014-01-01

    Guidelines for validating whole slide imaging (WSI) for primary diagnosis in surgical pathology have been recommended by an expert panel commissioned by the College of American Pathologists. The implementation of such a system using these validation guidelines has not been reported from the community hospital setting. The objective was to implement a WSI system, validate each pathologist using the system and run the system in parallel with routine glass slide interpretation. Six pathologists re-reviewed approximately 300 previously diagnosed specimens each, divided equally between glass slides and digital images (scanned at ×20). Baseline intraobserver discordance rates (glass to glass) were calculated and compared to discordance rates between the original glass slide interpretation and the reviewed digital slide interpretation. A minimum of 3 months was used as the washout period. After validation, a subset of daily cases was diagnosed in parallel using traditional microscopy (TM) and WSI over an 8-month period. The TM and WSI discordance rates ranged from 3.3% to 13.3% and 2.1% to 10.1%, respectively. There was no statistically significant difference among the pathologists. The parallel study yielded similar rates of discordances. In our laboratory, after appropriate implementation and training, there was no difference between the WSI and TM methods. PMID:25535591

  14. Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili national hospital, Tanzania

    PubMed Central

    2014-01-01

    Background Surgical site infections (SSIs) remain a common and widespread problem contributing to a significant morbidity and mortality, attributed partly by the increase in antimicrobial resistance among the etiological agents. This study was done to determine the spectrum of bacterial isolates and their susceptibility patterns causing SSIs at Muhimbili National Hospital, Tanzania. Methods This descriptive cross sectional study was conducted between September, 2011 and February, 2012. Pus swabs or pus were cultured on blood agar (Oxoid, UK) and MacConkey agar (Oxoid, UK) and incubated aerobically at 37°C for 18–24 hours. Bacterial identification was done using API 20E and VITEK and antimicrobial susceptibility was determined by Kirby Bauer disc diffusion. Results Of the 100 patients, from whom wound swabs were collected, 90 (90%) had positive aerobic bacterial growth. A total of 147 pathogenic bacteria were isolated, including 114 (77.5%) gram negative and 33(22.5%) gram positive organisms. The most prevalent bacterial species were Pseudomonas aeruginosa (16.3%), followed by Staphylococcus aureus (12.2%) and Klebsiella pneumoniae (10.8%). Of the 18?S. aureus , 8 (44%) were methicillin resistant Staphylococcus aureus (MRSA) and three of them (17%) were carrying both MRSA and induced clindamycin resistance (ICR). Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were observed in 23 (79.3%) of the 29 isolates tested. Majority of Escherichia coli 12 (92.3%) and K. pneumoniae 11 (69%) isolates were ESBL producers. About 63% (93/147) were multiple-drug resistance (MDR) isolates, and the overall MDR among Gram positive and Gram negative bacteria was 60.6% (20/33) and 61.4%, (73/114), respectively. The prevalence of MDR for E. coli, A. baumannii and P. stuartii was 100% each. Majority (97%) of the Gram negative bacteria were resistant to more than four categories (classes) of antibiotics. Conclusion A high proportion (63%) of the isolates causing SSIs in this tertiary hospital were MDR, of which (90%) were resistant to more than four classes of antibiotics. In the light of these findings, an urgent and significant change in antibiotic prescription policy is required at this National hospital. PMID:25100042

  15. Major Harvey Cushing's difficulties with the British and American armies during World War I.

    PubMed

    Carey, Michael E

    2014-08-01

    This historical review explores Harvey Cushing's difficulties with both the British and American armies during his World War I service to definitively examine the rumor of his possible court martial. It also provides a further understanding of Cushing the man. While in France during World War I, Cushing was initially assigned to British hospital units. This service began in May 1917 and ended abruptly in May 1918 when the British cashiered him for repeated censorship violations. Returning to American command, he feared court martial. The army file on this matter (retrieved from the United States National Archives) indicates that US Army authorities recommended that Cushing be reprimanded and returned to the US for his violations. The army carried out neither recommendation, and no evidence exists that a court martial was considered. Cushing's army career and possible future academic life were protected by the actions of his surgical peers and Merritte Ireland, Chief Surgeon of the US Army in France. After this censorship episode, Cushing was made a neurosurgical consultant but was also sternly warned that further rule violations would not be tolerated by the US Army. Thereafter, despite the onset of a severe peripheral neuropathy, probably Guillian Barré's syndrome, Cushing was indefatigable in ministering to neurosurgical needs in the US sector in France. Cushing's repeated defying of censorship regulations reveals poor judgment plus an initial inability to be a "team player." The explanations he offered for his censorship violations showed an ability to bend the truth. Cushing's war journal is unclear as to exactly what transpired between him and the British and US armies. It also shows no recognition of the help he received from others who were instrumental in preventing his ignominious removal from service in France. Had that happened, his academic future and ability to train future neurosurgical leaders may have been seriously threatened. Cushing's foibles notwithstanding, all realized that he contributed greatly to both British and US war neurosurgery. United States Army surgeons who operated upon brain wounds in France recognized Cushing as their leader. PMID:24949679

  16. Isolation and antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia

    PubMed Central

    2014-01-01

    Background Staphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital. Methods A cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors. Results Of the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus. Conclusion The prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents. PMID:24949197

  17. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south side. - Fitzsimons General Hospital, Officers' Garage, West Pennington Avenue, West of Building 129, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south and west sides. - Fitzsimons General Hospital, Utilities Storeroom, West Pennington Avenue, East of Building No. 145, Aurora, Adams County, CO

  19. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Storage Sheds, Northeast Corner of West Pennington Avenue & North Eighth Street, Aurora, Adams County, CO

  20. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover) south and east sides. - Fitzsimons General Hospital, Nurses' Garage, East of Building No. 121, Aurora, Adams County, CO

  1. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), showing west side. - Fitzsimons General Hospital, Fire Equipment House, North Page Street, North of Building No. 228, Aurora, Adams County, CO

  2. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south side. - Fitzsimons General Hospital, Office Building, Northwest Corner of West McCloskey Avenue & North Tenth Street, Aurora, Adams County, CO

  3. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Post Exchange Garage, Northwest Corner of West Pennington Avenue & North Eighth Street, Aurora, Adams County, CO

  4. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), north side. - Fitzsimons General Hospital, Administration Building, Southeast Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

  5. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Storehouse, East Harlow Avenue, immediately South of Building 201, Aurora, Adams County, CO

  6. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Infirmary, Northwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  7. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), showing east side and north sides. - Fitzsimons General Hospital, Transformer House, North Page Street, immediately North of Building No. 217, Aurora, Adams County, CO

  8. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth clover), west side. - Fitzsimons General Hospital, Motor Transport Dispatcher's Office, Northeast Corner of East Harlow Avenue & North Tenth Street, Aurora, Adams County, CO

  9. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Nurses Quarters No. 3, Northwest Corner of West Harlow Avenue & North Seventh Street, Aurora, Adams County, CO

  10. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Tubercular Ward, Southeast Corner of East Harlow Avenue & South Page Street, Aurora, Adams County, CO

  11. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south sides. - Fitzsimons General Hospital, Officer Recreation Building, West Harlow Avenue, immediately East of Building 118, Aurora, Adams County, CO

  12. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), west and north sides of the southern wing. - Fitzsimons General Hospital, Laundry, Southeast corner of East Harlow Avenue & South Twelfth Street, Aurora, Adams County, CO

  13. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Tubercular Ward, Southwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  14. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), east side. - Fitzsimons General Hospital, Shops Building, Northwest Corner of West Pennington Avenue, & North Tenth Street, Aurora, Adams County, CO

  15. Photocopy of print from the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of print from the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Tool House, West Pennington Avenue, North of Building No. 140, Aurora, Adams County, CO

  16. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Artesian Well, East McCloskey Avenue, East of Building No. 231, Aurora, Adams County, CO

  17. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and west sides. - Fitzsimons General Hospital, Power House, Northwest Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  18. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), showing east side. - Fitzsimons General Hospital, Transformer House, North Page Street, immediately North of Building No. 216, Aurora, Adams County, CO

  19. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Turbercular Ward, Northwest Corner of Charlie Kelly Boulevard & South Hickey Street, Aurora, Adams County, CO

  20. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing southwest corner of building 732. - Fitzsimons General Hospital, Storehouses, Northwest Corner of East Harlow Avenue & North Thirteenth Street, Aurora, Adams County, CO

  1. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Ambulent Tubercular Ward, Southeast Corner of East Bushnell Avenue & South Hickey Street, Aurora, Adams County, CO

  2. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Workshop Building, East Harlow Avenue, immediately East of Building No. 529, Aurora, Adams County, CO

  3. Photocopy of photograph in Fitzsimons Army Medial Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medial Center Real Property Book (green cloth cover), south and west sides. - Fitzsimons General Hospital, Officers Quarters, Northeast Corner of West Harlow Avenue & North Seventh Street, Aurora, Adams County, CO

  4. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Post Exchange Garage, North Eighth Street, North of Building No. 143, Aurora, Adams County, CO

  5. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south side. - Fitzsimons General Hospital, Laboratory Annex, Northwest Corner of East McCloskey Avenue & North Twelfth Street, Aurora, Adams County, CO

  6. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Greenhouse, West Pennington Avenue, East of Building No. 139, Aurora, Adams County, CO

  7. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover) - Fitzsimons General Hospital, Quartermaster Store House, Northwest Corner of East I Avenue & North Twelfth Street, Aurora, Adams County, CO

  8. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and east sides. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

  9. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), probably southwest side. - Fitzsimons General Hospital, Operating Pavilion, West McAfee Avenue, East of Building No. 507, Aurora, Adams County, CO

  10. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Nurses' Quarters, Southwest Corner of West Harlow Avenue, & South Eighth Street, Aurora, Adams County, CO

  11. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), showing south and west sides. - Fitzsimons General Hospital, Salvage Building, Northeast Corner of East I Avenue & North Page Street, Aurora, Adams County, CO

  12. Photocopy of photograph from Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from Fitzsimons Army Medical Center real property book (green cloth cover), south and west sides. - Fitzsimons General Hospital, Gymnasium, Northeast Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  13. Photocopy of print in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of print in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south side. - Fitzsimons General Hospital, Female Dormitory, Southeast Corner of West McCloskey Avenue & North Seventh Street, Aurora, Adams County, CO

  14. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), probably south and west sides. - Fitzsimons General Hospital, Nurses' Quarters, Southeast Corner of West McAfee Avenue & South Hickey Street, Aurora, Adams County, CO

  15. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and north sides. - Fitzsimons General Hospital, Wagon Shed with Office, Southeast Corner of East J Avenue & North Tenth Street, Aurora, Adams County, CO

  16. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), looking east. - Fitzsimons General Hospital, Tennis Courts, Northeast Corner of East McCloskey Avenue & North Hickey Street, Aurora, Adams County, CO

  17. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Pharmacy & Prophylactic Station, Northwest Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

  18. 21. Post Engineer Office, Presidio of San Francisco, Letterman Army ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. Post Engineer Office, Presidio of San Francisco, Letterman Army Hospital. EKG Cardiology Clinic, Building 1049. December 1955. BUILDING 1049. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  19. [A surgical safety checklist implementation: experience of a start-up phase of a collaborative project in hospitals of Catalonia, Spain].

    PubMed

    Secanell, Mariona; Orrego, Carola; Vila, Miquel; Vallverdú, Helena; Mora, Núria; Oller, Anna; Bañeres, Joaquim

    2014-07-01

    Surgical patient safety is a priority in the national and international quality healthcare improvement strategies. The objective of the study was to implement a collaborative intervention with multiple components and to evaluate the impact of the patient surgical safety checklist (SSC) application. This is a prospective, longitudinal multicenter study with a 7-month follow-up period in 2009 based on a collaborative intervention for the implementation of a 24 item-SSC distributed in 3 different stages (sign in, time out, sign out) for its application to the surgical patient. A total number of 27 hospitals participated in the strategy. The global implementation rate was 48% (95%CI, 47.6%-48.4%) during the evaluation period. The overall compliance with all the items of the SSC included in each stage (sign in, time out, sign out) was 75,1% (95%CI, 73.5%-76.7%) for the sign in, 77.1% (95%CI, 75.5%-78.6%) for the time out and 88.3% (95%CI, 87.2%-89.5%) for the sign out respectively. The individual compliance with each item of the SSC has remained above 85%, except for the surgical site marking with an adherence of 67.4% (95%CI, 65.7%-69.1%)] and 71.2% (95%CI, 69.6%-72.9%)] in the sign in and time out respectively. The SSC was successfully implemented to 48% of the surgeries performed to the participating hospitals. The global compliance with the SSC was elevated and the intervention trend was stable during the evaluation period. Strategies were identified to allow of a higher number of surgeries with application of the SSC and more professional involvement in measures compliance such as surgical site marking. PMID:25128355

  20. A qualitative study comparing experiences of the surgical safety checklist in hospitals in high-income and low-income countries

    PubMed Central

    Aveling, Emma-Louise; McCulloch, Peter; Dixon-Woods, Mary

    2013-01-01

    Objective Bold claims have been made for the ability of the WHO surgical checklist to reduce surgical morbidity and mortality and improve patient safety regardless of the setting. Little is known about how far the challenges faced by low-income countries are the same as those in high-income countries or different. We aimed to identify and compare the influences on checklist implementation and compliance in the UK and Africa. Design Ethnographic study involving observations, interviews and collection of documents. Thematic analysis of the data. Setting Operating theatres in one African university hospital and two UK university hospitals. Participants 112?h of observations were undertaken. Interviews with 39 theatre and administrative staff were conducted. Results Many staff saw value in the checklist in the UK and African hospitals. Some resentment was present in all settings, linked to conflicts between the philosophy behind the checklist and the realities of local cultural, social and economic contexts. Compliance—involving use, completeness and fidelity—was considerably higher, though not perfect, in the UK settings. In these hospitals, compliance was supported by established structures and systems, and was not significantly undermined by major resource constraints; the same was not true of the low-income context. Hierarchical relationships were a major barrier to implementation in all settings, but were more marked in the low-income setting. Introducing a checklist in a professional environment characterised by a lack of accountability and transparency could make the staff feel jeopardised legally, professionally, and personally, and it encouraged them to make misleading records of what had actually been done. Conclusions Surgical checklist implementation is likely to be optimised, regardless of the setting, when used as a tool in multifaceted cultural and organisational programmes to strengthen patient safety. It cannot be assumed that the introduction of a checklist will automatically lead to improved communication and clinical processes. PMID:23950205

  1. US Army War College

    NSDL National Science Digital Library

    The Strategic Studies Institute is the primary research faculty of the U.S. Army War College, and includes both civilian scholars and uniformed military officers with extensive experience in national security and military affairs. The most common products of the Institute are SSI Studies which deal with topics having strategic implications for the Army, the Department of Defense, and the larger National Security community. Additional information is available on the mission, history, and organization of SSI, plus a link to the U.S. Army Military History Institute. http://carlisle-www.army.mil/usassi/

  2. Army Regulation 38510 Headquarters

    E-print Network

    US Army Corps of Engineers

    (para 23-6). o Clarifies policy for decommissioning sites with Nuclear Regulatory Commission licensed This major revision, dated 27 November 2013-- o Adds responsibility for U.S. Army Technical Center explosives safety policy and doctrine (para 1-4a(17)). o Provides guidance on the Army Readiness Assessment

  3. Environment US Army Corps

    E-print Network

    US Army Corps of Engineers

    three years here while his troops fattened themselves from the "breadbasket" of the Middle East. (PhotoEnvironment The Corps US Army Corps of Engineers ® January 2012 Vol. 13, No. 1 By Brenda Beasley's natural and cultural resources began getting some relief and improvement when the U.S. Army Corps

  4. WVU Healthcare Employee Donates to Pediatric Ophthalmology Lacy Fisher, surgical technician at Ruby Hospital, has been assisting our ophthalmologists for

    E-print Network

    Mohaghegh, Shahab

    from pediatric strabismus to cornea transplants. Lacy loves her work and the patients she cares for years old. Because Lacy wanted to do something special for the children cared for in pediatric on a child's face like a stuffed toy." "Lacy's contributions to the quality of care we provide our surgical

  5. Foramen magnum meningiomas: detailed surgical approaches and technical aspects at Lariboisière Hospital and review of the literature

    PubMed Central

    George, Bernard

    2007-01-01

    Foramen magnum meningiomas are challenging tumors, requiring special considerations because of the vicinity of the medulla oblongata, the lower cranial nerves, and the vertebral artery. After detailing the relevant anatomy of the foramen magnum area, we will explain our classification system based on the compartment of development, the dural insertion, and the relation to the vertebral artery. The compartment of development is most of the time intradural and less frequently extradural or both intraextradural. Intradurally, foramen magnum meningiomas are classified posterior, lateral, and anterior if their insertion is, respectively, posterior to the dentate ligament, anterior to the dentate ligament, and anterior to the dentate ligament with extension over the midline. This classification system helps to define the best surgical approach and the lateral extent of drilling needed and anticipate the relation with the lower cranial nerves. In our department, three basic surgical approaches were used: the posterior midline, the postero-lateral, and the antero-lateral approaches. We will explain in detail our surgical technique. Finally, a review of the literature is provided to allow comparison with the treatment options advocated by other skull base surgeons. PMID:17882459

  6. High quality surgical care at low cost: the diagnostic camp model of Burrows Memorial Christian Hospital (BMCH)

    Microsoft Academic Search

    J. Gnanaraj; Lau Ye Xiang Jason; Hannah Khiangte

    2007-01-01

    Background  The major problems that patients in rural areas face are related to accessibility, affordability and availability.\\u000a \\u000a \\u000a \\u000a Aims of the study  This study aims to evaluate how effectively the Diagnostic Camp Model of the institution meets the surgical needs of rural\\u000a patients, by examining the logistics, economics and extent of the service provided.\\u000a \\u000a \\u000a \\u000a Settings and design  A retrospective study of patients attending the

  7. A Study on the Usage Pattern of Antimicrobial Agents for the Prevention of Surgical Site Infections (SSIs) in a Tertiary Care Teaching Hospital

    PubMed Central

    Khan A.K, Afzal; P.V, Mirshad; Rashed, Mohammed Rafiuddin; Banu, Gausia

    2013-01-01

    Context: Inappropriate antimicrobial use increases the incidence of drug resistance, drug toxicity and superinfections, thereby increasing the healthcare costs. Various approaches for rationalizing the antimicrobial therapy, have been suggested. Collection of baseline data on the pattern of the antimicrobial use is usually suggested as the first step in this direction, which will help in identifying the problem areas, which demand our attention. Aims: To study the usage pattern of prophylactic antimicrobials in surgical patients, in order to detect any inappropriateness concerning the selection, timing, redosing and the duration of antimicrobial administration. Settings and Design: A retrospective review of the randomly selected medical records of general surgical cases over an 8 month period in a tertiary care teaching hospital. Methods and Material: The medical records of 258 patients who had undergone surgical procedures were verified for the appropriateness of the antimicrobial prophylaxis, with respect to the choice of the antimicrobial agent, the time of its administration, the intraoperative dosing, and the duration of the postoperative use. The obtained data was analyzed and conclusions were drawn with the help of descriptive statistics. Results: Third generation cephalosporins were used preoperatively in all the 258(100%) patients through the intravenous route. In addition, 77(30%) patients received metronidazole or amikacin. The antimicrobials were administered half an hour to one hour before the surgery. No intraoperative redosing was given. The duration of the postoperative prophylaxis was extended to 36 hours or more in 248(96%) of the cases. Conclusions: The timing of administration of the preoperative dose was appropriate and well delegated to the operating room nurse. The intra operative dose was appropriately omitted. The main concern was the increasing use of the third generation cephalosporins and the unnecessary prolonged duration of the postoperative prophylaxis, which needed to be addressed. PMID:23730643

  8. Optimization of surgical supply inventory and kitting

    E-print Network

    Schlanser, Matthew R. (Matthew Ross)

    2013-01-01

    This project centered on inventory optimization for operative custom surgical packs and soft good supplies for Massachusetts General Hospital (MGH), a 947-bed medical center. Custom surgical packs are used in every surgical ...

  9. Army Geospatial Center

    NSDL National Science Digital Library

    Based in Virginia, the primary mission of the Army Geospatial Center (AGC) is "to coordinate, integrate, and synchronize geospatial information requirements and standards across the Army." On the home page, visitors can learn about the AGC's ongoing initiatives via the How Can We Help You area. Here visitors can learn about different thematic projects dealing with civil works, terrain, imagery, and hydrology. Moving along, visitors can use the AGC Publications area to look through engineering manuals and reports. Some of the most intriguing works here are "Geographic Profiling Military Capabilities" and "El Nino-Its Far-Reaching Environment Effects on Army Tactical Decision Aids." Those persons interested in joining the AGC may wish to look over the Careers area. Additionally, the Press Room section features several dozen fact sheets which cover cultural mapping initiatives and electronic charting for navigation.

  10. December 2009 ARMY MEDICAL LOGISTICS

    E-print Network

    US Army Corps of Engineers

    FM 4-02.1 December 2009 ARMY MEDICAL LOGISTICS DISTRIBUTION RESTRICTION: Approved for public Medical Logistics Contents Page PREFACE...................................................................................................ix Chapter 1 OVERVIEW OF ARMY MEDICAL LOGISTICS................................................. 1-1 Section

  11. [Use of traditional Chinese medicine during the Red Army period in Chinese history].

    PubMed

    Wang, Fa-wei; Chen, Li-ping; Hu, Jian; Zhang, Gang

    2011-10-01

    In this paper, the authors make an analysis of the historical literature during the Red Army period of the agrarian revolution war, dealing with the situation of traditional Chinese medicine in the Red Army. During that time the Red Army had created revolutionary medical hospitals, gathering herbal medicine, growing herbal plants and producing Chinese medicines. At the same time the Red Army paid great attention to enriching Chinese medicine, cultivating practitioners and treating and preventing diseases using traditional Chinese medicine. During the Red Army period there was an extreme lack of medical facilities; traditional Chinese medicine played an important role in ensuring the fighting capabilities of the Red Army units. Looking back at the Red Army period, the development of our tradition can be seen, which enables future development of traditional Chinese medicine, as well as integrated medicine. PMID:22015198

  12. Educating the Army's Jedi

    E-print Network

    Benson, Kevin Charles

    2010-09-22

    “Butch” Saint was commissioned into the U.S. Army and armored cavalry from West Point. He served in Vietnam twice. Butch Saint was a powerful character with an ego to match. Prior to coming to Fort Leavenworth he commanded the 11th Armored Cavalry...

  13. Korean Army Hat

    E-print Network

    Hacker, Randi

    2013-08-14

    Broadcast Transcript: Here in South Korea, it doesn't matter how famous you are, if you're in the army--and Korean men are required to do about 2 years of military service--you wear your hat. This point was driven home recently when paparazzi...

  14. U.S. Army Says Goodbye to MASH

    NSDL National Science Digital Library

    2006-01-01

    Last U.S. MASH Unit Handed Over to Pakistanhttp://www.npr.org/templates/story/story.php?storyId=5219020Mission to quake-ravaged Kashmir is farewell for MASHhttp://www.usatoday.com/news/world/2006-02-15-mash-farewell_x.htmKorean War 50th Anniversary [Macromedia Flash Player]http://korea50.army.mil/index.htmlKorean War Casualty Listshttp://www.archives.gov/research/korean-war/casualty-lists/index.htmlM*A*S*H Television Show Guidehttp://www.tv.com/m-a-s-h/show/119/summary.htmlIn a remote valley in Pakistan this Thursday, the United States Army said farewell to the last remaining Mobile Army Surgical Hospital (MASH) unit. These tremendously helpful and durable units were best known as a result of the very popular television show set during the Korean War, which featured a wise-cracking cast that included Alan Alda, Loretta Swit, and Harry Morgan. This particular MASH unit had been stationed in northern Pakistan for four months helping give medical aid to the thousands of people affected by the October 8th earthquake that devastated the region. The Armyâ??s decision to donate the unit to Pakistan was part of a broader change in their medical operations, namely one that places a premium on the â??combat support hospitalâ? system. This system is inherently more flexible, and utilizes surgical squads that can go out into the field. Most of the Pakistani medical staff scheduled to take over the MASH unit had never seen the television show of the same name, but one of the spokesmen for the Pakistani Army, Major Farooq Nasir, mentioned that he had seen the show. He remarked, â??It was a nice comedy. They didnâ??t behave like that here. They were quite seriousâ?.The first link will take visitors to a news article from The Guardian that discusses the last MASH unit. The second link leads to a National Public Radio feature about the MASH units, and includes a brief interview with Rear Admiral Michael LeFever about the handover of the unit to Pakistan. The third link leads to some additional news coverage provided by USA Todayâ??s Paul Wiseman. The fourth link leads to a site created by the Department of Defense to provide information about the 50th Anniversary of the Korean War. The fifth link leads to a site provided by the National Archives, which allows users to search casualty lists from the Korean War. The final link will take users to a site created by TV.com that provides information about the television show MASH, complete with cast biographies and episode summaries.

  15. Experiences with Surgical treatment of chronic lower limb ulcers at a Tertiary hospital in northwestern Tanzania: A prospective review of 300 cases

    PubMed Central

    2012-01-01

    Background Chronic lower limb ulcers constitute a major public health problem of great important all over the world and contribute significantly to high morbidity and long-term disabilities. There is paucity of information regarding chronic lower limb ulcers in our setting; therefore it was necessary to conduct this study to establish the patterns and outcome of chronic lower limb ulcers and to identify predictors of outcome in our local setting. Methods This was a descriptive prospective study of patients with chronic lower limb ulcers conducted at Bugando Medical Centre between November 2010 and April 2012. Ethical approval to conduct the study was sought from relevant authorities. Statistical data analysis was done using SPSS version 17.0 and STATA version 11.0. Results A total of 300 patients were studied. Their ages ranged from 3 months to 85 years (median 32 years). The male to female ratio was 2:1. The median duration of illness was 44 days. Traumatic ulcer was the most frequent type of ulcer accounting for 60.3% of patients. The median duration of illness was 44 days. The leg was commonly affected in 33.7% of cases and the right side (48.7%) was frequently involved. Out of 300 patients, 212 (70.7%) had positive aerobic bacterial growth within 48 hours of incubation. Pseudomonas aeruginosa (25.5%) was the most frequent gram negative bacteria isolated, whereas gram positive bacteria commonly isolated was Staphylococcus aureus (13.7%). Twenty (6.7%) patients were HIV positive with a median CD4+ count of 350 cells/?l. Mycological investigation was not performed. Bony involvement was radiologically reported in 83.0% of cases. Histopathological examination performed in 56 patients revealed malignancy in 20 (35.7%) patients, of which malignant melanoma (45.0%) was the most common histopathological type. The vast majority of patients, 270 (90.0%) were treated surgically, and surgical debridement was the most common surgical procedure performed in 24.1% of cases. Limb amputation rate was 8.7%. Postoperative complication rate was 58.3% of which surgical site infection (77.5%) was the most common post-operative complications. The median length of hospital stay was 23 days. Mortality rate was 4.3%. Out of the two hundred and eighty-seven (95.7%) survivors, 253 (91.6%) were treated successfully and discharged well (healed). After discharge, only 35.5% of cases were available for follow up at the end of study period. Conclusion Chronic lower limb ulcers remain a major public health problem in this part of Tanzania. The majority of patients in our environment present late when the disease is already in advanced stages. Early recognition and aggressive treatment of the acute phase of chronic lower limb ulcers at the peripheral hospitals and close follow-up are urgently needed to improve outcomes of these patients in our environment. PMID:23020814

  16. Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; physician-owned hospitals: data sources for expansion exception; physician certification of inpatient hospital services; Medicare Advantage organizations and Part D sponsors: CMS-identified overpayments associated with submitted payment data. Final rule with comment period.

    PubMed

    2014-11-10

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2015 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. In this document, we also are making changes to the data sources permitted for expansion requests for physician-owned hospitals under the physician self-referral regulations; changes to the underlying authority for the requirement of an admission order for all hospital inpatient admissions and changes to require physician certification for hospital inpatient admissions only for long-stay cases and outlier cases; and changes to establish a formal process, including a three-level appeals process, to recoup overpayments that result from the submission of erroneous payment data by Medicare Advantage (MA) organizations and Part D sponsors in the limited circumstances in which the organization or sponsor fails to correct these data. PMID:25387387

  17. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property book (green cloth cover), showing east and most of south sides. - Fitzsimons General Hospital, Assembly Hall School, Northeast Corner of West McCloskey Avenue & North Tenth Street, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept. 29, 1934 when the revised Real Property form on building 256 was completed. - Fitzsimons General Hospital, Building 256, North side of East O'Niell Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  19. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept. 29, 1934 when the revised Real Property form on building 257 was completed. - Fitzsimons General Hospital, Building 257, North side of East O'Neill Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  20. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Red Cross Building, South Eighth Street Bounded by West McAfee Avenue on South & West Harlow Avenue on North, Aurora, Adams County, CO

  1. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides of building no. 715, now the south wing of building no. 508. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

  2. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and west sides of buildings no. 719, now the north wing of building no. 508. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

  3. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing part of east side and most of north side. - Fitzsimons General Hospital, Quartermaster's Storehouse, Southwest Corner of East I Avenue & North Twelfth Street, Aurora, Adams County, CO

  4. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph of south side before perpendicular wing added. - Fitzsimons General Hospital, Carpenter Shop Building, Southwest Corner of West I Avenue, & North Tenth Street, Aurora, Adams County, CO

  5. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and north sides. - Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of Building No. 516, East of corridor connecting Building No. 511 to Building No. 515, Aurora, Adams County, CO

  6. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), probably west and north sides. - Fitzsimons General Hospital, Officer Patient's Mess & Kitchen, Northeast Corner of West McAfee Avenue & South Hickey Street, Aurora, Adams County, CO

  7. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), north and east sides of the east/west wing. - Fitzsimons General Hospital, General Mess & Kitchen, Southwest Corner of East McAfee Avenue & South Twelfth Street, Aurora, Adams County, CO

  8. Photocopy of post card from Fitzsimons Army Medical Center Public ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of post card from Fitzsimons Army Medical Center Public Affairs Office, building 120. Photograph by Rocky Mountain photo. CO was no copyrighted and is , therefore, in the public domain. - Fitzsimons General Hospital, Memorial Tablet, West McAfee, South of Building No. 524, Aurora, Adams County, CO

  9. Photocopy of photograph from Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from Fitzsimons Army Medical Center real property book (green cloth cover), showing building 225's west and a north sides. This photograph is included because it shows how the west side of building 221 looked before the corridor between buildings 220 and 221 was added and because building 225 was built to the same plan as building 221. - Fitzsimons General Hospital, Hospital Corps Barracks, East Harlow Street, East of Building No. 220, Aurora, Adams County, CO

  10. Letterkenny Army Depot: The Army Teaches Business a Lesson in Lean Six Sigma

    E-print Network

    Harvey, Roger K.

    2006-05-23

    Letterkenny Army Depot: The Army Teaches Business a Lesson in Lean Six Sigma is a case study of Letterkenny Army Depot, one of five Army maintenance depots. Letterkenny recapitalizes missiles, HMMWV's, generators, and other ...

  11. Abortion - surgical

    MedlinePLUS

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion uses a vacuum to remove the fetus and related pregnancy material from the uterus. The procedure is ...

  12. Medulloblastoma in childhood-King Edward Memorial hospital surgical experience and review: Comparative analysis of the case series of 365 patients

    PubMed Central

    Muzumdar, Dattatraya; Deshpande, Amit; Kumar, Ratnesh; Sharma, Ankur; Goel, Naina; Dange, Nitin; Shah, Abhida; Goel, Atul

    2011-01-01

    Aim: Medulloblastoma is one of the most common posterior fossa tumors in childhood. The treatment-related side effects as well as predictive outcome still remain as a major challenge. The improved understanding of the disease and advances in molecular biology is changing the treatment paradigms from Chang's staging system to molecular risk stratification. However, surgery still remains as an important mainstay of therapy and is formidable. The role of radical surgery has always been a crucial factor in the outcome of these patients, the best survival being reported in patients who had total excision of the tumor and with no metastasis. Patient and Methods: An analysis of 365 patients (age<18 years) of medulloblastoma who underwent treatment at the Seth G.S. Medical College and King Edward VII Memorial hospital (KEM), Mumbai over a 25- year period (1985-2000 and 2001-2010) is presented. The clinical profile, radiological features, pathology and surgical nuances are discussed. Results: The most common age group affected was between 3 and 12 years. 75.3% presented with headaches, vomiting and 63.2% with papilledema. Sitting position was used in majority of cases. A total of 8 patients underwent shunting; all of them were in the postoperative period (5.19%). 92.2% (142 cases) had classical medulloblastoma, 5.1% (8 cases) had desmoplastic variant, 1.9% (3 cases) had anaplastic changes and 0.6% (1 case) had glial differentiation. The 5-year and 10-year progression free survival rate was 73 and 41% for average risk disease while for high risk disease rate it was 34%. The mortality rate was 2%. The quality of life was enhanced in patients who survived 5-10 years after treatment. Conclusion: Surgery for medulloblastoma is formidable. The option of sitting position for medulloblastoma surgery is still viable. A vigilant neuroanesthesiologist and a safe surgery are necessary to achieve a good postoperative result. Radiological characteristics are helpful adjuncts for determining effective surgical strategy. Permanent CSF drainage can be avoided in majority of patients and can be definitively considered in progressive symptomatic hydrocephalus. A safe maximal resection and a good Karnofsky score are paramount to ensure compliance with adjuvant therapy and contribute to an overall survival advantage. PMID:22069434

  13. Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting

    PubMed Central

    2012-01-01

    Background Typhoid intestinal perforation is still prevalent in many developing countries. Despite the advances in the management, the outcome in these patients in resource limited countries is still very poor. This study was to review our experiences on the surgical management of typhoid intestinal perforation and to determine the prognostic factors for mortality in our local setting. Methods This was a combined retrospective and prospective study of patients who were operated for typhoid intestinal perforation at Bugando Medical Centre between August 2006 and September 2011. Data collected were analyzed using SPSS computer software version 15. Results A total of 104 patients were studied representing 8.7% of typhoid fever cases. Males were affected twice more than the females (2.6:1). Their ages ranged from 8 to 76 years with a median age of 18.5 years. The peak age incidence was in the 11-20 years age group. Fever and abdominal pain were the most common presenting symptoms and majority of the patients (80.8%) perforated between within 14 days of illness. Chest and abdominal radiographs revealed pneumoperitonium in 74.7% of cases. Ultrasound showed free peritoneal collection in 85.7% of cases. Nine (10.2%) patients were HIV positive with a median CD4+ count of 261 cells/?l. The perforation-surgery interval was more than 72 hours in 90(86.5%) patients. The majority of patients (84.6%) had single perforations and ileum was the most common part of the bowel affected occurring in 86.2% of cases. Simple closure of the perforations was the most commonly performed procedure accounting for 78.8% of cases. Postoperative complication rate was 39.4% and surgical site infection was the most frequent complication in 55.5% of cases. Mortality rate was 23.1% and it was statistically significantly associated with delayed presentation, inadequate antibiotic treatment prior to admission, shock on admission, HIV positivity, low CD4 count (< 200 cells/?l), high ASA classes (III-V), delayed operation, multiple perforations, severe peritoneal contamination and presence of postoperative complications (P < 0.001). The median overall length of hospital stay was 28 days. Conclusion Typhoid intestinal perforation is still endemic in our setting and carries high morbidity and mortality. This study has attempted to determine the factors that statistically influence mortality in typhoid perforation in our environment. Appropriate measures focusing at these factors are vital in order to deliver optimal care for these patients in this region. PMID:22401289

  14. Surgical antibiotic prophylaxis: effect in postoperative infections

    Microsoft Academic Search

    A. Hita Fernández; V. Monge; M. A. Garcinuño

    2001-01-01

    Objective: to assess the risk of surgical wound infection and hospital acquired infections among patients with and without adequate antibiotic prophylaxis. Also, to provide models to predict the contributing factors of hospital infection and surgical wound infection. Design: survey study. Prospective cohort study over 14 months, with data collected by a nurse and a epidemiologist through visits to the surgical

  15. Robert R. Shaw, MD: thoracic surgical hero, Afghanistan medical pioneer, champion for the patient, never a surgical society president.

    PubMed

    Urschel, Harold C; Urschel, Betsey Bradley

    2012-06-01

    Dr Robert R. Shaw arrived in Dallas to practice Thoracic Surgery in 1937, as John Alexander's 7th Thoracic Surgical Resident from Michigan University Medical Center. Dr Shaw's modus operandi was, "You can accomplish almost anything, if you don't care who gets the credit." He was a remarkable individual who cared the most about the patient and very little about getting credit for himself. From 1937 to 1970, Dr Shaw established one of the largest lung cancer surgical centers in the world in Dallas, Texas. It was larger than M.D. Anderson and Memorial Sloan-Kettering Hospitals put together regarding the surgical treatment of lung cancer patients. To accomplish this, he had the help of Dr Donald L. Paulson, who trained at the Mayo Clinic and served as Chief of Thoracic Surgery at Brook Army Hospital during the Second World War. Following the War, because of his love for Texas, he ended up as a partner of Dr Shaw in Dallas. Together, they pursued the development of this very large surgical lung cancer center. Dr Shaw and his wife Ruth went to Afghanistan with Medico multiple times to teach men modern cardiac and thoracic surgery. They also served as consultants on Medico's Ship of Hope in Africa. Dr Shaw initiated multiple new operations including: 1) resection of Pancoast's cancer of the lung after preoperative irradiation; 2) upper lobe of the lung bronchoplasty, reattaching (and saving) the lower lobe to prevent the "disabling" pneumonectomy; and 3) resections of pulmonary mucoid impaction of the lung in asthmatics. Because of his humility and giving "the credit to others," Dr Shaw was never President of a major medical or surgical association. PMID:22632518

  16. Routine histopathologic examination of two common surgical specimens-appendix and gallbladder: is it a waste of expertise and hospital resources?

    PubMed

    Ramraje, Sushma N; Pawar, Veena I

    2014-04-01

    This study was undertaken to assess whether a routine histopathologic examination of two common surgical specimens (appendix and gallbladder) is needed and whether routine histopathologic examination has an impact on further management of patients. Histopathology reports of patients who had undergone appendicectomy and cholecystectomy, between 2006 and 2010, were analyzed retrospectively in the department of pathology of a tertiary care hospital. The case notes were retrieved in all cases of malignancies. Patients having a clinical diagnosis or suspicion of malignancy were excluded. The incidence and impact of unexpected pathologic diagnosis on postoperative management were noted. The study period included a total of 1,123 and 711 appendicectomy and cholecystectomy specimens, respectively. Fifteen (1.336 %) cases of appendicectomy specimens revealed incidental unexpected pathological diagnoses, which included tubercular appendicitis (n?=?2), parasite (n?=?8), neuroma (n?=?1), carcinoid (n?=?2), pseudomyxoma (n?=?1), and adenocarcinoma (n?=?1). About 88 % of such unexpected appendiceal findings had an impact on postoperative treatment. Unexpected pathologic gallbladder findings were found in 12 (1.68 %) of 711 cholecystectomy specimens. In 6 (0.84 %) cases, gallbladder cancer (GBC) was detected. Additional further management was required in 50 % of patients with unexpected gallbladder findings. Twenty of the total 1,834 specimens (1.090 %) had an impact on patient management or outcome and were not suspected on macroscopic examination at the time of surgery. These would have been missed had the specimens not been examined microscopically. The intraoperative diagnosis of the surgeon is therefore sometimes doubtful in detecting abnormalities of the appendix and gallbladder. This study supports the sending of all appendicectomy and cholecystectomy specimens for routine histopathological examination. Appendix and gallbladder should undergo routine histopathological examination. This is important in patients with advanced age and gallstones. Also, it is of great value in identifying unsuspected conditions which require further postoperative management. Selectively sending specimens for histopathological examination can result in reduced workload on the histopathology department without compromising patient safety. PMID:24891777

  17. US Army Corps of Engineers

    E-print Network

    US Army Corps of Engineers

    . The engineers organized the first U.S. Army tank units and developed chemical warfare munitions and defensive equipment. Armored units and chemical warfare became so important that the Army in 1918 created a separate Tank Corps and a Chemical Warfare Service. Brigadier General Amos Fries, a career engineer officer

  18. The evolution of casualty evacuation in the British Army in the 20th century (Part 2)--1918 to 1945.

    PubMed

    Bricknell, M C M

    2002-09-01

    This is the second in a series of papers that examine the evolution of the military casualty evacuation chain during the 20th century. The Spanish Civil War demonstrated to the world the revolutionary tactic of 'Blitzkrieg' developed by the Germans. This and the experience of the British Expeditionary Force in 1940 emphasised the need for mobility in forward medical units. The campaign in the Western Desert led to the creation of a number of new units such as the Field Surgical Unit and the Field Transfusion Unit which were introduced across the British Army as a result of the findings of the Hartgill Committee. The aeroplane transformed the evacuation chain from CCSs to base hospitals and beyond. PMID:12469437

  19. Surgical Management in Sicklemia

    PubMed Central

    Warner, Clinton E.

    1979-01-01

    A review of the history and pathophysiology of sickle cell disease is given. The clinical types (crises) are discussed along with their relationship to surgical occurrences, both elective and emergency. Specifics of perioperative management are discussed and the cardinal features of importance are enumerated. A retrospective study of sickle cell disease in a community hospital is presented, outlining the surgical experience over a ten-year period. PMID:448754

  20. Army Industrial, Landscaping, and Agricultural Water Use

    SciTech Connect

    McMordie Stoughton, Kate; Loper, Susan A.; Boyd, Brian K.

    2014-09-18

    The Pacific Northwest National Laboratory conducted a task for the Deputy Assistant Secretary of the Army to quantify the Army’s ILA water use and to help improve the data quality and installation water reporting in the Army Energy and Water Reporting System.

  1. National Hospital Discharge Survey

    Cancer.gov

    The National Hospital Discharge Survey (NHDS), which has been conducted annually since 1965, collects data from a sample of approximately 270,000 inpatient records acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days for all patients, general hospitals, or children's general hospitals are included in the survey. Information collected includes diagnoses, surgical and nonsurgical procedures, prescription and over-the-counter drugs, immunizations, allergy shots, anesthetics, and dietary supplements.

  2. Salvation Army : the next generation

    E-print Network

    Francpourmoi, Salomé

    2010-01-01

    The Salvation Army thrift stores are retail entities in the center of neighborhoods which collect and resell used objects. Although historically dear to many, it seems that the physical condition, market visibility, and ...

  3. Surgical experiences in Nepal.

    PubMed Central

    Melsom, M. A.

    1975-01-01

    Some examples of surgical problems presenting to the authors during a 2-year attachment to the British Military Hospital, Dharan, Nepal, are described. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 5 Fig. 6 Fig. 7 PMID:1200575

  4. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), apparently showing west side of building 732. In 1921, buildings 732 and 733 were combined and it is assumed that this photograph, which was taken after 1921, shows the section added to make buildings 732 and 733 once continuous building. - Fitzsimons General Hospital, Storehouses, Northwest Corner of East Harlow Avenue & North Thirteenth Street, Aurora, Adams County, CO

  5. [The seven wounds Ernst Jünger at the time of the Great War. Reflection of the health service of the imperial army].

    PubMed

    Ségal, Alain; Ferrandis, Jean-Jacques

    2012-01-01

    Thanks to Ernt Junger's amazing career--and despite his many injuries--we have a great view of the German Imperial Army's sanitary corps. This can be observed from the actions of the stretcher-bearers to German hospitals in general, and with the organization of their sanitary transport, as well as their medico-surgical concerns. We can see, therefore, that very few differences existed with the French medico-surgical structures except for the fact that,from the very beginning, Imperial medical warfare was able to adjust to the changes from field to trench situations. Thanks to its adaptable system of triage, and its ability to offer the most coherent medico-surgical choices and options, it was possible to save time. It enabled surgical actions in places that were close to the battlefield. Furthermore, we have been able to find out about the personal experience of an exceptional 20th century writer who later became a great European citizen. PMID:23038865

  6. 76 FR 56406 - Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ...Army; Army Research, Development and Engineering Command; Tank Automotive Research, Development and Engineering Center (TARDEC); Correction AGENCY...Automotive Research, Development and Engineering Center (TARDEC), 6501 East 11...

  7. Walter Reed Army Institute of Research

    NSDL National Science Digital Library

    Some readers might be aware of the well-known Walter Reed Hospital, but they may have never heard of the Walter Reed Army Institute of Research. Located in Silver Spring, Maryland, the Institute is the largest and most diverse biomedical research laboratory in the Department of Defense. First-time visitors will want to look over their "News" area, which provides a bit of background on their programs and research initiatives. Moving on, the "Divisions" area contains links to the Institute's different research divisions, which include military casualty research, preventive medicine, and retrovirology. In each of these sections, visitors can learn about their recent success stories, the history of each division, and about their formal training programs, and upcoming clinical trials. The site also includes information for those who might be interested in joining an upcoming clinical trial.

  8. Table 74. Percent and Number of Vietnam and Non-Vietnam Veterans Reporting Hospitalization Since Discharge From the Army for Conditions Classified as Cardiovascular Diseases (ICD-9, 390-459), and Odds Ratios, by Type of Condition

    E-print Network

    Table 74. Percent and Number of Vietnam and Non-Vietnam Veterans Reporting Hospitalization Since Ratios, by Type of Condition Vietnam Non-Vietnam Crude Results Multivariate Results Model 18 Model2b, alcohol use, marital status, and body mass index. a #12;Table 75. Percent and Number of Vietnam and Non-Vietnam

  9. Suicide in the US Army

    PubMed Central

    Lineberry, Timothy W.; O'Connor, Stephen S.

    2012-01-01

    Suicide in the US Army is a high-profile public health problem that is complex and poorly understood. Adding to the confusion surrounding Army suicide is the challenge of defining and understanding individuals/populations dying by suicide. Data from recent studies have led to a better understanding of risk factors for suicide that may be specifically associated with military service, including the impact of combat and deployment on increased rates of psychiatric illness in military personnel. The next steps involve applying these results to the development of empirically supported suicide prevention approaches specific to the military population. This special article provides an overview of suicide in the Army by synthesizing new information and providing clinical pearls based on research evidence. PMID:22958991

  10. Army High Performance Computing Research Center

    E-print Network

    Prinz, Friedrich B.

    Army High Performance Computing Research Center Applying advanced computational science Performance Computing Research Center Applying advanced computational science and engineering to critical Computing Research Center Applying advanced computational science and engineering to critical Army

  11. U.S. Army Public Health Command

    MedlinePLUS

    ... that determine the health and fitness of the U.S. Army... Deployment & Environmental Health Information pertinent to maintaining ... and drinking water safety and defense for the U.S. Army and other DoD customers... Workplace Safety & Health ...

  12. Water conservation opportunities at Army installations

    SciTech Connect

    Scholze, R.J.

    1997-06-01

    This paper reviews aspects of water conservation at Army installations describing the current status and usage on installations and unique attributes pertinent to Army conditions. It also describes a model water conservation analysis at one installation.

  13. Current strategy for surgical management of bronchiectasis

    Microsoft Academic Search

    Toshio Fujimoto; Ludger Hillejan; Georgios Stamatis

    2001-01-01

    Background. There are few current reports of surgical management for bronchiectasis because of its decline in prevalence, and it remains controversial as to which subgroups of patients would benefit from surgical management.Methods. We reviewed the medical records of all patients who underwent surgical resection for bronchiectasis between January 1, 1990, and December 31, 1997, at our hospital.Results. Ninety patients underwent

  14. Racial/Ethnic Differences in Receipt of Timely Adjuvant Therapy for Older Women with Breast Cancer: Are Delays Influenced by the Hospitals Where Patients Obtain Surgical Care?

    PubMed Central

    Freedman, Rachel A; He, Yulei; Winer, Eric P; Keating, Nancy L

    2013-01-01

    Objective To examine whether hospitals where patients obtain care explain racial/ethnic differences in treatment delay. Data Source Surveillance, Epidemiology, and End Results data linked with Medicare claims. Study Design We examined delays in adjuvant chemotherapy or radiation for women diagnosed with stage I–III breast cancer during 1992–2007. We used multivariable logistic regression to assess the probability of delay by race/ethnicity and included hospital fixed effects to assess whether hospitals explained disparities. Principal Findings Among 54,592 women, black (11.9 percent) and Hispanic (9.9 percent) women had more delays than whites (7.8 percent, p < .0001). After adjustment, black (vs. white) women had higher odds of delay (odds ratio = 1.25, 95 percent confidence interval = 1.10–1.42), attenuated somewhat by including hospital fixed effects (OR = 1.17, 95 percent CI = 1.02–1.33). Conclusions Hospitals are the important contributors to racial disparities in treatment delay. PMID:23663229

  15. Efficacy and safety of haloperidol prophylaxis for delirium prevention in older medical and surgical at-risk patients acutely admitted to hospital through the emergency department: study protocol of a multicenter, randomised, double-blind, placebo-controlled clinical trial

    PubMed Central

    2014-01-01

    Background Delirium is associated with substantial morbidity and mortality rates in elderly hospitalised patients, and a growing problem due to increase in life expectancy. Implementation of standardised non-pharmacological delirium prevention strategies is challenging and adherence remains low. Pharmacological delirium prevention with haloperidol, currently the drug of choice for delirium, seems promising. However, the generalisability of randomised controlled trial results is questionable since studies have only been performed in selected postoperative hip-surgery and intensive care unit patient populations. We therefore present the design of the multicenter, randomised, double-blind, placebo-controlled clinical trial on early pharmacological intervention to prevent delirium: haloperidol prophylaxis in older emergency department patients (The HARPOON study). Methods/Design In six Dutch hospitals, at-risk patients aged 70 years or older acutely admitted through the emergency department for general medicine and surgical specialties are randomised (n?=?390) for treatment with prophylactic haloperidol 1 mg or placebo twice daily for a maximum of seven consecutive days. Primary outcome measure is the incidence of in-hospital delirium within seven days of start of the study intervention, diagnosed with the Confusion Assessment Method, and the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for delirium. Secondary outcome measures include delirium severity and duration assessed with the Delirium Rating Scale Revised 98; number of delirium-free days; adverse events; hospital length-of-stay; all-cause mortality; new institutionalisation; (Instrumental) Activities of Daily Living assessed with the Katz Index of ADL, and Lawton IADL scale; cognitive function assessed with the Six-item Cognitive Impairment Test, and the Dutch short form Informant Questionnaire on Cognitive Decline in the Elderly. Patients will be contacted by telephone three and six months post-discharge to collect data on cognitive- and physical function, home residency, all-cause hospital admissions, and all-cause mortality. Discussion The HARPOON study will provide relevant information on the efficacy and safety of prophylactic haloperidol treatment for in-hospital delirium and its effects on relevant clinical outcomes in elderly at-risk medical and surgical patients. Trial registration EudraCT Number: 201100476215; ClinicalTrials.gov Identifier: NCT01530308; Dutch Clinical Trial Registry: NTR3207 PMID:25168927

  16. Sustainability: Preserving Choice for the Army

    E-print Network

    Hall, Sharon J.

    Sustainability: Preserving Choice for the Army Friday, October 19, 2012 12:00 - 1:30 p.m. (lunch will be provided) Wrigley Hall, Room 481 Richard Kidd Deputy Assistant of the Army, Energy and Sustainability infrastructure. The development of Army-wide sustainability principles coupled with investments, training

  17. ~us Army Corps of Engineers

    E-print Network

    US Army Corps of Engineers

    PLANT CONTROL RESEARCH PROGRAM MISCELLAr~EOUS PAPER A-gO-1 PLAN OF STUDY FOR DETERMII~II~G ECONOMIC VALUES OF AOUATIC PLANT MMiAGEMENT by Jim E. Henderson Environmer:tal Laboratory DEPARTMENT OF THE ARMY Piant Management 12 PERSONAL AUTHOR(S) Henderson, Jim E. 1].. TYPE OF REPORT 11b liME COVERED 14 DATE

  18. [Preparing army nurses for deployment].

    PubMed

    Ringeval, Jean-François; Bellard, Valérie; Melaine, Régis; Lefort, Hugues

    2014-09-01

    When on overseas operations, the nurses and doctors of the French army health service are confronted with exceptional situations, with a specific tactical and geographical environment and complex pathologies to treat. Initial and continuing training based on immersion Simulation is essential in order to be able to treat a war casualty in these conditions. PMID:25464632

  19. US Army Corps of Engineers

    E-print Network

    US Army Corps of Engineers

    ://www.usace.army.mil/inet/usace-docs/. This site is the only repository for all official USACE engineer regulations, circulars, manuals, and other channel structures. Appurtenant features covered include trashracks, gates, valves, and mechanical provide structural and seismic design guidance; Chapter 5 describes trashracks, bulkheads, gates, valves

  20. PROFESSIONAL SOLDIERS A VOLUNTEER ARMY

    E-print Network

    Bushman, Frederic

    PROFESSIONAL SOLDIERS A VOLUNTEER ARMY OR A DRAFT: WHO CAN AND SHOULD PROVIDE BSM SERVICES AND CBT REPRESENT ONE POINT OF VIEW #12;IS CBT-I REALLY EFFICACIOUS AND EFFECTIVE ? THE OLD PROBLEM IS CBT-I REALLY CBT-I TO BE READILY AVAILABLE ? ANSWER: MORE QUESTIONS . · WHAT IS THE TIME FRAME FOR "UNIVERSAL

  1. Surgical block scheduling in a system of hospitals: an application to resource and wait list management in a British Columbia health authority

    Microsoft Academic Search

    Pablo Santibáñez; Mehmet Begen; Derek Atkins

    2007-01-01

    Scheduling surgical specialties in a medical facility is a very complex process. The choice of schedules and resource availability\\u000a impact directly on the number of patients treated by specialty, cancellations, wait times, and the overall performance of\\u000a the system. In this paper we present a system-wide model developed to allow management to explore trade-offs between OR availability,\\u000a bed capacity, surgeons’

  2. Role of Gymnastics in the Army School of Physical Training

    PubMed Central

    Griffiths, DE; Hargrove, R; Clasper, J

    2006-01-01

    INTRODUCTION As a result of a single spinal injury seen at Frimley Park Hospital, we reviewed the injuries recorded at the Army School of Physical Training since December 1996. PATIENTS AND METHODS This was a retrospective review of all acute accidents and injuries recorded in the Accident Book since its inception. RESULTS Over 75% of the injuries that were serious enough to result in soldiers having their training terminated were as a direct result of gymnastic events such as vaulting, trampolining and somersaults. These events were also responsible for most of the small number of career-threatening injuries. CONCLUSIONS This raises questions about the inclusion of gymnastic events in course training programmes, especially when considering its relevance to army training in general. PMID:17002850

  3. Utility of compact ultrasound in a mass surgical selection program in Africa: experience of a sonologist at the MV Africa Mercy Hospital Ship's screening day.

    PubMed

    Harris, Robert D; Parker, Gary

    2015-02-01

    Compact ultrasound (US) was introduced in an austere setting with no other available imaging for an annual mass surgical screening day. Compact US examinations were performed on 25 patients from more than 7000 potential patients, as deemed possibly useful by the screening surgeons. Of the 20 patients with recorded data, compact US was helpful in 14 of 20 as a decision-making tool, obviating computed tomography for preoperative planning. Compact US was helpful in most cases, saving resources (computed tomography), technologist time, and radiation risk in this select population. PMID:25614408

  4. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  5. Army pushes new weapons effort

    Microsoft Academic Search

    C. A. Robinson Jr.

    1978-01-01

    The U.S. Army is conducting research for a directed energy weapons program which is to provide particle beam and high-energy laser weapons for ballistic missile defense in the late 1980s. A space-based neutral beam weapon and a ground-based charged particle device are being considered. The feasibility of a space-based laser weapon system is also explored. A ground-based technology demonstration program

  6. Army Precision at Central Headquarters

    ERIC Educational Resources Information Center

    Goldman, Jay P.

    2005-01-01

    William "Rob" Roberts wasn't thinking about working as a professional educator, much less running a major school system, when he decided he'd had enough of formal schooling himself at age 19. Rather, he dreamed of big adventures, flying combat aircraft for the military. When he discovered the U.S. Army didn't insist on two years of college, only…

  7. Hospitality Management Hospitality Management

    E-print Network

    McConnell, Terry

    Hospitality Management Hospitality Management Norm Faiola, Chair, 315-443-1710 Lyman Hall Faculty PROGRAM The Department of Hospitality Management requires a diversity of skills from many disciplines of the global hospitality industry. Academic Offerings HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR HOSPITALITY

  8. Surgical mortality score: Risk management tool for auditing surgical performance

    Microsoft Academic Search

    Vassilis G. Hadjianastassiou; Jan D. Poloniecki; Manolis C. Gavalas; David R. Goldhill

    2004-01-01

    Existing methods of risk adjustment in surgical audit are complex and costly. The present study aimed to develop a simple\\u000a risk stratification score for mortality and a robust audit tool using the existing resources of the hospital Patient Administration\\u000a System (PAS) database. This was an observational study for all patients undergoing surgical procedures over a two-year period,\\u000a at a London

  9. Health and Occupational Consequences of Spouse Abuse Victimization among Male U.S. Army Soldiers

    ERIC Educational Resources Information Center

    Bell, Nicole S.

    2009-01-01

    Little is known about health and occupational outcomes of male spouse abuse victims. In all, 11,294 male spouse abuse victims with a history of spouse abuse perpetration, 3,277 victims without prior spouse abuse perpetration, and 72,855 nonvictims and nonperpetrators were followed for 12 years to assess army attrition and hospitalization risk. In…

  10. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover). In that book, this photograph appears for building 706 was renumbered 353 and subsequently 202. The building in the photograph resembles building 204 more than it does building 202, but all Fitzsimons Real Property records indicate that the building in the photograph, showing west side, is early photograph of building 202. - Fitzsimons General Hospital, Motor Transport Garage, Northwest Corner of East Harlow Avenue, & North Twelfth Street, Aurora, Adams County, CO

  11. Presidential address: International medical graduates in the surgical workforce and the Veterans Affairs hospitals: where are we coming from? Where are we going?

    PubMed

    Itani, Kamal M F

    2008-09-01

    The demand for physicians has fluctuated from shortages to oversupply, with reliance on international medical graduates (IMGs) during periods of shortages. Twenty-four percent of the total physician workforce and 20% of general surgeons are IMGs. To address an estimated shortage of 200,000 physicians by 2020 to 2025, a constant and stable supply of IMG physicians, in addition to greater numbers of graduating medical students is needed. General surgery, especially in underserved areas, will be severely affected, and little has been done so far to address this shortage. Over the years, Veteran Affairs hospitals have addressed physician shortages in their facilities by relying on IMGs despite mounting difficulties with visa sponsorship. A sensible solution is presented to address general surgery shortages in the United States while preventing global brain drain. PMID:18718217

  12. Robotic surgical training.

    PubMed

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey. PMID:23528718

  13. [Analysis of non-confraternity sports accidents in the surgical department of a former district hospital during the period of 2 years].

    PubMed

    Raschka, Ch; Raschka, S; Peikert, T

    2009-12-01

    This epidemiological study analyses all n = 1,659 outpatient and inpatient non-confraternity sports accidents treated during a 2-year period in a former district hospital. The largest share with 40.6% is soccer, followed by cycling (15%), general fitness sports (7.6%), outdoor sports (6.5%), winter sports (5.5%), and riding (5.2%). Soccer injuries rise steadily until the age of 30. Of 86 horse riding accidents a total of 68 involved women, but only 18 men (ratio 8 : 2). 53% of the horse riding accidents among women concern the age group between 10 and 20 years. 70.6% (79%) of the athletes under (over) 20 years were male, 29.4% (21%) female (p < 0.05). Topographically the lower extremities represent the most affected body region in all sports (runners 84.4%, soccer players 60.2%). Most accidents occur on a Sunday. The most common diagnosis is contusion, most commonly in martial arts (60.8%), followed by horse riding (51%). There is an astonishing dominance of soccer accidents given the fact that this study records all athletes, not just club athletes, unlike insurance studies. Important preventive measures would be a comprehensive biological training prophylaxis and the provision of communication of age-specific accident prevention proposals for the mainly affected sports. PMID:20052829

  14. 77 FR 40030 - Army Science Board Summer Study Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-06

    ...please contact Mr. Justin Bringhurst at justin.bringhurst@us.army.mil or (703) 617-0263 or Carolyn German at carolyn.t.german@us.army.mil or (703) 617-0258. SUPPLEMENTARY INFORMATION: None. Brenda S. Bowen, Army...

  15. 75 FR 19302 - Radiation Sources on Army Land

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ...sources. The U.S. Army Safety Office which is the proponent for the Army Radiation Safety Program is revising the regulation...radiation sources include lasers and radio frequency sources...Army lands. The Radiation Safety Officer (RSO) must...

  16. An Improved Differential Army Classification System.

    ERIC Educational Resources Information Center

    Maier, Milton H.; Fuchs, Edmund F.

    Army personnel managers have a continuing need to select, classify, and assign to training and jobs large numbers of young men who enter the services. Since the Army Classification Battery (ACB) is an integral part of the assignment process, accuracy of scores has a significant influence on the appropriateness of assignments. A new ACB and…

  17. The MOVES institute's America's army operations game

    Microsoft Academic Search

    Michael Zyda; Alex Mayberry; Casey Wardynski; Russell Shilling; Margaret J. Davis

    2003-01-01

    If you go strictly by the number of young adults playing it at all hours, it's a success. But how does America's Army, the US Army's free PC game strategic communications tool, fare in the real world of costs and benefits? The answer is gratifying and the quality is award winning.

  18. Education and Training in the Army.

    ERIC Educational Resources Information Center

    Westmoreland, W. C.

    Higher education and the military have much in common: both are vitally concerned with youth and in preparing young people for effective functioning in society. The army is heavily involved in education and training; in addition to West Point, there is an Army school system which consists of 2 colleges, 20 branch schools, and 11 specialist…

  19. Montana State University 1 Military Science -Army

    E-print Network

    Maxwell, Bruce D.

    Montana State University 1 Military Science - Army ROTC Army Reserve Officers' Training Corps (ROTC) is a unique course of study that complements an existing degree-producing program-time soldier (one weekend a month and two weeks in the summer). ROTC enhances a student's education

  20. Thoracoscopy: a collaborative surgical approach.

    PubMed

    Brand, A F

    1995-07-01

    Perioperative nurses, surgeons, anesthesiologists, certified registered nurse anesthetists, and pharmacists are meeting the challenge of decreasing thoracic surgical patients' length of hospital stay with thoracoscopy. This innovative alternative to traditional thoracotomy procedures has been achieved through an attentive team approach using the fundamental perioperative skills of assessment, positioning, safety, and sharing of knowledge. PMID:7647761

  1. Surgical Planning Laboratory Image Gallery

    NSDL National Science Digital Library

    The Surgical Planning Laboratory of the Department of Radiology at Brigham and Women's Hospital and Harvard Medical School has a virtual treasure chest of visual anatomical information available at its web site. The SPL offers of series of over 60 MPEG movies on topics such as neurosurgery, multiple sclerosis, the brain, abdominal surgery, flow analysis, and thoracic surgery, among others.

  2. Violence against surgical residents.

    PubMed Central

    Barlow, C B; Rizzo, A G

    1997-01-01

    Violence against hospital personnel is underreported (less than one in five assaults), and accurate statistics as to the rate of violence against hospital personnel are thus difficult to establish. In the psychiatric discipline, an abundance of information has been published regarding violence in the health care setting, but few studies have examined violence outside psychiatric hospitals or by patients not diagnosed with psychiatric ailments. Using a survey that elicits information about workplace violence, we sought to gauge the prevalence of violent acts affecting general hospital workers who treat victims of violence on a daily basis. The survey was completed by a cohort of surgical staff nationwide (475 responses from 57 residency programs). Two hundred and eighty residents reported having witnessed one or more physical attacks, and 179 reported having been attacked. Violent acts were more likely to be committed in a public hospital than a private institution (P = 0.05). As shown in previous research, most attacks occurred in the emergency room (P = 0.01); the wards and parking lot were next in frequency. Women residents were more likely than men to call hospital security to intervene in a potentially violent situation (P = 0.04), and junior residents (postgraduate years 1-4) were more likely to be attacked than senior residents (> or = 5 years) (P = 0.04). The attacker was most likely to be a young black male between ages 19 and 30 (P = 0.01). We found no statistical relationship between the attacker and the victim regarding sex or race. Of the 475 respondents, 470 reported that they carry a gun themselves or know someone in the hospital environment who carries a gun. Images Figure 1. PMID:9291743

  3. Discrepant perceptions of communication, teamwork and situation awareness among surgical team members

    Microsoft Academic Search

    L. S. G. L. Wauben; C. M. Dekker-van Doorn; Wijngaarden van J. D. H; R. H. M. Goossens; R. Huijsman; J. Klein; J. F. Lange

    2011-01-01

    Objective: To assess surgical team members' differences in perception of non-technical skills. Design: Questionnaire design. Setting: Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Participants: Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. Methods: All surgical team members, of five hospitals, were asked to complete a questionnaire and

  4. Boxing-related injuries in the US Army, 1980 through 1985.

    PubMed

    Enzenauer, R W; Montrey, J S; Enzenauer, R J; Mauldin, W M

    1989-03-10

    Boxing-related injuries, serious enough to involve hospitalization in US Army hospitals, were studied from 1980 through 1985. On average, there were 67 hospitalizations annually, with the injured spending an average of 5.1 days in bed and 8.9 days disabled, unfit for duty. There was one death from serious head injury and one instance of unilateral blindness from ocular trauma requiring enucleation. Head injuries accounted for 68% of all the injuries and were more common in the younger and presumably less experienced boxers. The advisability of continued promotion of boxing in the military needs to be addressed. PMID:2918641

  5. Adverse events in surgical patients in Australia

    Microsoft Academic Search

    A. K. KABLE; R. W. GIBBERD; A. D. SPIGELMAN

    2002-01-01

    Objective. To determine the adverse event (AE) rate for surgical patients in Australia. Design. A two-stage retrospective medical record review was conducted to determine the occurrence of AEs in hospital admissions. Medical records were screened for 18 criteria and positive records were reviewed by two medical officers using a structured questionnaire. Setting. Admissions in 1992 to 28 randomly selected hospitals

  6. ARMY MASS TRANSPORTATION BENEFIT PROGRAM Outside the National Capital Region

    E-print Network

    Telephone (include area code): Army Civilian Employee Army Active Duty Enlisted Army Active Duty Officer Army Nonappropriated Fund Employee - Please provide 9-digit Standard NAFI Number: Effective Date 1 check one: First Name: MI: Last Four SSN: Residence State: Residence 9-digit ZIP Code: Installation

  7. Award Recipient U.S. Army Armament Research,

    E-print Network

    Magee, Joseph W.

    .S. Army Materiel Command--has been responsible for meeting this critical demand. ARDEC develops 90 percent customers but has also expanded its market. Since 2001, ARDEC's customer base has shifted from virtually 100 percent Army customers to approximately 83 percent Army and 17 percent non-Army, including organizations

  8. Predicting Surgical Site Infections in Real-Time Akpene Gbegnon

    E-print Network

    Street, Nick

    Predicting Surgical Site Infections in Real-Time Akpene Gbegnon University of Iowa Hospitals City, IA 52242 1-319-384-7359 john-cromwell@uiowa.edu ABSTRACT Surgical site infections (SSIs Sciences]: Medical Information Systems General Terms Experimentation Keywords Surgical Site Infections

  9. US Army Corps of EngineersR

    E-print Network

    US Army Corps of Engineers

    ............................................................................................................12 Intergovernmental Panel on Climate Change....................................................................13 Adaptations to Climate ChangeUS Army Corps of EngineersR ANNUAL REPORT ACTIVITIES OF THE INSTITUTE FOR WATER RESOURCES FISCAL

  10. U.S. Army Modernizes Munitions Plants

    ERIC Educational Resources Information Center

    Environmental Science and Technology, 1972

    1972-01-01

    Headquartered at Joliet, Illinois, the Army Ammunition Procurement and Supply Agency aims to mechanize and clean up its manufacturing facilities. Six go-co (government owned - contractor operated) plants involved in the modernization program are described. (BL)

  11. Energy Design Guides for Army Barracks: Preprint

    SciTech Connect

    Deru, M.; Zhivov, A.; Herron, D.

    2008-08-01

    The U.S. Army Corps of Engineers and NREL are developing target energy budgets and design guides to achieve 30% energy savings. This paper focuses the design guide for one type of barracks called unaccompanied enlisted personal housing.

  12. 32 CFR 631.14 - Army policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... § 631.14 Army policy. (a) Soldiers, military and/or Department...To safeguard the health and welfare of Soldiers. (4) When the type of offenses or the number of Soldiers frequenting an area is large enough...

  13. 32 CFR 631.14 - Army policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 631.14 Army policy. (a) Soldiers, military and/or Department...To safeguard the health and welfare of Soldiers. (4) When the type of offenses or the number of Soldiers frequenting an area is large enough...

  14. 32 CFR 631.14 - Army policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 631.14 Army policy. (a) Soldiers, military and/or Department...To safeguard the health and welfare of Soldiers. (4) When the type of offenses or the number of Soldiers frequenting an area is large enough...

  15. 32 CFR 631.14 - Army policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 631.14 Army policy. (a) Soldiers, military and/or Department...To safeguard the health and welfare of Soldiers. (4) When the type of offenses or the number of Soldiers frequenting an area is large enough...

  16. Energy Conservation in Army Industrial Facilities

    E-print Network

    Aveta, G. A.; Sliwinski, B. J.

    1984-01-01

    for approximately 19 percent of the Army's total energy consumption (approximately 44 million barrels of oil equivalent) and have reduced energy consumption approximately 26 percent below FY 75 levels. Highlights of the program include a comprehensive energy audit...

  17. Antiobiotic prophylaxis to prevent surgical site infections.

    PubMed

    Salkind, Alan R; Rao, Kavitha C

    2011-03-01

    Surgical site infections are the most common nosocomial infections in surgical patients, accounting for approximately 500,000 infections annually. Surgical site infections also account for nearly 4 million excess hospital days annually, and nearly $2 billion in increased health care costs. To reduce the burden of these infections, a partnership of national organizations, including the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention, created the Surgical Care Improvement Project and developed six infection prevention measures. Of these, three core measures contain recommendations regarding selection of prophylactic antibiotic, timing of administration, and duration of therapy. For most patients undergoing clean-contaminated surgeries (e.g., cardiothoracic, gastrointestinal, orthopedic, vascular, gynecologic), a cephalosporin is the recommended prophylactic antibiotic. Hospital compliance with infection prevention measures is publicly reported. Because primary care physicians participate in the pre- and postoperative care of patients, they should be familiar with the Surgical Care Improvement Project recommendations. PMID:21391526

  18. Surgical innovation

    Microsoft Academic Search

    Saumitra Saha

    2009-01-01

    Innovation has been an integral part of the progress of surgery. Technological advances have given a different dimension to\\u000a the intricacies of modern surgery. While some innovations have been ground-breaking, others made only a transitory impression.\\u000a This article attempts to distinguish between a true innovation and a technical refinement and explores the ethos and socio-economic\\u000a factors that propel surgical innovation.

  19. US Army battery needs -- Present and future

    SciTech Connect

    Hamlen, R.P.; Christopher, H.A.; Gilman, S. [Army Research Lab., Fort Monmouth, NJ (United States)

    1995-07-01

    The purpose of this paper is to describe the needs of the US Army for silent portable power sources, both in the near and longer term future. As a means of doing this, the programs of the Power Sources Division of the Army Research Laboratory will be discussed. The six program areas in which the Power Sources Division is engaged are: primary batteries, rechargeable batteries, reserve/fuze batteries, pulse batteries and capacitors, fuel cells, and thermophotovoltaic power generation.

  20. 32 CFR 655.10 - Oversight of radiation sources brought on Army land by non-Army entities (AR 385-10).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 false Oversight of radiation sources brought on Army land by non-Army...CONTINUED) ENVIRONMENTAL QUALITY RADIATION SOURCES ON ARMY LAND § 655.10 Oversight of radiation sources brought on Army land by...

  1. 32 CFR 655.10 - Oversight of radiation sources brought on Army land by non-Army entities (AR 385-10).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Oversight of radiation sources brought on Army land by non-Army...CONTINUED) ENVIRONMENTAL QUALITY RADIATION SOURCES ON ARMY LAND § 655.10 Oversight of radiation sources brought on Army land by...

  2. 32 CFR 655.10 - Oversight of radiation sources brought on Army land by non-Army entities (AR 385-10).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 2013-07-01 true Oversight of radiation sources brought on Army land by non-Army...CONTINUED) ENVIRONMENTAL QUALITY RADIATION SOURCES ON ARMY LAND § 655.10 Oversight of radiation sources brought on Army land by...

  3. 32 CFR 655.10 - Oversight of radiation sources brought on Army land by non-Army entities (AR 385-10).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 2011-07-01 true Oversight of radiation sources brought on Army land by non-Army...CONTINUED) ENVIRONMENTAL QUALITY RADIATION SOURCES ON ARMY LAND § 655.10 Oversight of radiation sources brought on Army land by...

  4. Surgical Technician

    NSDL National Science Digital Library

    John Hopkins Medical Institutes

    Viven Thomas was African American determined to make something of himself during the time of segregation, Alfred Blalock, a surgeon at Johns Hopkins Hospital. Thomas, initially hired as a janitor, was soon promoted by Blalock to learn the complexities of surgery, eventually becoming a trainer of novice surgeons and a major force in the advancement of African Americans in medicine.

  5. The MASSACHUSETTS GENERAL HOSPITAL SURGICAL SOCIETY

    E-print Network

    Mootha, Vamsi K.

    in morbidity and mortality were quite noteworthy. Innovative ways to increase donor organs that the MGH has their contributions in research. Their fertile imaginative minds produce results that stimulate others to pursue

  6. Air Force | Army | Marine Corps Navy & Coast Guard General of the Air Force/Army

    E-print Network

    Air Force | Army | Marine Corps Navy & Coast Guard O-10 General of the Air Force/Army (Reserved Conduct Medal Navy Reserve Meritorious Service Medal Navy Fleet Marine Force Ribbon Navy Expeditionary for Wartime) Fleet Admiral (Reserved for Wartime) General Admiral | Commandant of the Coast Guard O-9

  7. Army Distance Learning: Potential for Reducing Shortages in Army Enlisted Occupations.

    ERIC Educational Resources Information Center

    Shanley, Michael G.; Leonard, Henry A.; Winkler, John D.

    The potential of distance learning (DL) to expedite the U.S. Army's efforts to redress personnel shortages in Army enlisted occupations was studied by evaluating how DL-based training strategies might affect skill shortages in the following occupations: helicopter repairer; electronic switching system operator; microwave systems…

  8. The importance of surgeon volume and training in outcomes for vascular surgical procedures

    Microsoft Academic Search

    William H. Pearce; Michele A. Parker; Joe Feinglass; Michael Ujiki; Larry M. Manheim

    1999-01-01

    Purpose: Mortality and morbidity rates after vascular surgical procedures have been related to hospital volume. Hospitals in which greater volumes of vascular surgical procedures are performed tend to have statistically lower mortality rates than those hospitals in which fewer procedures are performed. Only a few studies have directly assessed the impact of the surgeon's volume on outcome. Therefore, the purpose

  9. Surgical Planning Laboratory

    NSDL National Science Digital Library

    As a laboratory within the Brigham and Women's Hospital, the Surgical Planning Laboratory (SPL) does research and development in image processing algorithms, software systems, and medical applications. While visitors with an interest in these matters will appreciate the sections of this site that provide details on this work, visitors from the health sciences will also appreciate the educational materials offered in the "Resources" area even more. In the "Training and Tutorials" area, visitors can learn more about medical imaging through a self-paced tutorial. Moving on, the "Image Gallery" area contains over forty medical images that can be useful for those who are looking to learn about identifying various neurological conditions. Finally, the site also has a database of publications created by members of the research team at the SPL.

  10. Army Energy and Water Reporting System Assessment

    SciTech Connect

    Deprez, Peggy C.; Giardinelli, Michael J.; Burke, John S.; Connell, Linda M.

    2011-09-01

    There are many areas of desired improvement for the Army Energy and Water Reporting System. The purpose of system is to serve as a data repository for collecting information from energy managers, which is then compiled into an annual energy report. This document summarizes reported shortcomings of the system and provides several alternative approaches for improving application usability and adding functionality. The U.S. Army has been using Army Energy and Water Reporting System (AEWRS) for many years to collect and compile energy data from installations for facilitating compliance with Federal and Department of Defense energy management program reporting requirements. In this analysis, staff from Pacific Northwest National Laboratory found that substantial opportunities exist to expand AEWRS functions to better assist the Army to effectively manage energy programs. Army leadership must decide if it wants to invest in expanding AEWRS capabilities as a web-based, enterprise-wide tool for improving the Army Energy and Water Management Program or simply maintaining a bottom-up reporting tool. This report looks at both improving system functionality from an operational perspective and increasing user-friendliness, but also as a tool for potential improvements to increase program effectiveness. The authors of this report recommend focusing on making the system easier for energy managers to input accurate data as the top priority for improving AEWRS. The next major focus of improvement would be improved reporting. The AEWRS user interface is dated and not user friendly, and a new system is recommended. While there are relatively minor improvements that could be made to the existing system to make it easier to use, significant improvements will be achieved with a user-friendly interface, new architecture, and a design that permits scalability and reliability. An expanded data set would naturally have need of additional requirements gathering and a focus on integrating with other existing data sources, thus minimizing manually entered data.

  11. OPTIMIZACION DEL PROCESO DE CIRUGIA EN HOSPITALES PUBLICOS. UNA APLICACION DE LA MODELACION MATEMATICA ENTERA EN LA PRESTACION DE ATENCIONES QUIRURGICAS EN EL HOSPITAL EL SALVADOR, SANTIAGO,CHILE. Optimizing the surgical process inpublic hospitals and appli- cation to Hospital El Salvador, in Santiago, Chile

    Microsoft Academic Search

    Axel A. Jansson; Carolina Delgado

    It is dealt on the allocation of resources for the provision of surgery medical services in hightly complex hospitals. In the analysis it was developed a full mathematical programming model, where the target function is to furnish the said demanded services, subject to the restrictions imposed by the availability of medical personnel, surgery accomodations, beds, equipment and miscellanea, all such

  12. ARMI National Atlas for Amphibian Distributions

    NSDL National Science Digital Library

    This site, from The Amphibian Research and Monitoring Initiative (ARMI), is a compilation of current and historic records of amphibian occurrences. The atlas is organized taxonomically. There are separate sections for frogs and toads, and salamanders and newts. The location of each species is mapped separately. The ARMI Atlas is meant to be an educational tool for people wanting to learn or teach others about amphibians. It can also serve as a reference for habitat managers and researchers, identifying areas where more research is needed, as well as providing information about research that has previously been done.

  13. 32 CFR 644.326 - Army military real property.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 true Army military real property. 644.326...Status § 644.326 Army military real property. Military real property, including industrial real property, under the control of the Department of the...

  14. Letterkenny Army Depot: Finance Innovations Support Lean Six Sigma Success

    E-print Network

    Harvey, Roger K.

    2006-09-15

    As a result of significant dollar savings to the Army and U.S. taxpayers, Letterkenny Army Depot received widespread public recognition in 2005. The depot received a public sector Shingo Prize for applying Lean principles ...

  15. 76 FR 6692 - Radiation Sources on Army Land

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ...rule, ``ionizing radiation source'' means any...would require a specific Nuclear Regulatory Commission (NRC) license or Army Radiation Authorization (ARA...20.1003. Special nuclear material has the same...1003. (b) Army radiation permits are...

  16. Stationary surgical smoke evacuation systems.

    PubMed

    2001-03-01

    Two types of systems are available for evacuating the surgical smoke created by electrosurgery and laser surgery: portable and stationary surgical smoke evacuation systems. While portable systems dominate the market today, stationary systems are an alternative worth considering--even though they are still in their infancy, with fewer than 90 systems installed to date. Stationary systems represent a major commitment on the part of the healthcare facility. Several system components must be installed as part of the physical plant (for instance, within the walls), making the system a permanent fixture in the surgical suite. Installation of these systems is often carried out during building construction or major renovation--although the systems can be cost-effective even if no renovations are planned. For this Evaluation, we tested three stationary systems. All three are adequate to capture surgical smoke and evacuate it from the operating room. These systems are easy to use, are quietter than their portable counterparts, and require minimal user maintenance. They represent an excellent option for most hospitals actively evacuating surgical smoke. In this article, we discuss the factors to consider when selecting from among these systems. We also offer guidance on choosing between stationary systems and portable ones. PMID:11321758

  17. Guidelines for reducing pathogens in veterinary hospitals: hospital design and special considerations.

    PubMed

    Portner, Joshua A; Johnson, Justine A

    2010-05-01

    Prevention of nosocomial infection begins with the hospital layout and identification of special considerations for particular patients. The construction of a new hospital or renovation of an existing hospital requires careful planning and consideration of the needs of the expected patient population and hospital staff. This article discusses considerations for preventing cross-contamination of pathogens through hospital design, as well as special considerations for particular patients, specifically those in isolation areas and surgical suites. PMID:20949419

  18. THE CHALLENGE OF MOLDS FOR THE U.S. ARMY

    EPA Science Inventory

    The US Army and all armies have been interested in molds since there were armies. The most obvious interest was human infections by molds like trench foot. Then there were losses of military animals and contamination of their fodder, most notably the Soviet loss of thousands o...

  19. U.S. Army High Energy Laser (HEL) technology program

    Microsoft Academic Search

    Michael J. Lavan; John J. Wachs

    2011-01-01

    The US Army is investing in Solid State Laser (SSL) technology to assess counter rocket, artillery, and mortar (C-RAM) and counter unmanned aerial vehicle (C-UAV) capabilities of solid state based HEL systems, as well as other potential applications for HELs of interest to the Army. The Army HEL program thrust areas are systematically moving the technology forward toward weaponization, including

  20. US Army battery needs-present and future

    Microsoft Academic Search

    R. P. Hamlen; H. A. Christopher; S. Gilman

    1995-01-01

    The purpose of this paper is to describe the needs of the US Army for silent portable power sources, both in the near and longer term future. As a means of doing this, the programs of the Power Sources Division of the Army Research Laboratory are discussed. The chief future needs for portable power sources for the US Army are:

  1. America's Army Game: Its (Virtual) Reality Representation and Cocaine

    Microsoft Academic Search

    Stefan Alexa

    2004-01-01

    The game chosen for the present research is developed by the American Army for the purpose of online training of the world wide public and recruitment. The America's Army game is an online game, a combination between entertainment and defence, being a result of the modelling and simulation ideas used by American Army after the 80'. The game is a

  2. A MATHEMATICAL MODEL FOR THE POPULATION DYNAMICS OF ARMY ANT

    E-print Network

    Bath, University of

    A MATHEMATICAL MODEL S FOR THE POPULATION DYNAMICS OF ARMY ANT N # N.F. BRITTO Centre for the population dynamics of the army ant c Eciton burchelli on Barro Colorado Island in Panama was set up. Introduction Army ants are among the most spectacular of social animals, living in organised r f colonies

  3. An examination of the US Army's Environmental Ethic

    E-print Network

    Danner, Benton Allen

    1997-01-01

    In this thesis I argue that the best justification for an environmental ethic for the US Army is one which is based on an anthropocentric or humanistic approach, and I evaluate the Armys Environmental Ethic in light of this. I then consider the Army...

  4. Raising a Pragmatic Army: Officer Education at the U.S. Army Command and General Staff College, 1946-1986

    E-print Network

    Stewart, Michael David

    2010-04-23

    RAISING A PRAGMATIC ARMY: Officer Education at the U.S. Army Command and General Staff College, 1946 - 1986 By Michael D. Stewart Department of History, University of Kansas Professor Theodore A. Wilson, Advisor This ...

  5. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army...

  6. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army...

  7. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army...

  8. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army...

  9. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army...

  10. Urogynecologic Surgical Mesh Implants

    MedlinePLUS

    ... Medical Devices Products and Medical Procedures Implants and Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants ... More in Products and Medical Procedures Implants and Prosthetics Urogynecologic Surgical Mesh Implants Pelvic Organ Prolapse (POP) ...

  11. U.S. Army Signal School.

    ERIC Educational Resources Information Center

    Army Signal Center and School, Fort Monmouth, NJ.

    The U. S. Army Signal School at Fort Monmouth, New Jersey, provides military education and appropriate practical training for Armed Forces men and women to prepare them for positions in communications-electronics activities and familiarize them with the application of doctrine, tactics, logistics, and electronic techniques pertinent to the…

  12. Robotic technology integration for army ground vehicles

    Microsoft Academic Search

    J. J. Jaczkowski

    2002-01-01

    This paper discusses the US Army Tank Automotive Research, Development and Engineering Center's (TARDEC's) four (4) axis strategy for integration of robotics into the legacy, interim, and objective forces. At the cornerstone of this strategy is the R&D effort concentrating on autonomous perception and navigation, intelligent tactical behavior, command and control, and man-robot interface entailed in the Demo III and

  13. Solar energy applications at Army ammunition plants

    Microsoft Academic Search

    A. P. Lowry; S. M. Moy

    1982-01-01

    The Army Ammunition Plants use significant quantities of fossil fuels. To reduce dependence on these scarce, costly, and non-renewable fuels, a study was conducted to investigate potential solar energy applications at the AAPs. Solar energy is a low-level energy source which is best applied to low temperature applications. It can be used at the AAPs to preheat boiler feedwater, provide

  14. Army Officer Education Program University of Michigan

    E-print Network

    Kamat, Vineet R.

    Army Officer Education Program University of Michigan (Ann Arbor/Dearborn/Flint) ROTC completion and teaching them leadership. Students join the ROTC program, take one elective each semester Officers Training Corps (ROTC) program. Why ROTC? The benefit of the ROTC program is that students fulfill

  15. Penal Units in the Red Army

    Microsoft Academic Search

    Alex Statiev

    2010-01-01

    This article compares German and Soviet ideas behind raising penal units on the Eastern Front during World War II and their employment in combat, but focuses on Soviet practice. In an attempt to tighten discipline in the Red Army, Stalin adopted the basic draconian measures used by Leon Trotsky, his most bitter rival, during the Civil War of 1918–1922 but

  16. 76 FR 12087 - Army Educational Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ...March 24, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks, Pennsylvania 17013. Time of Meeting: 8:30 a.m.-12:30 p.m. Proposed Agenda:...

  17. 76 FR 66282 - Army Educational Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-26

    ...November 15, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks, Pennsylvania 17013. Time of Meeting: 8:30 a.m.-12:30 p.m. Proposed Agenda:...

  18. 75 FR 7255 - Army Educational Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ...March 11, 2010. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks, Pennsylvania 17013. Time of Meeting: 8:30 a.m.-4 p.m. Proposed Agenda: Receive...

  19. U.S. Army Medical Department

    MedlinePLUS

    ... healthy, too. Research has also shown there are eye health benefits from eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut. Choose water instead of sugary drinks. My Health Stories Image-3 Excerpt-7 Army Leader ...

  20. The Army Dietitian's Role in Humanitarian Assistance

    Microsoft Academic Search

    M. P. Applewhite; L. S. Standage; C. D. Thomas

    1997-01-01

    LEARNING OUTCOME: Describe the roles the Army dietitian can provide in support of military medical nation assistance programs.Regional crises and conflicts present the predominant threat to US national security for the future. Peacetime engagement, as a guiding foreign policy is a coordinated effort of political, economic, and military assistance promoting stability throughout the world. Nation assistance, conducted by the US,

  1. Algeria's Army, Algeria's Agony Lahouari ADDI

    E-print Network

    Paris-Sud XI, Université de

    Sommaire · The real power. in a terrorized land · Guardian of the state · Smashing the thermometer in a terrorized land Western opinion is surprisingly untroubled by Algeria's anguish, which has lasted more than in January 1992, after the army canceled elections won by the Islamic Salvation Front (FIS). Blocked from

  2. DEPARTMENT OF THE ARMY COMPLETE STATEMENT

    E-print Network

    US Army Corps of Engineers

    SECRETARY OF THE ARMY (CIVIL WORKS) BEFORE THE SUBCOMMITTEE ON ENERGY AND WATER DEVELOPMENT COMMITTEE, environmental stewardship, and water supply services at existing water resources projects owned or operated, as called for in the FY 2006 Energy and Water Development Appropriations Act Conference Report. The FYDP

  3. DEPARTMENT OF THE ARMY COMPLETE STATEMENT

    E-print Network

    US Army Corps of Engineers

    SECRETARY OF THE ARMY (CIVIL WORKS) BEFORE THE SUBCOMMITTEE ON ENERGY AND WATER DEVELOPMENT COMMITTEE, recreation, environmental stewardship, and water supply services at existing water resources projects owned development plan (FYDP) is being provided, as called for in the FY 2006 Energy and Water Development

  4. Research in Army Training: Present and Future.

    ERIC Educational Resources Information Center

    Crawford, Meredith P.

    The paper shows the method of application of proven research procedures to Army training and illustrates the usefulness of research techniques in making training more effective and efficient. Objective measurements of soldier proficiency in common military skills and knowledge are described. (Author/se)

  5. Design of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

    PubMed Central

    Kessler, Ronald C.; Colpe, Lisa J.; Fullerton, Carol S.; Gebler, Nancy; Naifeh, James A.; Nock, Matthew K.; Sampson, Nancy A.; Schoenbaum, Michael; Zaslavsky, Alan M.; Stein, Murray B.; Ursano, Robert J.; Heeringa, Steven G.

    2014-01-01

    The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi-component epidemiological and neurobiological study designed to generate actionable evidence-based recommendations to reduce U.S. Army suicides and increase basic knowledge about the determinants of suicidality. This report presents an overview of the designs of the six component Army STARRS studies. These include: an integrated study of historical administrative data systems (HADS) designed to provide data on significant administrative predictors of suicides among the more than 1.6 million soldiers on active duty in 2004–2009; retrospective case-control studies of suicide attempts and fatalities; separate large-scale cross-sectional studies of new soldiers (i.e., those just beginning Basic Combat Training [BCT], who completed self-administered questionnaires [SAQ] and neurocognitive tests and provided blood samples) and soldiers exclusive of those in BCT (who completed SAQs); a pre-post deployment study of soldiers in three Brigade Combat Teams about to deploy to Afghanistan (who completed SAQs and provided blood samples) followed multiple times after returning from deployment; and a platform for following up Army STARRS participants who have returned to civilian life. DoD/Army administrative data records are linked with SAQ data to examine prospective associations between self-reports and subsequent suicidality. The presentation closes with a discussion of the methodological advantages of cross-component coordination. PMID:24318217

  6. Field procedures in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    PubMed

    Heeringa, Steven G; Gebler, Nancy; Colpe, Lisa J; Fullerton, Carol S; Hwang, Irving; Kessler, Ronald C; Naifeh, James A; Nock, Matthew K; Sampson, Nancy A; Schoenbaum, Michael; Zaslavsky, Alan M; Stein, Murray B; Ursano, Robert J

    2013-12-01

    The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi-component epidemiological and neurobiological study of unprecedented size and complexity designed to generate actionable evidence-based recommendations to reduce US Army suicides and increase basic knowledge about determinants of suicidality by carrying out coordinated component studies. A number of major logistical challenges were faced in implementing these studies. The current report presents an overview of the approaches taken to meet these challenges, with a special focus on the field procedures used to implement the component studies. As detailed in the paper, these challenges were addressed at the onset of the initiative by establishing an Executive Committee, a Data Coordination Center (the Survey Research Center [SRC] at the University of Michigan), and study-specific design and analysis teams that worked with staff on instrumentation and field procedures. SRC staff, in turn, worked with the Office of the Deputy Under Secretary of the Army (ODUSA) and local Army Points of Contact (POCs) to address logistical issues and facilitate data collection. These structures, coupled with careful fieldworker training, supervision, and piloting, contributed to the major Army STARRS data collection efforts having higher response rates than previous large-scale studies of comparable military samples. PMID:24038395

  7. The U.S. Army's VehicleThe U.S. Army's Vehicle Intelligence Program (AVIP):Intelligence Program (AVIP)

    E-print Network

    The U.S. Army's VehicleThe U.S. Army's Vehicle Intelligence Program (AVIP):Intelligence Program-5000 USA Phone: (810) 574-7413 Fax: (810) 574-6996 E-mail: GorsichD@tacom.army.mil IV2001 IEEE Intelligent;Vehicle IntelligenceVehicle Intelligence VI provides new driving functionalities, and enhances existing

  8. Diffusion of surgical technology. An exploratory study.

    PubMed

    Sloan, F A; Valvona, J; Perrin, J M; Adamache, K W

    1986-03-01

    The study presents an empirical analysis of the diffusion patterns of five surgical procedures. Roles of payer mix, regulatory policies, physician diffusion, competition among hospitals, and various hospital characteristics such as size and the spread of technologies are examined. The principal data base is a time series cross-section of 521 hospitals based on discharge abstracts sent to the Commission on Professional and Hospital Activities. Results on the whole are consistent with a framework used to study innovations in other contexts in which the decisions of whether to innovate and timing depend on anticipated streams of returns and cost. Innovation tends to be more likely to occur in markets in which the more generous payers predominate. But the marginal effects of payer mix are small compared to effects of location and hospital characteristics, such as size and teaching status. Hospital rate-setting sometimes retarded diffusion. Certificate of need programs did not. PMID:10317759

  9. The young diabetic subjects in the Israel Army.

    PubMed

    Amir, S; Galatzer, A; Karp, M; Laron, Z

    1994-01-01

    Between 1978 to 1986, 145 of the Type 1 diabetic patients under our care reached the age of 18 (military service recruitment age). Of the 77 (45 men, 32 women) who decided to volunteer for service, 60 (35 men, 25 women) responded to a questionnaire relating to the conditions of their military service following its completion-these comprised Group A. Of the 68 patients who did not volunteer for service (20 men, 48 women), 44 patients comprised Group B (10 men, 34 women). Group A and Group B were compared in regard to their diabetes history and diabetes management and control during two periods, 17-18 years and 18-20 years. Group A was also evaluated regarding military employment, working and accommodation conditions and diabetes management during army service. The patients in Group A came from a higher socioeconomic level (p < 0.009) and had a significantly higher educational level (p < 0.008). The men in Group A achieved significantly better diabetes control, as evaluated by HbA1, in both periods compared to all the others in both groups. During army service the patients in Group A underwent fewer hospitalizations than the others and only two of them developed complications, whereas among those in Group B 5 patients developed complications. Our data demonstrate that youngsters with Type 1 diabetes can maintain satisfactory diabetes management and control and can function not only adequately, but often far beyond, in the stressful situations with which they are confronted within the rigid authoritative system of military service. Our data also indicated that diabetic patients wishing to volunteer for such service constitute a selected group with a higher socioeconomic background and a higher motivation to prove themselves. PMID:8001719

  10. Uncommon surgical emergencies in neonatology.

    PubMed

    Angotti, R; Bulotta, A L; Ferrara, F; Molinaro, F; Cerchia, E; Meucci, D; Messina, M

    2014-01-01

    Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies. PMID:25669890

  11. Hospital Anxiety and Depression Scale (HADS): validation in a Greek general hospital sample

    Microsoft Academic Search

    Ioannis Michopoulos; Athanasios Douzenis; Christina Kalkavoura; Christos Christodoulou; Panayiota Michalopoulou; Georgia Kalemi; Katerina Fineti; Paulos Patapis; Konstantinos Protopapas; Lefteris Lykouras

    2008-01-01

    BACKGROUND: The Hospital Anxiety and Depression Scale (HADS) has been used in several languages to assess anxiety and depression in general hospital patients with good results. METHODS: The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens). The Beck Depression Inventory (BDI) and

  12. Randomized trial of a patient-centered hospital unit

    Microsoft Academic Search

    Diane P Martin; Paula Diehr; Douglas A Conrad; Julie Hunt Davis; Richard Leickly; Edward B Perrin

    1998-01-01

    Patient-centered hospital units have grown out of the national trend to greater consumerism, but few of these units have been evaluated rigorously. We used a randomized controlled trial to compare patient outcomes on the Planetree Model Hospital Unit with other medical-surgical units in the hospital. Planetree patients were significantly more satisfied than controls with their hospital stay, the unit's environment

  13. The Finnish Forward Surgical Team Experience During EUFOR Operation RD Congo in 2006

    Microsoft Academic Search

    Lauri Handolin; Teemu Elomaa

    2007-01-01

    The army Forward Surgical Team (FST) is a mobile surgical asset designed to provide life- and limbsaving combat surgery in\\u000a remote and austere terrains. Operation EUFOR RDC in Democratic Republic of the Congo (DRC) in 2006 was the first one planned\\u000a and conducted solely by the European Union Forces (EUFOR). The first two European FSTs reported in the present article

  14. Compare Hospitals

    MedlinePLUS

    2014 Leapfrog Hospital Survey Results Now Available Thank you for visiting the Leapfrog Hospital Survey Results Website. These results are based on surveys submitted by hospitals across the country that have demonstrated a commitment ...

  15. Discrepant perceptions of communication, teamwork and situation awareness among surgical team members

    Microsoft Academic Search

    L. S. G. L. Wauben; C. M. Dekker-van Doorn; J. H. D. Van Wijngaarden; R. H. M. Goossens; R. Huijsman; J. Klein; J. F. Lange

    2011-01-01

    Objective To assess surgical team members’ differences in perception of non-technical skills. \\u000aDesign Questionnaire design. \\u000aSetting Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. \\u000aParticipants Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. \\u000aMethods All surgical team members, of five hospitals, were asked to complete a questionnaire and

  16. Medical Robots Surgical Assistants

    E-print Network

    Pulfrey, David L.

    1 Medical Robots Surgical Assistants · Efficacy of Procedure ­ Accuracy ­ Longevity ­ Invasiveness · Augment human capabilities ­ Enabling new procedures ­ Time under anaesthetic #12;2 Surgical Robots) ­ Sensei (Hansen Medical) Autonomous Surgical Robots Robodoc.com #12;3 Guided Surgical Robots Makosurgical

  17. Simulation in Surgical Education

    PubMed Central

    de Montbrun, Sandra L.; MacRae, Helen

    2012-01-01

    The pedagogical approach to surgical training has changed significantly over the past few decades. No longer are surgical skills solely acquired through a traditional apprenticeship model of training. The acquisition of many technical and nontechnical skills is moving from the operating room to the surgical skills laboratory through the use of simulation. Many platforms exist for the learning and assessment of surgical skills. In this article, the authors provide a broad overview of some of the currently available surgical simulation modalities including bench-top models, laparoscopic simulators, simulation for new surgical technologies, and simulation for nontechnical surgical skills. PMID:23997671

  18. Automation impact study of Army Training Management

    SciTech Connect

    Sanquist, T.F.; Schuller, C.R.; McCallum, M.C.; Underwood, J.A.; Bettin, P.J.; King, J.L.; Melber, B.D.; Hostick, C.J.; Seaver, D.A.

    1988-01-01

    The main objectives of this impact study were to identify the potential cost savings associated with automated Army Training Management (TM), and to perform a cost-benefit analysis for an Army-wide automated TM system. A subsidiary goal was to establish baseline data for an independent evaluation of a prototype Integrated Training Management System (ITMS), to be tested in the fall of 1988. A structured analysis of TM doctrine was performed for comparison with empirical data gathered in a job analysis survey of selected units of the 9ID (MTZ) at Ft. Lewis, Washington. These observations will be extended to other units in subsequent surveys. The survey data concerning staffing levels and amount of labor expended on eight distinct TM tasks were analyzed in a cost effectiveness model. The main results of the surveys and cost effectiveness modelling are summarized. 18 figs., 47 tabs.

  19. U.S. Army Corps of Engineers

    NSDL National Science Digital Library

    The U.S. Army Corps of Engineers has a long and distinguished history which can be traced back to 1775 when the Continental Congress organized an army with a chief engineer and two assistants. Today the Corps has over 37,000 dedicated civilians and soldiers delivering services in more than 130 countries worldwide. The website provides a veritable cornucopia of these activities, divided into thematic sections that include Missions, Locations, Careers, and Library. On the homepage, visitors can make their way through the Most Requested area, which includes items like Hurricane Sandy, Civil Works Plan, and numerous others. In the Missions area, visitors can learn about everything from domestic civil works programs to operations in Afghanistan and Iraq. Persons looking for Corps projects in certain regions can use the interactive Locations map to do so. The site is rounded out by the Media area, which features fact sheets, videos, and other items. [KMG

  20. Pursuing efficiency in surgical practice.

    PubMed

    Wyllie, J H; Kidson, I G; Wyllie, D H

    1988-11-26

    To examine fluctuations in numbers of patients on surgical wards the dates of admission from January of each of the 5556 patients admitted from 1 January 1985 to 31 December 1987 were examined during computerised audit of a single surgical firm. The numbers of patients under the care of the firm fluctuated widely, often exceeding the 38 beds nominally available. Duration of stay varied from two days or less (3062 admissions) to more than a month (163 admissions). One patient was in hospital for 278 days. The patients admitted for more than a month (2.9% of the total) filled 28% of the beds; not all these patients were elderly. A further increase in throughput of patients undergoing elective operations might be achieved by always admitting patients on the day of operation, and perhaps by discharging patients even sooner than at present. Efficiency would increase but so would overall costs. PMID:3146368

  1. Current Approaches for the Prevention of Surgical Site Infections

    Microsoft Academic Search

    Sander Florman; Ronald Lee Nichols

    2007-01-01

    Surgical site infections (SSIs) are the most common type of nosocomial infection among surgical patients and are commonly caused by the patients' own microbial flora. The prevalence of SSI is a major concern because of the associated increase in the incidence of morbidity and mortality, length of hospitalization and cost of care for postoperative patients. Key factors that determine whether

  2. Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction

    Microsoft Academic Search

    Robert H. Jones; Eric J. Velazquez; Robert E. Michler; George Sopko; Jae K. Oh; Christopher M. O'Connor; James A. Hill; Lorenzo Menicanti; Zygmunt Sadowski; Patrice Desvigne-Nickens; Jean-Lucien Rouleau; Kerry L. Lee

    2009-01-01

    Background Surgical ventricular reconstruction is a specific procedure designed to reduce left ventricular volume in patients with heart failure caused by coronary artery disease. We conducted a trial to address the question of whether surgical ventricular recon- struction added to coronary-artery bypass grafting (CABG) would decrease the rate of death or hospitalization for cardiac causes, as compared with CABG alone.

  3. Robotic technology integration for Army ground vehicles

    Microsoft Academic Search

    J. J. Jaczkowski

    2001-01-01

    This paper will discuss the U.S. Army Tank-Automotive Research, Development and Engineering Center's (TARDEC's) four (4) axis strategy for integration of robotics into the legacy, interim and objective forces. At the cornerstone of this strategy is the R&D effort concentrating on autonomous perception and navigation, intelligent tactical behavior, command and control, and man-robot interface entailed in the Demo III and

  4. Army nurses in wartime: distinction and pride.

    PubMed

    Higgins, L P

    1996-08-01

    Nurses have served with distinction in wartime since Florence Nightingale went to the Crimea. Women often accompanied their husbands to battle during the Revolutionary and Civil Wars, caring for the sick and wounded. Although not officially given officer status until 1920, Army nurses served in the Spanish-American War and World War I. As officers, thousands of nurses served in subsequent wars, distinguishing themselves by their heroism, devotion to duty, and sheer tenacity of spirit. PMID:8772301

  5. Amphibian Research and Monitoring Initiative (ARMI)

    Microsoft Academic Search

    Erin Muths; Robin E. Jung; Larissa L. Bailey; Michael J. Adams; P. Stephen Corn; C. Kenneth Dodd; G Ary M. Fellers; Walter J. Sadinski; Cecil R. Schwalbe; Susan C. Walls; Robert N. Fisher; Alisa L. Gallant; William A. Battaglin; D. Earl Green

    Abstract. Most research to assess amphibian,declines has focused on local-scale projects on one or a few species. The Amphibian Research and Monitoring Initiative (ARMI) is a national program,in the United States mandated,by congressional directive and implemented,by the U.S. Department of the Interior (specifically the U.S. Geological Survey, USGS). Program goals are to monitor changes in populations of amphibians,across U.S. Department

  6. Surgical innovation as sui generis surgical research.

    PubMed

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients. PMID:24242289

  7. A Targeted E-Learning Program for Surgical Trainees to Enhance Patient Safety in Preventing Surgical Infection

    ERIC Educational Resources Information Center

    McHugh, Seamus Mark; Corrigan, Mark; Dimitrov, Borislav; Cowman, Seamus; Tierney, Sean; Humphreys, Hilary; Hill, Arnold

    2010-01-01

    Introduction: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. Methods: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An…

  8. Surgical Planning Laboratory Anatomy Browser

    NSDL National Science Digital Library

    The Surgical Planning Laboratory (SPL) of the Department of Radiology at Brigham and Women's Hospital and Harvard Medical School has made a virtual treasure chest of visual anatomical information available at its web site. Highlights of the site include the Brain Atlas datasets: complex java applets that allow users to see parts of a schematic brain and heart. Users can rotate the images, and either click on parts of the images or on a listing of anatomical names and have those parts of the images labelled.

  9. Energy Design Guides for Army Barracks

    SciTech Connect

    Deru, M.; Zhivov, A.; Herron, D.

    2008-01-01

    The Energy Policy Act of 2005 requires federal facilities to be built to achieve 30% energy savings over the 2004 International Energy Code or American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 90.1-2004, as appropriate. The Engineer Research and Development Center of the U.S. Army Corps of Engineers and the National Renewable Energy Laboratory (NREL) are developing target energy budgets and design guides with a prescriptive path to achieve 30% energy savings over a baseline built to the minimum requirements of ANSI/ASHRAE/IESNA Standard 90.1-2004. This project covers eight building types in 15 U.S. climate zones. The building types include barracks, administrative buildings, a maintenance facility, a dining facility, a child development center, and an Army reserve center. All the design guides will be completed by the end of 2008. This paper focuses on the design guide for one type of barracks called unaccompanied enlisted personal housing (UEPH). The UEPH buildings are similar to apartment buildings with double occupancy units. For each building type, a baseline was established following typical Army construction and ASHRAE Standard 90.1 Appendix G modeling rules. Improvements in energy performance were achieved for the envelope using the NREL optimization platform for commercial buildings and previous ASHRAE design guides. Credit was also taken for tightening the building envelope by using proposed envelope leakage rates from ASHRAE and the Army. Two HVAC systems, including a dedicated outdoor air system, were considered. The final results achieved 29% site energy savings in two climates and greater than 30% site energy savings in all other climates. Results of this study were implemented in the Army's standard RFP process for new UEPH barracks construction in late 2007. New UEPH design/construction begun in 2008 and beyond will require the contractor to design and construct a UEPH facility that meets the target energy budget developed in this study using either a custom design or the design guide's prescriptive path developed as part of this study.

  10. Battles between an insurgent army and an advanced army - focus on strategy

    NASA Astrophysics Data System (ADS)

    Sen, Surajit; Shanahan, Linda

    2008-03-01

    Detailed and aggregate analyses of the outcome of past battles focusing on rates of troop losses or on the ratios of forces on each side is at the heart of present knowledge about battles. Here we present non-equilibrium statistical mechanics based studies of possible outcomes of well matched strategic battles by a ``blue'' army against insurgency based attacks by well matched opponents in a ``red'' army in red territory. We assume that the red army attacks with randomly varying force levels to potentially confuse and drive the blue's strategies. The temporal evolution of the model battles incorporate randomness in the deployment of the reds and hence possess attendant history dependence. Our results reveal that while unpredictable events play a major role in battles, a balance between risk of exposure in a battlefield and the use of short range intelligence is needed in determining whether one side can decimate the other, and hence force a battle to end.

  11. Surgical training in Guyana: the next generation

    PubMed Central

    Cameron, Brian H.; Martin, Carlos; Rambaran, Madan

    2015-01-01

    Summary The pioneering surgical training partnership between the Canadian Association of General Surgeons (CAGS) and the University of Guyana has successfully graduated 14 surgeons since 2006. The association has recruited 29 surgeons who have made 75 teaching visits to Guyana, and CAGS involvement has been critical to providing local credibility to the program, organizing the curriculum structure and developing rigorous examinations. The program is now locally sustained, with graduates leading a number of clinical hospital programs. The initial diploma qualification is being reassessed, as other specialties have introduced postgraduate Master of Medicine degree programs. Many graduates are pursuing additional training opportunities overseas, and almost all of those remaining in Guyana have returned to the tertiary centre from the regional hospitals. The program has succeeded in training surgeons and raising the standards of surgical care in Guyana, but broader health system efforts are necessary to retain surgeons in outlying regional hospitals. PMID:25621909

  12. Surgical training in Guyana: the next generation.

    PubMed

    Cameron, Brian H; Martin, Carlos; Rambaran, Madan

    2015-02-01

    The pioneering surgical training partnership between the Canadian Association of General Surgeons (CAGS) and the University of Guyana has successfully graduated 14 surgeons since 2006. The association has recruited 29 surgeons who have made 75 teaching visits to Guyana, and CAGS involvement has been critical to providing local credibility to the program, organizing the curriculum structure and developing rigorous examinations. The program is now locally sustained, with graduates leading a number of clinical hospital programs. The initial diploma qualification is being reassessed, as other specialties have introduced postgraduate Master of Medicine degree programs. Many graduates are pursuing additional training opportunities overseas, and almost all of those remaining in Guyana have returned to the tertiary centre from the regional hospitals. The program has succeeded in training surgeons and raising the standards of surgical care in Guyana, but broader health system efforts are necessary to retain surgeons in outlying regional hospitals. PMID:25621909

  13. Heritage of army audiology and the road ahead: the Army Hearing Program.

    PubMed

    McIlwain, D Scott; Gates, Kathy; Ciliax, Donald

    2008-12-01

    Noise-induced hearing loss has been documented as early as the 16th century, when a French surgeon, Ambroise Paré, wrote of the treatment of injuries sustained by firearms and described acoustic trauma in great detail. Even so, the protection of hearing would not be addressed for three more centuries, when the jet engine was invented and resulted in a long overdue whirlwind of policy development addressing the prevention of hearing loss. We present a synopsis of hearing loss prevention in the US Army and describe the current Army Hearing Program, which aims to prevent noise-induced hearing loss in soldiers and to ensure their maximum combat effectiveness. PMID:18923117

  14. Photocopy of plan (in U.S. Army office of Army Engineers ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of plan (in U.S. Army office of Army Engineers plans and drawings, Fort Hancock and Sandy hook proving ground, record group 7, drawer 44, Cartographic and Architectural branc, The National Archives, Washington, DC), U.S. Engineer Office, New York District, Harbor Defenses of New York Mine Boathouse, location plan and elevations, Fort Hancock, New Jersey, July 1943 Detail of western docking structure - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

  15. The Army Family Team Building Program: Facilitating a Transformative Learning Process--An Intrinsic Case Study

    ERIC Educational Resources Information Center

    Gall, Joseph A.

    2009-01-01

    This study sought to understand how the Army Family Team Building program influences self-reliance and self-sufficiency in Army spouses as they integrate into the Army community. The purpose of the Army Family Team Building program is to empower Army spouses with knowledge and skills, which foster well-being and improve quality of life. The…

  16. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

    PubMed Central

    Ursano, Robert J.; Colpe, Lisa J.; Heeringa, Steven G.; Kessler, Ronald C.; Schoenbaum, Michael; Stein, Murray B.

    2014-01-01

    Importance/Objective Although the suicide rate in the U.S. Army has traditionally been below age-gender matched civilian rates, it has climbed steadily since the beginning of the Iraq and Afghanistan conflicts and since 2008 has exceeded the demographically matched civilian rate. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multicomponent epidemiological and neurobiological study designed to generate actionable evidence-based recommendations to reduce Army suicides and increase knowledge about risk and resilience factors for suicidality and its psychopathological correlates. This paper presents an overview of the Army STARRS component study designs and of recent findings. Design/Setting/Participants/Intervention Army STARRS includes six main component studies: (1) the Historical Administrative Data Study (HADS) of Army and Department of Defense (DoD) administrative data systems (including records of suicidal behaviors) for all soldiers on active duty 2004–2009 aimed at finding administrative record predictors of suicides; (2) retrospective case-control studies of fatal and nonfatal suicidal behaviors (each planned to have n = 150 cases and n = 300 controls); (3) a study of new soldiers (n = 50,765 completed surveys) assessed just before beginning basic combat training (BCT) with self-administered questionnaires (SAQ), neurocognitive tests, and blood samples; (4) a cross-sectional study of approximately 35,000 (completed SAQs) soldiers representative of all other (i.e., exclusive of BCT) active duty soldiers; (5) a pre-post deployment study (with blood samples) of soldiers in brigade combat teams about to deploy to Afghanistan (n = 9,421 completed baseline surveys), with sub-samples assessed again one, three, and nine months after returning from deployment; and (6) a pilot study to follow-up SAQ respondents transitioning to civilian life. Army/DoD administrative data are being linked prospectively to the large-scale survey samples to examine predictors of subsequent suicidality and related mental health outcomes. Main outcome measures Measures (self-report and administratively recorded) of suicidal behaviors and their psychopathological correlates. Results Component study cooperation rates are comparatively high. Sample biases are relatively small. Inefficiencies introduced into parameter estimates by using nonresponse adjustment weights and time-space clustering are small. Initial findings show that the suicide death rate, which rose over 2004–2009, increased for those deployed, those never deployed, and those previously deployed. Analyses of administrative records show that those deployed or previously deployed were at greater suicide risk. Receiving a waiver to enter the Army was not associated with increased risk. However, being demoted in the past two years was associated with increased risk. Time in current deployment, length of time since return from most recent deployment, total number of deployments, and time interval between most recent deployments (known as dwell time) were not associated with suicide risk. Initial analyses of survey data show that 13.9% of currently active non-deployed regular Army soldiers considered suicide at some point in their lifetime, while 5.3% had made a suicide plan, and 2.4% had attempted suicide. Importantly, 47–60% of these outcomes first occurred prior to enlistment. Prior mental disorders, in particular major depression and intermittent explosive disorder, were the strongest predictors of these self-reported suicidal behaviors. Most onsets of plans-attempts among ideators (58.3–63.3%) occurred within the year of onset of ideation. About 25.1% of non-deployed U.S. Army personnel met 30-day criteria for a DSM-IV anxiety, mood, disruptive behavior, or substance disorder (15.0% an internalizing disorder; 18.4% an externalizing disorder) and 11.1% for multiple disorders. Importantly, three-fourths of these disorders had pre-enlistment onsets. Conclusions Integration across component studies creates strengths going well

  17. [An apothecary from the Cévennes region on the rolls of Oriental Pyrenees Army in 1793].

    PubMed

    Guibert, Marie-Sophie

    2015-01-01

    In 1793 during the french Revolution, the decret of February 23rd orders a big recruitment of 300 000 people. The city of Alès (Cevennes) has to supply ninety-seven soldiers to establish the battalion of the Gard. They will be allocated to the "Armée des Pyrénées-Orientales" (Army of the Eastern Pyrenees) which is going to defend the border with Spain. These armies have to face the influx of wounded persons but especially the devastation of the epidemics. Besides the soldiers, are enlisted the officers of health, the doctors, the surgeons and the pharmacists. So the city of Alès indicates to be of use to this army the youngest of the doctors, freshly honed of the university of Montpellier and two old pharmacists (51 y. and 61 y. old). They were allocated to the hospital of Narbonne where they worked to fight against the epidemics, in particular by the disinfection of rooms. The oldest of them succumbed to the disease. Two others, safe and sound income in their home town, played a notables' role. PMID:25807665

  18. 32 CFR 651.14 - Integration with Army planning.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...installation and Army master planning functions and plans...Any installation management plans, particularly...force development planning, and materiel acquisition planning. (28) Environmental Noise Management Program....

  19. Obstructive sleep apnea in loudly snoring army conscripts.

    PubMed

    Mäkelä, Jyrki P; Savolainen, Seppo

    2007-08-01

    One of the hallmarks of obstructive sleep apnea (OSA) is loud snoring. Army conscripts sleep in barracks, and loud snorers are easily detected. We made polygraphic recordings from these snorers during one night spent in the hospital, to find the ones suffering from OSA. Forty-nine conscripts (all male; mean age, 21 +/- 2 years; body mass index, 25 +/- 3 kg/m2) were studied; 32 (65%) complained about daytime sleepiness, and one had caused a shipwreck during an episode of fatigue. Oxygen levels decreased 4 to 9% >20 times per hour (4-9% oxygen desaturation index [ODI4] of >20 hours) for three subjects (6%). Eleven additional subjects (22%) had ODI4 values of >10 hours. Four (8%) of them did not complain about daytime sleepiness. The mean apnea index (AI) was 11 +/- 13 hours; 20 patients (41%) had AI values exceeding 10 hours. ODI4 and AI were significantly correlated (r = 0.67; p < 0.001). Body mass index did not correlate significantly with ODI4 or apnea index. Approximately one-fifth of loudly snoring conscripts suffer from OSA. Loud snorers should be examined before being selected for duties requiring maintenance of high alertness. PMID:17803083

  20. Incontinence Treatment: Surgical Treatments

    MedlinePLUS

    ... Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding ... changes Dietary changes Medication Bowel management/retraining program Biofeedback therapy Surgical treatments Newer procedures or devices Tips ...

  1. DEPARTMENT OF THE ARMY u.s. ARMY CORPS OF ENGINEERS

    E-print Network

    US Army Corps of Engineers

    -Dade County, Florida, Project Implementation Report and Integrated Environmental Impact Statement (PIRIEIS) 1 Project Implementation Report and Environmental Impact Statement u.S. Army Corps of Engineers Response Implementation Report (PIR) with integrated Environmental Impact Statement (EIS). The !EPR panel reviewed

  2. The NASA/Army Autonomous Rotorcraft Project

    NASA Technical Reports Server (NTRS)

    Whalley, M.; Freed, M.; Takahashi, M.; Christian, D.; Patterson-Hine, A.; Schulein, G.; Harris, R.

    2002-01-01

    An overview of the NASA Ames Research Center Autonomous Rotorcraft Project (ARP) is presented. The project brings together several technologies to address NASA and US Army autonomous vehicle needs, including a reactive planner for mission planning and execution, control system design incorporating a detailed understanding of the platform dynamics, and health monitoring and diagnostics. A candidate reconnaissance and surveillance mission is described. The autonomous agent architecture and its application to the candidate mission are presented. Details of the vehicle hardware and software development are provided.

  3. Results of NASA/Army transmission research

    NASA Technical Reports Server (NTRS)

    Coy, John J.; Townsend, Dennis P.; Coe, Harold H.

    1988-01-01

    Since 1970 the NASA Lewis Research Center and the U.S. Army Aviation Systems Command have shared an interest in advancing the technology for helicopter propulsion systems. In particular, that portion of the program that applies to the drive train and its various mechanical components are outlined. The major goals of the program were (and continue to be) to increase the life, reliability, and maintainability, reduce the weight, noise, and vibration, and maintain the relatively high mechanical efficiency of the gear train. Major historical milestones are reviewed, significant advances in technology for bearings, gears, and transmissions are discussed, and the outlook for the future is presented. The reference list is comprehensive.

  4. Health profile of Danish army personnel.

    PubMed

    Dahl, S; Kristensen, S

    1997-06-01

    The purpose of the present study was to delineate a health profile of professional Danish army personnel. Two-hundred twenty officers, noncommissioned officers, and gunners on active duty at Varde Barracks, housing the South Jutland Artillery Regiment and the Danish Army Artillery School, were asked about their physical and psychological health, interpersonal relations, and working conditions as well as their dietary, drinking, and smoking habits. Measurements were made of resting pulse rate, blood pressure, height, weight, waist and hip girth, and pulmonary function. The ratio of waist-to-hip girth and body mass index (BMI) were calculated. Psychological well-being was evaluated using the 12-item version of the General Health Questionnaire (GHQ). Psychosomatic symptoms were frequently reported, but very few of those surveyed appeared to have psychiatric disorders as measured by the GHQ. Also, somatic health problems were frequently reported, the most frequent being lower-back pain, mild chest pain, and sensory disorders. Differences in interpretation and reporting of "lasting health problems" may explain the relatively high score for this question. The interpersonal relations, both upward and downward in the hierarchy rank order, received high scores. Compared with the general population, alcohol consumption was very low, whereas smoking-in particular heavy smoking-was much more frequent among professional Danish army personnel. Lung function testing showed significantly poorer mean values of forced expiratory volume in 1st second of expiration and mean forced expiratory flow 25 to 75% of forced vital capacity among smokers compared with nonsmokers, although the mean values for the whole group of both smokers and nonsmokers were well above reference values for all lung function parameters. The frequency of moderately overweight individuals (25 < BMI < or = 30) was significantly higher among the male army personnel than in the general population, whereas this was not the case for obesity (BMI > 30). Abdominal obesity, regarded as an independent risk factor for the development of ischemic heart disease, stroke, diabetes, hypertension, and all-cause mortality, was present in 5%, and 3% belonged to the highest-risk group by having a low BMI as well as abdominal obesity. PMID:9183168

  5. 32 CFR 655.10 - Use of radiation sources by non-Army entities on Army land (AR 385-11).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 true Use of radiation sources by non-Army entities on Army...CONTINUED) ENVIRONMENTAL QUALITY RADIATION SOURCES ON ARMY LAND § 655.10 Use of radiation sources by non-Army entities on...

  6. 1. 1943 Plan View of 'Fort Lewis Station Hospital, Section ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. 1943 Plan View of 'Fort Lewis Station Hospital, Section No. 5.' Drawn by V. Steinbrueck for J.C. Boespflug Construction Co. July 23, 1943. HABS 8x10' negative was made from an 8.5 x 11' copy on card stock in the collection of the Community Library, Madigan Army Medical Center, Fort Lewis, WA. - Madigan Hospital, Bounded by Wilson & McKinley Avenues & Garfield & Lincoln Streets, DuPont, Pierce County, WA

  7. PATROLLING THE HOMEFRONT: THE EMOTIONAL LABOR OF ARMY WIVES VOLUNTEERING IN FAMILY READINESS GROUPS

    E-print Network

    Gassmann, Jaime Nicole Noble

    2010-08-30

    This dissertation examines the emotional labor of Army wives as they volunteer in Army-mandated family-member support groups in each unit called Family Readiness Groups (FRGs). Since its inception, the Army has relied ...

  8. 32 CFR Appendix G to Part 623 - Continental US Army Boundaries

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 true Continental US Army Boundaries G Appendix G to Part 623 National Defense Department of Defense...AND EQUIPMENT LOAN OF ARMY MATERIEL Pt. 623, App. G Appendix G to Part 623—Continental US Army...

  9. CDRP - Funded Institutions - Daniel Freeman Memorial Hospital

    Cancer.gov

    Centinela Freeman Regional Medical Center Memorial Campus is owned and operated by Memorial Campus local hospital administrtors, physicians and community leaders. Memorial Campus is a 358-bed acute care community hospital offering a wide array of greatly needed medical and surgical services, including cancer treatment, obstetrics, neonatal intensive care, pediatrics, neurology, neurosurgery, acute rehabilitation and emergency room services. Memorial Campus continues the hospital's almost 50-year mission of service to the Inglewood community since it acquired the facility in 2001.

  10. Commentary on "The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)": Army STARRS: a Framingham-like study of psychological health risk factors in soldiers.

    PubMed

    Ressler, Kerry J; Schoomaker, Eric B

    2014-01-01

    Although historically the Army suicide rate has been significantly lower than the civilian rate, in 2004, the suicide and accidental death rates began trending upward. By 2008, the Army suicide rate had risen above the national average (20.2 per 100,000). In 2009, 160 active duty Soldiers took their lives, making suicide the third leading cause of death among the Army population. If accidental death, frequently the result of high-risk behavior, is included, then more Soldiers died by their own actions than in combat in 2009. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) was thus created in 2009 to begin to address these problems. The Army STARRS project is a large consortium of seven different studies to develop data-driven methods for mitigating or preventing suicide behaviors and improving the overall mental health and behavioral functioning of Army Soldiers during and after their Army service. The first research articles from the Army STARRS project were published in late 2013 and early 2014. This work has already begun to outline important facets of risk in the military, and it is helping to drive an empirically derived approach to improvements in understanding mental disorders and risk behavior and to improve prevention and support of mental health and resilience. The Framingham Heart Study, started in the 1940s, marked a watershed event in utilizing large cross-sectional and prospective longitudinal collaborative research to identify and understand risk factors for cardiovascular disease. The Army STARRS project, through its collaborative, prospective, and robust innovative design and implementation, may provide the beginning of a similar scientific cohort in mental disorders. The work of this project will help understand biological and psychological aspects of military service, including those leading to suicide. When coupled with timely feedback to Army leadership, it permits near real-time steps to diagnose, mitigate, and manage emerging mental health issues and the root causes of risk and resilience in Army Soldiers, with potential impact extending across many traumatized populations-not unlike a parallel process that has markedly improved survival and recovery from physical combat wounds. PMID:24865196

  11. [Does scrotal blunt trauma require surgical treatment?].

    PubMed

    Paparel, Philippe; Badet, Lionel; Voiglio, Eric; Colombel, Marc; Rouviere, Olivier; Caillot, Jean-Louis; Martin, Xavier

    2003-09-01

    Blunt trauma to the scrotum is increasingly frequent and is mainly due to motor vehicle accidents, especially with direct trauma from a motorbike petrol tank or falling astride a bicycle frame. The surgical exploration of these cases of trauma remains a controversial issue. However, according to the authors, the presence of haematocele on clinical examination justifies systematic early surgical exploration, which shortens the patient's length of hospital stay allowing more rapid return to work. Ultrasound is only really indicated in the case of scrotal trauma without haematocele, looking for rupture of the tunica albuginea or intratesticular haematoma. PMID:14650283

  12. Hospital Hints

    MedlinePLUS

    ... hospital. You will need: Bathrobe and slippers (put your name on each item); most hospitals provide special bed ... medicines , including prescription and over-the-counter drugs Your allergies Names and telephone numbers (home and business) to contact ...

  13. Norovirus - hospital

    MedlinePLUS

    ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ... to understand an outbreak, such as in a hospital setting. This test is done by collecting a ...

  14. The automated Army ROTC Questionnaire (ARQ)

    NASA Technical Reports Server (NTRS)

    Young, David L. H.

    1991-01-01

    The Reserve Officer Training Corps Cadet Command (ROTCCC) takes applications for its officer training program from college students and Army enlisted personnel worldwide. Each applicant is required to complete a set of application forms prior to acceptance into the ROTC program. These forms are covered by several regulations that govern the eligibility of potential applicants and guide the applicant through the application process. Eligibility criteria changes as Army regulations are periodically revised. Outdated information results in a loss of applications attributable to frustration and error. ROTCCC asked for an inexpensive and reliable way of automating their application process. After reviewing the process, it was determined that an expert system with good end user interface capabilities could be used to solve a large part of the problem. The system captures the knowledge contained within the regulations, enables the quick distribution and implementation of eligibility criteria changes, and distributes the expertise of the admissions personnel to the education centers and colleges. The expert system uses a modified version of CLIPS that was streamlined to make the most efficient use of its capabilities. A user interface with windowing capabilities provides the applicant with a simple and effective way to input his/her personal data.

  15. FM 6-22 (FM 22-100) Army Leadership

    E-print Network

    US Army Corps of Engineers

    FM 6-22 (FM 22-100) Army Leadership Competent, Confident, and Agile OCTOBER 2006 DISTRIBUTION and complex security environment we face. FM 6-22 is the Army's keystone field manual on leadership. It establishes leadership doctrine and fundamental principles for all officers, noncommissioned officers

  16. VIRTUAL TESTING AND PROGRESSIVE FAILURE ANALYSIS OF ARMY COMPOSITE BRIDGE

    Microsoft Academic Search

    Ayman Mosallam; Frank Abdi; Xiaofeng Su

    Military composite bridges offer many unique advantages for the army including its lightweight (high strength-to-weight ratio), as compared to comparable steel and aluminum bridges, as well as its superior corrosion resistance properties that are preferred in harsh environmental conditions. This paper presents the results of a part of a comprehensive research program sponsored by the US Army TARDEC to develop

  17. Explaining Recent Army and Navy Minority Recruiting Trends. Research Brief

    ERIC Educational Resources Information Center

    Steinberg, Paul

    2009-01-01

    Between 2000 and 2007, the representation of blacks among high-quality Army recruits declined, while in the Navy, black representation remained stable; the representation of Hispanics among high-quality recruits in both the Army and Navy grew during this period. RAND researchers identified factors that explain these recruiting trends and found…

  18. Discourses of Gender in the Contemporary British Army

    Microsoft Academic Search

    Rachel Woodward; Patricia Winter

    2004-01-01

    This article is about the discourses of gender which circulate within debates about the inclusion of women in the British Army. Drawing on material from elite policy debates within the British Ministry of Defence, Army, and Parliament, the article uses a methodology informed by theories of discourse analysis to examine how the figures of the male and female soldier are

  19. Quality of ROTC Accessions to the Army Officer Corps.

    ERIC Educational Resources Information Center

    Gilbert, Arthur C. F.; And Others

    Comparisons are made of the groups of Army officers that were procured through various programs and of various categories within the Army Reserve Officers' Training Program (ROTC). The criterion for these comparisons was the final course grades in the Officer Basic Courses (OBC) of the 13 career branches. Two samples were studied; one sample…

  20. Soldier Education in the British Army, 1920-2007

    ERIC Educational Resources Information Center

    Beach, Jim

    2008-01-01

    This article surveys the history of compulsory education for soldiers' career advancement in the British army. It begins with an examination of the organizational context before analyzing the rationale, syllabus, teaching and assessment of soldier education. It concludes that for members of the army education organization their self-perception as…

  1. England’s Barmy ArmyCommercialization, Masculinity and Nationalism

    Microsoft Academic Search

    Matthew Parry; Dominic Malcolm

    2004-01-01

    This article examines a group of English cricket supporters known as the Barmy Army which explicitly and self-consciously challenges the traditions of spectatorship in English cricket. Following a discussion of who the Barmy Army are and a description of the distinctive characteristics of the style of their support, we seek to examine the factors which have led to the group’s

  2. Posttraumatic Stress Disorder Among Army Nurse Corps Vietnam Veterans.

    ERIC Educational Resources Information Center

    Stretch, Robert H.; And Others

    1985-01-01

    Investigated posttraumatic stress disorder (PTSD) among Army nurse veterans. Analysis of questionnaire data (N=712) revealed a current PTSD rate for Vietnam veteran nurses of 3.3 percent. This rate is comparable to that found among nonnurse active duty Army Vietnam veterans and is much lower than estimates for civilian Vietnam veterans.…

  3. Intelligence within BAOR and NATO's Northern Army Group

    Microsoft Academic Search

    Richard J. Aldrich

    2008-01-01

    During the Cold War the UK's principal military role was its commitment to the North Atlantic Treaty Organisation (NATO) through the British Army of the Rhine (BAOR), together with wartime command of NATO's Northern Army Group. The possibility of a surprise attack by the numerically superior Warsaw Pact forces ensured that great importance was attached to intelligence, warning and rapid

  4. Electrical energy reduction for army installations. Final report

    Microsoft Academic Search

    Windingland

    1981-01-01

    This report describes an analysis of electrical energy consumption of selected Army buildings at representative Army installations and of methods that can be used to reduce electrical consumption and associated utility costs at these installations. The report defines various techniques such as power factor correction, lighting reduction, motor voltage controllers, and the benefits derived from their application. The report shows

  5. Surgical checklists: the human factor

    PubMed Central

    2013-01-01

    Background Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. Methods Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. Results Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. Conclusion In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed. PMID:23672665

  6. Organizational Determinants of Work Outcomes and Quality Care Ratings Among Army Medical Department Registered Nurses

    PubMed Central

    Patrician, Patricia A.; Shang, Jingjing; Lake, Eileen T.

    2010-01-01

    The Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and several single-item measures were administered to registered nurses (RNs) working within 23 U.S.-based Army Medical Department (AMEDD) hospitals. Data were analyzed with logistic regression for nested data. Unfavorable nursing practice environments had a substantial association with job dissatisfaction (OR 13.75, p < .01), emotional exhaustion (OR 12.70, p < .01), intent to leave (OR 3.03, p < .01), and fair to poor quality of care (OR 10.66, p < .01). This study provides the first system-wide analyses of nursing practice environments in AMEDD hospitals in the U.S. Similar to findings in civilian samples, poor quality work environments are associated with less favorable RN work outcomes and quality of care ratings. PMID:20151409

  7. Suicide prevention program in the Army of Serbia and Montenegro.

    PubMed

    Dedic, Gordana; Gordana, Dedic J; Panic, Milivoje; Milivoje, Panic

    2007-05-01

    Suicide, as one of the greatest problems of maladjustment to the military environment, has been a subject of investigation in the Army of Serbia and Montenegro (former Yugoslav Army) for more than six decades. The Suicide Prevention Program was implemented in December 2003. The aim of the study was to follow-up the application of the Suicide Prevention Program in the Army of Serbia and Montenegro and its effect on the suicide rate and to compare its incidence in civilians. Results of the program application showed that the number of suicides in the Army of Serbia and Montenegro was constantly reducing over the period 2004 to 2005. For soldiers, it was even four times less than in the civilian male population, particularly in the period of adaptation to the military environment. Since the Suicide Prevention Program in the Army of Serbia and Montenegro proved to be successful in decreasing the suicide number, it should be further improved and routinely applied. PMID:17521110

  8. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2014-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  9. Greek hospitals: how well their resources are used

    Microsoft Academic Search

    Dimitris I. Giokas

    2001-01-01

    The paper concerns the use of different estimation methods (parametric and non-parametric), jointly or individually, as means of ascertaining relative efficiency, as well as specific estimates of the efficient marginal costs of hospital services (inpatient days in medical care, inpatient days in surgical area, etc.) of public, general and teaching hospitals in Greece. In addition, the efficient cost of hospitals

  10. DEPARTMENT OF THE ARMY ER 200-1-4 CECW-B U.S. Army Corps of Engineers

    E-print Network

    US Army Corps of Engineers

    .............................................................................. C-1 Appendix D- Memorandum of Understanding Between the U.S. Nuclear Regulatory Commission and the U.Si DEPARTMENT OF THE ARMY ER 200-1-4 CECW-B U.S. Army Corps of Engineers CEMP-R Washington, D 6 Policy....................................................................................... 3 6

  11. Supreme Court declines appeal of surgical technician.

    PubMed

    1998-10-30

    The U.S. Supreme Court declined to hear a case of a man who lost his job as a surgical technician because he has HIV. [Name removed] sued the Borgess Medical Center for removing him from his job, charging violations of the American with Disabilities Act and the Federal Rehabilitation Act. The hospital contended that [name removed]'s HIV infection posed a direct threat to patient safety, because his work required him to occasionally handle body tissues and suture patients. By declining to hear the case, the Supreme Court upheld the earlier ruling by the 6th U.S. Circuit Court of Appeals which sided with the hospital. PMID:11366004

  12. Surgical treatment of the failing heart.

    PubMed

    Singh, R R; Lisle, T C; Kron, I L

    2005-08-01

    Heart failure is one of the leading causes of hospitalization worldwide. Currently, most therapeutic strategies are aimed at resolving the acute exacerbation of failure, resulting in a high readmission rate. Despite significant advances in the medical treatment of heart failure, the results are far from perfect. Mortality remains high and hospitalization costly. Surgical management is still required for patients with end-stage heart failure. Unfortunately, its evolution has occurred in a less structured fashion. In addition to transplantation, strategies for the treatment of heart failure currently under investigation include implantation of pacemakers, left ventricular reconstruction, mitral valve repair, coronary revascularization, cardiomyoplasty and mechanical circulatory support. In the end however, the surgical management of patients with heart failure rests on the type of underlying cardiomyopathy. Hence, care must be taken to accurately diagnose these patients as either having dilated or ischemic cardiomyopathy. PMID:16177673

  13. Orthopedic Surgery in Rural American Hospitals: A Survey of Rural Hospital Administrators

    ERIC Educational Resources Information Center

    Weichel, Derek

    2012-01-01

    Rural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities. Methods: All hospitals in 5 states…

  14. General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators

    ERIC Educational Resources Information Center

    Zuckerman, Randall; Doty, Brit; Gold, Michael; Bordley, James; Dietz, Patrick; Jenkins, Paul; Heneghan, Steven

    2006-01-01

    Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural…

  15. U.S. Army Center of Military History

    NSDL National Science Digital Library

    2013-01-10

    The U.S. Army Center of Military History (CMH) is a directorate within the office of the Administrative Assistant to the Secretary of the Army. It provides a vast range of services designed to support the historical research efforts of different sections and organizations within the Army. First-time visitors may wish to start at the Medal of Honor area, which provides some detailed information about this most celebrated award, along with its recipients. The Force Structure and Unit History Branch area provides information about the various units and divisions within the Army, including those that no longer exist. The Army Museum System area provides detailed information about the various museums around the United States that cover the vast military history of the different states. The Artwork & Images area contains hundreds of artistic images that include dramatic paintings of key military excursions, along with thematic photographic collections like Army Libraries Through the Years and Buffalo Soldiers on the Eve of World War II. Visitors shouldn't leave without looking over the The Green Books series. This series covers all aspects of the Army's involvement in World War II; titles include "The War in the Pacific," "The Middle East Theater," and "The Technical Services." [KMG

  16. Designing and implementing the Army Nursing Leader Academy.

    PubMed

    Dunemn, Kathleen; Hopkins-Chadwick, Denise L; Connally, Tina; Bramley, Kelly

    2011-01-01

    In 2008, the Chief of the Army Nurse Corps directed a thorough review of existing training programs available to and provided for Army Nursing personnel for the development of full-spectrum leaders for Army Nursing. The review provided the gap analysis necessary to restructure courses provided by the Department of Nursing Science at the Army Medical Department Center and School. This new grouping of courses is referred to as the Army Nursing Leader Academy. The Army Nursing Leader Academy is the first of its kind in that it addresses career-long learning of all Army Nursing by focusing on building skills, knowledge, and behaviors to produce sustainable, full-spectrum leaders. The Nursing Leader Academy consists of a series of sequential nurse leader development courses combined with a web based resource center. Grounded in the Patient CaringTouch System, guided by nurse competencies, and gauged by the Leader Capabilities Map, the Nursing Leader Academy provides learning that is relevant and timely designed to reinforce enterprise values and culture to ensure readiness for successive roles and positions. Full implementation of the Nursing Leader Academy will include the evidence-based elements of formal schooling, coaching, self-development, functional/technical (competency attainment), and professional experiences. PMID:22124867

  17. [Coproductive teamwork in surgical cancer treatment].

    PubMed

    Konishi, Toshiro; Harihara, Yasushi; Furushima, Kaoru

    2013-04-01

    With regard to surgical treatment of cancer, there is a strong demand for safe treatment with few errors: treatment must be based on transparency, understandability, and rationality. There is also demand for treatment which is quick, efficient and not wasteful. Rather than maintaining our current pyramidal system which has doctors standing as authorities at the top, there is a need for a flat, non-authoritarian system at every level and section of the hospital. As we change methodology, electronic medical records and clinical pathways will be important tools. Among the surgical department's treatment team in our hospital, there are many branches at work on peri-operative management aside from operations; There are teams for infection control (ICT), nutrition support (NST), decubitus and stoma management, rehabilitaion, and chemotherapy, and team cooperation after discharge from hospital. In addition, the collaborative and coproductive team focusing on pain releif and palliative care in terminal phase (PCT) is important. Having introduced each of the parts of team treatment within the setting of the surgical department, the need now for strong leadership from young and brightful surgeons is also emphasized. PMID:23848009

  18. Relation of Surgical Volume to Outcome in Eight Common Operations

    PubMed Central

    Khuri, Shukri F.; Daley, Jennifer; Henderson, William; Hur, Kwan; Hossain, Monir; Soybel, David; Kizer, Kenneth W.; Aust, J. Bradley; Bell, Richard H.; Chong, Vernon; Demakis, John; Fabri, Peter J.; Gibbs, James O.; Grover, Frederick; Hammermeister, Karl; McDonald, Gerald; Passaro, Edward; Phillips, Lloyd; Scamman, Frank; Spencer, Jeannette; Stremple, John F.

    1999-01-01

    Objective To examine, in the Veterans Health Administration (VHA), the relation between surgical volume and outcome in eight commonly performed operations of intermediate complexity. Summary Background Data In multihospital health care systems such as VHA, consideration is often given to closing low-volume surgical services, with the assumption that better surgical outcomes are achieved in hospitals with larger surgical volumes. Literature data to support this assumption in intermediate-complexity operations are either limited or controversial. Methods The VHA National Surgical Quality Improvement Program data on nonruptured abdominal aortic aneurysmectomy, vascular infrainguinal reconstruction, carotid endarterectomy (CEA), lung lobectomy/pneumonectomy, open and laparoscopic cholecystectomy, partial colectomy, and total hip arthroplasty were used. Pearson correlation, analysis of variance, mixed effects hierarchical logistic regression, and automatic interaction detection analysis were used to assess the association of annual procedure/specialty volume with risk-adjusted 30-day death (and stroke in CEA). Results Eight major surgical procedures (68,631 operations) were analyzed. No statistically significant associations between procedure or specialty volume and 30-day mortality rate (or 30-day stroke rate in CEA) were found. Conclusions In VHA hospitals, the procedure and surgical specialty volume in eight prevalent operations of intermediate complexity are not associated with risk-adjusted 30-day mortality rate from these operations, or with the risk-adjusted 30-day stroke rate from CEA. Volume of surgery in these operations should not be used as a surrogate for quality of surgical care. PMID:10493488

  19. Accelerating surgical training and reducing the burden of surgical disease in Haiti before and after the earthquake.

    PubMed

    DeGennaro, Vincent A; DeGennaro, Vincent A; Kochhar, Amit; Nathan, Nirmal; Low, Christopher; Avashia, Yash J; Thaller, Seth R

    2012-11-01

    In general, university-based global health initiatives have tended to focus on expanding access to primary care. In the past, surgical programs may have been characterized by sporadic participation with little educational focus. However, there have been some notable exceptions with plastic surgery volunteer missions. We offer another model of regularly scheduled surgical trips to rural Haiti in plastic and general surgery. The goal of these trips is to reduce the burden of surgical disease and ultimately repair every cleft lip/palate in Haiti. Another principal objective is to accelerate the training of American residents through increased case load and personal interaction with attending surgeons in a concentrated period. Diversity of the case load and the overall number of surgeries performed by residents in a typical surgical trip outpaces the experiences available during a typical week in an American hospital setting. More importantly, we continue to provide ongoing training to Haitian nurses and surgeons in surgical techniques and postoperative care. Our postoperative complication rate has been relatively low. Our follow-up rates have been lower than 70% despite intensive attempts to maintain continued communication with our patients. Through our experiences in surgical care in rural Haiti, we were able to quickly ramp up our trauma and orthopedic surgical care immediately after the earthquake. Project Medishare and the University of Miami continue to operate a trauma and acute care hospital in Port au Prince. The hospital provides ongoing orthopedic, trauma, and neurosurgical expertise from the rotating teams of American surgeons and training of Haitian surgeons in modern surgical techniques. We believe that surgical residencies in the United States can improve their training programs and reduce global surgical burden of disease through consistent trips and working closely with country partners. PMID:23154377

  20. Micro-area variation in hospital use.

    PubMed Central

    Tedeschi, P J; Wolfe, R A; Griffith, J R

    1990-01-01

    Many recent studies have demonstrated that hospital utilization rates vary widely across small geographic areas. The variation is often attributed to the style of practice of the provider. This study demonstrates that hospital utilization varies widely between "micro" areas within individual hospital market areas. Further, the study demonstrates that hospital utilization rates within a hospital market area are more similar to each other than to rates in "micro" areas within other hospital market areas. After adjustment for available demographic, socioeconomic, and epidemiological factors, the utilization rates within "micro" areas are highly related to the group of hospitals that dominates the market area. After simultaneously adjusting for age and poverty, the market share-dominant group explains 35 percent of the variance in surgical use rates of "micro" areas and 39 percent of the variance in medical use rates. PMID:2312305

  1. THE U.S. ARMY CORPS OF ENGINEERS AND NATURAL RESOURCES MANAGEMENT

    E-print Network

    US Army Corps of Engineers

    #12;THE U.S. ARMY CORPS OF ENGINEERS AND NATURAL RESOURCES MANAGEMENT ON ARMY INSTALI.JATIONS 1941 in Publication Data Arnold, James R. The U.S. Army Corps of Engineers and natural resources management on army century. 4. Natural resources--United States--Management--History--20th century. 5. Land use

  2. Aggressive Management of Surgical Emergencies

    PubMed Central

    Bengmark, Stig

    2006-01-01

    Increasing evidence suggests that two factors significantly influence outcome in a surgical emergency – premorbid health and the degree of inflammation during the first 24 h following trauma. Repeat observations suggest that the depth of post-trauma immunoparalysis reflects the height of early inflammatory response. Administration to surgical emergencies, as was routine in the past, of larger amounts of fluid and electrolytes, fat, sugar and nutrients seems counterproductive as it increases immune dysfunction, impairs resistance to disease and, in fact, increases morbidity. Instead, strong efforts should be made to limit the obvious superinflammation, which occurs during the first 24 h after trauma and, thereby, reduce the subsequent immuno-paralysis. paralysis. Several approaches show efficacy in limiting early superinflammation such as strict control of blood glucose, avoida nce of stored blood when possible, supply of antioxidants, live lactic acid bacteria and plant fibres. This review focuses mainly on use of live lactic acid bacteria and plant fibres, often called synbiotics. Encouraging experience is reported from clinical trials in liver transplantation, severe pancreatitis and extensive trauma. Immediate control of inflammation by enteral nutrition and supply of antioxidants, lactic acid bacteria and fibres is facilitated by feeding tubes, introduced as early as possible on arrival at the hospital. PMID:17132308

  3. [Surgical management of acute abdominal pain in children].

    PubMed

    Scheye, T

    1999-01-01

    Acute abdominal pain is one of the most frequent causes of admission to an emergency department of a children's hospital. It continues to be a clinical challenge and the diagnosis viewed with the most apprehension is acute appendicitis. The clinical examination must be meticulous and repeated in order to assess the evolution of the abdominal syndrome and to adapt the paraclinic examinations. All the abdominal pains are not surgical but justify an admission for observation in pediatric surgical department. PMID:10642638

  4. Physical fitness profile of Army ROTC cadets.

    PubMed

    Thomas, David Q; Lumpp, Samantha A; Schreiber, Jamee A; Keith, James A

    2004-11-01

    One role of Army Reserved Officer's Training Corps (ROTC) programs is to physically prepare cadets for the demands of a military career. Cadets participate in physical training 3 days per week as part of their military science curriculum. Limited research has been conducted on the fitness level of ROTC cadets; therefore, the purpose of this study was to profile the physical fitness status of a cadre of ROTC cadets. Forty-three cadets (30 men and 13 women) performed Army Physical Fitness Test (APFT) assessments (2-mile run, 2-minute maximum push-ups and sit-ups) and clinical assessments of fitness (Bruce protocol Vo(2)max, underwater weighing, and 1 repetition maximum [1RM] bench press tests). Mean +/- standard deviations were calculated to provide the physical fitness profile for each parameter. Male cadets (21 +/- 2.2 years; height 177.4 +/- 6.6 cm; mass 79.2 +/- 9.4 kg) scored 49.6 +/- 6.1 ml.kg(-1).min(-1) for Vo(2)max, 14.8 +/- 4.2% fat, 86.5 +/- 24.9 kg 1RM bench press, 2-mile run of 13.97 +/- 1.4 minutes, 70.5 +/- 12.8 sit-ups, and 60.2 +/- 13.2 push-ups. Female cadets (20 +/- 2.4 years; height 165.1 +/- 8.0 cm; mass 63.5 +/- 10.0 kg) scored 40.8 +/- 3.9 ml.kg(-1).min(-1) for Vo(2) max, 23.9 +/- 3.8% fat, 35.3 +/- 8.2 kg 1RM bench press, 2-mile run of 17.0 +/- 1.6 minutes, 65.0 +/- 12.9 sit-ups, and 33.3 +/- 11.2 push-ups. The mean scores were above the 83rd percentile on all APFT items and average (percent fat) to above average (Vo(2)max and men's bench press scores) when compared with peer-age and sex-corrected norms. Only the women's bench press score was below average. With the exception of the women's bench press, these ROTC cadets possessed average to above average levels of fitness. PMID:15574107

  5. 32 CFR 581.2 - Army Discharge Review Board.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...administrative proceeding in which the Army introduced evidence developed by or as a direct or indirect result of compelled urinalysis testing administered for the purpose of identifying drug abusers (either for the purpose of entry into a treatment...

  6. 32 CFR 581.2 - Army Discharge Review Board.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...administrative proceeding in which the Army introduced evidence developed by or as a direct or indirect result of compelled urinalysis testing administered for the purpose of identifying drug abusers (either for the purpose of entry into a treatment...

  7. 32 CFR 581.2 - Army Discharge Review Board.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...administrative proceeding in which the Army introduced evidence developed by or as a direct or indirect result of compelled urinalysis testing administered for the purpose of identifying drug abusers (either for the purpose of entry into a treatment...

  8. 32 CFR 581.2 - Army Discharge Review Board.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...administrative proceeding in which the Army introduced evidence developed by or as a direct or indirect result of compelled urinalysis testing administered for the purpose of identifying drug abusers (either for the purpose of entry into a treatment...

  9. 32 CFR 581.2 - Army Discharge Review Board.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...administrative proceeding in which the Army introduced evidence developed by or as a direct or indirect result of compelled urinalysis testing administered for the purpose of identifying drug abusers (either for the purpose of entry into a treatment...

  10. 78 FR 60864 - Army Science Board Fall Plenary Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ...1530--Until completion (UTC). Location: Hyatt Regency Crystal City, 2799 Jefferson Davis Hwy., Arlington, VA 22202...CONTACT: Army Science Board Designated Federal Official, 2530 Crystal Drive, Suite 7098. Arlington, VA 22202. Brenda S....

  11. 78 FR 69077 - Army Education Advisory Subcommittee Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ...for the members of the public to present their issues for review and discussion. FOR FURTHER INFORMATION CONTACT: For information, please contact Dr. Robert Savukinas, at robert.savukinas@us.army.mil. Written submissions are to...

  12. A BSN Program for the U.S. Army Reserve.

    ERIC Educational Resources Information Center

    Foley, Barbara Jo; And Others

    1993-01-01

    The U.S. Army Reserve offers a nursing program through Regis College in Weston, Massachusetts. The collaborative effort has resulted in an innovative program that can serve as a model for other colleges and universities. (JOW)

  13. 78 FR 33074 - Army Science Board Summer Study Session

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-03

    ...predictive analysis and the related potential human and ethical dimensions. Planning for Climate Change study 2013--This study considers the most likely climate change scenarios and assesses how the changes might change the way the Army fights,...

  14. Development of aeronautical engines by the Army and Navy

    NASA Technical Reports Server (NTRS)

    1921-01-01

    Different aircraft engines are categorized as being of interest to only the Army or Navy or to both armed services. A listing of the different engines is presented along with some statistics, namely, horsepower.

  15. 77 FR 9633 - Army National Cemeteries Advisory Commission (ANCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ...on preserving the Tomb of the Unknown Soldier including the cracks in the large marble sarcophagus, the adjacent marble slabs, and the potential replacement marble stone for the sarcophagus already gifted to the Army. [ssquf]...

  16. American Hospital Directory

    MedlinePLUS

    ... Outpatient Welcome Understanding and using Free Hospital Profiles Free Hospital Profiles How to look up a hospital ... more than 50 hospitals.) How to see the Free Hospital Profile The Free Hospital Profile is displayed ...

  17. Characterization of aerosols produced by surgical procedures

    SciTech Connect

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)

    1994-07-01

    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  18. A targeted e-learning program for surgical trainees to enhance patient safety in preventing surgical infection

    Microsoft Academic Search

    Seamus M McHugh; Mark Corrigan; Borislav D Dimitrov; Seamus Cowman; Sean Tierney; Hilary Humphreys; Arnold DK Hill

    2010-01-01

    INTRODUCTION: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty.\\u000aMETHODS: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An educational Web site was developed targeting deficiencies highlighted in the

  19. The U. S. Army Topographical Engineers in the Mexican War

    E-print Network

    Traas, Adrian George

    1971-01-01

    THE U. S. ARMY TOPOGRAPHICAL ENGINEERS IN THE MEXICAN WAR A Thesis by ADRIAN GEORGE TRAAS Submitted to the Graduate College of Texas A&M University in partial fulfillment of the requirement for the degree of MASTER OF ARTS December 1971... Major Subject: History THE U. S. ARMY TOPOGRAPHICAL ENGINEERS IN THE MEXICAN WAR A Thesis by ADRIAN GEORGE TRAAS Approved as to style and content by: (Chairman of Committee) (Member) ( esd of Department) (Member) December 1911 ABSTRACT The U...

  20. Feminism and the exclusion of army women from combat

    Microsoft Academic Search

    Laura L. Miller

    1998-01-01

    Although claiming to represent the views of military women on the combat exclusion policy, feminist activists actually represent\\u000a only a minority of Army women. Most women soldiers do support opening the combat arms to women, however only on a volunteer\\u000a basis and with physical qualifications for those jobs. Most Army women are not interested in serving in the combat arms,

  1. The Unreal Enemy of America’s Army

    Microsoft Academic Search

    Robertson Allen

    2011-01-01

    This paper explores the characterizations of enemies in military-themed video games, with special attention given to the games Conflict: Desert Storm and America’s Army. I demonstrate how the public enemy of America’s Army is one not confined to any nationality, ethnicity, or political agenda. This marks a significant departure from games such as Conflict: Desert Storm. I argue that the

  2. Toward fluorescence detection of protein residues on surgical instruments

    NASA Astrophysics Data System (ADS)

    Richardson, Patricia R.; Jones, Anita C.; Baxter, Robert L.; Baxter, Helen C.; Whittaker, A. Gavin; Campbell, Gaynor A.

    2004-06-01

    Prion proteins are the infectious agents that cause Creutzfeldt-Jakob Disease (CJD) in humans. These proteins are particularly resistant to normal sterilization procedures, and the theoretical risk of prion transmission via surgical instruments is of current public and professional concern. We are currently investigating fluorescence methods for the detection of proteins on surfaces, with a view to developing an optical-fiber-based system for routine, online monitoring of residual protein contamination on surgical instruments, in hospital sterilization departments. This paper presents preliminary results on the detection of femtomole amounts of fluorescently labelled protein on surgical steel and discusses some of the problems involved in the detection of fluorescence from metal samples.

  3. This publication is available at Army Knowledge Online (https://armypubs.us.army.mil/doctrine/index.html).

    E-print Network

    US Army Corps of Engineers

    in this emerging domain requires exceptional situational awareness, a profound understanding of foreign culture and integrated use of military information support, cyber, and civil affairs operations. The relevance of Army

  4. Hospital fundamentals.

    PubMed

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID:24918827

  5. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were with treatment can elucidate the problems that exist and so enable them to be solved. PMID:7819893

  6. Latex allergy in hospital employees.

    PubMed

    Lai, C C; Yan, D C; Yu, J; Chou, C C; Chiang, B L; Hsieh, K H

    1997-04-01

    The purpose of this study was to investigate the prevalence and risk factors of latex-allergy in hospital personnel and the presence of latex-specific IgE in a latex-allergic group in Taiwan. A total of 1,021 hospital employees were initially screened for latex allergy with a questionnaire, which included sex, age, job categories, number of years of employment, daily working hours, frequency of latex glove wearing, symptoms of immediate reactions to latex gloves and history of previous atopic diseases. Among them, 70 hospital employees (6.8%; 95% confidence interval 1.9%-11.8%) had symptoms associated with glove wearing. The frequencies in different job categories were 28.3% of surgical nurses, 9.2% of surgeons, 5.8% of regular floor nurses, 5.2% of technicians, 4.6% of physicians, and 4.5% of laboratory researchers. The symptoms were significantly related to the frequency of latex glove exposure, surgical work, current hand eczema and history of atopic dermatitis. In contrast, the number of years of employment, daily working hours and previous history of hand eczema were not correlated with the symptoms of latex allergy. Latex-specific IgE was assayed by the dot blot method in 36 hospital employees of the latex allergic group (positive rate, 55.6%). We concluded that the prevalence of latex-allergy among hospital personnel was 6.9% and certain predisposing factors such as atopic dermatitis, current hand eczema ad surgical work may play a critical role in triggering and aggravating the symptoms. PMID:9136513

  7. Smart surgical tool.

    PubMed

    Huang, Huan; Yang, Lih-Mei; Bai, Shuang; Liu, Jian

    2015-02-01

    A laser-induced breakdown spectroscopy (LIBS) guided smart surgical tool using a femtosecond fiber laser is developed. This system provides real-time material identification by processing and analyzing the peak intensity and ratio of atomic emissions of LIBS signals. Algorithms to identify emissions of different tissues and metals are developed and implemented into the real-time control system. This system provides a powerful smart surgical tool for precise robotic microsurgery applications with real-time feedback and control. PMID:25649628

  8. Smart surgical tool

    NASA Astrophysics Data System (ADS)

    Huang, Huan; Yang, Lih-Mei; Bai, Shuang; Liu, Jian

    2015-02-01

    A laser-induced breakdown spectroscopy (LIBS) guided smart surgical tool using a femtosecond fiber laser is developed. This system provides real-time material identification by processing and analyzing the peak intensity and ratio of atomic emissions of LIBS signals. Algorithms to identify emissions of different tissues and metals are developed and implemented into the real-time control system. This system provides a powerful smart surgical tool for precise robotic microsurgery applications with real-time feedback and control.

  9. Desarrollo multidisciplinario de la cirugía robótica en un hospital universitario de tercer nivel: organización y resultados

    Microsoft Academic Search

    Elena Ortiz Oshiro; Ángel Ramos Carrasco; Jesús Moreno Sierra; Cristina Pardo Martínez; Isabel Galante Romo; Fernando Bullón Sopelana; Pluvio Coronado Martín; Iván Mansilla García; María Escudero Mate; José A. Vidart Aragón; Ángel Silmi Moyano; Jesús Álvarez Fernández-Represa

    2010-01-01

    BackgroundDa Vinci system (Intuitive Surgical®) is a surgical telemanipulator providing many technical advantages over conventional laparoscopic approach (3-D vision, ergonomics, highly precise movements, endowrist instrumentation…) and it is currently applied to several specialties throughout the world since 2000. The first Spanish public hospital incorporating this robotic technology was Hospital Clinico San Carlos (HCSC) in Madrid, in July 2006.We present the

  10. Preparing for the downsizing and closure of Letterman Army Medical Center: a case study.

    PubMed

    Bales, J D

    1993-02-01

    Letterman Army Medical Center (LAMC) began a phased downsizing in July 1991 which will lead to closure by June 30, 1994. An analysis of the downsizing and closure process has yielded information which can be valuable to medical treatment facility managers faced with similar challenges in the future. By review and analysis of documentation, this case study extracted and interpreted pertinent information from historical records and from personnel involved in planning for the downsizing and closure of LAMC. This study provides managers of military hospitals that are downsizing or closing with a summary of issues for planning, compiled by their relative importance, and a description of methods employed by LAMC for managing these issues. PMID:8441503

  11. Clinical trials of surgical treatment of malignant diseases

    Microsoft Academic Search

    Mitsuru Sasako

    2005-01-01

    The Dutch Gastric Cancer Study Group Trial was the first clinical phase III trial to be carried out in the field of cancer surgery. In spite of the excellent quality of the trial, it was heavily criticized for the poor quality of the treatment itself. Actually, the hospital mortality after the new surgical treatment (D2 lymph node dissection for gastric

  12. Advances in the surgical repair of ruptured abdominal aortic aneurysms

    Microsoft Academic Search

    R. C Darling; J. A Cordero; B. B Chang; D. M Shah; P. S. K Paty; W. E Lloyd; R. P Leather

    1996-01-01

    Over the past two decades, the mortality rate for elective repair of infrarenal abdominal aortic aneurysms has improved to an acceptable level (<5%). However, surgical results of ruptured abdominal aortic aneurysms have remained fairly constant with about 50% in hospital mortality rates. Growing experience with the use of the left retroperitoneal exposure for elective aortic surgery allowed the authors to

  13. Critical appraisal of surgical venous access in children

    Microsoft Academic Search

    M. A. Hollyoak; T. H. Ong; J. F. Leditschke

    1997-01-01

    Central venous catheters (CVC) have become an important adjunct to the overall management of paediatric patients, but their use is associated with frequent complications resulting in premature removal. This report evaluates the insertion techniques and complications of 295 consecutive surgically inserted CVC from 1987 to 1991 in a paediatric hospital. Fully implanted catheters had significantly less incidence of catheter-related problems

  14. Predisposing factors for delirium in the surgical intensive care unit

    Microsoft Academic Search

    Mustafa Aldemir; Sakir Özen; Ismail H Kara; Bilsel Baç

    2001-01-01

    BACKGROUND: Delirium is a sign of deterioration in the homeostasis and physical status of the patient. The objective of our study was to investigate the predisposing factors for delirium in a surgical intensive care unit (ICU) setting. METHOD: Between January 1996 and 1997, we screened prospectively 818 patients who were consecutive applicants to the general surgery service of Dicle-University Hospital

  15. 3D Surgical Simulation

    PubMed Central

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  16. The impact of minimally invasive surgical techniques.

    PubMed

    Darzi, Sir Ara; Munz, Yaron

    2004-01-01

    The use of minimally invasive techniques (MIT) in patient care is well documented in ancient history; however, it was not until the 1990s that advancements in technology enabled surgeons to realize the true potential of this approach. The minimally invasive approach has revolutionized surgical care, significantly reducing postoperative pain, recovery time, and hospital stays with marked improvements in cosmetic outcome and overall cost-effectiveness. It is now used around the world and in all major fields of surgery, compelling changes in training programs in order to assure quality control and patient safety. The bond between surgeons practicing minimally invasive surgery (MIS) and the high-tech industry is of utmost importance to future developments. Surgical robotic systems represent the most technologically advanced product of this collaboration, and their potential application in MIS shows much promise. As technology advances, additional developments in MIT are likely. PMID:14746519

  17. The Comparative Assessment and Improvement of Quality of Surgical Care in the Department of Veterans Affairs

    Microsoft Academic Search

    Shukri F. Khuri; Jennifer Daley; William G. Henderson

    2002-01-01

    rompted by the need to assess comparatively the quality of surgical care in 133 Veter- ans Affairs (VA) hospitals, the Department of Veterans Affairs conducted the National VA Surgical Risk Study between October 1, 1991, and December 31, 1993, in 44 VA medical centers. The study developed and validated models for risk adjustment of 30- day morbidity and 30-day mortality

  18. Human cystic echinococcosis in the West Bank of Palestine: surgical incidence and seroepidemiological study

    Microsoft Academic Search

    N. Abu-Hasan; M. Daragmeh; K. Adwan; K. Al-Qaoud; S. Abdel-Hafez

    2002-01-01

    The surgical incidence of cystic echinococcosis (CE) due to Echinococcus granulosus was investigated in hospitals of the West Bank, Palestinian Authority between January 1990 and December 1997. Serum samples from school-children in Yata town, which showed the highest surgical incidence, were tested for anti-hydatid antibodies. A total of 390 surgically confirmed cases were recorded throughout the 8-year period, with an

  19. Hospital Readmissions after Colectomy: A Population-Based Study

    PubMed Central

    Krell, Robert W; Girotti, Micah E; Fritze, Danielle; Campbell, Darrell A; Hendren, Samantha

    2013-01-01

    Background: Surgical readmissions will be targeted for reimbursement cuts in the near future. We sought to understand differences between hospitals with high and low readmission rates in a statewide surgical collaborative to identify potential quality improvement targets. Study Design: We studied 5,181 patients undergoing laparoscopic or open colectomy at 24 hospitals participating in the Michigan Surgical Quality Collaborative between May 2007 and Jan 2011. We first calculated hospital risk-adjusted 30-day readmission rates. We then compared reasons for readmission, risk-adjusted complication rates, risk-adjusted inpatient length of stay and composite process compliance across readmission rate quartiles. Results: Hospitals with the lowest 30-day readmission rates averaged 5.1%, compared to 10.3% in hospitals with the highest rates (p<0.01). Despite wide variability in readmission rates, reasons for readmission were similar between hospitals. Compared to hospitals with low readmission rates, hospitals with high readmission rates had higher risk-adjusted complication rates (29% vs. 22%, p=0.03), but similar median length of stay (5.5 days vs. 5.6, p=0.61). While measures to reduce complications were associated with lower surgical site infection rates, they were not associated with reduced overall complication or readmission rates. There was wide variation in complication rates among hospitals with similar readmission rates. Conclusions: There is wide variation in hospital readmission rates after colectomy that correlates with overall complication rates. However, the wide variation in complication rates among hospitals with similar readmission rates suggests that hospital complication rates explain little of their readmission rates. Preventing readmissions after colectomy in hospitals with high readmission rates will require more attention to different care processes currently unmeasured in many clinical registries as well as complication prevention. PMID:24246621

  20. The Amphibian Research and Monitoring Initiative (ARMI): 5-year report

    USGS Publications Warehouse

    Muths, Erin; Gallant, Alisa L.; Campbell Grant, Evan H.; Battaglin, William A.; Green, David E.; Staiger, Jennifer S.; Walls, Susan C.; Gunzburger, Margaret S.; Kearney, Rick F.

    2006-01-01

    Executive Summary The Amphibian Research and Monitoring Initiative (ARMI) is an innovative, multidisciplinary program that began in 2000 in response to a congressional directive for the Department of the Interior to address the issue of amphibian declines in the United States. ARMIi??s formulation was cross-disciplinary, integrating U.S. Geological Survey scientists from Biology, Water, and Geography to develop a course of action (Corn and others, 2005a). The result has been an effective program with diverse, yet complementary, expertise. ARMIi??s approach to research and monitoring is multiscale. Detailed investigations focus on a few species at selected local sites throughout the country; monitoring addresses a larger number of species over broader areas (typically, National Parks and National Wildlife Refuges); and inventories to document species occurrence are conducted more extensively across the landscape. Where monitoring is conducted, the emphasis is on an ability to draw statistically defensible conclusions about the status of amphibians. To achieve this objective, ARMI has instituted a monitoring response variable that has nationwide applicability. At research sites, ARMI focuses on studying species/environment interactions, determining causes of observed declines, and developing new techniques to sample populations and analyze data. Results from activities at all scales are provided to scientists, land managers, and policymakers, as appropriate. The ARMI program and the scientists involved contribute significantly to understanding amphibian declines at local, regional, national, and international levels. Within National Parks and National Wildlife Refuges, findings help land managers make decisions applicable to amphibian conservation. For example, the National Park Service (NPS) selected amphibians as a vital sign for several of their monitoring networks, and ARMI scientists provide information and assistance in developing monitoring methods for this NPS effort. At the national level, ARMI has had major exposure at a variety of meetings, including a dedicated symposium at the 2004 joint meetings of the Herpetologistsi?? League, the American Society of Ichthyologists and Herpetologists, and the Society for the Study of Amphibians and Reptiles. Several principal investigators have brought international exposure to ARMI through venues such as the World Congress of Herpetology in South Africa in 2005 (invited presentation by Dr. Gary Fellers), the Global Amphibian Summit, sponsored by the International Union for Conservation of Nature (IUCN) and Wildlife Conservation International, in Washington, D.C., 2005 (invited participation by Dr. P.S. Corn), and a special issue of the international herpetological journal Alytes focused on ARMI in 2004 (edited by Dr. C.K. Dodd, Jr.). ARMI research and monitoring efforts have addressed at least 7 of the 21 Threatened and Endangered Species listed by the U.S. Fish and Wildlife Service (California red-legged frog [Rana draytonii], Chiricahua leopard frog [R. chiricahuensis], arroyo toad [Bufo californicus], dusky gopher frog [Rana sevosa], mountain yellow-legged frog [R. muscosa], flatwoods salamander [Ambystoma cingulatum], and the golden coqui [Eleutherodactylus jasperi]), and 9 additional species of concern recognized by the IUCN. ARMI investigations have addressed time-sensitive research, such as emerging infectious diseases and effects on amphibians related to natural disasters like wildfire, hurricanes, and debris flows, and the effects of more constant, environmental change, like urban expansion, road development, and the use of pesticides. Over the last 5 years, ARMI has partnered with an extensive list of government, academic, and private entities. These partnerships have been fruitful and have assisted ARMI in developing new field protocols and analytic tools, in using and refining emerging technologies to improve accuracy and efficiency of data handling, in cond

  1. Preventing Venous Thromboembolism in Hospitalized Patients

    MedlinePLUS

    ... not promote universal VTE prevention regardless of a patient’s individual risks for VTE and bleeding. What are the cautions ... not apply to patients hospitalized for surgery. Surgical patients have different risk levels for both VTE and bleeding than nonsurgical ...

  2. Public protests after rape in Pakistani hospital.

    PubMed

    Ahmad, K

    1999-08-21

    This is a report on a hospital gang rape of a 16-year-old female patient in Swabi, Pakistan. The patient had been admitted for surgical treatment of renal colic when the tragic incident occurred. The hospital's medical superintendent, deputy medical superintendent, and the staff in charge of the ward were all accused and suspended. The patient, who was from a very poor socioeconomic background, suffered vaginal tears. Hearing the news, elders of the Swabi district denounced the incident by making intensive protests on loudspeakers. Rape cases are increasing in Pakistan¿s hospitals, but most of them go unreported because of the stigma attached to such abuse. PMID:10466681

  3. The Best of Intentions. Interior Architecture: Massachusetts General Hospital

    ERIC Educational Resources Information Center

    Ryder, Sharon Lee

    1974-01-01

    The Massachusetts General Hospital/Surgical and Special Services study, an information processing system for redesigning an outmoded existing hospital, structured information into small-scale elements that could be analyzed, reassembled into different solutions, and the solution selected that best accommodates all of the complex requirements. (MF)

  4. Conceptual Design for the Amphibian Research and Monitoring Initiative (ARMI)

    NASA Astrophysics Data System (ADS)

    Battaglin, W. A.; Langtimm, C. A.; Adams, M. J.; Gallant, A. L.; James, D. L.

    2001-12-01

    In 2000, the President of the United States (US) and Congress directed Department of Interior (DOI) agencies to develop a program for monitoring trends in amphibian populations on DOI lands and to conduct research into causes of declines. The U.S. Geological Survey (USGS) was given lead responsibility for planning and implementing the Amphibian Research and Monitoring Initiative (ARMI) in cooperation with the National Park Service (NPS), Fish and Wildlife Service, and Bureau of Land Management. The program objectives are to (1) establish a network for monitoring the status and distribution of amphibian species on DOI lands; (2) identify and monitor environmental conditions known to affect amphibian populations; (3) conduct research on causes of amphibian population change and malformations; and (4) provide information to resource managers, policy makers, and the public in support of amphibian conservation. The ARMI program will integrate research efforts of USGS, other Federal, and non-federal herpetologists, hydrologists, and geographers across the Nation. ARMI will conduct a small number (~20) of intensive research efforts (for example, studies linking amphibian population changes to hydrologic conditions) and a larger number (~50) of more generalized inventory and monitoring studies encompassing broader areas such as NPS units. ARMI will coordinate with and try to augment other amphibian inventory studies such as the National Amphibian Atlas and the North American Amphibian Monitoring Program. ARMI will develop and test protocols for the standardized collection of amphibian data and provide a centrally managed database designed to simplify data entry, retrieval, and analysis. ARMI pilot projects are underway at locations across the US.

  5. Behavioral Health Competence: An Exploration of Army Reserve Occupational Therapists

    PubMed Central

    Arthur, Paul B.; DeCleene, Kate

    2014-01-01

    The behavioral health competence of Army Reserve Occupational Therapists (OT) was examined by electronic survey to determine current levels of competence and highlight pre-deployment training needs. Results indicated that while Army Reserve OTs report high levels of behavioral health competence, many questions regarding diagnosis, assessment, evaluation, treatment planning, intervention, and progress arose throughout deployment. OT’s often relied on skills from Level II fieldwork education and entry-level didactic education for competency. Perceived competencies may be compromised by curriculum changes in entry-level education, available fieldwork settings, and a lack of adequate training currently available prior to deployment. PMID:25368437

  6. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  7. Allocation of surgical procedures to operating rooms.

    PubMed

    Ozkarahan, I

    1995-08-01

    Reduction of health care costs is of paramount importance in our time. This paper is a part of the research which proposes an expert hospital decision support system for resource scheduling. The proposed system combines mathematical programming, knowledge base, and database technologies, and what is more, its friendly interface is suitable for any novice user. Operating rooms in hospitals represent big investments and must be utilized efficiently. In this paper, first a mathematical model similar to job shop scheduling models is developed. The model loads surgical cases to operating rooms by maximizing room utilization and minimizing overtime in a multiple operating room setting. Then a prototype expert system which replaces the expertise of the operations research analyst for the model, drives the modelbase, database, and manages the user dialog is developed. Finally, an overview of the sequencing procedures for operations within an operating room is also presented. PMID:8522909

  8. Surgical Instrument Restraint in Weightlessness

    NASA Technical Reports Server (NTRS)

    Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

    2000-01-01

    Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

  9. Integrating the Army Geospatial Enterprise : synchronizing geospatial-intelligence to the dismounted soldier

    E-print Network

    Richards, James E., S.M. Massachusetts Institute of Technology

    2010-01-01

    The Army's Geospatial Enterprise (AGE) has an emerging identity and value proposition arising from the need to synchronize geospatial information activities across the Army in order to deliver value to military decision ...

  10. The potential of America's Army, the video game as civilian-military public sphere

    E-print Network

    Li, Zhan, 1979-

    2004-01-01

    The US Army developed multiplayer online First Person Shooter video game, America's Army, was examined as the first instance of an entirely state-produced and directed enterprise leveraging video game popular culture. ...

  11. 32 CFR 552.38 - Acquisition of maneuver agreements for Army commanders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 true Acquisition of maneuver agreements for Army commanders...Therein § 552.38 Acquisition of maneuver agreements for Army commanders. (a) Authorization. After a maneuver is authorized by the...

  12. 32 CFR 553.7 - Design and layout of Army national cemeteries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...NATIONAL CEMETERIES § 553.7 Design and layout of Army national cemeteries. (a) General cemetery layout plans, landscape planting plans and gravesite layout plans for Army national cemeteries will be maintained by The Adjutant General....

  13. 32 CFR 553.7 - Design and layout of Army national cemeteries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...NATIONAL CEMETERIES § 553.7 Design and layout of Army national cemeteries. (a) General cemetery layout plans, landscape planting plans and gravesite layout plans for Army national cemeteries will be maintained by The Adjutant General....

  14. Inappropriate Halsted mastectomy and patient volume in Italian hospitals.

    PubMed Central

    Grilli, R; Mainini, F; Penna, A; Bertolini, G; Scorpiglione, N; Torri, V; Liberati, A

    1993-01-01

    To study whether Halsted mastectomy was used only when properly indicated, a prospective survey was undertaken on the process of care of 985 breast cancer patients seen consecutively at 62 general hospitals in Northern and Central Italy. Overall, 79% of Halsted mastectomies were performed inappropriately. The procedure was less likely to be performed on more educated patients and, other factors considered, on those seen at hospitals with larger volume. We conclude that the measurement of utilization of a surgical procedure for which only a few appropriate indications exist may help identify important relationships between hospital characteristics and quality of surgical care. PMID:8259814

  15. Surgical team mapping: implications for staff allocation and coordination.

    PubMed

    Sykes, Mark; Gillespie, Brigid M; Chaboyer, Wendy; Kang, Evelyn

    2015-02-01

    Perioperative team membership consistency is not well researched despite being essential in reducing patient harm. We describe perioperative team membership and staffing across four surgical specialties in an Australian hospital. We analyzed staffing and case data using social network analysis, descriptive statistics, and bivariate correlations and mapped 100 surgical procedures with 171 staff members who were shared across four surgical teams, including 103 (60.2%) nurses. Eighteen of 171 (10.5%) staff members were regularly shared across teams, including 12 nurses, five anesthetists, and one registrar. We found weak but significant correlations between the number of staff (P < .001), procedure start time (P < .001), length of procedure (P < .05), and patient acuity (P < .001). Using mapping, personnel can be identified who may informally influence multiple team cultures, and nurses (ie, the majority of team members in surgery) can lead the development of highly functioning surgical teams. PMID:25645040

  16. Surgical versus nonsurgical rejuvenation.

    PubMed

    Fitzgerald, Rebecca; Graivier, Miles H; Kane, Michael; Lorenc, Z Paul; Vleggaar, Danny; Werschler, Wm Philip; Kenkel, Jeffrey M

    2010-01-01

    The number of cosmetic procedures for facial rejuvenation has increased steadily over the past decade. The increase in the application of nonsurgical modalities, particularly injectable shaping agents, has been remarkable. As knowledge and experience about facial aging has increased, techniques and tools have improved, and it is increasingly apparent that surgical and nonsurgical/injectable modalities are complementary. PMID:20844298

  17. CULTIVATING NETWORKS: IMPLEMENTING SURGICAL

    E-print Network

    Sahay, Sundeep

    i CULTIVATING NETWORKS: IMPLEMENTING SURGICAL TELEMEDICINE Margunn Aanestad THE INTERVENTIONAL TELEMEDICINE by Margunn Aanestad Submitted as partial fulfilment of the requirements of the degree Doctor;iii TABLE OF CONTENTS 1. Introduction 1 2. Telemedicine ­ visions and challenges 3 3. Related research

  18. Multimedia architecture for teleradiology in the U.S. Army virtual radiology environment

    Microsoft Academic Search

    Jay F. Cook; William J. Chimiak

    1998-01-01

    The U.S. Army Medical Command, lead by the Brooke Army Medical Center, has embarked on a futuristic project which will revolutionize the practice of radiology in the DoD. The U.S. Army Virtual Radiology Environment (USAVRE) is a CONUS-based network that connects all the Army's major medical centers and Regional Medical Commands (RMC). The purpose of the USAVRE is to improve

  19. Repeated multi-centre prevalence surveys of hospital-acquired infection in Greek hospitals

    Microsoft Academic Search

    A. Gikas; I. Pediaditis; M. Roumbelaki; G. Troulakis; J. Romanos; Y. Tselentis; CICNet

    1999-01-01

    Three prevalence studies for the estimation of hospital-acquired infections (HAIs) were carried out in eight Greek hospitals on an annual basis during the years 1994–1996. The overall prevalence of HAI was 6·8, 5·5 and 5·9% for the three years, respectively. Among these, urinary tract infections ranged from 22·4 to 38·2%, lower respiratory tract infections ranged from 21·1 to 32·6%, surgical

  20. Hospital Greenspace Lawson Memorial Hospital,

    E-print Network

    in the surrounding local community. This reduced the number to 15 facilities. Each of these was visited to ground in the Highlands where the greening of hospital space should be piloted. The clear ambition of the local community support Clinical credibility Community buy in Environmental expertise Project management support Funding

  1. Antibiotic Prophylaxis and Incisional Surgical Site Infection Following Colorectal Cancer Surgery: An Analysis of 330 Cases

    Microsoft Academic Search

    Varut Lohsiriwat; Darin Lohsiriwat

    2009-01-01

    Objective: To evaluate the rate of incisional surgical site infection (SSI) following colorectal cancer surgery in a university hospital and to determine whether duration of prophylactic antibiotic administration can affect the development of this complication. Material and Method: The medical records of 330 patients with colorectal cancer undergoing elective oncological resection between 2003 and 2006 at Siriraj Hospital were reviewed.

  2. Surgical management of esophageal strictures after caustic burns: A 30 years of experience

    Microsoft Academic Search

    Yong Han; Qing-Shu Cheng; Xiao-Fei Li; Xiao-Ping Wang

    AIM: To analyze a 30-year historical series of patients treated in our hospital, who ingested corrosive substances, and to assess the effectiveness of surgical therapy administered in patients with strictures after caustic injury in esophagus during this period. METHODS: A total of 79 cases of caustic burns in esophagus were treated in Tangdu Hospital from 1971 to 2001. Their clinical

  3. Risks and risk-analysis for the development of pressure ulcers in surgical patients

    Microsoft Academic Search

    Bastiaan Paul Johan Aart Keller

    2006-01-01

    With prevalence figures of 13% for university hospitals and 23% for general hospitals, pressure ulcers are a major health care issue in The Netherlands. Pressure ulcers in surgical patients are frequently encountered, as is illustrated by reported incidence rates up to 66%. The number of patients at risk will probably also grow, due to an ageing population. In an extensive

  4. Army ant prey availability and consumption by chimpanzees (Pan troglodytes vellerosus) at Gashaka (Nigeria)

    Microsoft Academic Search

    C. Schöning; D. Ellis; A. Fowler; V. Sommer

    2007-01-01

    Army ant predation by chimpanzees has been studied as an intriguing example of tool use and a possible case of cultural variation. However, the importance of army ant prey in chimpanzee diet and feeding ecology is still only poorly understood. We studied the availability and consumption of army ants in a population of the chimpanzee subspecies Pan troglodytes vellerosus in

  5. G93-1145 Management of the Army Cutworm and Pale Western Cutworm

    Microsoft Academic Search

    Gary L. Hein; John B. Campbell; Stephen D. Danielson; James A. Kalisch

    1993-01-01

    This NebGuide describes the life cycle of the army cutworm and pale western cutworm, and provides recommendations for management.The army cutworm, Euxoa auxiliaris, and the pale western cutworm, Agrotis orthogonia, are sporadic pests that are distributed throughout the Great Plains. The army cutworm can be found throughout Nebraska, but is more common in the western half of the state. Because

  6. Attitudes to the Army and ProNuclear Activism in Three Student Groups

    Microsoft Academic Search

    Patrick G. L. Heaven; John D. Brewer; C. L. Bester

    1986-01-01

    The study investigated the correlates of attitudes toward the army and pro-nuclear activism among students in Australia, N. Ireland and (white) South Africa. Results showed the South Africans to be most favorably disposed toward the army and also to be most favorably disposed toward the deployment of nuclear weapons. Across the three groups those with positive attitudes toward the army

  7. Development of a ROTC/Army Career Commitment Model: Final Report, Volume I.

    ERIC Educational Resources Information Center

    Card, J. J.; And Others

    The ROTC/Army Career Commitment Model focused on the process of career commitment during the young adult years by examining the career path of an Army officer via the ROTC route. Research questions were related to who joins ROTC and why, who remains as a career Army officer and why, and background factors which increase or decrease commitment to…

  8. 32 CFR 562.8 - Army Advisory Panel on ROTC Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 true Army Advisory Panel on ROTC Affairs. 562.8 Section 562.8 National...TRAINING CORPS § 562.8 Army Advisory Panel on ROTC Affairs. (a) The Army Advisory Panel on ROTC Affairs (AAP) was established on...

  9. 32 CFR 562.8 - Army Advisory Panel on ROTC Affairs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2009-07-01 true Army Advisory Panel on ROTC Affairs. 562.8 Section 562.8 National...TRAINING CORPS § 562.8 Army Advisory Panel on ROTC Affairs. (a) The Army Advisory Panel on ROTC Affairs (AAP) was established on...

  10. 32 CFR 562.8 - Army Advisory Panel on ROTC Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2009-07-01 true Army Advisory Panel on ROTC Affairs. 562.8 Section 562.8 National...TRAINING CORPS § 562.8 Army Advisory Panel on ROTC Affairs. (a) The Army Advisory Panel on ROTC Affairs (AAP) was established on...

  11. 32 CFR 562.8 - Army Advisory Panel on ROTC Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Army Advisory Panel on ROTC Affairs. 562.8 Section 562.8 National...TRAINING CORPS § 562.8 Army Advisory Panel on ROTC Affairs. (a) The Army Advisory Panel on ROTC Affairs (AAP) was established on...

  12. 32 CFR 562.8 - Army Advisory Panel on ROTC Affairs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Army Advisory Panel on ROTC Affairs. 562.8 Section 562.8 National...TRAINING CORPS § 562.8 Army Advisory Panel on ROTC Affairs. (a) The Army Advisory Panel on ROTC Affairs (AAP) was established on...

  13. 78 FR 21919 - Finding of No Significant Impact and Final Programmatic Environmental Assessment for Army 2020...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-12

    ...Environmental Assessment for Army 2020 Force Structure Realignment AGENCY...FNSI) for implementation of force structure realignment to reduce...Environmental Assessment for Army 2020 Force Structure Realignment (PEA...Chief of Staff of the Army, G-3/5/7 has signed the...

  14. Health Hazard Assessment and Toxicity Clearances in the Army Acquisition Process

    NASA Technical Reports Server (NTRS)

    Macko, Joseph A., Jr.

    2000-01-01

    The United States Army Materiel Command, Army Acquisition Pollution Prevention Support Office (AAPPSO) is responsible for creating and managing the U.S. Army Wide Acquisition Pollution Prevention Program. They have established Integrated Process Teams (IPTs) within each of the Major Subordinate Commands of the Army Materiel Command. AAPPSO provides centralized integration, coordination, and oversight of the Army Acquisition Pollution Prevention Program (AAPPP) , and the IPTs provide the decentralized execution of the AAPPSO program. AAPPSO issues policy and guidance, provides resources and prioritizes P2 efforts. It is the policy of the (AAPPP) to require United States Army Surgeon General approval of all materials or substances that will be used as an alternative to existing hazardous materials, toxic materials and substances, and ozone-depleting substances. The Army has a formal process established to address this effort. Army Regulation 40-10 requires a Health Hazard Assessment (HHA) during the Acquisition milestones of a new Army system. Army Regulation 40-5 addresses the Toxicity Clearance (TC) process to evaluate new chemicals and materials prior to acceptance as an alternative. U.S. Army Center for Health Promotion and Preventive Medicine is the Army's matrixed medical health organization that performs the HHA and TC mission.

  15. Comprehensive Soldier Fitness: A Vision for Psychological Resilience in the U.S. Army

    ERIC Educational Resources Information Center

    Casey, George W., Jr.

    2011-01-01

    The stress and strain on the U.S. Army's community due to nearly a decade of protracted war is well documented in the press and in scientific literature. In response, the Army's Comprehensive Soldier Fitness (CSF) program is a preventive program that seeks to enhance psychological resilience among all members of the Army community, which includes…

  16. ARMY ANT RAID ATTENDANCE AND BIVOUAC-CHECKING BEHAVIOR BY NEOTROPICAL MONTANE FOREST BIRDS

    E-print Network

    O'Donnell, Sean

    ARMY ANT RAID ATTENDANCE AND BIVOUAC-CHECKING BEHAVIOR BY NEOTROPICAL MONTANE FOREST BIRDS SEAN O at army ant swarm raids (n 5 48) in a neotropical montane forest. All observations were during seasons when Nearctic migrant birds are present. Bird species differed in army ant raid-attending behavior

  17. 32 CFR 552.25 - Entry regulations for certain Army training areas in Hawaii.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...regulations for certain Army training areas in Hawaii. 552.25 Section 552.25 National...Regulations for Certain Army Training Areas in Hawaii § 552.25 Entry regulations for certain Army training areas in Hawaii. (a) Purpose. (1) This...

  18. 32 CFR 552.25 - Entry regulations for certain Army training areas in Hawaii.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...regulations for certain Army training areas in Hawaii. 552.25 Section 552.25 National...Regulations for Certain Army Training Areas in Hawaii § 552.25 Entry regulations for certain Army training areas in Hawaii. (a) Purpose. (1) This...

  19. 32 CFR 552.25 - Entry regulations for certain Army training areas in Hawaii.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...regulations for certain Army training areas in Hawaii. 552.25 Section 552.25 National...Regulations for Certain Army Training Areas in Hawaii § 552.25 Entry regulations for certain Army training areas in Hawaii. (a) Purpose. (1) This...

  20. 32 CFR 552.25 - Entry regulations for certain Army training areas in Hawaii.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...regulations for certain Army training areas in Hawaii. 552.25 Section 552.25 National...Regulations for Certain Army Training Areas in Hawaii § 552.25 Entry regulations for certain Army training areas in Hawaii. (a) Purpose. (1) This...

  1. 32 CFR 552.25 - Entry regulations for certain Army training areas in Hawaii.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...regulations for certain Army training areas in Hawaii. 552.25 Section 552.25 National...Regulations for Certain Army Training Areas in Hawaii § 552.25 Entry regulations for certain Army training areas in Hawaii. (a) Purpose. (1) This...

  2. a Miscellaneous Paper A-96-1 US Army Corps

    E-print Network

    US Army Corps of Engineers

    or approval of the use of such commercial products. *PRINTED ON RECYa..ED PAPER #12;Aquatic Plant Control A-96-1 June 1996 US Army Corps of Engineers Waterways Experiment Station Aquatic Plant Control. publication. or promotional purposes. Citation of trade names does not constitute an official endorsement

  3. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept 29, 1934 when the revised Real Property form on building 255 was completed. - Fitzsimons General Hopital, Building 255, North side of East O'Niell Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  4. MEMORANDUM OF UNDERSTANDING UNITED STATES ARMY CORPS OF ENGINEERS

    E-print Network

    US Army Corps of Engineers

    of the United States, and applies to all structures, from the smallest floating dock to the largest commercial authorization from the Secretary of the Army, acting through the Corps, for the construction of any structure in or over any navigable water of the United States. Structures or work outside the limits defined

  5. http://www.tad.usace.army.mil/ Afghan Safety Professionals

    E-print Network

    US Army Corps of Engineers

    had fire prevention safety for all." One valuable TAA employee took the training to heart. Hamid, a 36, with the paving and U.S. ARMY CORPS OF ENGINEERS TRANSATLANTIC DIVISION PUBLICATION CFC Adds Online Option throughout Afghanistan. To ensure mission accomplishment, training is a major tool in the quest. Safety

  6. Training in Mechanized Stock Accounting Systems in Army Logistics.

    ERIC Educational Resources Information Center

    Leedy, Herbert B.

    Army experience with a small mechanized stock accounting system, the NCR 500, was studied with respect to personnel and training, in order to improve implementation of newer and more complex computer-based logistics systems. Officers and enlisted personnel in various duty positions connected with NCR 500 systems in four Far Eastern commands were…

  7. US army chemical corps Vietnam veterans health study: preliminary results

    Microsoft Academic Search

    Han K. Kang; Nancy A. Dalager; Larry L. Needham; Donald G. Patterson; Genevieve M. Matanoski; Sukon Kanchanaraksa; Peter S. J. Lees

    2001-01-01

    The long-term health consequences of exposure to phenoxyherbicides used in Vietnam has been a great concern to the veterans. In addition to the Air Force Ranch Hand personnel, Army Chemical Corps personnel who served in Vietnam are thought to have had some of the highest herbicide exposures. The Department of Veterans Affairs commenced a study of veterans who served in

  8. Using AI Planning Techniques for Army Small Unit Operations 

    E-print Network

    Tate, Austin; Levine, John; Jarvis, Peter; Dalton, Jeffrey

    In this paper, we outline the requirements of a planning and decision aid to support US Army small unit operations in urban terrain and show how AI planning technologies can be exploited in that context. The work is a rare example of a comprehensive...

  9. 2007 NCTE Presidential Address: Where Ignorant Armies Clash by Night

    ERIC Educational Resources Information Center

    Yatvin, Joanne

    2008-01-01

    This article presents the text of Joanne Yatvin's presidential address, delivered at the NCTE Annual Convention in New York City in November 2007. The title of her presidential address, "Where Ignorant Armies Clash by Night," was taken from Matthew Arnold's (1867) poem "Dover Beach." Yatvin states that the federal government has usurped the right…

  10. Flagging vigilance: the post-Vietnam "Hollow Army"

    E-print Network

    Lee, Robert Matthew

    2001-01-01

    " Meyer in his 1980 White Paper. In his assessment, Meyer raised several questions regarding the post-Vietnam army's ability to meet its missions of deterrence and preparedness for war due to several maladies afflicting the force at the time. Ultimately...

  11. The United States School Garden Army. Bulletin, 1919, No. 26

    ERIC Educational Resources Information Center

    Francis, J. H.

    1919-01-01

    The name of the United States School Garden Army was adopted in March, 1918. The work of the organization is an expansion of work undertaken by the Bureau of Education in 1914. The scale upon which it was done was limited by the finances that could be secured for it. The acute demand for food production growing out of the war conditions made…

  12. Integration of New Technology in Army Libraries. Appendices.

    ERIC Educational Resources Information Center

    DAMANS and Associates, Rockville, MD.

    Eight appendices provide information related to a study which was conducted to determine the feasibility of introducing new automatic techniques to Army library technical processing activities; to examine and recommend appropriate systems and configurations for library automation; and to determine costs of implementing the recommendations. The…

  13. U.S. ARMY CORPS OF ENGINEERS BUILDING STRONG

    E-print Network

    Farritor, Shane

    of Engineers. "We are working closely with state and local emergency management teams to identify potential flood areas, provide residents with the most current information and help protect vital public their possessions and property. Maps for potential flood areas can be found at: www.nwo.usace.army.mil

  14. Suicide in the Army National Guard: An Empirical Inquiry

    ERIC Educational Resources Information Center

    Griffith, James

    2012-01-01

    Since 2004, suicides in the U.S. military have risen, most notably in the Army National Guard (ARNG). Data used in this study were obtained for suicides occurring from 2007 to 2010 and for a random sample of nonsuicides from the general ARNG population. Of the military-related variables considered, a few showed relationships to suicide. Rather,…

  15. Solar energy applications at Army Ammunition Plants. Technical report

    Microsoft Academic Search

    A. P. Lowry; S. M. Moy

    1982-01-01

    The Army Ammunition Plants (AAPs) use significant quantities of fossil fuels. To reduce dependence on these scarce, costly, and non-renewable fuels, a study was conducted to investigate potential solar energy applications at the AAPs. Solar energy is a low-level energy source which is best applied to low temperature applications. It can be used at the AAPs to preheat boiler feedwater,

  16. Learning Organization Dimensions of the Sri Lanka Army

    ERIC Educational Resources Information Center

    Dahanayake, Nishada Dhananjaya; Gamlath, Sharmila

    2013-01-01

    Purpose: This study intends to investigate the extent to which the Sri Lanka Army can be described as a learning organization. Design/methodology/approach: The main tool of analysis used was the Dimensions of the Learning Organization Questionnaire (DLOQ) developed by Marsick and Watkins, with the exclusion of the sections on financial and…

  17. Net Zero Ft. Carson: making a greener Army base

    EPA Science Inventory

    The US Army Net Zero program seeks to reduce the energy, water, and waste footprint of bases. Seventeen pilot bases aim to achieve 100% renewable energy, zero depletion of water resources, and/or zero waste to landfill by 2020. Some bases are pursuing Net Zero in a single secto...

  18. The British Army's percussion hand grenades, 1914–16

    Microsoft Academic Search

    D. M. Leeson

    2010-01-01

    There are deep disagreements among historians of the Great War concerning the British Army's willingness and ability to adapt itself to the conditions of trench warfare on the Western Front. One possible way of shedding new light on this old controversy is by closely studying one small case of successful adaptation: the case of the hand grenade. Unlike their French

  19. Bidding for Army Career Specialties: Improving the ROTC Branching Mechanism

    Microsoft Academic Search

    Tayfun Sönmez

    2011-01-01

    Motivated by historically low retention rates of graduates at USMA and ROTC, the Army recently introduced branch-for-service incentives programs where cadets could bid an additional three years of active duty service obligation to obtain higher priority for their desired career specialties. The full potential of this highly innovative program is not utilized, due to the ROTC's choice of a poorly

  20. Arms and the Campus in 1975: Army ROTC in Transition.

    ERIC Educational Resources Information Center

    Wright, Billy J.

    The basic problem confronting ROTC is mission accomplishment--obtaining officers in sufficient numbers to meet Army requirements. Problems bearing on mission accomplishment are generally a reflection of the society as a whole. Although, for the first time in several years, this year's enrollment exceeds that of the previous year, ROTC is far from…

  1. US army land condition-trend analysis (LCTA) program

    Microsoft Academic Search

    Victor E. Diersing; Robert B. Shaw; David J. Tazik

    1992-01-01

    The US Army Land Condition-Trend Analysis (LCTA) program is a standardized method of data collection, analysis, and reporting designed to meet multiple goals and objectives. The method utilizes vascular plant inventories, permanent field plot data, and wildlife inventories. Vascular plant inventories are used for environmental documentation, training of personnel, species identification during LCTA implementation, and as a survey for state

  2. 77 FR 4026 - Army Education Advisory Subcommittee Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-26

    ...February 23, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks, Pennsylvania 17013. Time of Meeting: 8:30 a.m.-13:00 p.m. Proposed Agenda: The...

  3. 78 FR 23759 - Army Education Advisory Subcommittee Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-22

    ...May 16, 2013. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks, Pennsylvania 17013. Time of Meeting: 8:30 a.m.--13:30 p.m. Proposed Agenda: The...

  4. 77 FR 27209 - Army Education Advisory Subcommittee Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ...May 31, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks, PA 17013. Time of Meeting: 8:30 a.m.-13:30 p.m. Proposed Agenda: The purpose of...

  5. Environmental regulatory compliance on army lands: A case study

    Microsoft Academic Search

    Robert B. Shaw; Richard D. Laven

    1993-01-01

    A ``finding of no significant impact'' (FONSI) resulting from an environmental assessment (EA) was reported by the US Army in June 1986 for the construction and utilization of a multipurpose range complex (MPRC) at the Pohakuloa Training Area, Hawaii. There was little public response, and the US Fish and Wildlife Service and state agencies were consulted and had few comments

  6. Chromium contamination in Army face masks. Final report

    SciTech Connect

    Not Available

    1989-01-01

    The National Research Council's Committee on Toxicology's Subcommittee on Chromium Contamination in Army Face Masks reviewed the possible health risks to soldiers associated with exposure to U.S. Army gas-mask canisters containing activated charcoal impregnated with hexavalent chromium, a carcinogen. The canisters are attached to masks used to detoxify toxic gases, such as hydrogen chloride and cyanogen chloride. In 1982, reports surfaced of dark smudges on the faces of mask users; the smudges were traced to leaking of activated charcoal fines from canisters. The carbon smudging was also associated with some exposure to hexavalent chromium. The subcommittee's review of data provided by the Army on the amounts of chromium released during tests of gas-mask canisters indicated that the amounts of insoluble hexavalent chromium--chromium (VI)--found in the C2 canister (developed by the Canadian Army) and in the field-fixed and redesigned M10Al canisters are well within the limits implied by standards set by the National Institute for Occupational Safety and Health under worst-case mask use conditions.

  7. Tutorial: Proxmark, the Swiss Army Knife for RFID Security Research

    E-print Network

    Garcia, Flavio D.

    Tutorial: Proxmark, the Swiss Army Knife for RFID Security Research Flavio D. Garcia, Gerhard de, a versatile tool for RFID security research. It can be used to analyze and reverse engineer RFID protocols de to recover the secret key. Furthermore, we describe the practical cryptanalysis of several proprietary RFID

  8. One Team Destined For Greatness US Army Corps of Engineers

    E-print Network

    Johnson, Eric E.

    Operations Model (URGWOM) URGWOM Project Manager Amy Louise January 10, 2013 #12;US Army Corps of Engineers Collaboration of water management organizations Flood control Reservoir operations San Juan-Chama Project, IBWC, UNM, USGS Santa Fe, Caballo Soil & Water Conservation District, Colorado Division of Water

  9. Evaluation of soil toxicity at Joliet Army Ammunition Plant

    Microsoft Academic Search

    Michael Simini; J. C. Amos; R. S. Wentsel; R. T. Checkai; C. T. Phillips; N. A. Chester; M. A. Major

    1995-01-01

    Environmental toxicity testing and chemical analyses of soil were performed as part of an ecological risk assessment at the Joliet Army Ammunition Plant (JAAP), Joliet, Illinois. Soils were collected from an area where munitions were loaded, assembled, and packed (area L7, group 1), and from an area where waste explosives were burned on unprotected soil (area L2). Control samples were

  10. Assessing the Performance of the Army Reserve Components School System.

    ERIC Educational Resources Information Center

    Winkler, John D.; And Others

    The operation of the U.S. Army's Reserve Components (RC) school system was assessed. Three areas were identified that were fundamental to the system where organizational changes could make a difference. First, the project assessed training requirements and school delivery of courses. In serving a sizable training requirement for reclassification…

  11. Master Resilience Training in the U.S. Army

    ERIC Educational Resources Information Center

    Reivich, Karen J.; Seligman, Martin E. P.; McBride, Sharon

    2011-01-01

    The U.S. Army Master Resilience Trainer (MRT) course, which provides face-to-face resilience training, is one of the foundational pillars of the Comprehensive Soldier Fitness program. The 10-day MRT course is the foundation for training resilience skills to sergeants and for teaching sergeants how to teach these skills to their soldiers. The…

  12. Virtual Hospital

    NSDL National Science Digital Library

    Provided and maintained by the University of Iowa Health Care, the Virtual Hospital is designed as a "medical reference and health promotion tool for health care providers and patients." To that end, the site offers current and authoritative medical information for patients and professional and pedagogical information for health care providers. The former includes patient educational briefs browseable by organ system or by a topical list, a collection of peer-reviewed and annotated Web resources, an internal search engine, and archives of a column offering medical advice to middle-aged users. Resources in the health care provider section include several digital libraries aimed at certain specialties (Pediatrics, Pediatric Radiology, Family Medicine, and Medical Student); multimedia textbooks and teaching files grouped by organ system; lectures and publications; and clinical practice guidelines. Additional resources at the site include links to the Virtual Children's and Virtual Naval Hospitals, an internal search engine, and online continuing education courses.

  13. Is Hospital Teaching Status a Key Factor in Hospital Charge for Children with Hip Fractures?

    PubMed Central

    Gao, Yubo; Pugely, Andrew; Karam, Matthew; Phisitkul, Phinit; Mendoza, Sergio; Johnston, Richard C.

    2013-01-01

    OBJECTIVE Proximal femur fractures cause significant pain and economic cost among pediatric patients. The purposes of this study were (a) to evaluate the distribution by hospital type (teaching hospital vs non-teaching hospital) of U.S. pediatric patients aged 1-20 years who were hospitalized with a closed hip fracture and (b) to discern the mean hospital charge and hospital length of stay after employing propensity score to reduce selec-tion bias. METHODS The 2006 Healthcare Cost and Uti-lization Project (HCUP) Kids’ Inpatient Database (KID) was queried for children aged up to 20 years that had principle diagnosis of hip fracture injury. Hip fractures were defined by International Classifi-cation of Diseases, 9th Revision, Clinical Modifica-tion codes 820.0, 820.2 and 820.8 under Section “Injury and Poisoning (800-999)” with principle internal fixation procedure codes 78.55, 79.15 and 79.35. Patient demographics and hospital status were presented and analyzed. Differences in mean hospital charge and hospital length of stay by hospital teaching status were assessed via two propensity score based methods. RESULTS In total, 1,827 patients were nation-ally included for analysis: 1,392 (76.2%) were treated at a teaching hospital and 435 (23.8%) were treated at a non-teaching hospital. The average age of the patients was 12.88 years old in teaching hospitals vs 14.33 years old in nonteaching hospitals. The propensity score based ad-justment method showed mean hospital charge was $34,779 in teaching hospitals and $32,891 in the non-teaching hospitals, but these differences were not significant (p=0.2940). Likewise, mean length of hospital stay was 4.1 days in teaching hospitals and 3.89 days in non-teaching hospitals, but these differences were also not significant (p=0.4220). Conclusions Hospital teaching status did not affect length of stay or total hospital costs in children treated surgically for proximal femur fractures. Future research should be directed at identifying factors associated with variations in hospital charge and length of stay. PMID:24027472

  14. 21 CFR 878.4040 - Surgical apparel.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4040 Surgical apparel. (a) Identification. Surgical...

  15. Nosocomial infection, indices of intrinsic infection risk, and in-hospital mortality in general surgery

    Microsoft Academic Search

    M. Delgado-rodríguez; A. Gomez-ortega; J. Llorca; M. Lecuona; T. Dierssen; M. Sillero-arenas; A. Sierra

    1999-01-01

    The objectives of this paper are to assess whether two indices of intrinsic infection risk (the SENIC and the NNIS index) predict in-hospital mortality and the attributable in-hospital mortality due to nosocomial infection in surgical patients. A prospective study on 4714 patients admitted to three hospitals has been carried out. The relative risk and its 95% confidence interval (CI) were

  16. ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2002

    Microsoft Academic Search

    CRAIG A. PEDERSEN; PHILIP J. SCHNEIDER; DOUGLAS J. SCHECKELHOFF

    Results of the 2002 ASHP nation- al survey of pharmacy practice in hospital settings that pertain to dispensing and ad- ministration are presented. A stratified random sample of pharmacy directors at 1101 general and children's medical-surgical hospitals in the United States were surveyed by mail. SMG Market- ing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn

  17. Epidemiological approach to surgical management of the casualties of war.

    PubMed Central

    Coupland, R. M.

    1994-01-01

    The nature of modern conflicts precludes adequate medical care for most people wounded in wars. The traditional military approach of echeloned care for those wounded on the battlefield has limited relevance. I present an alternative, epidemiological approach whereby some effective care may reach many more. For a surgical facility to have a positive impact by using surgical and anaesthetic competence there must be access to the wounded; security for staff and patients; and a functioning hospital infrastructure. These all depend on respect for the first Geneva convention. Early hospital admission for urgent surgery is not so important if there is adequate first aid beforehand. The hospitals of the International Committee of the Red Cross have provided surgical care for thousands of wounded people by fulfilling these conditions. People wounded in modern conflicts would fare better if these priorities were recognised and less emphasis was placed on the more spectacular aspects of surgical care that benefit only a few. Images p1695-a FIG 2 FIG 3 FIG 1 PMID:8025468

  18. Reducing surgical site infections in hepatopancreatobiliary surgery

    PubMed Central

    Ceppa, Eugene P; Pitt, Henry A; House, Michael G; Kilbane, E Molly; Nakeeb, Attila; Schmidt, C Max; Zyromski, Nicholas J; Lillemoe, Keith D

    2013-01-01

    Objectives Patients undergoing complex hepatopancreatobiliary (HPB) operations are at high risk for surgical site infection (SSI). Factors such as biliary obstruction, operative time and pancreatic or biliary fistulae contribute to the high SSI rate. The purpose of this study was to analyse whether a multifactorial approach would reduce the incidence and cost of SSI after HPB surgery. Methods From January 2007 to December 2009, 895 complex HPB operations were monitored for SSI through the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). In 2008, surgeon-specific SSI rates were provided to HPB surgeons, and guidelines for the management of perioperative factors were established. Observed SSI rates were monitored before and after these interventions. Hospital cost data were analysed and cost savings were calculated. Results Observed SSI for hepatic, pancreatic and complex biliary operations decreased by 9.6% over a 2-year period (P < 0.03). The excess cost per SSI was US$11 462 and was driven by increased length of stay and hospital readmission for infection. Surgeons rated surgeon-specific feedback on SSI rate as the most important factor in improvement. Conclusions High SSI rates following complex HPB operations can be improved by a multifactorial approach that features process improvements, individual surgeon feedback and reduced variation in patient management. PMID:23557410

  19. Going to the Hospital

    MedlinePLUS

    ... or music player with earphones Before a Planned Hospital Stay Keep in mind that hospitals are not ... a short time in the hospital. During the Hospital Stay While the person with Alzheimer’s is in ...

  20. Surgical lessons from the lake.

    PubMed

    Kothari, Shanu N

    2014-12-01

    After circumnavigating Lake Michigan during a sabbatical in the summer of 2011, the lessons learned from this experience and the surgical parallels between boating and life as a surgeon will be discussed. Topics will include the use of surgical checklists, teamwork and communication, leadership, and surgical mentorship. PMID:25440476

  1. Mentoring in surgical training.

    PubMed

    Rashid, Prem; Narra, Maruthi; Woo, Henry

    2015-04-01

    Surgical mentors have helped trainees develop fulfilling and academically productive careers, while supervisors are formally assigned to impart skills and oversee training. This paper reviews the comparative roles of the supervisor and mentor and how they overlap, while exploring the impact of the 'unknown' mentor. While the supervisor's role in directing the student is formally recognized, the mentee will personally select a mentor who successfully models the career and life balance to which the mentee aspires. The unknown mentor is known only to the mentee. The mentee's commitment to communicating with both mentor and supervisor is crucial to success. Better processes can be used to guide the mentor relationship. Confusion between the two roles - mentor and supervisor - is due to their complementary nature as well as an overlap in roles. Both remain essential to the growth and development of the surgical trainee. The unknown mentor could give detached advice and guidance to the student, while acting as a positive role model. PMID:25649003

  2. Postthrombotic Syndrome: Surgical Possibilities

    PubMed Central

    Khanna, Ajay K.; Singh, Shivanshu

    2012-01-01

    Postthrombotic syndrome (PTS) is a late outcome of deep vein thrombosis characterized by cramping pain, swelling, hyperpigmentation, eczema, lipodermatosclerosis, and ulceration in the leg due to increased venous outflow resistance and reflux venous flow. Newer surgical and endovascular interventions have a promising result in the management of postthrombotic syndrome. Early surgical or endovascular interventions in appropriately selected patients may decrease the incidence of recurrent ulceration and skin changes and provide a better quality of life. Duplex and IVUS (intravenous ultrasound) along with venography serve as cornerstone investigative tools for assessment of reflux and obstruction. Venous obstruction, if present, should be addressed earlier than reflux. It requires endovenous stenting, endophlebectomy, or open bypass procedures. Venous stripping, foam sclerotherapy, radiofrequency, or laser ablation are used to abolish superficial venous reflux. Valvuloplasty procedures are useful for incompetent but intact deep venous valves, while transposition or axillary vein autotransplantation is done for completely destroyed valves. PMID:22084674

  3. Surgical Device Engineering

    NSDL National Science Digital Library

    Techtronics Program,

    This unit focuses on teaching students about the many aspects of biomedical engineering (BME). Students come to see that BME is a broad field that relies on concepts from many engineering disciplines. They also begin to understand some of the special considerations that must be made when dealing with the human body. Activities and class discussions encourage students to think as engineers to come up with their own solutions to some of medical challenges that have been solved throughout the history of BME. Class time iincludes brainstorming and presenting ideas to the class for discussion. Specific activities include examination of the material properties and functions of surgical instruments and prosthetics, a simulation of the training experience of a surgical resident, and an investigation of the properties of fluid flow in vascular tissue.

  4. Pelvic Exenteration: Surgical Approaches

    PubMed Central

    2012-01-01

    Although the incidence of local recurrence after curative resection of rectal cancer has decreased due to the understanding of the anatomy of pelvic structures and the adoption of total mesorectal excision, local recurrence in the pelvis still remains a significant and troublesome complication. While surgery for recurrent rectal cancer may offer a chance for a cure, conservative management, including radiation and chemotherapy, remain widely accepted courses of treatment. Recent improvement in imaging modalities, perioperative care, and surgical techniques, including bone resection and wound coverage, have allowed for reductions in operative mortality, though postoperative morbidity still remains high. In this review, the techniques, including surgical approaches, employed for management of locally recurrent rectal cancer are highlighted. PMID:23346506

  5. Spacecraft surgical scrub system

    NASA Technical Reports Server (NTRS)

    Abbate, M.

    1980-01-01

    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  6. [The Jewish Hospital in Budapest under the Nazi occupation (1944-1945)].

    PubMed

    Weisskopf, Varda

    2008-01-01

    On March 19, 1944 the German army invaded and occupied Hungary. The Waffen-SS soldiers captured the buildings of the Jewish community in Budapest, including the famous and important Jewish hospital on Szabolcs Street, founded in 1802. The Jewish hospital moved into a school belonging to the Jewish community on 44 Wesselényi Street. The hospital personnel managed to smuggle out medical equipment, and operating rooms were transferred into this central, temporary medical location. Other hospitals were founded, some inside the ghetto, others outside. The Judenrat supplied these hospitals with medical equipment obtained through contributions from Jews. The temporary hospitals admitted sick patients and a great number of those injured as a result of the war in Budapest. These hospitals operated with poor equipment. Surgeries were sometimes performed on kitchen tables, and medical equipment was sterilized by burning the synagogue's benches and library books. As of December 1944, there was no electricity in the hospitals. Thus doctors were forced to operate by the light of candles and flashlights. Nevertheless, they managed to save numerous lives. In spite of the terrible conditions under which the medical staff worked, they were committed to their mission, and their courage deserves appreciation. Ghetto Budapest was liberated by the Red army on 18th January, 1945. Thousands of Jews were released from the temporary hospitals. PMID:18300630

  7. The development of postgraduate surgical training in Guyana

    PubMed Central

    Cameron, Brian H.; Rambaran, Madan; Sharma, Deen P.; Taylor, Robert H.

    2010-01-01

    Background Like many developing countries, Guyana has a severe shortage of surgeons. Rather than rely on overseas training, Guyana developed its own Diploma in Surgery and asked for assistance from the Canadian Association of General Surgeons (CAGS). This paper reviews the initial results of Guyana’s first postgraduate training program. Methods We assisted with program prerequisites, including needs assessment, proposed curriculum, University of Guyana and Ministry of Health approval, external partnership and funding. We determined the outputs and outcomes of the program after 2 years, and we evaluated the impact of the program through a quantitative/qualitative questionnaire administered to all program participants. Results Five residents successfully completed the 2-year program and are working in regional hospitals. Another 9 residents are in the training program. Twenty-four modules or short courses have been facilitated, alternating Guyanese with visiting Canadian surgical faculty members coordinated through CAGS. A postgraduate structure, including an Institute for Health Sciences Education and Surgical Postgraduate Education Committee, has been developed at the Georgetown Public Hospital Corporation (GPHC). An examination structure similar to Canada’s has been established. Hospital staff morale is greater, surgical care is more standardized and academic opportunities have been enhanced at GPHC. Four regional hospitals have welcomed the new graduates, and surgical services have already improved. Canadian surgeons have a greater understanding of and commitment to surgical development in low-income countries. Conclusion Guyana has proven that, with visiting faculty assistance, it can mount its own postgraduate training suitable to national needs and will provide a career path to encourage its own doctors to remain and serve their country. PMID:20100407

  8. US Army Research Office research in progress, July 1, 1991--June 30, 1992

    SciTech Connect

    Not Available

    1992-12-31

    The US Army Research Office, under the US Army Materiel Command (AMC), is responsible for coordinating and supporting research in the physical and engineering sciences, in materials science, geosciences, biology, and mathematics. This report describes research directly supported by the Army Research Projects Agency, and several AMC and other Army commands. A separate section is devoted to the research program at the US Army Research, Development and Standardization Group - United Kingdom. The present volume includes the research program in physics, chemistry, biological sciences, mathematics, engineering sciences, metallurgy and materials science, geosciences, electronics, and the European Research Program. It covers the 12-month period from 1 July 1991 through 30 June 1992.

  9. Surgical Gloves: Current Problems

    Microsoft Academic Search

    Maher O. Osman; Steen L. Jensen

    1999-01-01

    .   One century ago surgical gloves were introduced to practice as part of the new antiseptic technique and originally to protect\\u000a the hands of the surgeon and his assistants from the harmful dermatologic effects of powerful antiseptics (e.g., carbolic\\u000a acid) in use at that time. Since then, the wearing of gloves during surgery has been standard practice. Furthermore, the protection

  10. Surgical mission planning in the developing world.

    PubMed

    McClenaghan, F; Fell, M; Martin, D; Smith, G; McGurk, M

    2013-12-01

    Surgical missions to the developing world have been criticized for their lack of outcome analysis. Reported studies indicate a high rate of postoperative complications. An integrated pathway developed for surgical missions and a report of its performance in action is presented herein. Patients were optimized for surgery by a medical team from the UK for a minimum of 14 days preoperatively. They were then transferred to hospital for surgery and returned when stable. At the completion of the mission a junior doctor remained behind for 3 weeks to chart the patients' progress. Thirty case patients were treated over a 2-week period. The complication rate at 3 weeks postoperatively was 7/30. Twenty-two operations were classified as complex (over 1h with more than one flap) and eight as simple (under 1h with minimal flaps). Of those undergoing the simple operations, 2/8 encountered complications at an average of 5 days postoperatively (range 3-7 days). Many medical teams depart in an elevated atmosphere of accomplishment, which without an outcome analysis gives a false impression of their positive impact. Outcome analysis is essential to honestly appraise the effect of surgical missions. PMID:24016548

  11. Intravenous lipids in adult surgical patients.

    PubMed

    Klek, Stanislaw; Waitzberg, Dan L

    2015-01-01

    Parenteral nutrition is considered an essential element of the perioperative management of surgical patients. It is recommended in patients who require nutritional therapy but in whom the enteral route is contraindicated, not recommended or non-feasible. The new generation of lipid emulsions (LEs) based on olive and fish oils are safe and may improve clinical outcome in surgical patients. The increased provision of n-3 polyunsaturated fatty acids in fish oil-containing LEs seems to be associated with fewer infectious complications and shorter ICU and hospital stays following major abdominal surgery. Increased provision of olive oil in the absence of fish oil may also exert beneficial effects, but a clear conclusion on this is limited due to the low number of available studies. Hence, at the moment, the evidence supports the use of n-3-polyunsaturated fatty acid-enriched LEs as a part of the parenteral nutrition regimen for selected groups of patients, such as those with major surgical trauma or those undergoing extended resections or liver transplantation. PMID:25471807

  12. Basilar invagination: Surgical results

    PubMed Central

    Joaquim, Andrei F.; Ghizoni, Enrico; Giacomini, Leonardo A.; Tedeschi, Helder; Patel, Alpesh A.

    2014-01-01

    Introduction: Basilar invagination (BI) is a congenital craniocervical junction (CCJ) anomaly represented by a prolapsed spine into the skull-base that can result in severe neurological impairment. Materials and Methods: In this paper, we retrospective evaluate the surgical treatment of 26 patients surgically treated for symptomatic BI. BI was classified according to instability and neural abnormalities findings. Clinical outcome was evaluated using the Nürick grade system. Results: A total of 26 patients were included in this paper. Their age ranged from 15 to 67 years old (mean 38). Of which, 10 patients were male (38%) and 16 (62%) were female. All patients had some degree of tonsillar herniation, with 25 patients treated with foramen magnum decompression. Nine patients required a craniocervical fixation. Six patients had undergone prior surgery and required a new surgical procedure for progression of neurological symptoms associated with new compression or instability. Most of patients with neurological symptoms secondary to brainstem compression had some improvement during the follow-up. There was mortality in this series, 1 month after surgery, associated with a late removal of the tracheal cannula. Conclusions: Management of BI requires can provide improvements in neurological outcomes, but requires analysis of the neural and bony anatomy of the CCJ, as well as occult instability. The complexity and heterogeneous presentation requires attention to occult instability on examination and attention to airway problems secondary to concomitant facial malformations. PMID:25210337

  13. Point-to-Point Verification of Monitored Sensors at Reynolds Army Clinic and Hospital Final Report

    E-print Network

    Martinez, J.; Linenschmidt, S.; Turner, D.

    , it was not possible to calibrate all the temperature sensors. However, calibration procedures for supply, return, mixed, and preheat temperature sensors were provided to RACH facility personnel. They have been instructed to resume calibration as soon as outside... provided by Johnson Controls. Verification/Calibration Procedures According to the ?As built? mechanical drawings for the RACH facility, there are thirty seven air handler units serving the complex. There are fifteen VAV air handler systems...

  14. Continuous Commissioning of the Reynolds Army Community Hospital, Fort Sill, Oklahoma

    E-print Network

    Turner, W. D.; Baltazar-Cervantes, J. C.; Martinez, J. T.

    2007-01-01

    ,000 $300,000 $400,000 $500,000 $600,000 De c - 0 3 Ja n - 0 4 Fe b- 0 4 Ma r - 0 4 Ap r - 0 4 Ma y - 0 4 J un- 0 4 Ju l - 0 4 Au g - 0 4 Se p - 0 4 Oct - 0 4 No v - 0 4 De c - 0 4 Ja n - 0 5 Fe b- 0 5 Ma r - 0 5 Ap r - 0 5 Ma y - 0 5 J un- 0 5 Ju l - 0 5 Au... g - 0 5 Se p - 0 5 Oct - 0 5 No v - 0 5 De c - 0 5 Ja n - 0 6 Fe b- 0 6 Ma r - 0 6 Ap r - 0 6 Ma y - 0 6 J un- 0 6 Ju l - 0 6 Au g - 0 6 Se p - 0 6 Oct - 0 6 C u mu lat i ve S a vin g s ( $) Electricity Gas Total Verification Period CC Period...

  15. Surgical embolectomy for acute massive pulmonary embolism

    PubMed Central

    Yavuz, Senol; Toktas, Faruk; Goncu, Tugrul; Eris, Cuneyt; Gucu, Arif; Ay, Derih; Erdolu, Burak; Tenekecioglu, Erhan; Karaagac, Kemal; Vural, Hakan; Ozyazicioglu, Ahmet

    2014-01-01

    Objective: Acute massive pulmonary embolism (PE) is associated with significant mortality rate despite diagnostic and therapeutic advances. The aim of this study was to analyze our clinical outcomes of patients with acute massive PE who underwent emergency surgical pulmonary embolectomy. Methods: This retrospective study included 13 consecutive patients undergoing emergency surgical pulmonary embolectomy for acute massive PE at our institution from March 2000 to November 2013. The medical records of all patients were reviewed for demograhic and preoperative data and postoperative outcomes. All patients presented with cardiogenic shock with severe right ventricular dysfunction confirmed by echocardiography, where 4 (30.8%) of the patients experienced cardiac arrest requiring cardiopulmonary resuscitation before surgery. Results: The mean age of patients was 61.8 ± 14 years (range, 38 to 82 years) with 8 (61.5%) males. The most common risk factors for PE was the history of prior deep venous thrombosis (n = 9, 69.2%). There were 3 (23.1%) in-hospital deaths including operative mortality of 7.7% (n = 1). Ten (76.9%) patients survived and were discharged from the hospital. The mean follow-up was 25 months; follow-up was 100% complete in surviving patients. There was one case (7.7%) of late death 12 months after surgery due to renal carcinoma. Postoperative echocardiographic pressure measurements demonstrated a significant reduction (P < 0.001). At final follow-up, all patients were in New York Heart Association class I and no readmission for a recurrent of PE was observed. Conclusion: Surgical pulmonary embolectomy is a reasonable option and could be performed with acceptable results, if it is performed early in patients with acute massive PE who have not reached the profound cardiogenic shock or cardiac arrest. PMID:25664045

  16. Energy engineering analysis program, Anniston Army Depot; Energy Survey of Industrial Facilities (Ind); executive summary

    SciTech Connect

    NONE

    1988-11-01

    This report presents the results of the Army Industrial Facility Energy Survey of the Army Tank Rebuild Area at Anniston Army Depot (AAD). This project is being performed by Science Applications International Corporation (SAIC) under Contract No. DACA01-83-C-00099. The report includes an analyses of energy use within the industrial area, and supplies the identification and evaluation of energy conservation opportunities. The results obtained from the recommended projects indicate that the energy use of the manufacturing area could be reduced by 25 percent. Such savings assume that there will be no change in the level of production as well as no change in the production hours. Anniston Army Depot is commonly known as the Tank rebuild center of the free world and ranks among the largest US ammunition storage facilities. It is a part of the Army`s Depot System Command (DESCOM), which is a major subordinate command bf the US Army Materiel Development and Readiness Command (DARCOM).

  17. Towards National Surgical Surveillance in the UK – A Pilot Study

    PubMed Central

    Agha, Riaz

    2012-01-01

    Objective The Bristol heart inquiry in the United Kingdom (UK) highlighted the lack of standards for evaluating surgical performance and quality. In 2009, the World Health Organisation (WHO) proposed six standardised metrics for surgical surveillance. This is the first study to collect and analyse such metrics from a cohort of National Health Service (NHS) Trusts in England, helping to determine their feasibility and utility in measuring surgical performance, its impact on public health and mortality, and for tracking surgical trends over time. Methods Freedom of Information Act 2000 (FOI) requests for WHO standardised surgical metrics were made to 36 NHS Trusts in England during July to November 2010. Additional data on Hospital Standardised Mortality Ratio (HSMR), Patient Safety Score and Abdominal Aortic Aneurysm (AAA) volume and mortality was obtained from Dr Foster Health and The Guardian Newspaper. Analysis was performed using mixed-effect logistic regression. Results 30/36 trusts responded (83%). During 2005–9, 5.4 million operations were performed with a 24.2% increase in annual number of operations. This rising volume within hospitals was associated with lower mortality ratios. A 10% increase in operative volume was associated with a lower day of surgery death rate (DDR OR?=?0.94, p?=?0.056) and post-operative inpatient 30-day mortality (PDR30 OR?=?0.93, p?=?0.001). For every 10,000 more operations that an NHS Trust does, a 4% drop in PDR30 mortality was achieved. A 10% increase in the volume of elective AAAs was associated with lower elective AAA (OR?=?0.96, p?=?0.032) and emergency AAA (OR?=?0.95, p?=?0.009) PDR30 mortality. Lower DDR mortality was noted for emergency AAA mortality (OR?=?0.95, p?=?0.025) but not elective AAAs (OR?=?0.97, p?=?0.116). Conclusion Standarised surgical metrics can provide policy makers and commissioners with valuable summary data on surgical performance allowing for statistical process control of a complex intervention. This study has shown their collection is feasible albeit using FOI and the first to show a statistically significant volume-outcome relationship for surgery as a whole within hospitals. It adds weight to the argument that patients are safer in larger hospitals or those that become larger by growing their patient base. Together with other measures, such metrics can help build a picture of surgical surveillance in the UK and potentially lead us to safer surgery. PMID:23239962

  18. Starting a General Surgery Program at a Small Rural Critical Access Hospital: A Case Study from Southeastern Oregon

    ERIC Educational Resources Information Center

    Doty, Brit Cruse; Heneghan, Steven; Zuckerman, Randall

    2007-01-01

    Context: Surgical services are frequently unavailable in rural American communities. Therefore, rural residents often must travel long distances to receive surgical care. Rural hospitals commonly have difficulty providing surgical services despite potential economic benefits. Purpose: The purpose of this project was to identify the key challenges…

  19. Chimpanzees prey on army ants at Seringbara, Nimba Mountains, Guinea: Predation patterns and tool use characteristics.

    PubMed

    Koops, Kathelijne; Schöning, Caspar; McGrew, William C; Matsuzawa, Tetsuro

    2015-03-01

    Chimpanzees are renowned for their use of foraging tools in harvesting social insects and some populations use tools to prey on aggressive army ants (Dorylus spp.). Tool use in army ant predation varies across chimpanzee study sites with differences in tool length, harvesting technique, and army ant species targeted. However, surprisingly little is known about the detailed ecology of army ant predation. We studied army ant predation by chimpanzees (Pan troglodytes verus) at the Seringbara study site in the Nimba Mountains, Guinea (West Africa), over 10 years (2003-2013). We investigated chimpanzee selectivity with regards to army ant prey species. We assessed the temporal variation in army ant-feeding and examined whether army ant predation was related to rainfall or ripe fruit availability. Moreover, we examined whether chimpanzees showed selectivity regarding plant species used for tool manufacture, as well as the relationship between tool species preference and tool collection distance. Lastly, we measured tool properties and investigated the use of tool sets and composite tools in army ant predation. Seringbara chimpanzees preyed on one army ant species (D. nigricans) more often than expected based on encounter rates, which may be explained by the overlap in altitudinal distribution between chimpanzees and D. nigricans. Army ant predation was not related to rainfall or fruit availability. Chimpanzees were selective in their choice of tool materials and collected their preferred tool species (Alchornea hirtella) from greater distances than they did other species. Lastly, Seringbara chimpanzees used both tool sets and composite tools (tree perch) in army ant predation. Tool types (dig vs. dip) differed in width and strength, but not length. Tool composites were found at 40% of ant-feeding sites. Our study sheds new light on the ecology of army ant predation and provides novel insights into chimpanzee selection of army ant prey and tool species. Am. J. Primatol. 77:319-329, 2015. © 2014 Wiley Periodicals, Inc. PMID:25315798

  20. Demographic, Physical, and Mental Health Factors Associated with Deployment of U.S. Army Soldiers to the Persian Gulf

    PubMed Central

    Bell, Nicole S.; Amoroso, LTC Paul J.; Williams, Jeffrey O.; Yore, Michelle M.; Engel, LTC Charles C.; Senier, Laura; DeMattos, Annette C.; Wegman, David H.

    2007-01-01

    A total of 675,626 active duty Army soldiers who were known to be at risk for deployment to the Persian Gulf were followed from 1980 through the Persian Gulf War. Hospitalization histories for the entire cohort and Health Risk Appraisal surveys for a subset of 374 soldiers were used to evaluate prewar distress, health, and behaviors. Deployers were less likely to have had any prewar hospitalizations or hospitalization for a condition commonly reported among Gulf War veterans or to report experiences of depression/suicidal ideation. Deployers reported greater satisfaction with life and relationships but displayed greater tendencies toward risk-taking, such as drunk driving, speeding, and failure to wear safety belts. Deployed veterans were more likely to receive hazardous duty pay and to be hospitalized for an injury than nondeployed Gulf War-era veterans. If distress is a predictor of postwar morbidity, it is likely attributable to experiences occurring during or after the war and not related to prewar exposures or health status. Postwar excess injury risk may be explained in part by a propensity for greater risk-taking, which was evident before and persisted throughout the war. PMID:11050874