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1

Marketing Analysis to Determine the Consumer Demand for Ambulatory Surgery at Darnall Army Community Hospital, Fort Hood, Texas.  

National Technical Information Service (NTIS)

As of mid-1982, Walter Reed Army Medical Center was the only US Army medical treatment facility with and organized ambulatory surgical program. This study seeks to determine consumer demand for ambulatory surgery at Darnall Army Community Hospital. It ana...

J. L. McNeil

1982-01-01

2

The Falklands war: Army field surgical experience.  

PubMed Central

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

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

1983-01-01

3

Pharmaceutical services in a United States Army field hospital.  

PubMed

Pharmaceutical services in a United States Army field hospital are described. The field hospital was deployed to Honduras to support United States troops during military exercises. Pharmaceutical services were provided from a large tent near the hospital, which consisted of an emergency treatment facility, two operating rooms, and a small medical-surgical ward. One pharmacist and four technicians provided outpatient pharmaceutical services 10 hours per day, seven days per week; pharmacy personnel were on call at other times. The majority of pharmacy time was spent prepackaging and labeling medications for use by medical teams visiting local villages to provide health care to Honduran natives. The pharmacy's drug distribution, inventory control, and intravenous admixture activities in light of limited personnel and storage space, long supply lines, and lack of an aseptic working area are described. Pharmacist-physician interactions regarding drug therapy and common ailments of United States troops and Honduran natives are also discussed. During a two-month period, the field hospital pharmacy dispensed approximately 24,000 prescriptions. Pharmaceutical services played an important role in the success of the field hospital's mission and provided aid to the population of an impoverished country that might not otherwise have received it. PMID:3985020

Dasher, T

1985-03-01

4

Surgical Volume Matters: Helping Patients Pick Hospitals.  

National Technical Information Service (NTIS)

The purpose of this project was to (1) learn how Medicare patients currently choose hospitals for surgery and (2) determine how best to inform Medicare beneficiaries about the relative quality of surgical providers. We conducted telephone interviews with ...

J. D. Birkmeyer L. Schwartz S. Woloshin

2004-01-01

5

Costs of surgical procedures in Indian hospitals  

PubMed Central

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.

Chatterjee, Susmita; Laxminarayan, Ramanan

2013-01-01

6

Predictors of Enrollment in TRICARE Prime at Blanchfield Army Community Hospital.  

National Technical Information Service (NTIS)

In preparation for TRICARE, a survey of 987 beneficiaries from the Fort Campbell catchment area was conducted in order to estimate enrollment in TRICARE Prime at Blanchfield Army Community Hospital (BACH). The survey was also used to identify variables th...

D. A. Brandsma

1997-01-01

7

Nursing Processes and Patient Outcomes in U.S. Army Hospitals.  

National Technical Information Service (NTIS)

The aim of this research study was to describe patient outcomes in active duty personnel, military retirees, and military family members, and associated nursing organizational structures and processes in four U.S. Army hospitals. This continues a study pr...

B. J. Foley

2005-01-01

8

Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital.  

National Technical Information Service (NTIS)

General Leonard Wood Army Community Hospital's (GLWACH) Partnership Forum, a collection of supervisors, employees, and union representatives, feel the current incentive award program is a major source of worker discontent. Therefore, they commissioned thi...

M. L. Cox

2001-01-01

9

Hazardous Waste Surveys of Two Army Installations and an Army Hospital.  

National Technical Information Service (NTIS)

This study describes a preliminary assessment of Army hazardous waste production and disposal requirements, as defined by the Resource Conservation and Recovery Act of 1976 and the Environmental Protection Agency's Proposed Guidelines and Regulations and ...

D. Kraybill T. Mullen B. Donahue

1980-01-01

10

Strategic Analysis and Associated Management Products Supporting the Reengineering of Bayne-Jones Army Community Hospital: Consultative Products and Findings.  

National Technical Information Service (NTIS)

In support of strategic reengineering of Bayne-Jones Army Community Hospital (BJACH), this consultative project provides a strategic analysis of the hospital, an overview of planned strategies of the hospital, and five management products based upon requi...

L. Fulton

1998-01-01

11

Trends in specialized surgical procedures at teaching and nonteaching hospitals.  

PubMed

Teaching hospitals are the principal site of many specialized surgical procedures. The recipients of these procedures tend to be younger, male, and nonwhite and tend to reside in either the poorest or the most affluent neighborhoods. Although the numbers of these procedures performed at major teaching hospitals increased dramatically between 1989 and 1995, they accounted for only a modest proportion of hospital discharges and patient days. Concentration of specialized surgical procedures in major teaching hospitals will likely continue. This trend has implications not only for these hospitals but for health care purchasers, policymakers, medical educators, and clinical researchers as well. PMID:10645091

Levin, R; Moy, E; Griner, P F

2000-01-01

12

Physician Acceptance of Gateway to Care at Irwin Army Community Hospital (Final Report, July 1991-July 1992).  

National Technical Information Service (NTIS)

Gateway to Care, the Department of the Army coordinated care program, was initiated at Irwin Army Community Hospital, Fort Riley, Kansas on January 8, 1992. In a coordinated care environment, even more than a traditional staff or free market health care e...

K. M. Curtis

1992-01-01

13

Energy Engineering Analysis Program. Irwin Army Community Hospital, Fort Riley, Kansas. Volume 2. Narrative. Final report  

SciTech Connect

This report covers the Prefinal Submittal for Study of Irwin Army Community Hospital Energy Engineering Analysis Program, Fort Riley, Kansas. Generally, this project consists of conducting and analyzing a coordinated energy study, including a detailed energy survey of the entire hospital facility while integrating any available prior or on-going energy conservation studies. Included in this study are the Hospital (Building 600), the Energy Plant (Building 615), Nurses Quarters (Building 610), family housing barracks Barnes Hall (Building 620) and Kimball Hall (Building 621). Illustrated in Exhibit No. 1 is the site plan showing the general location of the five buildings in the hospital complex. Identify and analyze all possible Energy Conservation Opportunities (ECO`s) in and around the five building hospital complex. Analysis to include energy savings, dollar savings, cost of implementation, simple payback period, savings to investment ratio and life cycle cost analysis. Recommend Energy Conservation Opportunities (ECO`s) for energy programming implementation.

NONE

1992-01-01

14

Study of the Average Cost of Obstetric Services Delivered at Womack Army Community Hospital, Fort Bragg, North Carolina.  

National Technical Information Service (NTIS)

This study was conducted to determine if the cost per patient of obstetric services at Womack Army Community Hospital would increase significantly after the implementation of a Civilian Health and Medical Program of the Uniformed Services -- Preferred Pro...

J. H. Brooks

1985-01-01

15

Analysis of the Effectiveness of the Retail Pharmacy Utilization Intervention at General Leonard Wood Army Community Hospital.  

National Technical Information Service (NTIS)

In September 2008, the General Leonard Wood Army Community Hospital (GLWACH) Pharmacy Department executed an initiative to reduce the utilization of retail pharmacy services. This initiative was implemented due to the increase in retail prescription drug ...

S. A. Moore-Velbis

2009-01-01

16

Study to Determine the Success of Implementing the Workload Management System for Nurses at Moncrief Army Community Hospital.  

National Technical Information Service (NTIS)

A descriptive study of the Workload Management System for Nurses (WMSN) was performed at Moncrief Army Community Hospital, Fort Jackson, South Carolina from 1 July to 16 December 1988. Descriptive and correlational statistics were generated from data coll...

T. A. Newton

1989-01-01

17

Advanced Product Development for Combat Casualty Care at the U.S. Army Institute of Surgical Research.  

National Technical Information Service (NTIS)

The Institute of Surgical Research (USAISR) is the U.S. Army s lead research laboratory for improving the care of combat casualties. The Institute follows a rigorous process for analyzing patterns of injury and the burden of disease to determine where res...

D. G. Baer J. C. Wenke L. L. McGhee M. A. Dubick V. A. Convertino

2010-01-01

18

Assessment of the Organizational Culture of Dewitt Army Community Hospital One Year After the Implementation of Total Quality Management.  

National Technical Information Service (NTIS)

Dewitt Army Community Hospital (DACH), a 68 bed hospital located at Ft. Belvoir, Virginia is now one year into its quality transformation. Over the course of the past year, the hospital has invested heavily in adopting the TQM philosophy, spending over $1...

M. P. Goodwin

1994-01-01

19

Study To Determine The Extent of Social Support and Burnout Among Nurses at Womack Army Community Hospital  

National Technical Information Service (NTIS)

This study was done on behalf of the hospital commander to find out why the nursing staff within Womack Army Community Hospital seemed to be suffering a state of physical, emotion and mental exhaustion or better known as worker burnout. The author conclud...

J. A. Voetsch

1986-01-01

20

[Experience in delivering specialized surgical care in a large hospital].  

PubMed

Medical troops supply in local armed conflicts demonstrated advantages of fast evacuation of wounded personnel by aviation from the seat of combat actions to the stage of specialized surgical care. Wounded in head, breast, abdomen (particularly in case of multiple and combined character of wounds) are evacuated for treatment to central military hospitals equipped with modern diagnostic and medical equipment, completed with qualified specialists and having the opportunity of prolonged treatment. Surgical care in the zone of combat actions is confined to hemostasis, intensive therapy -to supporting of main vital functions. The article contains the data about terminations of wounded personnel treatment in central military-fleet clinical hospital. PMID:8754084

Sharaevski?, G Iu; Tkachev, A E; Kovalev, V I; Gurich, V D; Levchuk, A L; Umerov, E Kh

1996-05-01

21

Hospital process compliance and surgical outcomes in Medicare beneficiaries  

PubMed Central

Objectives We sought to determine whether high rates of compliance with perioperative process of care measures used for public reporting and pay-for-performance are associated with lower rates of risk-adjusted mortality and complications with high-risk surgery. Design, Setting and Participants Retrospective analysis of Medicare inpatient claims data from beneficiaries undergoing one of six high-risk surgeries in 2,000 hospitals during 2005 and 2006. Hierarchal logistic regression models assessed the relationship between adverse outcomes and hospital compliance with the surgical processes of care reported in Hospital Compare. Primary Outcome 30-day post-operative mortality, venous thromboembolism, surgical site infection. Results Process compliance ranged from 53.7 percent in low compliance hospitals to 91.4 percent in the highest. Risk-adjusted outcomes did not vary at high compliance hospitals relative to average compliance for mortality (OR = 0.98, 95% CI 0.92, 1.05), surgical site infection (OR = 1.01, 95% CI 0.90, 1.13), or venous thromboembolism (OR = 1.04, 95% CI 0.89, 1.2) or in lowest compliance. Outcomes also did not vary at low-compliance hospitals. Stratified analyses by operation type confirm these trends for the six procedures individually. Conclusions Currently available information on Hospital Compare will not help patients identify hospitals with better outcomes for high-risk surgery. CMS needs to identify higher leverage process measures and devote greater attention to profiling hospitals based on outcomes to improve public reporting and pay-for-performance efforts.

Nicholas, Lauren Hersch; Osborne, Nicholas H.; Birkmeyer, John D.; Dimick, Justin B.

2009-01-01

22

Mycobacterium goodii Infections Associated with Surgical Implants at Colorado Hospital  

PubMed Central

From February to October 2003, Mycobacterium goodii wound infections were identified among three patients who received surgical implants at a Colorado hospital. This report summarizes the investigation of the first reported nosocomial outbreak of M. goodii. Increased awareness is needed about the potential for nontuberculous mycobacteria to cause postoperative wound infections.

Gershman, Ken; Jensen, Bette; Arduino, Matthew J.; Yakrus, Mitchell A.; Cooksey, Robert C.; Srinivasan, Arjun

2004-01-01

23

Increasing Incidence of Varicella Hospitalizations in United States Army and Navy Personnel: Are Today's Teenagers More Susceptible. Should Recruits Be Vaccinated. (Reannouncement with New Availability Information).  

National Technical Information Service (NTIS)

Hospital records for 10 687 United States Army and Navy adult varicella (chickenpox) admissions were reviewed. Annual hospital admission rates for varicella increased more than fourfold in the active-duty army during 1980 to 1988 and more than 18-fold amo...

G. C. Gray L. A. Palinkas P. W. Kelley

1990-01-01

24

Educational Levels of Hospital Nurses and Surgical Patient Mortality  

PubMed Central

Context Growing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes. Objective To examine whether the proportion of hospital RNs educated at the baccalaureate level or higher is associated with risk-adjusted mortality and failure to rescue (deaths in surgical patients with serious complications). Design, Setting, and Population Cross-sectional analyses of outcomes data for 232–342 general, orthopedic, and vascular surgery patients discharged from 168 nonfederal adult general Pennsylvania hospitals between April 1, 1998, and November 30,1999, linked to administrative and survey data providing information on educational composition, staffing, and other characteristics. Main Outcome Measures Risk-adjusted patient mortality and failure to rescue within 30 days of admission associated with nurse educational level. Results The proportion of hospital RNs holding a bachelor’s degree or higher ranged from 0% to 77% across the hospitals. After adjusting for patient characteristics and hospital structural characteristics (size, teaching status, level of technology), as well as for nurse staffing, nurse experience, and whether the patient’s surgeon was board certified, a 10% increase in the proportion of nurses holding a bachelor’s degree was associated with a 5% decrease in both the likelihood of patients dying within 30 days of admission and the odds of failure to rescue (odds ratio, 0.95; 95% confidence interval, 0.91–0.99 in both cases). Conclusion In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.

Aiken, Linda H.; Clarke, Sean P.; Cheung, Robyn B.; Sloane, Douglas M.; Silber, Jeffrey H.

2010-01-01

25

Health-hazard evaluation report HETA 88-369-2141, Raymond W. Bliss Army Community Hospital, Ft. Huachuca, Arizona  

Microsoft Academic Search

In response to a request from a representative of the Raymond W. Bliss Army Community Hospital concerning indoor air quality at Greely Hall, Fort Huachuca (SIC-9711), Arizona, an environmental and ventilation survey was conducted. Greely Hall was a three story, multipurpose building with approximately 120,000 feet per floor. The building housed primarily offices, but also had a cafeteria, auditorium, computer

M. Klein; B. Gunter

1991-01-01

26

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

Code of Federal Regulations, 2010 CFR

...Payment for facility services related to covered ASC surgical procedures performed in hospitals...for facility services related to covered ASC surgical procedures performed in hospitals...to covered ambulatory surgical center (ASC) procedures performed in a hospital...

2009-10-01

27

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

Code of Federal Regulations, 2010 CFR

...Payment for facility services related to covered ASC surgical procedures performed in hospitals...for facility services related to covered ASC surgical procedures performed in hospitals...to covered ambulatory surgical center (ASC) procedures performed in a hospital...

2010-10-01

28

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

Code of Federal Regulations, 2010 CFR

...hospitalization, medical or surgical treatment, examinations...hospitalization, medical or surgical treatment, examinations...800). (a) General. This section...hospitalization, medical or surgical treatment, examination...injury and some essential activity or...of some task or operation the trainee must...

2009-07-01

29

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

Code of Federal Regulations, 2010 CFR

...hospitalization, medical or surgical treatment, examinations...hospitalization, medical or surgical treatment, examinations...800). (a) General. This section...hospitalization, medical or surgical treatment, examination...injury and some essential activity or...of some task or operation the trainee must...

2010-07-01

30

Impact of age on in-hospital mortality of surgical patients in a German university hospital  

Microsoft Academic Search

Although the frequency of major surgical procedures in elderly patients is increasing, the impact of age as an independent factor on in-hospital mortality and capacity planning is uncertain. Therefore, we analyzed how age, gender, number of diagnoses, and number of operations per patient are reflecting the demographic changes going on in the last decade. Furthermore, we analyzed the influence of

Andrej Udelnow; Steffen Leinung; Dierk Schreiter; Manfred Schönfelder; Peter Würl

2005-01-01

31

Horizontal strabismus surgical outcomes in a teaching hospital.  

PubMed

Strabismus may result in impaired stereopsis, diplopia, undesirable appearance, amblyopia and negative psychological impact. This study provides epidemiological and surgical outcome information about patients attending University College Hospital Galway requiring strabismus surgery. We report a retrospective analysis of 75 consecutive patients, who underwent horizontal strabismus surgery. Sixty-one (81.3%) patients had clinically significant refractive errors, hyperopia being the most common. Thirty-four (45.3%) patients had amblyopia and nine (12%) required further treatment. A cosmetically acceptable result with a post-operative ocular deviation within 25 prism dioptres of straight (grade 2) was achieved in 70/75 (93.3%) of patients. The overall mean change in ocular deviation per mm of muscle operated was 3.25 prism dioptre/mm. The outcomes of strabismus surgery in an Irish hospital compare very favourably with other jurisdictions. This data will help plan service delivery. PMID:24988834

Idrees, Z; Dooley, I; Fahy, G

2014-06-01

32

Energy Engineering Analysis Program, Redstone Arsenal, Alabama. Energy survey of Fox Army Community Hospital. Part 3 - executive summary. Final report  

SciTech Connect

This is the executive summary of an Energy Engineering Analysis Program (EEAP) Study that was conducted at the Fox Army Community Hospital, Redstone Arsenal, Alabama by the firm of BENATECH, INC. Work was begun on the hospital energy audit during November, 1985 under Contract No. DACAOl-85-C-O131. A total of 88 energy conservation opportunities (ECOs) were investigated, resulting in 7 projects being recommended. A three volume report has been prepared that describes in detail the work accomplished during the study. Volume I, Part 1 of 2, provides all the descriptive Narrative for the report. Volume I, Part 2 of 2, contains a copy of the Scope of Work and the Program Documentation. Volume II contains ECO calculations and backup technical details. Volume III contains computer simulation printouts. This executive summary follows the narrative outline with minor modifications and summaries in the form of charts and graphs for easier interpretation.

NONE

1987-03-01

33

Use of perioperative antibiotic prophylaxis in selected surgical procedures — Results of a survey in 889 surgical departments in German hospitals  

Microsoft Academic Search

Summary In 1989, a survey on perioperative antibiotic prophylaxis was conducted in 2,739 surgical (general surgical, orthopedic, traumatologic, and cardiothoracic) departments of German hospitals. In all, 889 (32.5%) questionnaires were returned. Regarding the choice of antibiotic and the duration of prophylaxis the respective rates of correct statements were as follows: 32.6% and 55.0% in gastric surgery, 29.5% and 42.9% in

Ines Kappstein; F. D. Daschner

1991-01-01

34

Study to Analyze and Develop a Community Relations Program for Dewitt Army Hospital, Fort Belvoir, Virginia.  

National Technical Information Service (NTIS)

An effective community relations program is the administrative program which can influence the community's feelings and attitudes toward the hospital. Hospitals and other health care institutions want consumers to view their institutions as a positive asp...

P. M. Reed

1980-01-01

35

Characterization of Aerosols Produced during Surgical Procedures in Hospitals  

Microsoft Academic Search

In orthopedic surgical procedures, surgical power tools, such as electrocautery, bone saws, reamers, and drills, are commonly used. In laboratory experiments using these tools, it has been demonstrated that inhalable aerosols can be produced. In order to assess the potential exposure of health care workers to these aerosols during orthopedic surgery, it is necessary to characterize the aerosols. In this

H. C. Yeh; R. S. Turner; R. K. Jones; B. A. Muggenburg; D. L. Lundgren; J. P. Smith

1995-01-01

36

A prospective study of surgical site infections in a pediatric hospital in Mexico City  

Microsoft Academic Search

Background: Pediatric surgical site infection (SSI) rates in the United States range from 2.5% to 4.4%. There is little data regarding their risk factors among children. We quantified SSI rates and identified risk factors of SSI in a tertiary care pediatric teaching hospital in Mexico City. Methods: All neurosurgical, cardiovascular, and general surgical patients who underwent operation between Aug 1,

Juan D. Porras-Hernández; Diana Vilar-Compte; Miguel Cashat-Cruz; Ricardo M. Ordorica-Flores; Eduardo Bracho-Blanchet; Carlos Avila-Figueroa

2003-01-01

37

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

ERIC Educational Resources Information Center

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…

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

2008-01-01

38

Surgical infections surveillance: Results of a sixmonth incidence study in two Italian hospitals  

Microsoft Academic Search

In a six-month incidence study of surgical wound infections (SWI) in two Italian hospitals, 1,019 surgical patients, in three general surgery wards, and 433 surgical patients in one orthopedics ward were studied. For the SWI surveillance, the DANOP-DATA system was used: this microcomputer program was developed by Danish authors and tested in a European multicenter study coordinated by the World

M. L. Moro; L. Sommella; M. Gialli; L. Tavanti; L. Ciolli; R. Masini; L. Capaccioli; R. Torrioli; E. Tresalti

1991-01-01

39

Strategic Marketing Plan for Women and Infant Services, DeWitt Army Community Hospital and the DeWitt Health Care System.  

National Technical Information Service (NTIS)

This market research paper analyzes DeWitt Army Community Hospital and the DeWitt Health Care System's Women and Infant Services from a marketing perspective, and proposes 10 'action plans' for attracting and retaining more patients. Maternal/Child Health...

K. E. Soh

1999-01-01

40

[Surgical treatment for gastric cancer in a specialized service: the Rebagliati Hospital experience].  

PubMed

The results of the surgical treatment for gastric cancer within a specialized surgical service in this pathology are described in this work. This system for surgical treatment of gastric cancer is new in our country. The implementation process included prepare a team of surgeons and establish protocols and guides to surgical treatment, based on the recommendations of the Japanese Gastric Cancer Association. Additional training in the Japanese advanced surgical technique was required, as well as a strict documentation of the cases. During 2004, 139 surgical interventions were carried out on 137 patients with tumoral gastric pathology. Surgical mortality was 2.1% and morbidity was 21.8%. The average resected glands was 38.6.t 13.7 (range: 20-87) for distal gastrectomy and 46.6 +/- 16.2 (range: 24-87) for total gastrectomy. The stay in the hospital was 11.7 +/- 6.3 days (range: 5-37) for distal gastrectomy and 14.8 +/- 11.3 days (range: 7-56) for total gastrectomy. The hospital and surgeon volumes are underlined as important factors in determining the short and long term results. Implementation of specialized surgical units in general hospitals, for surgical treatment of gastric cancer, is recommended. PMID:16237467

Portanova, Michel; Vargas, Fernando; Lombardi, Emilio; Carbajal, Ramiro; Palacios, Nestor; Rodriguez, Cesar; Orrego, Jorge; Ferreyra, Mario

2005-01-01

41

Mortality control charts for comparing performance of surgical units: validation study using hospital mortality data  

Microsoft Academic Search

Objective To design and validate a statistical method for evaluating the performance of surgical units that adjusts for case volume and case mix. Design Validation study using routinely collected data on in-hospital mortality. Data sources Two UK databases, the ASCOT prospective database and the risk scoring collaborative (RISC) database, covering 1042 patients undergoing surgery in 29 hospitals for gastro-oesophageal cancer

Peter McCulloch; Adrian C Steger; Irving S Benjamin; Jan D Poloniecki

2003-01-01

42

[The main field hospitals of the French and Polish armies behind the lines in 1807].  

PubMed

The health requirements of the French and Polish troops fighting in Pomerania, mainly those of General Zajaczek's Observation Corps (Second Legion), forced the interim Polish authorities to establish main field hospitals in the Spring of 1807. Firstly, at M?awa, and then in the former storehouses on the Vistula at Tokary and Dobrzyków. Though the latter were situated in two localities, they nevertheless constituted an administrative whole. Of temporary character, these large hospitals (M?awa was capable of accommodating up to 1000 patients, Tokary and Dobrzyków up to 2000 patients) were closed after the end of hostilities. In spite of the temporary character of the field hospitals, the daily death rate was only several persons (sometimes there were a dozen or so fatalities, which also constituted a small number). During the establishment of the main field hospitals, a number of people demonstrated a degree of organisational talent. These included Józef Wybicki, representative of the Governing Committee and Stanis?aw Breza, director of internal affairs. Later there was Rev. Józef Poniatowski, war commander, also local officials such as Józef Zab?ocki and Teodor Miko?aj Dembowski, as well as representatives of the health service such as Dr. Hiacynt Dziarkowski, and Dr. Micha? Bergonzoni. Other people worth mentioning include the hospital personnel (Colonel Teodor Pretwitz was Commanding Officer of the field hospitals in M?awa, Tokary and Dobrzyków) who helped the sick and wounded soldiers, often under the difficult conditions of supplies and staff shortages. These shortages were a result of the scale of the enterprise, the poor relations between staff members, such as the conflict between Dr. Dziarkowski and Colonel Pretwitz, reservations about the competence of the head doctor Juliusz Szamborski. But most of all these shortages were a result of requisitions ordered by French Commissioners and Ward Heads. In spite of the problems main field hospitals achieved their purpose and gained recognition by high-ranking Polish and French commanding officers, especially General Zajaczek. PMID:11876206

Srogosz, T

2000-01-01

43

Electronic medical records and cost efficiency in hospital medical-surgical units.  

PubMed

This study examines the impact of electronic medical records (EMRs) on cost efficiency in hospital medical-surgical units. Using panel data on California hospitals from 1998 to 2007, we employed stochastic frontier analysis (SFA) to estimate the relationships between EMR implementation and the cost inefficiency of medical-surgical units. We categorized EMR implementation into three stages based on the level of sophistication. We also examined the effects of specific EMR systems on cost inefficiency. Our SFA models addressed potential bias from unobserved heterogeneity and heteroskedasticity. EMR Stages 1 and 2, nursing documentation, electronic medication administration records, and clinical decision support were associated with significantly higher inefficiency. PMID:20812460

Furukawa, Michael F; Raghu, T S; Shao, Benjamin B M

2010-01-01

44

Reducing serious injury from falls in two veterans' hospital medical-surgical units.  

PubMed

A large veteran's hospital participated in a year-long collaborative project across 9 hospitals to reduce serious injury from falls in acute care, targeting medical-surgical units. The primary objective of this project was to develop and test a set of interventions (bundles) to prevent serious physical injury (fractures and hemorrhagic bleeds) from patient falls. The interventions were implemented using tests of change on 2 medical-surgical units focused on engaging unit-based staff and combining innovations for vulnerable populations at greatest risk for injury if they fall. PMID:19092477

Quigley, Patricia A; Hahm, Bridget; Collazo, Sonia; Gibson, Wanda; Janzen, Sandra; Powell-Cope, Gail; Rice, Fanny; Sarduy, Innette; Tyndall, Kyna; White, Susan V

2009-01-01

45

Study to Compare the Cost of Continuing to Offer Inpatient Services at DeWitt Army Community Hospital Versus Paying Civilian Providers for Inpatient Services at the Prevailing CHAMPUS Reimbursement Rates.  

National Technical Information Service (NTIS)

This Graduate Management Project compares the cost of continuing to offer inpatient services at DeWitt Army Community Hospital (DACH) versus paying civilian providers for providing these services at the prevailing CHAMPUS rate (a 'make' or 'buy' decision)...

J. R. Stewart

1997-01-01

46

[Early gastric cancer surgically treated at Rebagliati Hospital: study of 76 cases during 5 years].  

PubMed

This report describes the characteristics of early gastric cancer surgically treated in the Gastric Cancer Unit at Rebagliati National Hospital between January 2004 and December 2008. Mean age was 68 years; males, distal location, submucosa infiltration and intestinal histological type predominate in these patients. Lymph node involvement was 13%. PMID:20644605

Portanova, Michel; Mena, Victor; Yábar, Alejandro

2010-01-01

47

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

PubMed

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

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

2009-05-01

48

Surgical treatment of ovarian cancer in different hospital categories – A prospective nation-wide study in Finland  

Microsoft Academic Search

This prospective nation-wide study was performed to evaluate the effect of hospital category and subspeciality training on surgical treatment of ovarian cancer. Data were obtained from a questionnaire filled in by the operating unit, and from the surgical and histopathology reports. The survey included 307 patients. Half of them were operated in the university hospitals where gynaecologic oncologists performed 72%

Salla Kumpulainen; Tapio Kuoppala; Arto Leminen; Jorma Penttinen; Ulla Puistola; Eero Pukkala; Risto Sankila; Juha Mäkinen; Seija Grénman

2006-01-01

49

SPL: The Surgical Planning Laboratory, Brigham and Women's Hospital  

NSDL National Science Digital Library

A project of Brigham and Women's Hospital and Harvard Medical School's Department of Radiology, SPL is a multidisciplinary research institution "combining the fields of Computer Science and MRI Radiology towards a goal of real-time 3D imaging of patients during surgery." Professionals in the fields of radiology or 3D modelling, as well as curious general users, will find numerous items of interest at the site. In addition to a very large collection of full-text reports and research papers, the site has two primary features. The first, the Case of the Month, presents a radiology case study for each month of the year from July 1995 through October 2001. Each case study includes 3D models and radiology images. Some are also illustrated with MPEG animations. The other main section of the site is the AnatomyBrowser, a JAVA applet that combines 3D models, scans, and text on selected anatomical structures. The AnatomyBrowser section currently contains ten anatomical atlas cases, four clinical cases, and a selection of related scholarly cases. Additional features at the site include a collection of images and MPEG movies and a list of upcoming lectures, courses, and presentations by SPL staff. Faster connections and newer browsers are recommended for viewing this site.

1995-01-01

50

Hospital Compare Data May Not Help Surgical Patients Find Hospitals with Better Outcomes  

MedlinePLUS

... Health Systems Hospital Resources Long-Term Care Resources Primary Care Resources System Design Resources Prevention & Chronic Care Announcements Evidence-Based Decisionmaking Improving Primary Care Practice Resources Quality & Patient Safety Comprehensive Unit-based ...

51

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

PubMed Central

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.

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

2000-01-01

52

Army Lawyer.  

National Technical Information Service (NTIS)

The Army Lawyer is published monthly by The Judge Advocate General's Legal Center and School, Charlottesville, Virginia, for the official use of Army lawyers in the performance of their legal responsibilities. Articles in this issue include: The Law in th...

A. B. Ching A. M. Tulud C. E. Black C. J. Strong

2008-01-01

53

An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals.  

PubMed

This study analyzed data from the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database to assess contaminant exposures in general medical and surgical hospitals. Seventy-five inspections conducted in these hospitals from 2005 through 2009 were identified. Five categories of inspections were conducted, the three most common being complaint-based, planned, and referral-based inspections. Complaint-based inspections comprised the majority of inspections-55 (73%) of the 75 conducted. The overall violation rate for all inspection types was 68%. This finding was compared to the violation rates of planned inspections (100%), referral-based inspections (83%), and complaint-based inspections (62%). Asbestos was the hazardous substance most commonly sampled and cited by OSHA in hospitals, with 127 samples collected during 24 inspections; 31% of the total 75 inspections resulting in one or more violations were due to asbestos. PMID:23521143

Knight, Jordan L; Sleeth, Darrah K; Larson, Rodney R; Pahler, Leon F

2013-04-01

54

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

Microsoft Academic Search

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

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

1996-01-01

55

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

PubMed Central

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.

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

2014-01-01

56

Hospital acquired infections among patients admitted in the medical and surgical wards of a non-teaching secondary care hospital in northern India.  

PubMed

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

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

2014-02-01

57

Organizational Effects on Patient Satisfaction in Hospital Medical-Surgical Units  

PubMed Central

Objective The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients’ satisfaction with nursing care in hospitals. Background Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited. Methods The data source for this study was the Outcomes Research in Nursing Administration Project, a multi-site organizational study to investigate relationships among nurse staffing, organizational context and structure and patient outcomes. The sample for this study was 2720 patients and 3718 RNs in 286 medical-surgical units in 146 hospitals. Results Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status and better symptom management were also associated with higher levels of patient satisfaction. Conclusions Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses’ work engagement and effective symptom management, are important influences on patient satisfaction.

Bacon, Cynthia Thornton; Mark, Barbara

2010-01-01

58

Cost of a cardiac surgical and a general thoracic surgical patient to the National Health Service in a London teaching hospital.  

PubMed Central

The cost of the inpatient stay for a typical aortic valve replacement and for an oesophagectomy were determined by recording and costing every aspect of the patients' care from admission until discharge. This method of cost calculation was found to be satisfactory and could be used by other centres to allow comparisons between hospitals or countries. At St Thomas's Hospital in 1977 the cost of a cardiac operation was 2755 pounds, an oesophagectomy 1870 pounds, and a general surgical operation 564 pounds.

Morgan, K D; Disbury, F C; Braimbridge, M V

1979-01-01

59

Adult Surgical Emergencies in a Developing Country: The Experience of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria  

Microsoft Academic Search

The goal of this study was to examine the adult surgical emergencies seen at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, with a view to proffering preventive solutions where appropriate and improving outcome. From the register of patients seen at the Casualty department and from the operations register in the main operation room of NAUTH, names and hospital numbers

Gabriel U. Chianakwana; Chima C. Ihegihu; Pius I. S. Okafor; Stanley N. C. Anyanwu; Okechukwu O. Mbonu

2005-01-01

60

Best practices for preventing hospital-acquired pressure injuries in surgical patients.  

PubMed

Hospital-acquired pressure ulcers (HAPUs) and deep tissue injuries (DTIs), while considered to be preventable in most cases continue to affect many patients in acute care facilities. Surgical patients have an especially high risk of developing HAPUs for several reasons, including immobility during the intraoperative and immediate postoperative periods. HAPUs are responsible for significant patient harm in the form of pain, increased susceptibility to infection, and delayed recovery. Perioperative nurses must take a proactive and comprehensive approach to protecting their patients from pressure injuries, including HAPUS and DTIs. PMID:21434513

Cherry, Cecile; Moss, Jacqueline

2011-03-01

61

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

SciTech Connect

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.

Tuenge, Jason R.

2011-01-17

62

Can we reduce secondary surgical interventions and length of hospitalization in percutaneous nephrolithotomy?  

PubMed

Purpose: To evaluate the success and complication rates of percutaneous nephrolithotomy (PNL) operations and to determine the effect of postoperative late removal of an open-end ureter catheter on hospital stay and on secondary interventions. Materials and Methods: The records of 198 patients (97 female, 101 male) who had PNL between May 2009 and February 2012 were retrospectively reviewed. The open-end ureter catheter which was placed during the operation was removed at the end of the operation in the first 53 patients ( group 1) and 12 hours after the nephrostomy catheter in 145 patients ( group 2). Results: PNL intervention was performed in 198 patients with a mean age of 40.83 ± 13.64 years and mean stone load of 9.82 ± 5.37cm2 (range 2 to 26 cm2). When clinically insignificant stone pieces < 4 mm were accepted as successful, the total success rate was 80.80 % (79.2% in group1 and 81.4% in group 2, P = .50). The hospitalization period was significantly reduced in group 2 (3.45 ± 0.95 days vs. 2.61 ± 0.65 days; P = .006). While secondary surgical intervention was not necessary in any of the patients in group 2 (0.0%), but 4 patients (7.5%) required ureterorenoscopy plus double-J stent placement following the primary procedure in group 1 (P = .006). Conclusion: PNL is a safe procedure with a high success rate and a short hospitalization period. There was a significant decrease in the hospitalization period and secondary surgical intervention rates with the postoperative late removal of the open-end ureter catheter. PMID:25015599

Delikta?, Hasan; Yapici, Onur; Ozen, Utku; Yalçin, Engin; Sahin, Hayrettin

2014-01-01

63

Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait.  

PubMed Central

BACKGROUND: Ureteric lithiasis is a common urological problem in Kuwait. Because of the different interventional approaches, we carried out an audit on the morbidity associated with the surgical management of the disorder. PATIENTS AND METHODS: The surgical records were reviewed of all patients with the diagnosis of ureteric lithiasis that were managed surgically by ureteroscopy or ureterolithotomy in Mubarak Al-Kabeer Hospital in Kuwait between January 1996 and December 1999. Patients' bio-data, location of calculi, indications for surgical intervention, types of therapeutic interventions, operating surgeon and complications were analysed. Patients managed primarily and successfully by extracorporeal shockwave lithotripsy were excluded from this analysis. RESULTS: A total of 1383 patients with ureteric calculus were managed in the period under review--775 (56%), 567 (41%), and 41 (3%) patients were managed by extracorporeal shockwave lithotripsy, ureteroscopy and ureterolithotomy, respectively. The 608 patients managed by ureteroscopy or ureterolithotomy had a total of 710 operations. The commonest surgical procedure performed was ureteroscopy with Dormia basket with or without double 'J' stenting and this accounted for 418 (58.9%) operations. The least common procedure was ureteric meatotomy with Dormia basket and with or without double 'J' stenting in 9 (1.3%) patients. The overall complication rate was 110 out of 710 (15.5%) operations. Of the complications, 101 (92%) were minor (e.g. haematuria, fever, and mucosal injury). Nine (8%) complications were major complications (e.g. ureteric perforation and ureteric avulsions). Ureterolithotomy and ureteroscopy with intracorporeal lithotripsy were associated with the highest complication rates. CONCLUSIONS: This analysis has shown that with technological advances, the treatment of ureteric lithiasis has improved and major complications have decreased. However, with so many therapeutic options to choose from, there is a need to audit the various therapeutic options and select those associated with the least morbidity rates in each urology unit.

Kehinde, E. O.; Al-Awadi, K. A.; Al-Hunayan, A.; Okasha, G. H.; Al-Tawheed, A.; Ali, Y.

2003-01-01

64

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

PubMed Central

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.

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

2012-01-01

65

Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds.  

National Technical Information Service (NTIS)

This study was conducted to determine if ethics committees should be a decision making and review mechanism. A survey was distributed to all continental US Army hospitals with over one hundred operating beds. The survey measured attitudes on the roles of ...

L. W. Briggs

1985-01-01

66

Army Lawyer.  

National Technical Information Service (NTIS)

The Army Lawyer (ISSN 0364-1287, USPS 490-330) is published monthly by The Judge Advocate General s Legal Center and School, Charlottesville, Virginia, for the official use of Army lawyers in the performance of their legal responsibilities. Articles in th...

A. B. Ching A. M. Tulud C. E. Kitchel C. J. Strong

2007-01-01

67

Army Lawyer.  

National Technical Information Service (NTIS)

The Army Lawyer (ISSN 0364-1287, USPS 490-330) is published monthly by The Judge Advocate General s Legal Center and School, Charlottesville, Virginia, for the official use of Army lawyers in the performance of their legal responsibilities. Articles in th...

A. B. Ching A. M. Tulud C. J. Strong

2009-01-01

68

Surgical management of Diabetic foot ulcers: A Tanzanian university teaching hospital experience  

PubMed Central

Background Diabetic foot ulcers (DFUs) pose a therapeutic challenge to surgeons, especially in developing countries where health care resources are limited and the vast majority of patients present to health facilities late with advanced foot ulcers. A prospective descriptive study was done at Bugando Medical Centre from February 2008 to January 2010 to describe our experience in the surgical management of DFUs in our local environment and compare with what is known in the literature. Findings Of the total 4238 diabetic patients seen at BMC during the period under study, 136 (3.2%) patients had DFUs. Males outnumbered females by the ratio of 1.2:1. Their mean age was 54.32 years (ranged 21-72years). Thirty-eight (27.9%) patients were newly diagnosed diabetic patients. The majority of patients (95.5%) had type 2 diabetes mellitus. The mean duration of diabetes was 8.2 years while the duration of DFUs was 18.34 weeks. Fourteen (10.3%) patients had previous history of foot ulcers and six (4.4%) patients had previous amputations. The forefoot was commonly affected in 60.3% of cases. Neuropathic ulcers were the most common type of DFUs in 57.4% of cases. Wagner's stage 4 and 5 ulcers were the most prevalent at 29.4% and 23.5% respectively. The majority of patients (72.1%) were treated surgically. Lower limb amputation was the most common surgical procedure performed in 56.7% of cases. The complication rate was (33.5%) and surgical site infection was the most common complication (18.8%). Bacterial profile revealed polymicrobial pattern and Staphylococcus aureus was the most frequent microorganism isolated. All the microorganisms isolated showed high resistance to commonly used antibiotics except for Meropenem and imipenem, which were 100% sensitive each respectively. The mean hospital stay was 36.24 ± 12.62 days (ranged 18-128 days). Mortality rate was 13.2%. Conclusion Diabetic foot ulceration constitutes a major source of morbidity and mortality among patients with diabetes mellitus at Bugando Medical Centre and is the leading cause of non-traumatic lower limb amputation. A multidisciplinary team approach targeting at good glycaemic control, education on foot care and appropriate footware, control of infection and early surgical intervention is required in order to reduce the morbidity and mortality associated with DFUs. Due to polymicrobial infection and antibiotic resistance, surgical intervention must be concerned.

2011-01-01

69

Misdiagnosis and Quality of Management in Paediatric Surgical Patients Referred to a Tertiary Care Hospital  

PubMed Central

Background: The literature on diagnosis and management prior to transfer paediatric surgical patients to a tertiary care center is scarce. In referral centers, it is common to receive patients previously subjected to inadequate or inappropriate health care. Aim: Analyze the prevalence of misdiagnosis and quality of management in patients before being referred and factors related to misdiagnosis and inadequate management. Design: Prospective, longitudinal, comparative study between patients with appropriate and inappropriate submission diagnosis and between patients with adequate or inadequate treatment. Setting: Third level care hospital, Mexico City. Participants: Newborn to adolescents referred to Paediatric Surgery Department. Intervention(s): None. Main Outcome Measure(s): Misdiagnosis and quality of management prior to being referred. Result: Two hundred patients were evaluated. Correlation between submission diagnosis and final diagnosis showed that 70% were correct and 30% incorrect; 48.5% were properly managed and 51.5% inappropriately managed. Incorrect diagnosis was more frequent when referred from first-or second-level hospitals and in inflammatory conditions. Patients referred by paediatricians had a higher rate of adequate management. Conclusion: We present the frequency of incorrect diagnosis and inadequate patient management in a highly selected population. Sample size should be increased as well as performing these studies in other hospital settings in order to determine whether the results are reproducible.

Cazares-Rangel, Joel; Zalles-Vidal, Cristian; Davila-Perez, Roberto

2014-01-01

70

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

PubMed Central

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.

2014-01-01

71

WORK-RELATED STRESS AND COPING: A SURVEY ON MEDICAL AND SURGICAL NURSES IN A MALAYSIAN TEACHING HOSPITAL  

Microsoft Academic Search

Background: A cross-sectional study on work-related stressors among nurses in a public teaching hospital had also attempted to explore functions of coping strategies in determining stress. Materials and Methods: A structured bilingual questionnaire (English-Malay) on symptoms and sources of stress, and coping style measure was disseminated to medical and surgical nurses working in a teaching hospital in Kuala Lumpur. Socio

ZA Emilia; I Noor Hassim

72

Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital  

PubMed Central

Background Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran. Methods Patients (n = 802) who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups. Results Of the 802 patients, 139 suffered from SSI (17.4%). In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation) hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001. Conclusion In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature), this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and approximating the timing of shaving to the operation and substituting cefazolin for cefaluthin when prophylactic antibiotic is to be administered, the SSI may be reduced to a more acceptable level.

Razavi, Seyd Mansour; Ibrahimpoor, Mohammad; Sabouri Kashani, Ahmad; Jafarian, Ali

2005-01-01

73

Forward surgery and combat hospitals: the origins of the MASH.  

PubMed

The U.S. Army adopted forward surgical hospitals (SHs) during World War I on the advice of the British and French armies. The purposes were not just to save lives, but to benefit the military by returning more patients to duty and reducing the size of the hospital system through fewer infections and shorter hospital stays. The Army examined the utility of the units at the end of the war and retained them for any future conflicts, but opposition also survived. The question was the utility for the Army: was it worth making a substantial investment, and reducing care for other wounded soldiers, for the most grievously wounded, perhaps 1 percent of the total? Devising an effective way to organize forward SHs was a problem in the interwar years and early in World War II (WWII). But from the late 1930s, the Army never reexamined whether it should provide forward surgery, only how to do so, including pushing surgeons even further forward on the battlefield. At the end of WWII, the Mobile Army Surgical Hospital (MASH) was created to perform the mission, although the MASH was only the latest format. PMID:22653962

Marble, Sanders

2014-01-01

74

Implementation of the WHO Surgical Safety Checklist in an Ethiopian Referral Hospital  

PubMed Central

Background The WHO Surgical Safety Checklist has a growing evidence base to support its role in improving perioperative safety, although its impact is likely to be directly related to the effectiveness of its implementation. There remains a paucity of documented experience from low-resource settings on Checklist implementation approaches. We report an implementation strategy in a public referral hospital in Addis Ababa, Ethiopia, based on consultation, local leadership, formal introduction, and supported supervision with subsequent audit and feedback. Methods Planning, implementation and assessment took place from December 2011 to December 2012. The planning phase, from December 2011 until April 2012, involved a multidisciplinary consultative approach using local leaders, volunteer clinicians, and staff from non-governmental organisations, to draw up a locally agreed and appropriate Checklist. Implementation in April 2012 involved formal teaching and discussion, simulation sessions and role play, with supportive supervision following implementation. Assessment was performed using completed Checklist analysis and staff satisfaction questionnaires at one month and further Checklist analysis combined with semi-structured interviews in December 2012. Results and discussion Checklist compliance rates were 83% for general anaesthetics at one month after implementation, with an overall compliance rate of 65% at eight months. There was a decrease in Checklist compliance over the period of the study to less than 20% by the end of the study period. The ‘Sign out’ section was reported as being the most difficult section of the Checklist to complete, and was missed completely in 21% of cases. The most commonly missed single item was the team introduction at the start of each case. However, we report high staff satisfaction with the Checklist and enthusiasm for its continued use. Conclusion We report a detailed implementation strategy for introducing the WHO Surgical Safety Checklist to a low-resource setting. We show that this approach can lead to high completion rates and high staff satisfaction, albeit with a drop in completion rates over time. We argue that maximal benefit of the Surgical Safety Checklist is likely to be when it engenders a conversation around patient safety within a department, and when there is local ownership of this process.

2014-01-01

75

Characterization of Colonizing Staphylococcus aureus Isolated from Surgical Wards' Patients in a Nigerian University Hospital  

PubMed Central

In contrast to developed countries, only limited data on the prevalence, resistance and clonal structure of Staphylococcus aureus are available for African countries. Since S. aureus carriage is a risk factor for postoperative wound infection, patients who had been hospitalized in surgical wards in a Nigerian University Teaching Hospital were screened for S. aureus carriage. All S. aureus isolates were genotyped (spa, agr) and assigned to multilocus sequence types (MLST). Species affiliation, methicillin-resistance, and the possession of pyrogenic toxin superantigens (PTSAg), exfoliative toxins (ETs) and Panton-Valentine Leukocidin (PVL) were analyzed. Of 192 patients screened, the S. aureus carrier rate was 31.8 % (n?=?61). Of these isolates, 7 (11.5%) were methicillin-resistant (MRSA). The isolates comprised 24 spa types. The most frequent spa types were t064, t084, t311, and t1931, while the most prevalent MLST clonal complexes were CC5 and CC15. The most frequent PTSAg genes detected were seg/sei (41.0%) followed by seb (29.5%), sea (19.7%), seh (14.7%) and sec (11.5). The difference between the possession of classical and newly described PTSAg genes was not significant (63.9% versus 59.0% respectively; P?=?0.602). PVL encoding genes were found in 39.3% isolates. All MRSA isolates were PVL negative, SCCmec types I and VI in MLST CC 5 and CC 30, respectively. Typing of the accessory gene regulator (agr) showed the following distribution: agr group 1 (n?=?20), group II (n?=?17), group III (n?=?14) and group IV (n?=?10). Compared to European data, enterotoxin gene seb and PVL-encoding genes were more prevalent in Nigerian methicillin-susceptible S. aureus isolates, which may therefore act as potential reservoir for PVL and PTSAg genes.

Kolawole, Deboye O.; Adeyanju, Adeniran; Schaumburg, Frieder; Akinyoola, Akinyele L.; Lawal, Oladejo O.; Amusa, Yemisi B.; Kock, Robin; Becker, Karsten

2013-01-01

76

Characterization of colonizing Staphylococcus aureus isolated from surgical wards' patients in a Nigerian university hospital.  

PubMed

In contrast to developed countries, only limited data on the prevalence, resistance and clonal structure of Staphylococcus aureus are available for African countries. Since S. aureus carriage is a risk factor for postoperative wound infection, patients who had been hospitalized in surgical wards in a Nigerian University Teaching Hospital were screened for S. aureus carriage. All S. aureus isolates were genotyped (spa, agr) and assigned to multilocus sequence types (MLST). Species affiliation, methicillin-resistance, and the possession of pyrogenic toxin superantigens (PTSAg), exfoliative toxins (ETs) and Panton-Valentine Leukocidin (PVL) were analyzed. Of 192 patients screened, the S. aureus carrier rate was 31.8 % (n?=?61). Of these isolates, 7 (11.5%) were methicillin-resistant (MRSA). The isolates comprised 24 spa types. The most frequent spa types were t064, t084, t311, and t1931, while the most prevalent MLST clonal complexes were CC5 and CC15. The most frequent PTSAg genes detected were seg/sei (41.0%) followed by seb (29.5%), sea (19.7%), seh (14.7%) and sec (11.5). The difference between the possession of classical and newly described PTSAg genes was not significant (63.9% versus 59.0% respectively; P?=?0.602). PVL encoding genes were found in 39.3% isolates. All MRSA isolates were PVL negative, SCCmec types I and VI in MLST CC 5 and CC 30, respectively. Typing of the accessory gene regulator (agr) showed the following distribution: agr group 1 (n?=?20), group II (n?=?17), group III (n?=?14) and group IV (n?=?10). Compared to European data, enterotoxin gene seb and PVL-encoding genes were more prevalent in Nigerian methicillin-susceptible S. aureus isolates, which may therefore act as potential reservoir for PVL and PTSAg genes. PMID:23935883

Kolawole, Deboye O; Adeyanju, Adeniran; Schaumburg, Frieder; Akinyoola, Akinyele L; Lawal, Oladejo O; Amusa, Yemisi B; Köck, Robin; Becker, Karsten

2013-01-01

77

Uppsala University Hospital 300 years--a survey of the surgical development.  

PubMed

Professor Lars Roberg, the initiator of the Nosocomium Academicum (1708), our first university hospital in Sweden, claimed that 'no-one who does not understand surgery is a completely trained doctor'. However, it was not until the end of 19th century that modern surgery was born. The Academic Hospital was opened in 1867, and at the turn of that century Uppsala had a flourishing period under the influence of Karl Gustav Lennander, professor of surgery. In 1889 he performed the first appendectomy in Scandinavia. At the end of the 19th century the surgical tree began to branch out. In Uppsala gynaecology and obstetrics was the first to be an independent speciality (1891). It was followed by ophthalmology (1894) with Allvar Gullstrand as professor and head of the department. Gullstrand received the Nobel Prize in medicine in 1911. A separate department for diseases of the ear, nose, and throat was founded in 1916 with the Nobel laureate Robert Bárány as head. Thoracic surgery began in Uppsala in the 1940s with lung surgery and was separated from general surgery in 1958 with Viking Olov Björk as head of the department. Björk introduced open heart surgery in Uppsala. In 1951 reconstructive plastic surgery was organized by Tord Skoog, who devoted special interest to operations for cleft lip and palate surgery. Neurosurgery was established in 1962, and Uppsala has held a prominent position in the development of modern neurointensive care. During the 1970s general surgery became subspecialized into gastrointestinal, endocrine, and vascular surgery. At the same time fracture surgery was transferred to the orthopaedists, and urological surgery became an independent speciality. Transplantation surgery was introduced in Uppsala in 1967, when Professor Lars Thorén performed the first kidney transplantation. Today Uppsala has a leading position in transplantation of pancreatic islets cells. PMID:19242867

Johansson, Henry

2009-01-01

78

Surgical Treatment of Otosclerosis: Eight years' Experience at the Jordan University Hospital  

PubMed Central

Introduction: To report the experience of the Jordan University Hospital with respect to the surgical treatment of otosclerosis and to compare results and complications with published studies. Materials and Methods: The medical records of all patients who underwent stapes surgery for otosclerosis at the Jordan University Hospital during the period January 2003 to December 2010 were reviewed. Results: Out of 130 patients who underwent stapes surgery, 104 (80%) fulfilled the criteria and were enrolled in this study. There were 68 (65.4%) females and 36 (34.6%) males (female-to-male ratio, 1.9: 1). The disease was bilateral in 86 (82.7%) patients. Family history for otosclerosis was positive in 37(35.6%) patients. Tinnitus was observed at presentation in 82 (78.8%) patients and spontaneously resolved or improved in 51(62.2%) patients after surgery. Air bone gap after surgery was ? 10 dB in 79 (76.0%) patients, between 10 and 20 dB in 10 (9.6%) patients, and between 20 and 30 dB in four (3.8%) patients. Complications occurred in 17(16.3%) patients, which included: one (1.0%) deaf ear, two (2.0%) sensorineural hearing loss, two (2.0%) facial nerve palsy, six (5.8%) vertigo lasting more than 7 days, three (2.9%) chorda tympani damage, one (1.0%) floating of footplate, and two (2.0%) perforation of the tympanic membrane. Conclusion: The results of this study are comparable with those reported in the literature by surgeons with the same level of experience, but below than those with large series experience. Therefore, we believe that an experienced general ear, nose, and throat (ENT) surgeon can perform stapes surgery safely and successfully in the absence of an otologist.

Mahafza, Tareq; AL-Layla, Abdelmonem; Tawalbeh, Mohammed; Abu-yagoub, Yagoub; Atwan Sulaiman, Ahmad

2013-01-01

79

Uppsala University Hospital 300 years--a survey of the surgical development  

PubMed Central

Professor Lars Roberg, the initiator of the Nosocomium Academicum (1708), our first university hospital in Sweden, claimed that ‘no-one who does not understand surgery is a completely trained doctor’. However, it was not until the end of 19th century that modern surgery was born. The Academic Hospital was opened in 1867, and at the turn of that century Uppsala had a flourishing period under the influence of Karl Gustav Lennander, professor of surgery. In 1889 he performed the first appendectomy in Scandinavia. At the end of the 19th century the surgical tree began to branch out. In Uppsala gynaecology and obstetrics was the first to be an independent speciality (1891). It was followed by ophthalmology (1894) with Allvar Gullstrand as professor and head of the department. Gullstrand received the Nobel Prize in medicine in 1911. A separate department for diseases of the ear, nose, and throat was founded in 1916 with the Nobel laureate Robert Bárány as head. Thoracic surgery began in Uppsala in the 1940s with lung surgery and was separated from general surgery in 1958 with Viking Olov Björk as head of the department. Björk introduced open heart surgery in Uppsala. In 1951 reconstructive plastic surgery was organized by Tord Skoog, who devoted special interest to operations for cleft lip and palate surgery. Neurosurgery was established in 1962, and Uppsala has held a prominent position in the development of modern neurointensive care. During the 1970s general surgery became subspecialized into gastrointestinal, endocrine, and vascular surgery. At the same time fracture surgery was transferred to the orthopaedists, and urological surgery became an independent speciality. Transplantation surgery was introduced in Uppsala in 1967, when Professor Lars Thorén performed the first kidney transplantation. Today Uppsala has a leading position in transplantation of pancreatic islets cells.

2009-01-01

80

Study to Determine the Best Method of Improving the Flow of Patients Through the Surgical Critical Care Units at Letterman Army Medical Center.  

National Technical Information Service (NTIS)

The study is an attempt to determine the most appropriate use of limited resources at Letterman Army Medical Center. A critical care bed shortage existed which prompted cancellation of surgeries and deferment of patients from the emergency room who were p...

F. E. Davison

1989-01-01

81

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

PubMed

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

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

2014-06-01

82

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

PubMed Central

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.

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

2013-01-01

83

Two Armies.  

National Technical Information Service (NTIS)

Colonel Raspeguy, veteran of Dien Bien Phu: 'I'd like France to have two armies: one for display, with lovely guns, tanks, little soldiers, fanfares, staffs, distinguished and doddering generals, and dear little regimental officers who would be deeply con...

D. P. Bolger

1989-01-01

84

Postoperative Pain Management among Surgically Treated Patients in an Ethiopian Hospital  

PubMed Central

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.

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

2014-01-01

85

Early experience with the da Vinci® surgical system robot in gynecological surgery at King Abdulaziz University Hospital  

PubMed Central

Background: The purpose of this study was to review our experience and the challenges of using the da Vinci® surgical system robot during gynecological surgery at King Abdulaziz University Hospital. Methods: A retrospective study was conducted to review all cases of robot-assisted gynecologic surgery performed at our institution between January 2008 and December 2010. The patients were reviewed for indications, complications, length of hospital stay, and conversion rate, as well as console and docking times. Results: Over the three-year period, we operated on 35 patients with benign or malignant conditions using the robot for a total of 62 surgical procedures. The docking times averaged seven minutes. The mean console times for simple hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy were 125, 47, and 62 minutes, respectively. In four patients, laparoscopic procedures were converted to open procedures, giving a conversion rate of 6.5%. All of the conversions were among the first 15 procedures performed. The average hospital stay was 3 days. Complications occurred in five patients (14%), and none were directly related to the robotic system. Conclusion: Our early experience with the robot show that with proper training of the robotic team, technical difficulty with the robotic system is limited. There is definitely a learning curve that requires performance of gynecological surgical procedures using the robot.

Sait, Khalid H

2011-01-01

86

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

SciTech Connect

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.

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

87

The World Health Organization's 'Surgical Safety Checklist': should evidence-based initiatives be enforced in hospital policy?  

PubMed Central

Objectives To assess the awareness and voluntary usage of the World Health Organization's Surgical Safety Checklist (WHO SSC), just prior to its mandatory implementation. Design Questionnaire-based, prospective, telephone survey. Setting Patients are exposed to systematic risks and principles of surgical safety are inconsistently applied even in sophisticated settings. The evidence-based WHO SSC addresses shortfalls to promote patient safety. It was formally introduced in the United Kingdom in January 2009 and became a mandatory preoperative requirement in all hospitals from February 2010. Participants Two hundred and thirty-eight hospitals, both private and government-run, in the UK. Main outcome measures Appreciation among senior theatre personnel as to the existence, implementation and usage of the WHO SSC concept. Results Almost all had heard of the SSC, but in only two-thirds of hospitals was its use mandatory. Where the SSC was not compulsory, 80% were using it informally or sporadically. One-quarter of senior theatre personnel in hospitals without compulsory use indicated they did not know or that their department did not plan on using the checklist in the next six months, despite the deadline for implementation. Conclusions If the SSC is to optimize safety, then greater education and awareness is required.

Sivathasan, Niroshan; Rakowski, Krzysztof R M; Robertson, Bernard F M; Vijayarajan, Lavnya

2010-01-01

88

78 FR 74825 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...  

Federal Register 2010, 2011, 2012, 2013

...services. The OPPS was first implemented for...and certain inpatient hospital services...using the hospital inpatient wage index value...devices used for the treatment of cancer, and...that require an inpatient stay that are paid...hospital OPPS was first...

2013-12-10

89

42 CFR 416.75 - Performance of listed surgical procedures on an inpatient hospital basis.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Performance of listed surgical procedures on an...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM...Before January 1, 2008 § 416.75 Performance of listed surgical procedures on an...

2013-10-01

90

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

PubMed Central

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.

2014-01-01

91

Army's Core Competencies.  

National Technical Information Service (NTIS)

In October 2011, the United States Army published doctrine espousing its newest core competencies: Combined Arms Maneuver (CAM) and Wide Area Security (WAS). The Army's use of the term 'core competencies' introduced questions of validity since the Army fa...

R. E. Dunning

2013-01-01

92

76 FR 42169 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...  

Federal Register 2010, 2011, 2012, 2013

...Hospital Inpatient VBP Program...Expansion of Facility Capacity...OPPS was first implemented...necessary for the treatment of Medicare...hospital inpatient market basket...providers are first learning...examination or treatment for a medical...to these facilities in order...from the first year of...

2011-07-18

93

Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital  

PubMed Central

Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital employing a core strategy of post-prescriptive audit with intervention and feedback. Methods For one hour twice weekly, an infectious diseases physician and a clinical pharmacist audited medical records of inpatients receiving systemic antimicrobial therapy and made non-binding, written recommendations that were subsequently scored for implementation. Defined daily doses (DDDs; World Health Organization Center for Drug Statistics Methodology) and acquisition costs per admission and per patient-day were calculated monthly for all administered antimicrobial agents. Results The antimicrobial stewardship team (AST) made one or more recommendations for 313 of 367 audits during a 16-month intervention period (September 2009 – December 2010). Physicians implemented recommendation(s) from each of 234 (75%) audits, including from 85 of 115 for which discontinuation of all antimicrobial therapy was recommended. In comparison to an 8-month baseline period (January 2009 – August 2009), there was a 22% decrease in defined daily doses per 100 admissions (P = .006) and a 16% reduction per 1000 patient-days (P = .013). There was a 32% reduction in antimicrobial acquisition cost per admission (P = .013) and a 25% acquisition cost reduction per patient-day (P = .022). Conclusions An effective antimicrobial stewardship program was implemented with limited resources on the medical-surgical service of a 100-bed community hospital.

2012-01-01

94

78 FR 9940 - Naugatuck Valley Surgical Center, Department of Saint Mary's Hospital, Waterbury, CT: Notice of...  

Federal Register 2010, 2011, 2012, 2013

...Center, Department of Saint Mary's Hospital, Waterbury, CT: Notice of Affirmative Determination, Regarding Application...investigation resulted in a negative determination based on the findings that there was no shift in the supply of services to a...

2013-02-12

95

Fat necks: Modification of a standard surgical airway protocol in the pre-hospital environment  

Microsoft Academic Search

We report two cases of trauma where a surgical airway was required. In both cases soft tissue swelling of the neck made modification of the Advanced Trauma Life Support (ATLS) airway guidelines necessary. A gum elastic bougie was used to guide a standard endotracheal tube into a cricothyroidotomy incision and secure the airway. Slight departure from standard techniques may be

Andrew Morris; David Lockey; Timothy Coats

1997-01-01

96

Efficacy of Parenteral Nutrition Supplemented With Glutamine Dipeptide to Decrease Hospital Infections in Critically Ill Surgical Patients  

PubMed Central

Background Nosocomial infections are an important cause of morbidity and mortality in the surgical intensive care unit (SICU). Clinical benefits of glutamine-supplemented parenteral nutrition may occur in hospitalized surgical patients, but efficacy data in different surgical subgroups are lacking. The objective was to determine whether glutamine-supplemented parenteral nutrition differentially affects nosocomial infection rates in selected subgroups of SICU patients. Methods This was a double-blind, randomized, controlled study of alanyl-glutamine dipeptide-supplemented parenteral nutrition in SICU patients requiring parenteral nutrition and SICU care after surgery for pancreatic necrosis, cardiac, vascular, or colonic surgery. Subjects (n = 59) received isocaloric/isonitrogenous parenteral nutrition, providing 1.5 g/kg/d standard glutamine-free amino acids (STD-PN) or 1.0 g/kg/d standard amino acids + 0.5 g/kg/d glutamine dipeptide (GLN-PN). Enteral feedings were advanced as tolerated. Nosocomial infections were determined until hospital discharge. Results Baseline clinical/metabolic data were similar between groups. Plasma glutamine concentrations were low in all groups and were increased by GLN-PN. GLN-PN did not alter infection rates after pancreatic necrosis surgery (17 STD-PN and 15 GLN-PN patients). In nonpancreatic surgery patients (12 STD-PN and 15 GLN-PN), GLN-PN was associated with significantly decreased total nosocomial infections (STD-PN 36 vs GLN-PN 13, P < .030), bloodstream infections (7 vs 0, P < .01), pneumonias (16 vs 6, P < .05), and infections attributed to Staphylococcus aureus (P < .01), fungi, and enteric Gram-negative bacteria (each P < .05). Conclusions Glutamine dipeptide-supplemented parenteral nutrition did not alter infection rates following pancreatic necrosis surgery but significantly decreased infections in SICU patients after cardiac, vascular, and colonic surgery.

Estivariz, Concepcion F.; Griffith, Daniel P.; Luo, Menghua; Szeszycki, Elaina E.; Bazargan, Niloofar; Dave, Nisha; Daignault, Nicole M.; Bergman, Glen F.; McNally, Therese; Battey, Cindy H.; Furr, Celeste E.; Hao, Li; Ramsay, James G.; Accardi, Carolyn R.; Cotsonis, George A.; Jones, Dean P.; Galloway, John R.; Ziegler, Thomas R.

2011-01-01

97

Medical and surgical ward rounds in teaching hospitals of Kuwait University: students' perceptions  

PubMed Central

Background Teaching sessions for medical students during ward rounds are an essential component of bedside teaching, providing students with the opportunity to regard patients as actual people, and to observe their physical conditions directly, allowing a better understanding of illnesses to be developed. We aim to explore medical students’ perceptions regarding medical and surgical ward rounds within the Faculty of Medicine at Kuwait University, and to evaluate whether this teaching activity is meeting the expectation of learners. Methods A pretested questionnaire was used to collect data from 141 medical students during the 2012–2013 academic year. They were asked to provide their current and expected ratings about competencies that were supposed to be gained during ward rounds, on a scale from 1 (lowest) to 5 (highest). Mean scores were calculated, and the Student t-test was used to compare results. P < 0.05 was the cut-off level for significance. Results Only 17 students (12.1%) declined to participate in the study. The students’ current competency scores (for competencies taught within both disciplines – medical and surgical) were significantly lower than the scores indicating students’ expectations (P < 0.001). The best-taught competency was bedside examination, in both medical (mean: 3.45) and surgical (mean: 3.05) ward rounds. However, medical ward rounds were better than surgical rounds in covering some competencies, especially the teaching of professional attitude and approach towards patients (P < 0.001). Conclusion Both medical and surgical ward rounds were deficient in meeting the students’ expectations. Medical educators should utilize the available literature to improve the bedside teaching experience for their students.

AlMutar, Sara; AlTourah, Lulwa; Sadeq, Hussain; Karim, Jumanah; Marwan, Yousef

2013-01-01

98

An audit of aspects of informed consent and pain relief in general surgical units of korle bu teaching hospital.  

PubMed

SummaryThere is the need to adequately inform patients about their disease, treatment options, surgery and post-operative complications. Adequate pain relief after surgery leads to less morbidity. Two important aspects of surgical practice are being addressed in this paper, the need for informed consent and post operative pain relief.A questionnaire survey was carried out in 100 patients on the four general surgical wards of the Korle Bu Teaching Hospital, just before they were discharged from hospital. They were asked what they knew or had been informed about their diagnosis, operation and complications of surgery. On pain relief, patients were asked about their experiences on the first post-operative day and what relief they had from analgesics.Twenty four did not know the diagnosis and 36 were not told what operation they were going to have before surgery. Although 75 were eventually told what operation they had, only 64 said they knew the operation. Sixty eight did not know what to expect after surgery; 87 did not know about possible complications. On the first post-operative day there was significant pain (scores 4 and 5) felt by 24 patients at rest and 46 on movement. The most frequently prescribed analgesic was pethidine.Patient information in General surgery at the Korle Bu Teaching Hospital is unsatisfactory. Post-operative analgesia is also poor. There is the need for surgeons to either train doctors to administer consent or administer it themselves. Anaesthetists should assume a leading role in managing post-operative pain. PMID:17299545

Clegg-Lamptey, Jna; Hodasi, Wm

2005-06-01

99

Trends and Variations in the Rates of Hospital Complications, Failure-to-Rescue and 30-Day Mortality in Surgical Patients in New South Wales, Australia, 2002-2009  

PubMed Central

Background Despite the increased acceptance of failure-to-rescue (FTR) as an important patient safety indicator (defined as the percentage of deaths among surgical patients with treatable complications), there has not been any large epidemiological study reporting FTR in an Australian setting nor any evaluation on its suitability as a performance indicator. Methods We conducted a population-based study on elective surgical patients from 82 public acute hospitals in New South Wales, Australia between 2002 and 2009, exploring the trends and variations in rates of hospital complications, FTR and 30-day mortality. We used Poisson regression models to derive relative risk ratios (RRs) after adjusting for a range of patient and hospital characteristics. Results The average rates of complications, FTR and 30-day mortality were 13.8 per 1000 admissions, 14.1% and 6.1 per 1000 admission, respectively. The rates of complications and 30-day mortality were stable throughout the study period however there was a significant decrease in FTR rate after 2006, coinciding with the establishment of national and state-level peak patient safety agencies. There were marked variations in the three rates within the top 20% of hospitals (best) and bottom 20% of hospitals (worst) for each of the four peer-hospital groups. The group comprising the largest volume hospitals (principal referral/teaching hospitals) had a significantly higher rate of FTR in comparison to the other three groups of smaller-sized peer hospital groups (RR?=?0.78, 0.57, and 0.61, respectively). Adjusted rates of complications, FTR and 30-day mortality varied widely for individual surgical procedures between the best and worst quintile hospitals within the principal referral hospital group. Conclusions The decrease in FTR rate over the study period appears to be associated with a wide range of patient safety programs. The marked variations in the three rates between- and within- peer hospital groups highlight the potential for further quality improvement intervention opportunities.

Ou, Lixin; Chen, Jack; Assareh, Hassan; Hollis, Stephanie J.; Hillman, Ken; Flabouris, Arthas

2014-01-01

100

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

PubMed

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

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

1993-01-01

101

Attitudes to cancer of medical and surgical nurses in a district general hospital  

Microsoft Academic Search

The personal beliefs and attitudes of nurses can have serious implications for their practice. Yet there are a lack of studies on nurses' attitudes to cancer in the UK in general, and in Northern Ireland specifically. The need for such studies is further emphasized by the importance of nurses' role in the Cancer Units of district general hospitals, as proposed

Eilis McCaughan; Kader Parahoo

2000-01-01

102

Meat and Fish Entree Item Production Guides Prepared for Walter Reed Army Medical Center.  

National Technical Information Service (NTIS)

Traditionally, Army hospitals have used their own recipe systems and have developed their own menus independent of the Armed Forces Recipe Service and other Army menu planners. The recipes, then, that WRAMC requested NARADCOM to develop into production gu...

R. Young, C. Shaw, J. Darsch, J. Tuomy, G. Walker

1977-01-01

103

Surgical treatment of myelomeningocele: year 2000 hospitalization, outcome, and cost analysis in the US  

Microsoft Academic Search

Objective  To review cases of surgical repair for myelomeningocele (MMC) using a large inpatient database from the year 2000.\\u000a \\u000a \\u000a \\u000a Materials and methods  The Nationwide Inpatient Sample (NIS) database with 7.45 million patient admissions for 2000 was retrospectively studied for\\u000a the first 5 procedure diagnosis of MMC repair (ICD-9 CM procedure code 0352) and ages of less than 1 year. Eighty-eight patient\\u000a stays were

Anthony H. Sin; Mahmoud Rashidi; Gloria Caldito; Anil Nanda

2007-01-01

104

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

Microsoft Academic Search

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

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

1997-01-01

105

Atrial septal defects: Pattern, clinical profile, surgical techniques and outcome at Innova heart hospital: A 4-year review  

PubMed Central

Background: Atrial septal defect (ASD) is a congenital heart defect that leads to shunting of blood between left and right atria. It may be asymptomatic and sometimes may present with heart failure. Surgical repair is definitive, but currently non-surgical procedure is used to close the defect. Materials and Methods: It is a retrospective study of patients who underwent transcatheter closure of ASD at Innova Heart Hospital, Hyderabad, India. Echocardiography was repeated at intervals of 24 hours, then at 1, 3 and 6 months after the procedure to assess complications. The morphological characteristics of the ASD, including its diameter, location, shape and the width of surrounding septal margins, were also evaluated. Results: From April 2007 to June 2011, 69 consecutive children (29 males, 40 females) with a median age of 9.0 years (range = 3.2–19 years) registered with diagnosis of ASD. The median weight was 31.5 kg (range = 7.5–39.0 kg). Five patients (7.2%) were young children aged 3–5 years. Forty-four (63.8%) of these children presented with symptoms of heart failure, whereas 47 (68.1%) of the cases repaired with device were large-sized ASD. The most common interventional procedures done were Searcare Heart® and Amplatzer® technique with a highest success rate obtained in 2010. Conclusions: ASD is a common congenital heart disease with a high success rate for those who undergo intervention.

Adiele, Daberechi K.; Chinawa, Josephat M.; Arodiwe, Ijeoma O.; Gouthami, V.; Murthy, K. S.; Eze, John C.; Obidike, Egbuna. O.; Ujunwa, Fortune A.

2014-01-01

106

Tuberculous bowel obstruction at a university teaching hospital in Northwestern Tanzania: a surgical experience with 118 cases  

PubMed Central

Background Bowel obstruction resulting from intestinal tuberculosis has been reported to be more prevalent in developing countries including Tanzania. This study was undertaken to describe the clinicopathological profile, surgical management and outcome of tuberculous intestinal obstruction in our local setting and to identify factors responsible for poor outcome among these patients. Methods This was a prospective descriptive study of patients operated for tuberculous intestinal obstruction at Bugando Medical Centre (BMC) in northwestern Tanzania from April 2008 to March 2012. Ethical approval to conduct the study was obtained from relevant authorities. Statistical data analysis was performed using SPSS version 17.0. Results A total of 118 patients with tuberculous intestinal obstruction were studied. The male to female ratio was 1.8: 1. The median age was 26 years (range 11-67 years). The modal age group was 21-30 years. Thirty-one (26.3%) patients had associated pulmonary tuberculosis and 25 (21.2%) patients were HIV positive with a median CD4+ count of 225 cells /?l. Small bowel strictures were the most common operative findings accounting for 72.9% of cases. The ileo-caecal region was the commonest area of involvement in 68 (57.6%) patients. The right hemicolectomy with ileo-transverse anastomosis was the most frequent surgical procedure performed in 66 (55.9%) patients. Postoperatively all the patients received antituberculous drugs for a period of one year. Postoperative complication rate was 37.3% and surgical site infection (SSI) was the most frequent complication in 42.8% of cases. HIV positivity and low CD4+ count were the main predictors of SSI (p?hospital stay was 24 days. Patients who had postoperative complications stayed longer in the hospital and this was statistically significant (p?=?0.011). Mortality rate was 28.8% and it was significantly associated with co-existing medical illness, delayed presentation, HIV positivity, low CD 4 count (<200 cells/?l), ASA class and presence of complications (p?

2013-01-01

107

Operationalizing Army Cyber.  

National Technical Information Service (NTIS)

The United States Army must conduct further organization design in order to operationalize ARCYBER. The current organization, manning, and operating construct are not aligned to optimize the performance of the organization. The Army has current models and...

B. J. Lieb

2013-01-01

108

Army Efficiency Initiatives.  

National Technical Information Service (NTIS)

In 1988 the Secretary of Defense directed the military services to incorporate Total Quality Management (TQM) principles throughout their organizations. Beginning in 1992, Total Army Quality (TAQ) was the Army's new management philosophy in response to th...

D. B. Rivers

2011-01-01

109

The results of the three-month co-operation between a German and a Greek surgical team in a role II military hospital in Afghanistan  

PubMed Central

Background and Aim: There are a lot of unique challenges for the military medical personnel assigned to Afghanistan. We evaluate the results of the co-operation between a German and a Greek surgical team during a 3-month period in a role II hospital. Materials and Methods: Patients who were admitted to the role II German hospital of Kunduz were evaluated. We reviewed the type of diseases, mechanism and location of injuries, management, types of surgical procedures, blood supply, and outcome. Results: The data included 792 ISAF patients, 18 NGOs patients, and 296 local patients. Out of them, 71.6% of the patients were ISAF personnel; 51 patients underwent a surgical operation; 35 of them were operated in an emergency base. Fifty-five surgical procedures were performed. In 22 (43.1%) of these patients, orthopedic procedures were performed, while in the rest 29 (56.9%) patients the operations were of general surgery interest. Gunshot injuries were the main mechanism of injury for locals, whereas ISAF personnel were usually presented with injuries after IEDs and rocket attacks. A total number of 11 patients were transferred to role III military hospitals for further treatment within 24 hours. Conclusions: The co-operation between surgical teams from different countries, when appropriately trained, staffed, and equipped, can be highly effective in a combat environment.

Gourgiotis, Stavros; Triantafyllou, Christos; Karamitros, Athanasios; Thinnes, Katrin; Thuringen, Wolfgang; Schmidt, Roland

2012-01-01

110

Causes for cancellation of elective surgical procedures in a Spanish general hospital.  

PubMed

Cancellation of scheduled surgery is undesirable for patients and an inefficient use of resources. We prospectively collected data for 52 consecutive months in a public general hospital to estimate the prevalence and causes. The overall cancellation rate was 6.5% (2559 of 39 115 scheduled operations). Cancellation by broad category was for 'medical reasons' in 50%, 'patient-related factors' in 23%, and due to 'administrative/logistic problems' in 25%. The commonest specific causes within these categories were respectively: infections/fever (18%), patient did not attend (20%) and lack of theatre time (23%). This data will help direct resources to target prevention of cancellations as a result of these main problems. PMID:19413817

González-Arévalo, A; Gómez-Arnau, J I; delaCruz, F J; Marzal, J M; Ramírez, S; Corral, E M; García-del-Valle, S

2009-05-01

111

Berlin questionnaire study in surgical patient in Alzahra Hospital in year 2010  

PubMed Central

Background: To examine the prevalence of high-risk subjects of obstructive sleep apnea (OSA) and its predictive factors in patients undergoing elective surgery by using the Berlin Questionnaire. Materials and Methods: 300 surgical ASA physical status I, II, III, and IV patients were surveyed. Patients were screened with the Berlin questionnaire for obstructive sleep apnea. Data of sex, age, BMI and HTN also evaluated. Data were analyzed by Chi-square test and P < 0.05 was meaningful. Results: The Berlin questionnaire identified 25.3% (76/300) of patients as being at high risk of sleep apnea (95% confidence interval, 20%-28%). This group consisted of 195 (65%) males and 105 (35%) females. The prevalence of high-risk subjects in men were more significantly than women (P = 0.001). High-risk subjects also were increasing with age (P = 0.000) and increasing with obesity (P = 0.000) and arterial hypertension (P = 0.000). Conclusions: Predictors of high risk for OSA-related symptoms were female sex, age more than 50 years, and body mass index.

Amra, Babak; Saberpur, Shahhin; Ghoharian, Vahid; Tabatabai, Sayed Abbas; Akbari, Mojtaba; Beni, Batool Hashemi

2013-01-01

112

The Burden of Surgical Diseases on Critical Care Services at a Tertiary Referral Hospital in Sub-Saharan Africa  

PubMed Central

In many developing countries including those of sub-Saharan Africa care of the critically ill is poorly developed. We therefore sought to elucidate the characteristics and outcomes of critically ill patients to better define the burden of disease and identify strategies for improving care. We conducted a cross sectional observation study of patients admitted to the intensive care unit at Kamuzu Central Hospital in 2010. Demographic, patient characteristics, clinical specialty and outcome data was collected. There were 234 patients admitted during the study period. Older age and admission from trauma, general surgery or medical services were associated with increased mortality. The lowest mortality was among obstetrical and gynecologic patients. Use of the ventilator and transfusions were not associated with increased mortality. Head injured patients had the highest mortality rate among all diagnoses. Rationing of critical care resources using admitting diagnosis or scoring tools can maximize access to critical care services in resource-limited settings. Furthermore, improvements on critical care services will be central to future efforts at reducing surgical morbidity and mortality and improving outcomes in all critically ill patients.

Tomlinson, Jared; Haac, Bryce; Kadyaudzu, Clement; Samuel, Jonathan C; Campbell, Emilia LP; Lee, Clara; Charles, Anthony G

2013-01-01

113

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

114

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

115

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

116

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

117

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

118

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

119

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

120

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

121

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

122

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

123

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

124

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

125

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

126

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

127

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

128

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

129

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

130

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

131

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

132

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

133

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

134

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

135

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

136

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

137

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

138

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

139

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

140

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

141

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

142

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

143

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

144

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

145

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

146

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

147

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

148

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

149

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

150

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

151

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

152

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

153

Modified Diet Recipes for Army Medical Facilities.  

National Technical Information Service (NTIS)

This report contains recipes suitable for therapeutic diet use in Army hospitals. Selection of the 124 recipes was based upon recipes found in the Armed Forces Recipe Service (AFRS) recipe file. Two hundred eighty-nine different modifications of these rec...

C. K. Townsend, C. P. Shaw, E. S. Blair, J. W. McNutt, M. V. Klicka

1983-01-01

154

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

155

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/

156

Study to Develop A Case Mix Model for the Allocation of Impatient Workload for Silas B. Hays Army Community Hospital Fort Ord, California.  

National Technical Information Service (NTIS)

This study was done to develop a case mix model for the Silas B. Hays Community Hospital at Fort Ord, CA.. The author states his particular model for this study is a good foundation which can be built upon to improve its usefulness to management. Medical ...

E. R. Ponatoski

1987-01-01

157

[Norman Bethune and field surgery of the Eighth Route Army].  

PubMed

With long-term war experience abroad, combined with the actual situation of health work in China, Bethune put forward a series of strategy and theory used in battlefield conditions of rescuing the wounded in China, such as "fire rescue, early debridement", "emergency blood transfusion in battlefield" and "the crowd blood bank", which effectively improved the rate of saving the battlefield wounded rate in the actual war. Combining with his own practice, he invented a variety of surgical instruments and equipment, such as "lugou bridge" medicine cabinet, "Bipp ointment", which have been widely used in the battlefield. He paid more attention to the construction of battlefield hospital, proposed the establishment of "Model Hospital" and "Special Surgery Hospital" in the rear of Anti-Japanese War, founded the health school, and wrote many battlefield medical books and skills data. Bethune trained a large number of medical personnel for the war front, laid the foundation for the field surgery education of the Eighth Route Army. PMID:24060028

Li, Yong; Luo, Chang-Kun; Wang, Lin; Chen, Hong; Zhu, Jian-Wu

2013-05-01

158

Army Occupational Therapy  

Microsoft Academic Search

An understanding of organization subsystems, is necessary to effect change within those subsystems. In describing the complex systems under which Army therapists function, some of the difficulties of a bureaucratic structure are identified and integrating techniques described. Because of the existing organization structure that blends both professional and military identification, Army therapists have been successful in achieving a considerable amount

Ruta Klavins

1983-01-01

159

Developing the Army Pentathlete.  

National Technical Information Service (NTIS)

The Army needs to develop a new breed of officer, the 'pentathlete', who is a leader, combat soldier, statesman and sociologist. How will they do it, and where will they find the personnel to fill the job. The Army is forced to deal with insurgency in Ira...

K. McElroy

2007-01-01

160

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

PubMed Central

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.

2014-01-01

161

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

PubMed Central

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.

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

2013-01-01

162

Racial disparities in clinical presentation, surgical treatment and in-hospital outcomes of women with breast cancer: analysis of nationwide inpatient sample database.  

PubMed

To examine racial/ethnic disparities in stage of disease and comorbidity (pre-treatment), surgical treatment allocation (breast-conserving surgery versus mastectomy), and in-hospital outcomes after surgery (post-treatment) among women with breast cancer. Nationwide inpatient sample is a nationwide clinical and administrative database compiled from 44 states representing 95 % of all hospital discharges in the Unites States. Discharges of adult women who underwent surgery for breast cancer from 2005 to 2009 were identified. Information about patients and hospitals characteristics was obtained. Multivariate logistic regression analyses were used to examine the risk adjusted association between race/ethnicity and the aforementioned outcomes (pre-treatment, treatment, and post-treatment). We identified 75,100 patient discharges. Compared to Whites, African-Americans (1.17, p < 0.001), and Hispanics (1.20, p < 0.001) were more likely to present with regional or metastatic disease. Similarly, African-American (1.58, p < 0.001) and Hispanics (1.11, p 0.003) were more likely to have comorbidity. Compared to Whites, African-Americans (0.71, p < 0.001), and Hispanics (0.77, p < 0.001) were less likely to receive mastectomy. Compared to Whites, African-Americans were more likely to develop post-operative complications (1.35, p < 0.001) and in-hospital mortality (1.87, p 0.13). Other racial groups showed no statistically significant difference compared to Whites. After controlling for potential confounders, we found racial/ethnic disparities in stage, comorbidity, surgical treatment allocation, and in-hospital outcomes among women with breast cancer. Future researches should examine the underlying factors of these disparities. PMID:23690143

Dehal, Ahmed; Abbas, Ali; Johna, Samir

2013-06-01

163

Army Learning Organisation Workshop.  

National Technical Information Service (NTIS)

This report outlines the conduct, philosophy, management and facilitation of the Army Learning Organisation Workshop held at HMAS Harman Conference Centre on 24 - 25 February 2009. The workshop presented an opportunity for particpants to discuss the relev...

C. Stothard D. McDowall M. Drobnjak S. Talbot

2013-01-01

164

Surgical treatment of dumbbell-shaped neurinomas: report of an experience with 57 cases in a single hospital  

Microsoft Academic Search

BackgroundDumbbell-shaped trigeminal neurinomas are rare benign tumors with a controversy regarding their treatment and surgical approaches. We conducted an investigation on elucidating a strategy for the treatment of DSTNs.

Liang-Fu Zhou; Ying Mao; Rong Zhang

2007-01-01

165

SURGICAL REPAIR OF BLADDER EXSTROPHY IN THE MODERN ERA: CONTEMPORARY PRACTICE PATTERNS AND THE ROLE OF HOSPITAL CASE VOLUME  

Microsoft Academic Search

PurposeBladder exstrophy is a rare condition, and data are lacking regarding practice patterns in its surgical management. We used a large nationwide database to investigate practice patterns of bladder exstrophy repair.

CALEB P. NELSON; RODNEY L. DUNN; JOHN T. WEI; JOHN P. GEARHART

2005-01-01

166

[Mortality in the surgical unit of a general hospital. Study of 27 postoperative deaths among patients operated on during 1990-1492].  

PubMed

This study takes in account all post operative deaths during the year 1990 in one surgical Professorial unit of Lille academic hospital (France). During this year, 1492 consecutive patients underwent surgery. The mean age of deceased patients was 63.7 years. 15 died after emergency procedure and 12 after elective surgery. Lastly 2 patients died without any operation. The most common condition encountered in those cases was oesophageal carcinoma, thereafter gastric or duodenal complicated peptic ulcer, and finally colonic carcinoma and diverticular disease. 13 patients had neoplasia (45%). From a critical point of view, 14 patients died after surgical indication or procedure of questionable legitimacy. The comparison with a similar study conducted five years ago and the analysis of these charts allow us to reaffirm some basic principles of surgery. PMID:1761598

Proye, C; Martinot, J C; Triboulet, J P; Carnaille, B; Sautier, M; Dromer, D; Camp, D

1991-11-01

167

Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.  

PubMed

EXECUTIVE SUMMARY The "Guideline for Prevention of Surgical Site Infection, 1999" presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.1,2 Part I, "Surgical Site Infection: An Overview," describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis. Part II, "Recommendations for Prevention of Surgical Site Infection," represents the consensus of the Hospital Infection Control Practices Advisory Committee (HICPAC) regarding strategies for the prevention of SSIs.3 Whenever possible, the recommendations in Part II are based on data from well-designed scientific studies. However, there are a limited number of studies that clearly validate risk factors and prevention measures for SSI. By necessity, available studies have often been conducted in narrowly defined patient populations or for specific kinds of operations, making generalization of their findings to all specialties and types of operations potentially problematic. This is especially true regarding the implementation of SSI prevention measures. Finally, some of the infection control practices routinely used by surgical teams cannot be rigorously studied for ethical or logistical reasons (e.g., wearing vs not wearing gloves). Thus, some of the recommendations in Part II are based on a strong theoretical rationale and suggestive evidence in the absence of confirmatory scientific knowledge.It has been estimated that approximately 75% of all operations in the United States will be performed in "ambulatory," "same-day," or "outpatient" operating rooms by the turn of the century.4 In recommending various SSI prevention methods, this document makes no distinction between surgical care delivered in such settings and that provided in conventional inpatient operating rooms. This document is primarily intended for use by surgeons, operating room nurses, postoperative inpatient and clinic nurses, infection control professionals, anesthesiologists, healthcare epidemiologists, and other personnel directly responsible for the prevention of nosocomial infections. This document does not: Specifically address issues unique to burns, trauma, transplant procedures, or transmission of bloodborne pathogens from healthcare worker to patient, nor does it specifically address details of SSI prevention in pediatric surgical practice. It has been recently shown in a multicenter study of pediatric surgical patients that characteristics related to the operations are more important than those related to the physiologic status of the patients.5 In general, all SSI prevention measures effective in adult surgical care are indicated in pediatric surgical care. Specifically address procedures performed outside of the operating room (e.g., endoscopic procedures), nor does it provide guidance for infection prevention for invasive procedures such as cardiac catheterization or interventional radiology. Nonetheless, it is likely that many SSI prevention strategies also could be applied or adapted to reduce infectious complications associated with these procedures. Specifically recommend SSI prevention methods unique to minimally invasive operations (i.e., laparoscopic surgery). Available SSI surveillance data indicate that laparoscopic operations generally have a lower or comparable SSI risk when contrasted to open operations.6-11 SSI prevention measures applicable in open operations (e.g., open cholecystectomy) are indicated for their laparoscopic counterparts (e.g., laparoscopic cholecystectomy). Recommend specific antiseptic agents for patient preoperative skin preparations or for healthcare worker hand/forearm antisepsis. Hospitals should choose from products recommended for these activitie PMID:10196487

Mangram, A J; Horan, T C; Pearson, M L; Silver, L C; Jarvis, W R

1999-04-01

168

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

Code of Federal Regulations, 2013 CFR

...performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public Health CENTERS FOR MEDICARE...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...performed in hospitals on an outpatient basis. (a) Basis...by an ASC in the same geographic area. (c)...

2013-10-01

169

Image review station for the surgical intensive care unit of the Hospital of the University of Minnesota: design and workflow evaluation  

NASA Astrophysics Data System (ADS)

A simple image review station has been designed for the surgical intensive care unit (SICU) of the Hospital of the University of Minnesota. The review station provides clinicians with digitized copies of all conventional films taken while a patient is in the SICU. The image review station consists of a single screen SPARCstation IPX. Images are acquired through a Kodak film digitizer and managed in cooperation with a bedside electronic medical record system on this unit. The review station software maintains a detailed log of all interactions that is routinely downloaded to a relational database for analysis of usage patterns.

Rehm, Kelly; Holm, John C.; Ritenour, E. R.; Goldberg, Marvin E.

1994-05-01

170

Immediate Postoperative Renal Function Deterioration in Cardiac Surgical Patients Predicts In-Hospital Mortality and Long-Term Survival  

Microsoft Academic Search

Postoperative renal function deterioration is a serious complication after cardiac surgery with cardiopulmonary bypass and is associated with increased in-hospital mortality. However, the long-term prognosis of patients with postoperative renal deterioration is not fully determined yet. Therefore, both in-hospital mortality and long-term survival were studied in patients with postoperative renal function deterioration. Included were 843 patients who underwent cardiac surgery

Berthus G. Loef; Anne H. Epema; Ton D. Smilde; Robert H. Henning; Tjark Ebels; Gerjan Navis; Coen A. Stegeman

2005-01-01

171

Peer-to-peer nursing rounds and hospital-acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project.  

PubMed

We conducted a quality improvement project in order to evaluate the effect of nurse-to-nurse bedside "rounding" as a strategy to decrease hospital-acquired pressure ulcers (HAPU) in a surgical intensive care unit. We instituted weekly peer-to-peer bedside skin rounds in a 17-bed surgical intensive care unit. Two nurses were identified as skin champions and trained by the hospital's certified WOC nurse to conduct skin rounds. The skin champion nurses conducted weekly peer-to-peer rounds that included discussions about key elements of our patients' skin status including current Braden Scale for Pressure Sore Risk score, and implementation of specific interventions related to subscale risk assessment. If a pressure ulcer was present, the current action plan was reevaluated for effectiveness. Quarterly HAPU prevalence studies were conducted from January 2008 to December 2010. Nineteen patients experienced a HAPU: 17 were located on the coccyx and 2 on the heel. Ten ulcers were classified as stage II, 3 PU were stage IV, 5 were deemed unstageable, and 1 was classified as a deep tissue injury. The frequency of preventive interventions rose during our quality improvement project. Specifically, the use of prevention surfaces increased 92%, repositioning increased 30%, nutrition interventions increased 77%, and moisture management increased 100%. Prior to focused nursing rounds, the highest HAPU prevalence rate was 27%. After implementing focused nursing rounds, HAPU rates trended down and were 0% for 3 consecutive quarters. PMID:22415120

Kelleher, Alyson Dare; Moorer, Amanda; Makic, MaryBeth Flynn

2012-01-01

172

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.

173

Army Wire Rope Inspection Program.  

National Technical Information Service (NTIS)

This report covers an investigation into the Army's wire rope nondestructive inspection procedures and needs. Major Army users of wire rope were located and surveyed for information on their wire rope inspection procedures. The Navy has conducted an inves...

K. S. Chapman

1983-01-01

174

Army Healthcare Enterprise Management System.  

National Technical Information Service (NTIS)

Introduction. The audit was performed in response to allegations to the Defense Hotline concerning the procurement of the Army Healthcare Enterprise Management System. The complaint alleged that the Army Healthcare Enterprise Management System was not pro...

2001-01-01

175

Prevalence of modifiable surgical site infection risk factors in hip and knee joint arthroplasty patients at an urban academic hospital.  

PubMed

Surgical site infections after hip and knee arthroplasty can be devastating if they lead to periprosthetic joint infection. We examined the prevalence of the modifiable risk factors for surgical site infection described by the American Academy of Orthopaedic Surgery Patient Safety Committee. Our study of 300 cases revealed that only 20% of all cases and 7% of revision cases for infection had no modifiable risk factors. The most common risk factors were obesity (46%), anemia (29%), malnutrition (26%), and diabetes (20%). Cases with obesity or diabetes were associated with all histories of remote orthopedic infection, 89% of urinary tract infections, and 72% of anemia cases. The high prevalence of several modifiable risk factors demonstrates that there are multiple opportunities for perioperative optimization of such comorbidities. PMID:23890832

Pruzansky, Jason S; Bronson, Michael J; Grelsamer, Ronald P; Strauss, Elton; Moucha, Calin S

2014-02-01

176

Surgical Outcome in Patients with Gastrointestinal Malignancies; A Report from a Large Referral Hospital, 2008-2010  

PubMed Central

BACKGROUND A considerable portion of gastrointestinal malignancies undergoes surgerywithout curative resection. This study was conducted to assess surgical outcomein patients with gastrointestinal cancers. METHODS We reviewed individuals with esophagus, stomach, colon and rectum cancersadmitted for surgical treatment after initial preoperative evaluations. Surgicaloutcome, stage of tumors and 1 and 5 years survival rate were assessedand analyzed. RESULTS Two hundred and fifty five patients with esophagus, stomach and colorectalmalignancies, who were admitted for surgical resection, were reviewed. Twohundred and twenty two patients were underwent surgery but tumor was not resectedin 41 cases (18.6%). Based on pathological assessment, stage of tumorswas III or IV in 108 individuals (48.9%). The proportion of tumor with advancedstage was significantly higher in patients with gastroesophageal cancersthan those with colorectal malignancies (62.6% versus 31.6%), p<0.0001). Theproportion of non-resectable tumor was also significantly higher in patientswith esophageal and gastric cancers (p=0.0001). Palliative surgery was donein 26.1% of patients treated by surgical resection. The proportion of palliativesurgery was significantly lower in patients with gastric cancer (p=0.001). 1 and5-year survival were significantly longer in colorectal cancer and those withcurative surgery (p=0.001). Survival of patients with palliative resection wasthe same as patient without tumor resection. CONCLUSION Despite preoperative evaluations, there are still a considerable proportionof patients who are diagnosed as inoperable during surgery. Further researchesseem to be necessary in order to provide more precise preoperative staging.Screening programs should also be considered for GI cancers in high-risk areas.It seems that palliative resection would not improve survival of patientswith advanced GI malignancies.

Soroush, Ahmadreza

2013-01-01

177

Army Business Transformation - Next Steps.  

National Technical Information Service (NTIS)

As a follow-on to the Army Science Board 2005 Summer Study on Best Practices, the Army Science Board was tasked to identify areas where alternative approaches and application of transforming practices and policy could benefit the Army in the areas of: (1)...

2006-01-01

178

Circulating immune parameters predicting the progression from hospital-acquired pneumonia to septic shock in surgical patients  

Microsoft Academic Search

INTRODUCTION: Hospital-acquired pneumonia after surgery is one of the major causes of septic shock. The excessive inflammatory response appears to be responsible for the increased susceptibility to infections and subsequent sepsis. The primary aim of this study was to investigate immune parameters at the onset of pneumonia, before the development of subsequent septic shock. The secondary aim was to investigate

Vera von Dossow; Koschka Rotard; Uwe Redlich; Ortrud Vargas Hein; Claudia D Spies

2005-01-01

179

Army Strong, Superintendent Savvy  

ERIC Educational Resources Information Center

Brigadier General Anthony "Tony" Tata of the U.S. Army had one of those "ah-ha" moments in April 2006 when, on the eve of an operation he was heading in Afghanistan, an Al Qaeda rocket shattered a nearby school. The attack killed a teacher and seven students and wounded dozens more. The rocket incident eventually nudged Tata toward a new mission:…

Mellon, Ericka

2011-01-01

180

Women in the Army.  

National Technical Information Service (NTIS)

This study examines the historical background, the present situation and the future indicators of the role women will play in the Army. It addresses the series of events that have contributed to the expanded utilization of women. The thesis presents the s...

A. G. Riolo

1980-01-01

181

Army Reserve and Vietnam.  

National Technical Information Service (NTIS)

The 1968 decision to mobilize units of the Army Reserve came three years after Secretary of Defense Robert McNamara first raised the idea with President Lyndon Johnson. In May and June of 1965, South Vietnamese forces suffered a string of defeats, and in ...

J. T. Currie

1984-01-01

182

Army Back Complaint Program.  

National Technical Information Service (NTIS)

The Army Back Complaint (ABC) Program packet provides recommended actions to develop and implement successful installation of ABC Programs. It is designed to be an educational tool to prevent injuries to the back, shoulder, or neck areas primarily as a re...

1988-01-01

183

2009 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Civilians.  

National Technical Information Service (NTIS)

Since 2005, the Annual Survey of Army Leadership (CASAL) has been an established effort by the Center for Army Leadership (CAL), Combined Arms Center (CAC) to assess and track trends in Army leader attitudes of leader development, the quality of leadershi...

J. P. Steele R. Riley

2010-01-01

184

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

Microsoft Academic Search

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

J. Gnanaraj; Lau Ye Xiang Jason; Hannah Khiangte

2007-01-01

185

[Cost analysis in nosocomial infections. A 1-year study in the Surgical Department of Riesa District Hospital].  

PubMed

A one-year investigation of 1.007 postoperative patients gave a nosocomial infection rate of 16.7 per cent, with wound infections accounting for 12.8 per cent and being on top of the list. Operations were subdivided by five groups (A-E), according to contamination of the surgical wound. Nosocomial infections were found to extend postoperative hospitalisation by 11 days and postoperative absenteeism from work by 20 days on average. The increased expenditures per patient by 6.350.- Marks on average, broken down by 1.950.- Marks for additional treatment and 4.400.- Marks for social services. PMID:3442144

Schäfer, U

1987-01-01

186

Predictors of hospital mortality in type A aortic dissections: a retrospective analysis of 148 consecutive surgical patients  

Microsoft Academic Search

Reports in the literature frequently concern miscellaneous types of dissections. This makes correct interpretation of data difficult. In order to assess the determinants of hospital mortality, the results of 148 consecutive patients over a 23-year period, all operated on for a type A dissection, were reviewed. Mean(s.d.) age was 56(13.1) years, 64% were male. An acute dissection (surgery within 14

1997-01-01

187

Central Materiel Services at Madigan Army Medical Center: A Case Study.  

National Technical Information Service (NTIS)

A case study of the Central Materiel Services department at Madigan Army Medical Center was conducted in three phases to establish inventory levels of equipment located throughout the clinical areas of the hospital, to determine stockage levels of the mos...

D. A. Bitterman

1995-01-01

188

High prevalence of methicillin resistant Staphylococcus aureus in the surgical units of Mulago hospital in Kampala, Uganda  

PubMed Central

Background There is limited data on Methicillin resistant Staphylococcus aureus (MRSA) in Uganda where, as in most low income countries, the routine use of chromogenic agar for MRSA detection is not affordable. We aimed to determine MRSA prevalence among patients, healthcare workers (HCW) and the environment in the burns units at Mulago hospital, and compare the performance of CHROMagar with oxacillin for detection of MRSA. Results One hundred samples (from 25 patients; 36 HCW; and 39 from the environment, one sample per person/item) were cultured for the isolation of Staphylococcus aureus. Forty one S. aureus isolates were recovered from 13 patients, 13 HCW and 15 from the environment, all of which were oxacillin resistant and mecA/femA/nuc-positive. MRSA prevalence was 46% (41/89) among patients, HCW and the environment, and 100% (41/41) among the isolates. For CHROMagar, MRSA prevalence was 29% (26/89) among patients, HCW and the environment, and 63% (26/41) among the isolates. There was high prevalence of multidrug resistant isolates, which concomitantly possessed virulence and antimicrobial resistance determinants, notably biofilms, hemolysins, toxin and ica genes. One isolate positive for all determinants possessed the bhp homologue which encodes the biofilm associated protein (BAP), a rare finding in human isolates. SCCmec type I was the most common at 54% prevalence (22/41), followed by SCCmec type V (15%, 6/41) and SCCmec type IV (7%, 3/41). SCCmec types II and III were not detected and 10 isolates (24%) were non-typeable. Conclusions Hyper-virulent methicillin resistant Staphylococcus aureus is prevalent in the burns unit of Mulago hospital.

2011-01-01

189

Outcome of Trans-Axillary Approach for Surgical Decompression of Thoracic Outlet: A Retrospective Study in a Tertiary Care Hospital  

PubMed Central

Objective The aim of this study was to evaluate the trans-axillary surgical approach in patients with thoracic outlet syndrome. Methods This retrospective study is comprised of data acquired from January 1998 until Oct 2008. Case histories of all the patients were reviewed from the Medical Records Department of Sher-i-Kashmir Institute. Relevant information and follow-up of the patients was carried out by examining the relevant clinical notes available by telephone interviews and personal contact whenever possible. All data was compiled and analyzed statistically. Results There were a total of 139 patients. The female: male ratio was about 6:1. Pain was the most common presenting symptom followed by weakness and parasthesia. Nerve conduction velocity was abnormal in 111 patients. Twenty-eight patients had abnormal Doppler study of subclavian vessels. Preoperative symptoms persisted in 13 patients. Overall, 126 patients showed improvement in symptoms and no recurrence or persistence of symptoms on follow-up examination. Conclusion Trans-axillary approach provides a good exposure and cosmesis in patients with thoracic outlet syndrome. It should be considered as the gold standard in the management of thoracic outlet syndrome.

Lattoo, Mohd Riyaz; Dar, Abdul Majeed; Wani, Mohd Lateef; Bhat, Mohd Akbar; Ahangar, Abdul Gani; Lone, Gh Nabi; Singh, Shyam; Zaman, Muzaffar; Lone, Reyaz Ahmad

2014-01-01

190

Filmless radiology at Brooke Army Medical Center  

NASA Astrophysics Data System (ADS)

The hospital at Brooke Army Medical Center in San Antonio, Texas has an essentially filmless radiology department. Mammography is one of the few services still using film. The radiology department at Brooke takes advantage of a very capable Lockheed Martin PACS to achieve the filmless operation. The old hospital has been replaced by a new hospital, the new Brooke Army Medical Center. As a basis for predictions of activity at new Brooke, the activities at the old Brooke Army Medical Center were examined. The heart of the PACS at Brooke is the image server with an associated database. The image server has the performance required to keep the radiologist from returning to film for diagnosis. A directly connected workstation can present a full screen of images in less than two seconds, even during the busiest hour of the day for this large hospital. In addition the database is used to organize the workflow for the radiology examinations through the hospital. Information about the activity at the new Brooke hospital is used to predict the utilization of the short term storage and the long term storage. In particular, the time that an examination will be retained on the new Brooke short term storage is measured. The Brooke medical complex generates 384.8 exams per day on a typical weekday. The number of exams on a weekend is 40 percent of the exams on the weekday. The storage required is 18.3 gigabytes per day in the short term storage of the Image Storage Unit (ISU) and 9.7 gigabytes per day in the archive. The 256 gigabytes of the ISU will hold 11.7 weeks or about 2.5 months of exams. The archive will hold four years of exams in tow jukeboxes. A working year will have an effective 300 days of equivalent weekday radiology load. By ten years from now the hospital complex can be expected to handle to load that is estimated to be about 160 percent of the current load. With the changes in the storage of disks and archive media that will have occurred by that time, the number of weeks of storage will be greater than that held now.

Wilson, Dennis L.

1997-05-01

191

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

192

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

193

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

194

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

195

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

196

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

197

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

198

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

199

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

200

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

201

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

PubMed Central

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.

2012-01-01

202

Integrating the 'TDA Army' into the 'Total Army'.  

National Technical Information Service (NTIS)

To meet today's full spectrum of mission requirements, the Army must maintain a broad range of land-force capabilities to support US joint commands and coalitions around the world. In consolidating its resources, the Army has failed to recognize, understa...

D. J. Kubik

1999-01-01

203

Army Science Board Ad Hoc Subgroup Report, Manning Army Systems.  

National Technical Information Service (NTIS)

This study examines the manning impliccations of fielding new Army equipment focusing on the potential personnel impact of complex systems. The impetus for this study was the growing concern that the Army might not be able to operate and maintain new tech...

J. Sternberg A. J. Alexander L. F. Chapman K. C. Emerson P. P. Sidwell

1982-01-01

204

US Army Medical Research and Development Report.  

National Technical Information Service (NTIS)

The Annual Progress Report, Fiscal Year 1979, summarizes research performed by the US Army Medical Bioengineering Research and Development Laboratory in projects authorized by The Surgeon General, US Army, and the Commander, US Army Medical Research and D...

J. N. Albertson

1979-01-01

205

Green Procurement: Army Progress, Installation Challenges.  

National Technical Information Service (NTIS)

The purpose is to provide information on the status of new initiatives for the advancement of the Army Green Procurement Program (GPP). The presentation contains the following sections: Army Policy Update, Army Strategy Document, Installation GPP Developm...

B. Martin

2011-01-01

206

Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: A tertiary hospital experience  

PubMed Central

Background Perforated peptic ulcer is a serious complication of peptic ulcers with potential risk of grave complications. There is paucity of published reports on perforated peptic ulcer disease in our local environment. This study was conducted to evaluate the clinical presentation, management and outcome of patients with peptic ulcer perforation in our setting and to identify predictors of outcome of these patients. Methods This was a combined retrospective and prospective study of patients who were operated for perforated peptic ulcers at Bugando Medical Centre between April 2006 and March 2011. Data were collected using a pre-tested and coded questionnaire and analyzed using SPSS computer software version 15.0. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study. Results A total of 84 patients were studied. Males outnumbered females by a ratio of 1.3: 1. Their median age was 28 years and the modal age group was 21-30 years. The median duration of illness was 5.8 days. The majority of patients (69.0%) had no previous history of treatment for peptic ulcer disease. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking was reported in 10.7%, 85.7% and 64.3% respectively. Eight (9.5%) patients were HIV positive with a median CD4 count of 220 cells/?l. Most perforations were located on the duodenum {90.4%) with the duodenal to gastric ulcers ratio of 12.7: 1. Graham's omental patch (Graham's omentopexy) of the perforations was performed in 83.3% of cases. Complication and mortality rates were 29.8% and 10.7% respectively. The factors significantly related to complications were premorbid illness, HIV status, CD 4 count < 200 cells/?l, treatment delay and acute perforation (P < 0.001). Mortality rate was high in patients who had age ? 40 years, delayed presentation (>24 hrs), shock at admission (systolic BP < 90 mmHg), HIV positivity, low CD4 count (<200 cells/?l), gastric ulcers, concomitant diseases and presence of complications (P < 0.001). The median overall length of hospital stay was 14 days. Excellent results using Visick's grading system were obtained in 82.6% of surviving patients. Conclusion Perforation of peptic ulcer remains a frequent clinical problem in our environment predominantly affecting young males not known to suffer from PUD. Simple closure with omental patch followed by Helicobacter pylori eradication was effective with excellent results in majority of survivors despite patients' late presentation in our center.

2011-01-01

207

Army Transformation: A Cultural Change.  

National Technical Information Service (NTIS)

Over the past seven years the Army has undergone one of the most aggressive periods of change in its long history. While almost completely engaged with the Global War on Terrorism, the Army has simultaneously modernized its legacy fleet, developed and dep...

R. T. King

2008-01-01

208

Army Energy Security Implementation Strategy.  

National Technical Information Service (NTIS)

Historically, the Army operated with the assumption that low cost energy would be readily available when and where it is needed. Now, however, reliable access to affordable, stable energy supplies is a significant challenge for the Army and the nation. Gi...

2009-01-01

209

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

PubMed Central

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.

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

2011-01-01

210

British army leadership: is it gendered?  

Microsoft Academic Search

Purpose – The purpose of this paper is to examine the role of the female British Army officer, to determine whether female Army officers lead in different ways to male Army officers. Design\\/methodology\\/approach – The conceptual framework was transformational and transactional leadership theory. Data were gathered in semi structured interviews with 24 Army officers, split 50:50 between men and women

Michael Dunn

2007-01-01

211

Army Alternative Ground Fuels Qualification.  

National Technical Information Service (NTIS)

Introduction: Tank Automotive Research, Development, and Engineering Center (TARDEC) Mission and Portfolio - Responsibilities as DOD Executive Agent for Ground Fuels & Lubricants. Why Alternative Fuels: - Payback - What Army Leaders Are Saying About Energ...

P. Muzzel

2012-01-01

212

Army Heart Monitor -- Model Iv.  

National Technical Information Service (NTIS)

Model IV of the Army Heart Monitor is an electronic device that monitors the electrocardiogram (ECG); sounds an alarm on diagnosing a high or low heart rate, excess electrical noise, cardiac arrest, or ventricular fibrillation; and displays the diagnosis ...

C. W. Ragsdale

1970-01-01

213

32 CFR 655.10 - Army entities on Army land (AR 385-11).  

Code of Federal Regulations, 2010 CFR

...ENVIRONMENTAL QUALITY] [Part 655 - RADIATION SOURCES ON ARMY LAND] [Sec. 655.10 Use of Radiation Sources by Non - Army entities on Army...true 655.10 Sec. 655.10 Use of radiation sources by non NATIONAL DEFENSE...

2003-01-01

214

32 CFR 655.10 - Army entities on Army land (AR 385-11).  

Code of Federal Regulations, 2010 CFR

...ENVIRONMENTAL QUALITY] [Part 655 - RADIATION SOURCES ON ARMY LAND] [Sec. 655.10 Use of Radiation Sources by Non - Army entities on Army...true 655.10 Sec. 655.10 Use of radiation sources by non NATIONAL DEFENSE...

2004-01-01

215

32 CFR 655.10 - Army entities on Army land (AR 385-11).  

Code of Federal Regulations, 2010 CFR

...ENVIRONMENTAL QUALITY] [Part 655 - RADIATION SOURCES ON ARMY LAND] [Sec. 655.10 Use of Radiation Sources by Non - Army entities on Army...false 655.10 Sec. 655.10 Use of radiation sources by non NATIONAL DEFENSE...

2002-07-01

216

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

Federal Register 2010, 2011, 2012, 2013

...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...

2011-09-13

217

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

218

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.

219

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.

220

Suicide in the US Army  

PubMed Central

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.

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

2012-01-01

221

Changing Norms: Keeping Army Test and Evaluation Flexible and Adaptable.  

National Technical Information Service (NTIS)

As the Army leadership continues to shape the Army Force Generation (ARFORGEN) concept to generate continuous readiness that supports strategic flexibility and depth to the US Army warfighters, the US Army Test and Evaluation Command (ATEC) leadership con...

R. Crevecoeur

2010-01-01

222

Army ground robotics research program  

NASA Astrophysics Data System (ADS)

The U.S. Army has committed to a paradigm shift in the way future ground military operations will be conducted. It envisions highly mobile, lethal, and survivable forces that seamlessly combine manned and unmanned elements. To support this vision, the U.S. Army Research Laboratory, together with an alliance of government, industrial and academic organizations, has embarked upon a concerted research program focusing upon development of the technologies required for autonomous ground mobility by unmanned systems. This paper will discuss technical activities of the past year and research directions for the future.

Bornstein, Jonathan A.

2002-07-01

223

Army Knowledge Management (AKM): Challenges Ahead.  

National Technical Information Service (NTIS)

Challenges exist in the areas of information technology and knowledge sharing throughout the Army. Organizations have tremendous amounts of information on computers but find it hard to share the information or knowledge outside of their community. Army Kn...

J. J. Bryant

2002-01-01

224

Army Reserve Engineering Pilot Program Savings Validation.  

National Technical Information Service (NTIS)

The Army Materiel Command (AMC) has been assigned the responsibility to establish and monitor the Army reverse engineering program. AMC has implemented the reverse engineering program through selected AMC Major Subordinate Commands (MSCs). The basic AMC p...

T. Worthington V. S. Bakhshi

1989-01-01

225

76 FR 12087 - Army Educational Advisory Committee  

Federal Register 2010, 2011, 2012, 2013

...the Army Education Advisory Committee. Dates of Meeting: 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:...

2011-03-04

226

Value Added Analysis for Army Equipment Modernization.  

National Technical Information Service (NTIS)

This paper describes the Value Added Analysis methodology which was used as part of the US Army's Planning, Programming, Budgeting, and Execution System to assist the Army leadership in evaluating and prioritizing competing weapon system alternatives duri...

A. G. Loerch R. R. Koury D. T. Maxwell

1995-01-01

227

Sustaining Army Civilians: Senior Leaders' Responsibility.  

National Technical Information Service (NTIS)

The most important Army asset is human capital. It is imperative that individuals on every level operate within the team to guarantee mission accomplishment. Developing quality professional Department of the Army Civilian (DAC) leaders provides a foundati...

G. A. Wait

2012-01-01

228

Tattooed Army Soldiers: Incidence, Behavior, and Risk.  

National Technical Information Service (NTIS)

Primary prevention is a priority for Army Medical Personnel. Despite societal popularity and a long association of tattooing in the military, little is known about the tattooed Army soldier, thus hampering primary health planning. Basic Recruits and Advan...

M. L. Armstrong

1998-01-01

229

Developing an Army Water Security Strategy.  

National Technical Information Service (NTIS)

Water Security Definition: The capacity to ensure that water of suitable quality is provided at a sustained rate sufficient to support all current and future Army missions as needed. Army water security should include deliberate efforts to minimize direct...

J. MacDonald-Wimbush M. Kodack

2011-01-01

230

Army Management Views, Volume Xv, Book Ii.  

National Technical Information Service (NTIS)

The document contains articles on management: Management at the DA level, management of major and intermediate Army commands, management at an Army installation, family housing management, industrial management, management and operations, and research/sys...

C. W. Dahlgren E. Bennewitz E. M. Becker M. Summers W. C. Gribble

1970-01-01

231

Training Strategies for Newly Designed Army Headquarters.  

National Technical Information Service (NTIS)

Agenda: *Recent organization history of Army Headquarters *Current view of Full Spectrum Operations -Combat (Offense, Defense) and Stability - Joint Operational Concepts -- USG policies -Secretary of the Army Functions *Organizing for Operations and Funct...

M. Gerner

2008-01-01

232

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

PubMed

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

Ségal, Alain; Ferrandis, Jean-Jacques

2012-01-01

233

Army Science Board 1988 Summer Study Army Testing.  

National Technical Information Service (NTIS)

The purpose of the study was to provide the Army with an assessment of the philosophy, methodology and effectiveness of its test program and to suggest ways by which the test and evaluation process could be improved in order to assure sound test programs ...

D. R. Horn D. Strother R. J. Baer

1989-01-01

234

Army Family Policies and Practices: A Summary of Regulations, Letters, Pamphlets, and Circulars That Impact on Army Families.  

National Technical Information Service (NTIS)

This report on Army family policies and practices lists and abstracts those Army policies that affect Army families. In addition, the report summarizes selected Army Regulations (ARs), DA Pamphlets (DA PAMs), and Training Circulars (TCs) and categorizes t...

M. Tankersley, K. Coolbaugh, J. Barokas

1990-01-01

235

U.S. Army Social Media Handbook.  

National Technical Information Service (NTIS)

The Army recognizes that social media has the ability to communicate with larger audiences faster and in new ways. It has become an important tool for Army messaging and outreach. The Army uses a variety of social media platforms designed to support a ran...

2011-01-01

236

Job Satisfaction Among Army Pharmacists.  

National Technical Information Service (NTIS)

The purpose of this study was to determine whether active duty Army pharmacists are satisfied with their job and further, to examine factors that may uniquely effect their job satisfaction. Job satisfaction was measured using a modified four-page question...

P. T. Bulato

1998-01-01

237

PEOPLE'S LIBERATION ARMY AFTER NEXT.  

National Technical Information Service (NTIS)

The 1999 PLA Conference, which was hosted jointly by the American Enterprise Institute and the U.S. Army War College's Strategic Studies Institute, convened September 10-12, 1999, at Carlisle Barracks, Pennsylvania. The goal of this conference was to comp...

S. M. Puska

2000-01-01

238

The Army's Delayed Entry Program  

Microsoft Academic Search

The Delayed Entry Program, which allows individuals to delay reporting for active duty up to 12 months after signing enlistment contracts, is a valuable management tool used by the U.S. Army Recruiting Command and other U.S. military recruiting organizations. Attrition from this program increases recruiting costs and reduces training efficiency. DEP attrition is analyzed here using microdata for individuals who

Cyril E. Kearl; Abraham Nelson

1992-01-01

239

Racial Extremism in the Army.  

National Technical Information Service (NTIS)

In this thesis I examine the problem of white supremacist extremism in the Army. I begin by analyzing the phenomenon in general. First, I define extremism in general, and then give a summary history of white racial extremism in the United States, to inclu...

W. M. Hudson

1998-01-01

240

Surgical morbidity and mortality meetings.  

PubMed Central

Morbidity and mortality meetings aim to improve the standards of surgical care, and are now required in all hospitals responsible for training junior surgical staff. If they are to receive support and achieve their aim, they must be carefully planned and well organised. This paper outlines considerations in setting up morbidity meetings and in making them a success.

Campbell, W. B.

1988-01-01

241

Tratamento cirúrgico do tumor de corpo carotídeo: experiência de 30 anos do Hospital de Clínicas da UFPR Surgical treatment of the carotid body tumor: a 30-year experience  

Microsoft Academic Search

Objective: Carotid body tumors are rare and they must always be part of the differential diagnosis of tumor masses in the cervical region. Advances in vascular surgical techniques have reduced the risks of perioperative complications such as carotid injury, stroke and death. The objective of this article is to report the authors' experience in 20 carotid body tumor resections. Methods:

Luís Henrique; Gil França; Caroline Gomes Bredt; Alessandra Vedolin

242

Army Precision at Central Headquarters  

ERIC Educational Resources Information Center

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…

Goldman, Jay P.

2005-01-01

243

Army pushes new weapons effort  

Microsoft Academic Search

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

C. A. Robinson Jr.

1978-01-01

244

Surgical Options  

MedlinePLUS

... Treatments for Spinal Pain Surgical Options Anterior Cervical Fusion Artificial Disc Replacement Bone Graft Alternatives Bone Morphogenetic ... Discectomy Percutaneous Vertebral Augmentation Posterior Cervical Foraminotomy Spinal Fusion ... Medicine Surgical Options Anterior Cervical ...

245

Medicare program; hospital outpatient prospective payment system and CY 2007 payment rates; CY 2007 update to the ambulatory surgical center covered procedures list; Medicare administrative contractors; and reporting hospital quality data for FY 2008 inpatient prospective payment system annual payment update program--HCAHPS survey, SCIP, and mortality. Final rule with comment period and final rule.  

PubMed

This final rule with comment period revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system, and to implement certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and the Deficit Reduction Act (DRA) of 2005. In this final rule with comment period, we describe changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2007. In addition, this final rule with comment period implements future CY 2009 required reporting on quality measures for hospital outpatient services paid under the prospective payment system. This final rule with comment period revises the current list of procedures that are covered when furnished in a Medicare-approved ambulatory surgical center (ASC), which are applicable to services furnished on or after January 1, 2007. This final rule with comment period revises the emergency medical screening requirements for critical access hospitals (CAHs). This final rule with comment period supports implementation of a restructuring of the contracting entities responsibilities and functions that support the adjudication of Medicare fee-for-service (FFS) claims. This restructuring is directed by section 1874A of the Act, as added by section 911 of the MMA. The prior separate Medicare intermediary and Medicare carrier contracting authorities under Title XVIII of the Act have been replaced with the Medicare Administrative Contractor (MAC) authority. This final rule continues to implement the requirements of the DRA that require that we expand the "starter set" of 10 quality measures that we used in FY 2005 and FY 2006 for the hospital inpatient prospective payment system (IPPS) Reporting Hospital Quality Data for the Annual Payment Update (RHQDAPU) program. We began to adopt expanded measures effective for payments beginning in FY 2007. In this rule, we are finalizing additional quality measures for the expanded set of measures for FY 2008 payment purposes. These measures include the HCAHPS survey, as well as Surgical Care Improvement Project (SCIP, formerly Surgical Infection Prevention (SIP)), and Mortality quality measures. PMID:17133695

2006-11-24

246

Parietal Lobe Epilepsy: Surgical Treatment and Outcome  

Microsoft Academic Search

Objective: Parietal lobe epilepsy (PLE) is neither common nor easily diagnosed because of its variable clinical features. To elucidate its characteristics and surgical outcome, the authors reviewed their surgical experiences. Methods: Between September 1994 and August 2001, 38 patients with PLE received surgical treatment at the Seoul National University Hospital. All patients underwent resection, mainly involving the parietal lobe. Results:

Chi Heon Kim; Chun-Kee Chung; Sang Kun Lee; Yoon Kyung Lee; Je G. Chi

2004-01-01

247

Surgical proctoring for gynecologic surgery.  

PubMed

Surgical proctoring allows a hospital's credentialing committee to objectively monitor, regulate, or oversee surgical privileging for its medical staff to ensure the safety and quality of care for its patients. The surgical proctor does not participate directly in patient care and does not establish a patient-physician relationship before the procedure and therefore is under no obligation to intervene if an intraoperative complication occurs or substandard care is witnessed. Good Samaritan legislation enacted in every state should provide immunity for the proctoring physician if intervention is necessary. Teleproctoring may become the most cost-effective method for institutions that are unable to identify a local proctor for surgical privileging. PMID:24402592

Heit, Michael

2014-02-01

248

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

ERIC Educational Resources Information Center

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…

Bell, Nicole S.

2009-01-01

249

Responding to the Call to Transform the Army Culture.  

National Technical Information Service (NTIS)

With the rate of change outside the Army accelerating, the need exists to create an Army organization that can accelerate the change inside the Army. This paper explores the Army culture required to excel in a world of accelerating change; an Army culture...

C. H. Driessanck

2003-01-01

250

Total Army 21st Century: A Selected Bibliography.  

National Technical Information Service (NTIS)

This bibliography supports the 'Total Army-21st Century' special theme of the U.S. Army War College's curriculum. Focusing on the Army National Guard, the Army Reserve, and the Active Army, it lists materials that will assist researchers in understanding ...

1999-01-01

251

Army Meter Data Management System (MDMS): A Case Study for Army MDMS Pilot.  

National Technical Information Service (NTIS)

What is the Army Meter Data Management System (MDMS). MDMS is an enterprise system to track the Army's energy and water consumption worldwide. It tracks meter data from advanced utility meters in a central database (MDMS Enterprise); automates meter data ...

C. Jones

2011-01-01

252

Army Business Transformation: The Utility of Using Corporate Business Models within the Institutional Army.  

National Technical Information Service (NTIS)

This thesis investigates the utility of transforming the Institutional Army through the use of corporate business models. Through a survey of the literature of published corporate business plans and models, military reports, Army depot case studies, and c...

J. J. Bailer

2007-01-01

253

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

National Technical Information Service (NTIS)

The Army has established a program to implement distance learning (DL) throughout both its Active and Reserve Component training systems and institutions. At the request of the Army's Deputy Chief of Staff for Personnel (DCSPER), RAND Arroyo Center undert...

M. G. Shanley H. A. Leonard J. D. Winkler

2001-01-01

254

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

255

32 CFR 651.5 - Army policies.  

Code of Federal Regulations, 2010 CFR

...integrated into other environmental reporting requirements...documentation. (10) Environmental analysis of strategic...goals for important environmental resources; (iii) Monitoring... (v) Adaptive management of Army...

2009-07-01

256

32 CFR 651.5 - Army policies.  

Code of Federal Regulations, 2010 CFR

...integrated into other environmental reporting requirements...documentation. (10) Environmental analysis of strategic...goals for important environmental resources; (iii) Monitoring... (v) Adaptive management of Army...

2010-07-01

257

Perspectives on Suicide in the Army National Guard.  

National Technical Information Service (NTIS)

Suicides in the US military were observed rising in 2004, most notably in the Army and Marine Corps, and particularly, in the Army National Guard (ARNG). Alarmed, Army leaders and researchers have offered various explanations and prescriptions, often lack...

J. Griffith M. Vaitkus

2013-01-01

258

World-Class Army Adaptive Training: Next Steps.  

National Technical Information Service (NTIS)

The future operating environment, combat lessons learned, and recent doctrine changes demand that the U.S. Army continually adapt its training. This paper will demonstrate that Army training objectives are clearly stated, show the Army is already pursuing...

C. Chappell G. W. Johnston

2009-01-01

259

U. S. Army Medical Department Journal, October-December 1999.  

National Technical Information Service (NTIS)

Clinical and nonclinical professional information designed to keep U. S. Army Medical Department personnel informed of healthcare, research, and combat and doctrine development information. The Army Medical Dept. Journal is prepared quarterly for the Army...

B. Nelson

1999-01-01

260

Army 'Reserve Components Transformation: Strategy for the 21st Century.  

National Technical Information Service (NTIS)

The Army reserve components need a 'transformation' strategy. 'Army Transformation' is underway, focused on sustaining the Legacy Force during transformation, building an Interim Force, and ultimate conversion to an Objective Force. While the 'Army Transf...

R. C. Hargreaves

2001-01-01

261

Historic Properties Report: Kansas Army Ammunition Plant, Parsons, Kansas.  

National Technical Information Service (NTIS)

This report represents the results of an historic properties survey of Kansas Army Ammunition Plant. Prepared for the United States Army Materiel Development and Readiness Command (DARCOM), the report is intended to assist the Army in bringing this instal...

J. Mueller L. B. Burns

1984-01-01

262

Department of the Army Acquisition Streamlining Course Notebook.  

National Technical Information Service (NTIS)

The purpose of the Army Streamlined Acquisition Program (ASAP) course is to make the Army acquisition management community more fully aware of the Army's acquisition streamlining initiatives and to provide insights into how they can be used to improve the...

1989-01-01

263

Marital and Job Satisfaction and Retention in the Army.  

National Technical Information Service (NTIS)

This paper has presented the results from two studies designed to illuminate the relationships among the Army experience, family life, job satisfaction, and intention to remain in the Army. The results from the first study indicated several areas of Army ...

J. C. Woefel J. M. Savell

1978-01-01

264

Aviation medicine and the Army.  

PubMed

The purpose of this short series of articles is not to present the reader with a vast amount of technical data, soon to be forgotten, but to provide some items of general interest from the past, present, and future of Army aviation. Obviously there will be a concentration on medical matters, but the aim is to give the reader a feel for the rapid progress being made in helicopter design and the likely problems we may face in the future. The first article serves as an introduction to the series and three further articles will cover various aspects of the speciality. The second will be concerned with AAC helicopter accidents and will include accident investigation, crashworthiness and the contribution made by pilot error. The third article will cover major environmental problems of helicopters, particularly noise, vibration and thermal stress. The fourth article will examine ways in which microprocessors and modern technology will affect future helicopter and ancillary equipment development; for instance, a helicopter with no external windows has been suggested, 'The Iron Cockpit'. The fifth article will be concerned with the clinical aspects of Army Aviation medicine. PMID:6396409

Vyrnwy-Jones, P; Thornton, R

1984-10-01

265

Trust: Implications for the Army Profession.  

National Technical Information Service (NTIS)

TRUST IS AT the heart of the Army Profession. As the Army transitions from an era of substantial operational deployments to an era characterized by training and preparing the force for the next series of conflicts, it will face several threats to trust. A...

C. D. Allen I. W. Braun

2013-01-01

266

Factors Influencing Job Satisfaction among Army Chaplains.  

National Technical Information Service (NTIS)

This research on job satisfaction among US Army chaplains is based on a mail survey response of 998 chaplains out of 1411 in the Army chaplaincy. Factors which influence job satisfaction were explored by means of a three-fold model: (1) How chaplains see ...

K. D. Johnson

1976-01-01

267

Current Trends in Army Social Work.  

National Technical Information Service (NTIS)

Although no formal 'State of the Army Social Work Program' presentation was included in the 1974 Current Trends in Army Social Work Course schedule, the Course Director suggested and it seems appropriate to include a few observations in this documentary t...

1974-01-01

268

Utility of Ada for Army Modeling.  

National Technical Information Service (NTIS)

The Ada computer programming language was developed by the Department of Defense. The DoD has mandated its use as the single, common high-order language. A US Army Audit Agency audit of the Army Models Improvement Program found that Ada is not being used ...

M. L. Yocom

1990-01-01

269

Army Medium Trucks: Acquisition Plans Need Safeguards.  

National Technical Information Service (NTIS)

The Army is modernizing its fleet of medium tactical vehicles through the Family of Medium Tactical Vehicles (FMTV) program, which is one of the Army's largest acquisition programs at a projected cost of $15.7 billion. From fiscal year 1991 through fiscal...

1998-01-01

270

Army Deployments of OIF and OEF.  

National Technical Information Service (NTIS)

In October 2008, the Vice Chief of Staff of the U.S. Army asked the RAND Arroyo Center to assess the demands placed upon the Army by the continuing deployments of soldiers to operations in Iraq and Afghanistan. In this analysis, numerous questions were ad...

D. Baiocchi L. L. McDonald T. M. Bonds

2010-01-01

271

Army Requirements for Digital Topographic Data.  

National Technical Information Service (NTIS)

The Engineer Topographic Lab recently completed a study which assessed the digital topographic data (DTD) needs of the US Army, The overall objective was to define Army DTD requirements for the Defense Mapping Agency (DMA) in order to allow them to consol...

R. A. Herrmann

1985-01-01

272

Future Army Bandwidth Needs and Capabilities.  

National Technical Information Service (NTIS)

Across the services, there is an increasing demand for communications capacity. For the U.S. Army, this is a result of the Army's transition to a new force structure that will be knowledge-based and network-centric. Since bandwidth facilitates communicati...

L. Joe I. Porche

2004-01-01

273

The Imperial Japanese Army and Politics  

Microsoft Academic Search

Much available literature on the military and politics in the imperial Japanese army has explained the various motives that led to the military's intervention in politics. The primary assumption of these previous analyses is that the soldiers were very conscious of their intervention. On the contrary, this article contends that the soldiers of the imperial Japanese army did not realize

Yoshihisa Nakamura; Ryoichi Tobe

1988-01-01

274

The MOVES institute's America's army operations game  

Microsoft Academic Search

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.

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

2003-01-01

275

Army Cultural Change and Effective Media Relations.  

National Technical Information Service (NTIS)

This paper focuses on the Army's need to be more successful in communicating its side of the story to American and international publics. It posits that Army culture and climate must continue to change in a way that encourages a more open relationship wit...

D. L. Baggio

2006-01-01

276

An Improved Differential Army Classification System.  

ERIC Educational Resources Information Center

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…

Maier, Milton H.; Fuchs, Edmund F.

277

Past, Present and Future of Army Dietetics.  

National Technical Information Service (NTIS)

The Army Medical Specialist Corps (AMSC) is one of six special branches within the Army Medical Department (AMEDD) that works together as part of the health care team in providing medical and health care to soldiers. The focus of this paper deals with the...

R. F. Lynch

1989-01-01

278

Occupational health and safety issues in military field hospitals.  

PubMed

This paper considers the occupational health and safety issues that apply within a military field hospital. It considers NHS occupational health and safety activities and examines how these might be applied within an Army Medical Services unit. Areas that are unique to field hospitals are highlighted in comparison with a static NHS hospital. Some issues for future work are also considered. PMID:11766206

Bricknell, M C

2001-10-01

279

Dental care needs of Army recruits.  

PubMed Central

To determine the prevalence amng current U.S. Army recruits of dental conditions requiring treatment, an assessment was done of the dental care needs of a 3 percent sample (N = 5,613) of incoming recruits at all seven U.S. Army reception stations that operate under a dental treatment planning concept. Both the treatment needs of the total sample and of each Army component--that is, Regular, Reserve, and National Guard forces--were quantified. The results indicated that the requirement for dental care among Army recruits currently being processed for training is approximately the same as it was for such recruits at the time that the Selective Service System draft was in effect, although the types of care needed have changed. Like the draft-based recruits, current Army recruits enter active-duty status with a substantial backlog of unmet dental care needs.

Parker, W A; Mangelsdorff, A D; Brunner, D G

1983-01-01

280

Surgical Simulation  

PubMed Central

Objective: To evaluate the effectiveness of surgical simulation compared with other methods of surgical training. Summary Background Data: Surgical simulation (with or without computers) is attractive because it avoids the use of patients for skills practice and provides relevant technical training for trainees before they operate on humans. Methods: Studies were identified through searches of MEDLINE, EMBASE, the Cochrane Library, and other databases until April 2005. Included studies must have been randomized controlled trials (RCTs) assessing any training technique using at least some elements of surgical simulation, which reported measures of surgical task performance. Results: Thirty RCTs with 760 participants were able to be included, although the quality of the RCTs was often poor. Computer simulation generally showed better results than no training at all (and than physical trainer/model training in one RCT), but was not convincingly superior to standard training (such as surgical drills) or video simulation (particularly when assessed by operative performance). Video simulation did not show consistently better results than groups with no training at all, and there were not enough data to determine if video simulation was better than standard training or the use of models. Model simulation may have been better than standard training, and cadaver training may have been better than model training. Conclusions: While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training.

Sutherland, Leanne M.; Middleton, Philippa F.; Anthony, Adrian; Hamdorf, Jeffrey; Cregan, Patrick; Scott, David; Maddern, Guy J.

2006-01-01

281

Comparison of minimally invasive surgical approaches for hysterectomy at a community hospital: robotic-assisted laparoscopic hysterectomy, laparoscopic-assisted vaginal hysterectomy and laparoscopic supracervical hysterectomy  

PubMed Central

The study reported here compares outcomes of three approaches to minimally invasive hysterectomy for benign indications, namely, robotic-assisted laparoscopic (RALH), laparoscopic-assisted vaginal (LAVH) and laparoscopic supracervical (LSH) hysterectomy. The total patient cohort comprised the first 237 patients undergoing robotic surgeries at our hospital between August 2007 and June 2009; the last 100 patients undergoing LAVH by the same surgeons between July 2006 and February 2008 and 165 patients undergoing LAVHs performed by nine surgeons between January 2008 and June 2009; 87 patients undergoing LSH by the same nine surgeons between January 2008 and June 2009. Among the RALH patients were cases of greater complexity: (1) higher prevalence of prior abdominopelvic surgery than that found among LAVH patients; (2) an increased number of procedures for endometriosis and pelvic reconstruction. Uterine weights also were greater in RALH patients [207.4 vs. 149.6 (LAVH; P < 0.001) and 141.1 g (LSH; P = 0.005)]. Despite case complexity, operative time was significantly lower in RALH than in LAVH (89.9 vs. 124.8 min, P < 0.001) and similar to that in LSH (89.6 min). Estimated blood loss was greater in LAVH (167.9 ml) than in RALH (59.0 ml, P < 0.001) or LSH (65.7 ml, P < 0.001). Length of hospital stay was shorter for RALH than for LAVH or LSH. Conversion and complication rates were low and similar across procedures. Multivariable regression indicated that LAVH, obesity, uterine weight ?250 g and older age predicted significantly longer operative time. The learning curve for RALH demonstrated improved operative time over the case series. Our findings show the benefits of RALH over LAVH. Outcomes in RALH can be as good as or better than those in LSH, suggesting the latter should be the choice primarily for women desiring cervix-sparing surgery.

Giep, Hoang N.; Hubert, Helen B.

2010-01-01

282

Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antimicrobial prophylaxis.  

PubMed Central

By use of techniques that have been developed to detect small numbers of methicillin-resistant staphylococci, we cultured samples from the nares and subclavian and inguinal areas of 29 patients before and after cardiac surgery and 10 patients before and after coronary angioplasty. Methicillin-resistant coagulase-negative staphylococci were recovered before the surgical or angioplasty procedure from 74% of patients. The quantitative recovery of methicillin-resistant isolates before cardiac surgery or coronary angioplasty was compared with the number of methicillin-resistant staphylococci detected at the same site 3 days after the procedure. In cardiac surgery patients (who received antibiotic prophylaxis), 17 of the 28 sites (61%) in which low-level colonization with methicillin-resistant strains was detected preoperatively contained high levels of methicillin-resistant staphylococci postoperatively. In contrast, coronary angioplasty patients (who did not receive antibiotic prophylaxis) did not have any of the 14 sites containing low levels of methicillin-resistant strains before angioplasty emerge to harbor high levels of methicillin-resistant staphylococci after angioplasty. Methicillin-resistant coagulase-negative staphylococci from each site in which high levels of methicillin-resistant staphylococci emerged postoperatively were paired with preoperative isolates from the same site. Identical antibiograms and plasmid profile patterns were demonstrated for seven of the pre- and postoperative isolate pairs, suggesting that the high levels of methicillin-resistant coagulase-negative staphylococci detected on the skin or in the nares after cardiac surgery were derived from methicillin-resistant organisms present at the site preoperatively in much smaller numbers. Images

Kernodle, D S; Barg, N L; Kaiser, A B

1988-01-01

283

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

PubMed

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

Raschka, Ch; Raschka, S; Peikert, T

2009-12-01

284

Modeling of Army Research Laboratory EMP simulators  

SciTech Connect

Models are required that permit the estimation of emitted field signatures from EMP simulators to design the simulator antenna structure, to establish the usable test volumes, and to estimate human exposure risk. This paper presents the capabilities and limitations of a variety of EMP simulator models useful to the Army's EMP survivability programs. Comparisons among frequency and time-domain models are provided for two powerful US Army Research Laboratory EMP simulators: AESOP (Army EMP Simulator Operations) and VEMPS II (Vertical EMP Simulator II).

Miletta, J.R.; Chase, R.J.; Luu, B.B. (Army Research Lab., Adelphi, MD (United States)); Williams, J.W.; Viverito, V.J. (Science Applications International Corp., Germantown, MD (United States))

1993-12-01

285

Pentomic Era. The U. S. Army between Korea and Vietnam.  

National Technical Information Service (NTIS)

In his history of the Army in the years between the Korean and Vietnam wars, Lieutenant Colonel A. J. Bacevich. US Army, accents the Army's mindfulness of the implications of nuclear warfare. The Army's concern, reflecting a complex mixing of institutiona...

A. J. Bacevich

1986-01-01

286

78 FR 64205 - Army Science Board Fall Plenary Meeting  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF DEFENSE Department of the Army Army Science Board Fall Plenary Meeting AGENCY: Department of the Army...Department of Defense cancelled the meeting of the U.S. Army Science Board on October 16, 2013. As a result, the...

2013-10-28

287

Army Transition Program: Time for Institutionalization or Termination.  

National Technical Information Service (NTIS)

This study examines the U. S. Army Transition Program. The thesis of the study is that the Army Transition Program is critical to meeting the needs of soldiers departing the Army voluntarily and involuntarily. Also, the program is critical to the Army in ...

R. F. Murtie

1996-01-01

288

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) , Ordnance Dept. U.S. Army, proposed addition to dock at Sandy Hook, 1918 Ordnance wharf and boathouse - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

289

Robotic surgical training.  

PubMed

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

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

2013-01-01

290

Army Reserve Training Seat Allocation Model.  

National Technical Information Service (NTIS)

This thesis reduces wasted Reserve training seats by one-fourth, improving resource use and increasing readiness. The Army Reserve currently uses approximately 80% of its scheduled Initial Entry Training seats each year (wasting over 3000 seats for soldie...

S. H. Brown

2002-01-01

291

Lessons Learned, Headquarters, US Army Support Thailand.  

National Technical Information Service (NTIS)

Army Engineer effort, supplemented by contract construction, continues toward the improvement of military facilities in support of the overall U S logistical support mission in Thailand. The Sattahip port area construction progresses within the port prope...

1968-01-01

292

76 FR 72914 - Army Educational Advisory Committee  

Federal Register 2010, 2011, 2012, 2013

...14, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall...Designated Federal Officer, Dept. of Academic Affairs, 122 Forbes Avenue, Carlisle, PA 17013. At any point, however, if...

2011-11-28

293

76 FR 66282 - Army Educational Advisory Committee  

Federal Register 2010, 2011, 2012, 2013

...15, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall...Designated Federal Officer, Dept. of Academic Affairs, 122 Forbes Avenue, Carlisle, PA 17013. At any point, however, if...

2011-10-26

294

Data Warehouse Architecture for Army Installations.  

National Technical Information Service (NTIS)

U.S. Army installations are enterprises performing tasks such as management of funds, budgeting, estimating, managing facilities, maintaining facilities, providing training, complying with environmental and safety laws and regulations. Installations use m...

P. V. Reddy C. G. Schroeder

1999-01-01

295

Army Enlistment Decision: A Selected, Annotated Bibliography.  

National Technical Information Service (NTIS)

This research note consists of an annotated bibliography describing Army enlistment decision research. The bibliography summarizes research undertaken from both the marketplace (economic) and motivational sociological and psychological perspectives. The r...

M. J. Wilson N. L. Gay B. F. Allen J. F. Celeste

1988-01-01

296

PREPARING THE ARMY FOR JOINT OPERATIONS  

Microsoft Academic Search

The National Security Strategy states that the military, which had been struc- tured for operations against the massive armies of the Warsaw Pact, must be transformed to handle new adversaries. The administration wants a broad portfolio of military capabilities, including \\

Bruce Pirnie

297

Army Environmental Policy and ISO 14001.  

National Technical Information Service (NTIS)

Since the 1970s, the U.S. Army has instituted environmental policies, programs, regulations, and management systems to ensure that its mission and support activities have minimal effects on the environment and comply with national policy. In recent years,...

R. Sinclair R. Tschirhart

2001-01-01

298

Developing Leaders in the Army Reserve.  

National Technical Information Service (NTIS)

This paper will examine leadership in the United States Army Reserve Troop Program Unit (TPU). It will examine the selection process and the training backgrounds required for the position as commander of a TPU. Leadership competencies and unit effectivene...

D. L. Nall

2005-01-01

299

Army Reserve (AR) Educational Assistance (EA) Study.  

National Technical Information Service (NTIS)

Problem Statement: *This study will investigate current trends and results of Army Reserve (AR) educational assistance (EA) program allocation, administration, execution, and cost on AR recruitment, retention, and attrition of Troop Program Unit (TPU) enl...

A. McGrath A. R. Cunningham D. Cherry

2008-01-01

300

Army Transformation: Navigating into the Blue Ocean.  

National Technical Information Service (NTIS)

The Malaysian Army (MA) is in the midst of transforming to be an objective force that is professional, versatile, credible, and capable of defending the nation's integrity, sovereignty, and interests by the year 2020. The Malaysian Government also is emba...

A. M. Ismail

2012-01-01

301

Army Program Managers: A Competency Perspective.  

National Technical Information Service (NTIS)

What characteristics distinguish successful Army program managers from their peers. The results of this study are based on the survey data obtained from program executive officers, program managers, and acquisition students, as well as interviews conducte...

B. J. Mc Veigh

1994-01-01

302

Spouse Influence in Army Organizational Change.  

National Technical Information Service (NTIS)

Commanders and other leaders in the Army must constantly consider how their organization is changing and how it must change to remain relevant and effective in its combat roles. When planning and conducting an organizational change, these commanders must ...

D. L. Edwards

2008-01-01

303

Army Study Program Fiscal Year 1993 Report.  

National Technical Information Service (NTIS)

This document contains The Army Study Program (TASP) for Fiscal Year 1993. This report describes the annual study program in terms of the issues addressed by these studies, functional addressed by these studies, functional area, and potential impact upon ...

1992-01-01

304

Water Sustainability Assessment for Ten Army Installations.  

National Technical Information Service (NTIS)

A key concern for the US Army is the vulnerability of military installations to critical resource issues. Water issues of concern, including adequate supply, increased cost of production per unit volume, quality, habitat degradation and salinity issues, a...

E. M. Jenicek, L. E. Curvey, M. S. Hessel, R. A. Carroll, R. M. Holmes

2011-01-01

305

WARSIM Enters the Scene in Army Training.  

National Technical Information Service (NTIS)

The Warfighter's Simulation (WARSIM) is the U.S. Army's next generation constructive simulation capability. Revolutionary in scope, WARSIM allows commanders and their staffs to train in the contemporary environment they will face in Iraq, Afghanistan, and...

E. Payne K. Dietrick

2005-01-01

306

Laser Issues for Army Aviation: Questions & Answers.  

National Technical Information Service (NTIS)

On the modern battlefield, lasers are used primarily as rangefinders and target designators; however, in the past the high cost and technological sophistication of lasers have limited their fielding to national armies. Their large size and power requireme...

C. E. Rash B. S. Reynolds J. Hauser

2001-01-01

307

Future Army Tactical Operation Center Concept.  

National Technical Information Service (NTIS)

The inefficiency, high complexity, and lack of mobility of current army tactical operation centers (TOC) will limit their effectiveness in the highly dynamic non-linear future battlefield. The extensive hardware, software, and manpower resources needed to...

A. Rodriquez J. E. Johnson J. P. Grills P. J. Emmerman

1999-01-01

308

How Directed Energy Benefits the Army.  

National Technical Information Service (NTIS)

Directed energy, primarily through use of high-energy lasers (HELs), has already demonstrated significant capability to meet Army needs, and current developments indicate there are future applications for HELs in numerous and varied mission areas. HELs co...

J. K. Souder D. B. Langille

2004-01-01

309

Leader Development for a Transforming Army.  

National Technical Information Service (NTIS)

The Army is heavily involved in the global war on terrorism while also undergoing transformation to handle future challenges. Changes are occurring across the spectrum of doctrine, organization, training, material, personnel, and facilities. These changes...

S. G. Yackley

2005-01-01

310

Surgical wound sepsis  

PubMed Central

With the help of a surgical nurse and using data-processing techniques, a prospective clinical study was conducted to determine the wound infection rate in two hospitals in Calgary. The overall sepsis rate was 5.2% and the clean wound rate 3.5%. The latter is the more meaningful figure as it allows for comparison between hospitals, specialties and individuals and is a good guide for hospital morbidity reviews. The groundwork for succeeding wound infection is laid in the operating theatre, and it is believed that wound infection would be reduced more by attention to Halsted's principles than by more rigid aseptic techniques. It is estimated that wound sepsis costs the Province of Alberta 1.5 million dollars per year for hospitalization alone. This amounts to roughly $1 per person per year. The annual cost of a prospective study such as the present one is approximately $7000. This is equivalent to the cost of hospitalizing 24 patients with infected wounds for one week (at $300 per week). One dividend of a prospective study is an associated reduction in infection rate. This reduction more than pays for the cost of the program.

Cruse, P. J. E.

1970-01-01

311

Assuring structural integrity in Army systems  

NASA Technical Reports Server (NTRS)

The object of this study was to recommend possible improvements in the manner in which structural integrity of Army systems is assured. The elements of a structural integrity program are described, and relevant practices used in various industries and government organizations are reviewed. Some case histories of Army weapon systems are examined. The mandatory imposition of a structural integrity program patterned after the Air Force Aircraft Structural Integrity Program is recommended and the benefits of such an action are identified.

1985-01-01

312

Army SATCOM OTM full elevation performance characterization”  

Microsoft Academic Search

The Army has a well established requirement for satellite communications (SATCOM) on-the-move (OTM), in order to support the needed level of real-time, tactically-relevant information on a non-contiguous battlefield. The US Army CERDEC Space and Terrestrial Communications Directorate Joint SATCOM Engineering Center (JSEC) is doing relevant research and development in order to provide the best SATCOM OTM technology for transition to

Herald Beljour; Saul Foresta; Rich Hoffmann; Laurie Shamblin; Joseph Shields; Andrew Stevens; Chip Uhler; Eric Carl; Michael Eriksson

2011-01-01

313

Physician-Owned Speciality Hospitals' Ability to Manage Medical Emergencies.  

National Technical Information Service (NTIS)

Physician-owned specialty hospitals are hospitals that primarily perform cardiac, orthopedic, or surgical procedures and are partially or fully owned by physician investors. Two recent deaths of specialty hospital patients have raised concerns about the a...

2008-01-01

314

Male parentage in army ants.  

PubMed

In most social insects workers do not mate, but have retained the ability to produce haploid eggs that can develop into viable male offspring. Under what circumstances this reproductive potential is realized and how the ensuing worker-queen conflict over male production is resolved, is an area of active research in insect sociobiology. Here we present microsatellite data for 176 males from eight colonies of the African army ant Dorylus (Anomma) molestus. Comparison with worker genotypes and inferred queen genotypes from the same colonies show that workers do not or at best very rarely reproduce in the presence of the queen. Queens of D. (A.) molestus are known to be highly multiply mated. This implies that workers are on average more closely related to queen sons than to other workers' sons, so that our results are consistent with predictions from inclusive fitness theory. It remains unknown, however, whether worker sterility is maintained by active worker policing or by self-restraint. PMID:16599973

Kronauer, Daniel J C; Schöning, Caspar; Boomsma, Jacobus J

2006-04-01

315

[Surgical tactics in destructive cholecystitis].  

PubMed

Bacteriological examinations of anaerobic and aerobic microflora of the bile, tissues of the gallbladder wall in 67 patients operated on with destructive cholecystitis have shown that surgical interventions should be performed within the first hours after admission to the hospital and must include special methods of purposeful antibacterial therapy during operation and in the postoperative period. PMID:3617369

Arik'iants, M S; Tyshko, A G; Kolesnikov, E B; Skiba, V V

1987-03-01

316

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.

1996-01-01

317

Structured recording of intraoperative surgical workflows  

NASA Astrophysics Data System (ADS)

Surgical Workflows are used for the methodical and scientific analysis of surgical interventions. The approach described here is a step towards developing surgical assist systems based on Surgical Workflows and integrated control systems for the operating room of the future. This paper describes concepts and technologies for the acquisition of Surgical Workflows by monitoring surgical interventions and their presentation. Establishing systems which support the Surgical Workflow in operating rooms requires a multi-staged development process beginning with the description of these workflows. A formalized description of surgical interventions is needed to create a Surgical Workflow. This description can be used to analyze and evaluate surgical interventions in detail. We discuss the subdivision of surgical interventions into work steps regarding different levels of granularity and propose a recording scheme for the acquisition of manual surgical work steps from running interventions. To support the recording process during the intervention, we introduce a new software architecture. Core of the architecture is our Surgical Workflow editor that is intended to deal with the manifold, complex and concurrent relations during an intervention. Furthermore, a method for an automatic generation of graphs is shown which is able to display the recorded surgical work steps of the interventions. Finally we conclude with considerations about extensions of our recording scheme to close the gap to S-PACS systems. The approach was used to record 83 surgical interventions from 6 intervention types from 3 different surgical disciplines: ENT surgery, neurosurgery and interventional radiology. The interventions were recorded at the University Hospital Leipzig, Germany and at the Georgetown University Hospital, Washington, D.C., USA.

Neumuth, T.; Durstewitz, N.; Fischer, M.; Strauss, G.; Dietz, A.; Meixensberger, J.; Jannin, P.; Cleary, K.; Lemke, H. U.; Burgert, O.

2006-03-01

318

Guideline for Prevention of Surgical Wound Infections.  

National Technical Information Service (NTIS)

Patients who undergo a surgical operation are at high risk of having 1 or more nosocomial infections. These infections develop in more surgical patients (8%) than in any other patient group, and about 70% of all nosocomial infections throughout the hospit...

B. P. Simmons

1982-01-01

319

Incorrect Surgical Counts: A Qualitative Analysis  

Microsoft Academic Search

Ensuring that patients remain free of unintended retained foreign bodies is a primary responsibility of perioperative nurses and surgical technologists. However, these incidents continue to occur despite hospital policies and AORN recommended practice guidelines for their prevention. To provide insight into how incorrect surgical counts occur, researchers conducted a qualitative analysis of the tasks and challenges faced by perioperative nurses

Aletha Rowlands; Richard Steeves

2010-01-01

320

Use of the Roentgen Ray by the Medical Department of the United States Army in the War with Spain (1898).  

National Technical Information Service (NTIS)

Soon after the discovery by Professor Roentgen of the new form of radiation and the placing on the market of apparatus for its production, the Surgeon-General of the Army supplied Roentgen-ray apparatus to several of the larger post hospitals. On the outb...

W. C. Borden

2000-01-01

321

Army Working Capital Fund: Actions Needed to Reduce Carryover at Army Depots.  

National Technical Information Service (NTIS)

The five Army depot maintenance activities support combat readiness by providing services to keep Army units operating worldwide. From fiscal years 2004 through 2007, the amount of new orders received to perform work increased 100 percent from $2.6 billio...

2008-01-01

322

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

ERIC Educational Resources Information Center

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…

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

323

Against medical advice: Part II, The Army experience 1971-1988.  

PubMed

The Army experience with discharges against medical advice (AMA) from 1971 to 1988 is analyzed. AMA discharges have declined in a statistically significant manner in both medical centers and community hospitals. Discharges have decreased among men but increased among women. AMA discharges have decreased for both blacks and whites. Among clinical services, only obstetrics and gynecology demonstrated statistically significant increases. Among patient categories, only family members showed an increase. The possible sources of these various changes are discussed. PMID:8441500

Jeffer, E K

1993-02-01

324

Surgical instruments  

US Patent & Trademark Office Database

A surgical instrument includes an elongated transmission waveguide defining a longitudinal axis. The transmission waveguide has a distal end and a proximal end. The at least one strike surface is formed on the proximal end and is configured to receive vibratory energy.

2012-07-24

325

Surgical Mesh  

MedlinePLUS

... complications associated with the mesh. The complications include adverse reactions to the mesh, adhesions (when the loops of ... continuing to analyze and evaluate incoming reports of adverse events, and are ... you’ve had a past reaction to materials used in surgical mesh or sutures, ...

326

Bot armies as threats to network security  

NASA Astrophysics Data System (ADS)

"Botnets", or "bot armies", are large groups of remotely controlled malicious software. Bot armies pose one of the most serious security threats to all networks. Botnets, remotely controlled and operated by botmasters or botherders, can launch massive denial of service attacks, multiple penetration attacks, or any other malicious network activity on a massive scale. While bot army activity has, in the past, been limited to fraud, blackmail, and other forms of criminal activity, their potential for causing large-scale damage to the entire internet; for launching large-scale, coordinated attacks on government computers and networks; and for large-scale, coordinated data gathering from thousands of users and computers on any network has been underestimated. This paper will not discuss how to build bots but the threats they pose. In a "botnet" or "bot army", computers can be used to spread spam, launch denial-of-service attacks against Web sites, conduct fraudulent activities, and prevent authorized network traffic from traversing the network. In this paper we discuss botnets and the technologies that underlie this threat to network and computer security. The first section motivates the need for improved protection against botnets, their technologies, and for further research about botnets. The second contains background information about bot armies and their key underlying technologies. The third section presents a discussion of the types of attacks that botnets can conduct and potential defenses against them. The fourth section contains a summary and suggestions for future research and development.

Banks, Sheila B.; Stytz, Martin R.

2007-04-01

327

Adverse events in surgical patients in Australia  

Microsoft Academic Search

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

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

2002-01-01

328

Army Selected Reserve Dental Readiness System (ASDRS): Historical Overview, Assessment and Recommendations.  

National Technical Information Service (NTIS)

The Army Selected Reserve Dental Readiness System (ASDRS) is a key dental program directed by the Assistant Secretary of the Army (Manpower & Reserve Affairs) starting in Fiscal Year (FY) 09. The Army National Guard and Army Reserve have steadily implemen...

J. R. Honey

2012-01-01

329

Army Energy and Water Reporting System Assessment  

SciTech Connect

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.

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

2011-09-01

330

Tackling surgical infection prevention takes teamwork.  

PubMed

Even though infection control practices have improved dramatically in the United States, surgical infections still are a problem for many hospitals, ranking as the second most common cause of nosocomial infections. But hospitals are finding ways to fight back by implementing best practices, redesigning systems, and using hospital-wide teams--which include administrators, surgeons, nurses, anesthesiologists, pharmacists, and environmental services staff--that cut across many departments. PMID:15559881

2004-10-01

331

Surgical Technician  

NSDL National Science Digital Library

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.

Institutes, John H.

332

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.

333

Political Training in the United States Army: A Reconsideration.  

National Technical Information Service (NTIS)

This study examines two questions. First, why has the United States Army rejected the idea that political training can influence combat motivation and military efficiency while other armies, such as the West German and Soviet, invest heavily in political ...

S. D. Wesbrook

1979-01-01

334

Analysis of Energy Conservation Alternatives for Standard Army Building.  

National Technical Information Service (NTIS)

This report describes energy conservation alternatives for five standard Army building designs. By surveying maps of major Army installations and using the Integrated Facilities System, the most popular designs were determined to be a two-company, rolling...

D. C. Hittle R. E. O'Brien G. S. Percivall

1983-01-01

335

Army Public Affairs: Suggested Changes to Win the Media War.  

National Technical Information Service (NTIS)

Fundamental differences exist between the organizations because the media enjoys great freedom to report news, whereas the Army is a structured organization that often views the media as too liberal. The Army imposed censorship in most conflicts since the...

C. D. Childers

1997-01-01

336

Description and Evaluation of the Army Communicative Skills Program.  

National Technical Information Service (NTIS)

The Army Communicative Skills Program is a recent effort by the Army to improve the writing, speaking, and reading effectiveness of all personnel. This report describes the program, the writing standard it mandates, the programs of instruction it offers, ...

L. A. Baker

1988-01-01

337

Changing Army Culture: Creating Adaptive and Critical Thinking Officer Corps.  

National Technical Information Service (NTIS)

As an open system organization the Army is constantly affected by variations in the environment that should ultimately spark change in the way Army leaders view, approach, and resolve problems. But this ability to demonstrate mental agility and adapt effe...

F. S. Clarke

2007-01-01

338

Army Institutional Training: Current Status and Future Research.  

National Technical Information Service (NTIS)

This document provides a listing of findings and issues resulting from an overview of current Army institutional training and, from the perspective and constraints of Army training, an overview of current learning theory and science. Findings and issues a...

F. Diedrich J. Sidman R. Semmens R. J. Pleban W. R. Bickley

2010-01-01

339

Army Conference Policy: Curing the Symptom Instead of the Disease.  

National Technical Information Service (NTIS)

The negative publicity associated with excessive spending on government conferences resulted in sweeping changes to OMB, DoD, and Army conference policies. These changes, as well as the effects of sequestration and continued budget cuts, require the Army ...

R. Swansiger

2013-01-01

340

Model of Emotion Management for U.S. Army Leaders.  

National Technical Information Service (NTIS)

Emotion management may be particularly important for effective Army leadership in certain performance domains. In addition to typical leadership tasks such as providing performance feedback, resolving conflicts and team- building activities, Army leaders ...

A. Shipman B. Vessey E. Day S. Connelly T. Friedrich

2010-01-01

341

Army's Facility Construction and Maintenance Process: An Assessment.  

National Technical Information Service (NTIS)

The Army and private sector follow similar steps in facility construction and maintenance, but they differ in carrying them out, especially in budget allocation and management. These differences-caused by the Army's operating environment-result in higher ...

D. R. Gallay M. Corfman P. R. Ober T. Muller W. B. Moore

2000-01-01

342

32 CFR 644.329 - Army civil works real property.  

Code of Federal Regulations, 2013 CFR

...Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Procedure for Placing Real Property in Excess Status § 644.329 Army civil works real property....

2013-07-01

343

32 CFR 644.326 - Army military real property.  

Code of Federal Regulations, 2013 CFR

...Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Procedure for Placing Real Property in Excess Status § 644.326 Army military real property....

2013-07-01

344

Adaptive Edge: Introducing Adaptive Skills Techniques to Army Special Forces.  

National Technical Information Service (NTIS)

For USSOCOM to maintain its upper hand in producing 'elite' Soldiers, a better understanding of current adaptive skills training in the United States Army and their current implementation in United States Army Special Forces Officer training program is ne...

M. D. Washburn M. L. Bandy S. D. Clay

2010-01-01

345

Integrating Global Trends Information into Army Strategic Planning Processes.  

National Technical Information Service (NTIS)

Effective strategic planning in the Army Long-Range Planning System (ALRPS) process must successfully relate Army long-range plans for all functional and special areas to the worldwide military, political, social, economic, demographic, environmental, and...

R. L. Schneider P. V. Reddy S. T. Ariaratnam V. J. McCleary

1993-01-01

346

Implementing new RAM initiatives in Army Test And Evaluation  

Microsoft Academic Search

This paper describes the processes for implementing new Department of the Army (DA) reliability policy directives issued by the Assistant Secretary of the Army for Acquisition, Logistics, and Technology, or ASA(ALT). It highlights key points of the implementation guide prepared by the U.S. Army Evaluation Center (AEC) and the U.S. Army Test and Evaluation Command (ATEC). The implementation plan herein

Ken Dalton; J. Brian Hall

2010-01-01

347

Demographic and Anthropometric Assessment of US Army Anthropometric Data Base.  

National Technical Information Service (NTIS)

It has been nearly 20 years since the last anthropometric survey of Army males was conducted and about eight years since the last survey of Army females. The purpose of this report is to assess the extent to which the Army's existing anthropometric data b...

B. Bradtmiller J. Ratnaparkhi I. Tebbetts

1985-01-01

348

Perspective on hybrid electric technology for future for army vehicles  

Microsoft Academic Search

Summary form only given. The U.S. Army is the primary provider of ground vehicles for both combat and tactical military applications. In keeping with its transformational goals, the Army has a great interest in making its future combat and tactical vehicle fleet significantly more fuel-efficient. At the same time the Army's emerging requirements mandate vehicles that are more mobile, survivable,

M. M. Freeman

2004-01-01

349

U.S. Army Acquisition -- The Program Office Perspective.  

National Technical Information Service (NTIS)

The U.S. Army Strategic Software Improvement Program (ASSIP) is a multiyear effort to improve the way the Army acquires software-intensive systems. As part of the ASSIP, the Carnegie Mellon Software Engineering Institute examined 12 of the Army's Acquisit...

K. L. Keeler

2005-01-01

350

Objective Force Disciplines: Making Army Transformation a Reality.  

National Technical Information Service (NTIS)

This monograph explores the validity of current United States Army Doctrine as it relates to enabling the future United States Army Objective Force in achieving the qualities outlined in the 2001 Objective Force White Paper as the Army begins its 'transfo...

J. M. Scott

2002-01-01

351

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

Microsoft Academic Search

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

Michael J. Lavan; John J. Wachs

2011-01-01

352

32 CFR 581.1 - Army Disability Review Board.  

Code of Federal Regulations, 2010 CFR

...2009-07-01 2009-07-01 false Army Disability Review Board. 581.1 Section 581.1 National...DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD § 581.1 Army Disability Review Board. (a) General provisions...

2009-07-01

353

32 CFR 581.1 - Army Disability Review Board.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 true Army Disability Review Board. 581.1 Section 581.1 National...DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD § 581.1 Army Disability Review Board. (a) General provisions...

2010-07-01

354

Procedural Integration in Support of Sustainability at Army Installations.  

National Technical Information Service (NTIS)

The Army Strategy for the Environment, (ASA (I&E), 2004), sets a new tone for the Army Environmental Program. The Army will 'transition from a compliance-based environmental program to a mission-oriented approach based on the principles of sustainability'...

2004-01-01

355

Evaluation of the Army Correction Program. Volume III. Program Analysis.  

National Technical Information Service (NTIS)

The analysis of the objectives of the Army Correction Program consist of three major components: Examination of the conformity of the Army correction objectives stated in Army Regulation 190-47 with the Department of Defense Instruction 1325.4 and with Ch...

R. Bhattacharyya A. L. Willey W. C. Parker J. T. Luftig

1977-01-01

356

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

Microsoft Academic Search

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

Stefan Alexa

2004-01-01

357

Is the Army's Reserve Component Imbalanced, Separate and Unequal.  

National Technical Information Service (NTIS)

This Strategy Research Project argues that the Army's Reserve Component (RC) is imbalanced, separate, and unequal. The Army's RC is the largest Reserve Component within the Department of Defense (DoD), providing 50 percent of the Army's forces and capabil...

T. D. Clifton

2012-01-01

358

Economies of Scale and Scope: The Case of Specialty Hospitals  

Microsoft Academic Search

Research Objective: The recent growth of physician-owned hospitals specializing in cardiac, orthopedic, and surgical specialty services (specialty hospitals) in the U.S. has generated considerable controversy, yet there is little understanding of the economic logic of organizing hospital services around these single specialties. Because specialty hospitals are small relative to the general hospitals with which they compete, an important economic question

Kathleen Carey; James F. Burgess; Gary J. Young

2010-01-01

359

ARI (Army Research Institute) Survey of Army Recruits 1984 - 1985: Methodology and Recommendations for Future Administrations.  

National Technical Information Service (NTIS)

This is a task final report. The volume overviews the survey administration procedures, including instrument design, data collection, data preparation, and processing techniques employed in the 1984 and 1985 ARI Surveys of Army Recruits. The report propos...

J. F. Celeste M. J. Wilson V. F. Ramsey T. W. Elig R. M. Pliske

1986-01-01

360

Army Strong: Equipped, Trained and Ready. Final Report of the 2010 Army Acquisition Review.  

National Technical Information Service (NTIS)

The Army continues to need modern equipment for soldiers to be decisive on the unpredictable, asymmetric battlefield of today and tomorrow. This need for modern equipment will be even harder to fill amid the nation's economic difficulties. Our study found...

2011-01-01

361

Army Excellence in Leadership (AXL): Educating Army Leaders with the Tripwire Film.  

National Technical Information Service (NTIS)

This research product contains an instructor's manual which describes how to use the Tripwire case study from the Army Excellence in Leadership (AXL) system within a traditional classroom setting. The manual is intended to help instructors prepare for cla...

K. A. Metcalf M. L. Zbylut

2007-01-01

362

Army Science Board Ad Hoc Sub-Group Report on Energy Needs of the Army.  

National Technical Information Service (NTIS)

This study examined future Army requirements for energy and development programs to assist in meeting anticipated energy needs. Specific items reviewed include current and projected mobility, weapons system, and installation requirements for energy in the...

H. M. Agnew R. A. Beaudet A. W. Betts E. O. Hartis W. K. Talley

1980-01-01

363

75 FR 7255 - Army Educational Advisory Committee  

Federal Register 2010, 2011, 2012, 2013

...11, 2010. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall...their statement to the Designated Federal Officer at USAWC, 122 Forbes Avenue, Carlisle, PA, at any point; however, if a...

2010-02-18

364

Army Physicians' Attitudes Towards Physicians' Assistants.  

ERIC Educational Resources Information Center

In February 1972 the U. S. Army Medical Field Service School will commence training a new category of health personnel, to be known as the physicians' assistant. This type of allied health personnel will be an assistant to the physician, trained to do many of the traditional tasks usually performed by a physician, but requiring less education.…

Stuart, Richard B.; Bair, Jeffrey H.

365

Profile of a Citizen Army: Shiloh's Soldiers  

Microsoft Academic Search

Based on an analysis of the letters, diaries, and reminiscences of approximately 450 raw recruits at the Battle of Shiloh in the American Civil War, the study elaborates a comparative profile of the Civil War volunteers in contrast to professional armies. The analysis assesses sources of combat motivation such as political articulateness, nationalism, attitudes toward officers, relations with the home

Joseph Allan Frank

1991-01-01

366

Multichannel Radio Communication Within the Army  

Microsoft Academic Search

Combat communications equipment is a highly specialized weapon in its own right. USASRDL has been an important factor in the development of combat communications and in the establishment of an industrial design capability for such equipment. An example is given by tracing the growth of Army multichannel communication systems from the radio-link equipment of the Tunisian campaign, through ``backbone'' radio

Lawrence G. Fobes

1960-01-01

367

Army Reserve Prior Service Market Profile.  

National Technical Information Service (NTIS)

Only about 28 percent of the 177,023 enlisted losses to the Active Army in FY 1993 either transferred to the Reserve Components (RC) or had completed all of their obligated service and were eligible for reserve service (RE). Of these 48,000 RC and RE loss...

K. M. Kocher G. Thomas

1995-01-01

368

Data fusion for Canadian army applications  

Microsoft Academic Search

We describe data fusion technology relevant to two applications of potential benefit to the Canadian army. The first application is a local situational awareness system (LSAS) while the second is a versatile surveillance platform. The LSAS improves an armored vehicle crew's ability to recognize and locate threats and hazards without leaving the relative safety of their vehicle. It is designed

David Gains

2007-01-01

369

Women Soldiers: On Joining the Army.  

ERIC Educational Resources Information Center

In this paper, differences in the backgrounds and attitudes of men and women enlisted in the Army are found to be significant. Women tend to be older, better educated, and less desperate to escape from the complexities and dilemmas of civilian life than male enlistees. (Author/WI)

Gottlieb, David

1978-01-01

370

Biometrics in US Army Accessions Command.  

National Technical Information Service (NTIS)

Army Accessions Command (AAC) recruits the Active and Reserve enlisted force and recruits and trains officers for the Active component, Reserve, and National Guard. Approximately 10% of the 17-24 Youth Market is not qualified to serve in the military due ...

C. Dossett J. Baird R. Height

2011-01-01

371

78 FR 18473 - Army Privacy Act Program  

Federal Register 2010, 2011, 2012, 2013

...filed in order to correct the mailing address in Sec. 505.12. The address for notifying the Army Litigation...552a). 0 2. Revise paragraph (b) (1) of Sec. 505.12 to read as follows: Sec. 505.12 Privacy Act enforcement...

2013-03-27

372

Analysis of Noise in US Army Aircraft.  

National Technical Information Service (NTIS)

Tape recordings were made of acoustical and electrical noise in the crew compartments and on the interphone lines of 7 models of U.S. Army aircraft, during flight operations. The data were analyzed to determine noise and speech levels in the communication...

A. J. Brouns R. A. Ely

1978-01-01

373

Disruptive Pattern Printed Canvas for Army Vehicles.  

National Technical Information Service (NTIS)

A design for the disruptive pattern printing of canvas used for canopies on army vehicles was developed by DSTO MRL Melbourne. The effect of exposure to a variety of climatic conditions on print durability and fabric properties was determined. Print Durab...

G. Southwell J. Stewart A. deForest

1992-01-01

374

Should there be an Australian Army Association.  

National Technical Information Service (NTIS)

An Australian Army Association (AAA) has never existed even though associations related to the Royal Australian Navy and Royal Australian Air Force have existed since 1920. The purpose of this study is to determine whether an AAA should be established. Wh...

M. C. Fielding

2006-01-01

375

Army Topo Strategy for the 1990's.  

National Technical Information Service (NTIS)

The U.S. Army has taken two critical steps designed to assure that the digital topographic data needs of our troops on the battlefield of the future are satisfied. The first step is to establish, in concert with the Defense Mapping Agency, standards and a...

J. A. Messmore, D. J. Scott

1987-01-01

376

U.S. Army Signal School.  

ERIC Educational Resources Information Center

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…

Army Signal Center and School, Fort Monmouth, NJ.

377

Die Neue Bundeswehr (The New Army).  

National Technical Information Service (NTIS)

The study concerns the paths and problems of the adaptation of the German Armed Forces to the extenuating challenges of national security following the end of the Cold War. The author prefaces the mentioning of the 'new army,' by discussing the changes th...

H. Biehl

1998-01-01

378

Army Family Violence Research Conference Recommendations.  

National Technical Information Service (NTIS)

A one and a half day conference was held at the Uniformed Services University of the Health Sciences (USUHS), the military medical school, in Bethesda, Maryland. The purpose of the conference was to formulate a research agenda for the Army in the field of...

1997-01-01

379

Dental Therapy Assistant: Attitudes of Army Dentists.  

ERIC Educational Resources Information Center

The U. S. Army Dental Corps has implemented a formal program based on the concept that dental care can be more efficiently and effectively provided with treatment teams composed of one dental officer, two dental therapy assistants, one basic assistant, and the shared support of other auxiliary personnel. Such a team will use three dental treatment…

Heid, Theodore H.; Bair, Jeffrey H.

380

Army Energy and Water Reporting System Assessment.  

National Technical Information Service (NTIS)

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 d...

M. J. Glardinelli P. C. Deprez

2011-01-01

381

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), cartographer unknown, title unknown, March 28, 1892 1890 lifesaving station shown near fort and beach, no boathouse near engineer's wharf - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

382

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) from Talcott, T.M.R., plot of a survey of site, Fort at Sandy Hook, NJ, 1859-1860 Detail of engineer's wharf - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

383

[Our surgical heritage: the surgical school of Halle].  

PubMed

The knowledge of the historical development of surgery including its increasing specialization is important for our efforts to preserve the unity of surgery. In the past distinguished surgeons essentially influenced the progress of surgery. The list of the directors of the surgical department of the Halle university hospital in the last 150 years with the outstanding Richard von Volkmann is an excellent example for this influence and will be presented here. PMID:11253543

Gläser, A

2001-02-01

384

Surgical infections in drug addicts  

Microsoft Academic Search

Infectious complications are responsible for a majority of the medical and surgical hospital admissions and 15% of the deaths\\u000a of drug addicts. The most common and serious complication is endocarditis, mostly of the right heart, caused by Staphylococci\\u000a and\\/or gram-negative rods. If the endocarditis is caused by the latter group of organisms, early operative intervention with\\u000a excision of the tricuspid

Toni Hau; Charles A. Kallick

1980-01-01

385

Indian Health Service, Hospital, Tuba City, Arizona.  

National Technical Information Service (NTIS)

The hospital project involves replacement of the existing 75-bed General Medical and Surgical (GM and S) hospital with a 125-bed GM and S hospital, with increased outpatient clinics, adjunct services, and supportive elements in order to provide a comprehe...

1971-01-01

386

Quality of Pharmaceutical Care in Surgical Patients  

PubMed Central

Background Surgical patients are at risk for preventable adverse drug events (ADEs) during hospitalization. Usually, preventable ADEs are measured as an outcome parameter of quality of pharmaceutical care. However, process measures such as QIs are more efficient to assess the quality of care and provide more information about potential quality improvements. Objective To assess the quality of pharmaceutical care of medication-related processes in surgical wards with quality indicators, in order to detect targets for quality improvements. Methods For this observational cohort study, quality indicators were composed, validated, tested, and applied on a surgical cohort. Three surgical wards of an academic hospital in the Netherlands (Academic Medical Centre, Amsterdam) participated. Consecutive elective surgical patients with a hospital stay longer than 48 hours were included from April until June 2009. To assess the quality of pharmaceutical care, the set of quality indicators was applied to 252 medical records of surgical patients. Results Thirty-four quality indicators were composed and tested on acceptability and content- and face-validity. The selected 28 candidate quality indicators were tested for feasibility and ‘sensitivity to change’. This resulted in a final set of 27 quality indicators, of which inter-rater agreements were calculated (kappa 0.92 for eligibility, 0.74 for pass-rate). The quality of pharmaceutical care was assessed in 252 surgical patients. Nearly half of the surgical patients passed the quality indicators for pharmaceutical care (overall pass rate 49.8%). Improvements should be predominantly targeted to medication care related processes in surgical patients with gastro-intestinal problems (domain pass rate 29.4%). Conclusions This quality indicator set can be used to measure quality of pharmaceutical care and detect targets for quality improvements. With these results medication safety in surgical patients can be enhanced.

de Boer, Monica; Ramrattan, Maya A.; Boeker, Eveline B.; Kuks, Paul F. M.; Boermeester, Marja A.; Lie-A-Huen, Loraine

2014-01-01

387

Army Transformation in the Age of Globalization - Implementing Directed Change with Strategic Management Design (SMD): An Analysis Based on the Army Staff in the German Ministry of Defense.  

National Technical Information Service (NTIS)

German Army Transformation will face a critical period after the structural 'New Army' reform in 2010. Political and military directives charter the Army to adopt and create capabilities for mission success in the contemporary and future security-politico...

C. Schaefer

2008-01-01

388

Surgical education in Mexico.  

PubMed

Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital. PMID:19603225

Cervantes, Jorge

2010-05-01

389

Do Antbirds Help or Hinder Army Ants?  

NSDL National Science Digital Library

In this activity, students examine the nature of the interaction between army ants and ant-following birds. Ant-following birds benefit from the relationship by staying just ahead of the ants and capturing prey animals that are disturbed by the ants. While early studies suggested that the birds' foraging might in turn benefit the ants, it is possible that the birds remove prey that the ants would capture. Using figures from a research paper, students determine whether the species interaction is mutualism, commensalism, or parasitism. Students design a hypothetical experiment to measure the effect of birds on army ant foraging success, interpret figures from a real experiment, and consider the consequences of the interaction on the ant colony and the forest community.

Kuhlmann, Mark

2010-02-16

390

Automation impact study of Army Training Management  

SciTech Connect

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.

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

391

Energy Design Guides for Army Barracks  

Microsoft Academic Search

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

M. Deru; A. Zhivov; D. Herron

2008-01-01

392

Implementing a Pediatric Surgical Safety Checklist in the OR and Beyond  

Microsoft Academic Search

An international study about implementation of the World Health Organization Surgical Safety Checklist showed that use of the checklist reduced complication and death rates in adult surgical patients. Clinicians at Children's Hospital Boston, Massachusetts, modified the Surgical Safety Checklist for pediatric populations. We pilot tested the Pediatric Surgical Safety Checklist and created a large checklist poster for each OR to

Elizabeth K. Norton; Shawn J. Rangel

2010-01-01

393

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

PubMed

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

Portner, Joshua A; Johnson, Justine A

2010-05-01

394

Surgical helmet systems.  

PubMed

A surgical helmet system (SHS) is either a loose-fitting hood or a hood combined with an integral gown (called a toga system). SHSs are used during orthopedic procedures to decrease the patient's risk of deep wound infection by keeping skin and other particles from the surgeon's face from falling into the open surgical site. They are also used to protect surgical staff from infectious blood splashes and potentially infectious aerosols generated by power tools during orthopedic procedures - and it is this aspect of SHS use that has attracted particular attention, given the intensified interest in healthcare worker (HCW) protection (e.g., against human immunodeficiency virus [HIV], tuberculosis [TB], and hepatitis C virus [HCV]) in hospitals today. Ironically, the very factors that have led to SHSs' recent popularity may limit the need for their use, inasmuch as facilities have instituted so many other effective infection control methods against bloodborne and airborne pathogens. Although SHSs do provide splash protection against bloodborne pathogens, institutions may already by adequately protecting their staff against this hazard. In addition, they may be using SHSs to provide other types of patient and HCW protection that are already being provided by existing infection control measures. SHSs are available in a wide variety of configurations. We evaluated a total of six SHSs: one hood and one toga system each from three manufacturers. The units we tested were among each manufacturer's bestselling systems. We examined how well they would protect patients against deep wound infections and HCWs against splashes and aerosolized particles. We also evaluated their comfort and ease of use for wearers. We found that all of the SHSs provided sufficient patient protection against particles shed by the surgeon. We also found that the hood-only units and the hood components of the toga units provided sufficient HCW splash protection. (The gown portion of the toga systems failed our fluid-resistance criterion. However, we did not test the separate surgical gowns that are used with the hood-only units, and we do not know if they provide any greater level of protection than the toga fabric does). We rated all hood-only units Acceptable. We rated all toga units Acceptable-Not Recommended because the level of patient and HCW protection provided by the toga systems did not justify their significantly higher cost. We did find differences in the level of HCW respiratory protection these systems provided against aerosols. However, we do not believe that this should be a significant selection consideration because there is no established need for respiratory protection during orthopedic procedures. (Respiratory protection is needed against TB aerosols, but hip and knee arthroplasty procedures are usually elective and would be delayed on any active or suspected TB patient until the patient is noninfectious). To establish the context for this study, we first present a Guidance Section, "Do You Need Surgical Helmet Systems for Orthopedic Procedures?" In this section, we discuss the infection risks present during orthopedic procedures. We also outline the protective measures that institutions may already have in place to reduce these risks. We then discuss how SHSs fit into the infection control picture. Supplementary material in this section includes a discussion of the respiratory protection needed against Mycobacterium tuberculosis and a table of factors affecting the choice among SHSs, respirator masks, and surgical masks for patient and HCW protection. Ultimately, the choice to use SHSs may be dictated by the training and preference of the surgical staff. But this Evaluation will help facilities to (1) make this decision and, if appropriate, (2) select the best system for their needs... PMID:8722101

1996-04-01

395

Energy Design Guides for Army Barracks  

SciTech Connect

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.

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

2008-01-01

396

Guide to Surgical Specialists  

MedlinePLUS

... the surgical care and prevention of traumatic injuries); pediatric surgical oncology (knowledge of the diagnosis and surgical care of ... and disorders of the cranial and spinal nerves. Pediatric neurosurgeons manage ... care, oncology care, and primary health care for women. Specialty ...

397

Review of ground water modeling needs for the US Army  

SciTech Connect

The report was prepared to assist the U.S. Army in remediation of ground water contamination from hazardous, toxic, and radioactive wastes at Army installations. The Waterways Experiment Station of the Army Corps of Engineers requested that the Water Science and Technology Board evaluate the state of the art in mathematical models of ground water flow and contaminant transport, and then advise the Corps of Engineers on how it might support and use such models to meet Army's ground water remediation needs over the next ten years. The study recommends that the Army develop in-house expertise in ground water modeling, expand partnership programs between the Army and academic researchers, and develop a ground water modeling support center to help focus research, technology transfer and training activities.

Not Available

1992-09-01

398

Heritage of Army Audiology and the Road Ahead: The Army Hearing Program  

PubMed Central

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.

Gates, Kathy; Ciliax, Donald

2008-01-01

399

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

400

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) Gillespie, G.L., map of a portion of Sandy Hook, NJ showing condition of beach in vicinity of dynamite gun emplacements, 1894 Engineer's wharf - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

401

42 CFR 413.124 - Reduction to hospital outpatient operating costs.  

Code of Federal Regulations, 2013 CFR

...center approved surgical procedures performed in the hospital outpatient setting under § 413.118 and hospital outpatient radiology services and other diagnostic procedures under § 413.122, the reduction is applicable only to the hospital-specific...

2013-10-01

402

Adverse outcomes in Belgian acute hospitals: retrospective analysis of the national hospital discharge dataset  

Microsoft Academic Search

Objective. The prevalence and variability of adverse outcome rates in Belgian acute hospitals is examined by using the national hospital discharge database. Design, setting, and participants. Retrospective analysis based on administrative data of all Belgian acute hospitals, covering the full medical (n = 1 024 743) and surgical (n = 633 027) in-patients population for the year 2000. Main outcome

KOEN VAN DEN HEEDE; WALTER SERMEUS; LUWIS DIYA; EMMANUEL LESAFFRE; ARTHUR VLEUGELS

2006-01-01

403

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

PubMed Central

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

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

2014-01-01

404

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

PubMed

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 beyond those in convent

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

2014-01-01

405

Operative surgical yield from general surgical outpatient clinics; time to change the way we practice?  

PubMed

The aim of this study was to compare the number of patients attending surgical outpatient clinics in a general hospital to the number of resulting elective procedures scheduled in a single year. Patients initially assessed at private consulting rooms are not included in this study. The number of surgical outpatient appointments issued in 2011 totalled 6503 with non-attendances running at 1489 (22.9%). The number of elective surgical theatre cases performed in 2011 (i.e. the surgical yield from that period) came to 1078 with an additional 1470 patients referred for endoscopy and 475 patients referred for minor operations. Operative surgical yield from the currently structured outpatient clinic model is low, with the number of theatre cases coming to only 16.58% of the original number of outpatient appointments issued. Recommendations for the improvement of outpatient services are made. These findings are relevant in the context of streamlining access to surgical services. PMID:24218748

Irfan, M; McGovern, M; Robertson, I; Waldron, R; Khan, I; Khan, W; Barry, K

2013-01-01

406

Hospital Quality: A PRIDIT Approach  

PubMed Central

Background Access to high quality medical care is an important determinant of health outcomes, but the quality of care is difficult to determine. Objective To apply the PRIDIT methodology to determine an aggregate relative measure of hospital quality using individual process measures. Design Retrospective analysis of Medicare hospital data using the PRIDIT methodology. Subjects Four-thousand-two-hundred-seventeen acute care and critical access hospitals that report data to CMS' Hospital Compare database. Measures Twenty quality measures reported in four categories: heart attack care, heart failure care, pneumonia care, and surgical infection prevention and five structural measures of hospital type. Results Relative hospital quality is tightly distributed, with outliers of both very high and very low quality. The best indicators of hospital quality are patients given assessment of left ventricular function for heart failure and patients given ?-blocker at arrival and patients given ?-blocker at discharge for heart attack. Additionally, teaching status is an important indicator of higher quality of care. Conclusions PRIDIT allows us to rank hospitals with respect to quality of care using process measures and demographic attributes of the hospitals. This method is an alternative to the use of clinical outcome measures in measuring hospital quality. Hospital quality measures should take into account the differential value of different quality indicators, including hospital “demographic” variables.

Lieberthal, Robert D

2008-01-01

407

Army Working Capital Fund: Actions Needed to Improve Budgeting for Carryover at Army Ordnance Activities.  

National Technical Information Service (NTIS)

From fiscal years 2004 through 2008, new orders received by the eight Army ordnance activities increased from $788 million to $1.5 billion. To the extent that the ordnance activities do not complete work at year end, the ordered and funded work is carried...

2009-01-01

408

ARI Survey of Army Recruits 1984: Tabular Description of NPS Army National Guard Accessions.  

National Technical Information Service (NTIS)

The ARI Survey of Army Recruits (more commonly known as the New Recruits Survey (NRS)) is conducted to obtain information on the characteristics, enlistment motivations, attitudes, and knowledge of recruits at the point of their initial entry into the U.S...

J. F. Celeste J. B. Davis D. C. Garver V. F. Nieva V. F. Ramsey

1986-01-01

409

Survey of Army Recruits: Codebook for Summer 85 Active Army Survey Respondents. Volume 1.  

National Technical Information Service (NTIS)

The ARI Survey of Army Recruits (more commonly known as the New Recruits Survey NRS) is conducted to obtain information on the characteristics, enlistment motivations, attitudes, and knowledge of recruits at the point of their initial entry into the U.S. ...

J. F. Celeste V. F. Ramsey

1986-01-01

410

A quantification of the physiological demands of the army emergency responder in the Australian army.  

PubMed

The Australian Defence Force is reviewing the physical demands of all employment categories in the Australian Army to establish valid and legally defensible assessments. The current assessments, performed in physical training attire, are not specific to job demands. Moreover, the fitness standards decrease based on age and are lower for females, and as job requirements are constant, these assessments are counterintuitive. With regard to the Army Emergency Responder employment category, tasks of physical demand in the present study were selected through consultation with subject-matter experts. Participants consisted of 10 qualified Army Emergency Responder soldiers and three noncareer firefighters under instruction. Real-life firefighting scenarios were witnessed by researchers and helped form task simulations allowing measurement of heart rate and oxygen consumption. Peak oxygen consumption ranged from 21.8 ± 3.8 to 40.0 ± 3.4 mL kg(-1) min(-1) during cutting activities and a search and rescue task, respectively, representing values similar to or higher than the current entry standards. Manual handling tasks were also assessed, with the heaviest measured being two soldiers lifting a 37.7-kg Utility Trunk to 150 cm. The findings provide a quantitative assessment of the physiological demands of Army Emergency Responders, and highlight the need for change in current fitness assessments. PMID:23756005

Tofari, Paul J; Laing Treloar, Alison K; Silk, Aaron J

2013-05-01

411

Army Division's Structure--What is Right for the Army of 1995 and Beyond.  

National Technical Information Service (NTIS)

This paper challenges whether the current division structure can remain as the base of maneuver considering the impacts force reductions and the revision of the current Airland Operations doctrine will have on our Army. The structure of our Table of Organ...

D. A. Rehm

1991-01-01

412

The NASA/Army Autonomous Rotorcraft Project  

NASA Technical Reports Server (NTRS)

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.

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

2002-01-01

413

Officials of the Army Ballistic Missile Agency  

NASA Technical Reports Server (NTRS)

Hermann Oberth (forefront) with officials of the Army Ballistic Missile Agency at Huntsville, Alabama in 1956. Left to right: Dr. Ernst Stuhlinger (seated); Major General H.N. Toftoy, Commanding Officer and person responsible for 'Project Paperclip,' which took scientists and engineers out of Germany after World War II to design rockets for American military use. Many of the scientists later helped to design the Saturn V rocket that took the Apollo 11 astronauts to the Moon. Dr. Eberhard Rees, Deputy Director, Development Operations Division Wernher von Braun, Director, Development Operations Division.

1956-01-01

414

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

Code of Federal Regulations, 2010 CFR

...2009-07-01 2009-07-01 false 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...

2009-07-01

415

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 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...

2010-07-01

416

US (United States) Army Medical Bioengineering Research and Development Laboratory Annual Progress Report FY1981.  

National Technical Information Service (NTIS)

The Annual Progress Report, Fiscal Year 1981, summarizes research performed by the US Army Medical Bioengineering Research and Development Laboratory in projects authorized by The Surgeon General, US Army, and the Commander, US Army Medical Research and D...

J. N. Albertson

1981-01-01

417

Installation Summaries From the FY 2001 Survey of Threatened and Endangered Species on Army Lands.  

National Technical Information Service (NTIS)

This report (part of a continuing series) summarizes the Army's threatened and endangered species data. It is collected from various sources including the Army's Environmental Quality Report (EQR), U.S. Fish and Wildlife Service (FWS), HQDA and Army insta...

A. M. Watland J. M. Bak S. Sekscienski B. Woodson

2002-01-01

418

US Army Medical Bioengineering Research and Development Laboratory Annual Progress Report FY 85. Volume 2.  

National Technical Information Service (NTIS)

The Annual Progress Report, Fiscal Year 1985, summarizes in two volumes the research performed by the US Army Medical Bioengineering Research and Development Laboratory in projects authorized by The Surgeon General, the US Army, and the Commander, US Army...

C. E. Pedersen

1985-01-01

419

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

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

Ressler, Kerry J; Schoomaker, Eric B

2014-01-01

420

Surgical Management of Hidradenitis Suppurativa  

PubMed Central

Background: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of skin, characterized by recurrent draining sinuses and abscesses, predominantly in skin folds carrying terminal hairs and apocrine glands. Method: This study reviewed 54 sites in 27 patients with moderate to extensive chronic inflammatory skin lesions treated surgically in our hospital from 2004 through 2009, with a follow-up of at least 6 months. Result: A total number of 54 operative procedures were performed during the study period with 42% (23 sites) involving the axilla, 20% (11 sites) involving the gluteal area, %24 (13 sites) involving the perineal area and 12% (7 sites) involving the inguinal region. Conclusion: Conservative treatment methods have little or no effects especially on gluteal, perineal/perianal, axillary hidradenitis suppurativa. The morbidity associated with the established form of this disease is significant, and the only successful treatment is wide surgical excision.

Menderes, Adnan; Sunay, Ozgur; Vayvada, Haluk; Yilmaz, Mustafa

2010-01-01

421

Electronic voice communications improvements for Army aircraft  

NASA Astrophysics Data System (ADS)

The communications systems on all Army aircraft flying today are based on design concepts that are over 50-years old. We have designed a totally modern, state-of-the-art communications system for Army aircraft, and have published two new specifications which contain many of the modern test procedures required to accurately test and evaluate the various components of the communication system. As a first step in the development of new test procedures, we evaluated both ASA and ANSI standards and found them lacking. The components of the new state-of-the-art communications system will include, as a minimum: high impedance DC powered noise canceling microphones (using piezoelectric ceramic, electret, or PVF2 diaphragms); earphone elements designed and tested to have flat frequency response when inside the circumaural earcup of the hearing protective device; and intercoms which replace positive peak-clipping with fast-acting AGC circuits and expander/compander circuits for maximum output signal without distortion, even under conditions of extremes stress. In the future, audio signals in the microphone will be converted into the digital mode or directly into the optical spectrum for high efficiency, and secure communications inside the aircraft. The savings in weight and security improvements will be considerable.

Mayer, M. S.

1982-08-01

422

New Tools and Metrics for Evaluating Army Distributed Learning. Monograph  

ERIC Educational Resources Information Center

Distributed learning (DL) is a key element of the Army's training strategy, and the Army has ambitious goals for expanding the future use of DL and for changing how it is developed and delivered. Program-level evaluation of DL can play an essential role in accomplishing those goals and in identifying strategic directions for the overall program.…

Straus, Susan G.; Shanley, Michael G.; Yeung, Douglas; Rothenberg, Jeff; Steiner, Elizabeth D.; Leuschner, Kristin J.

2011-01-01

423

20. Photocopy of original drawing by US Army Engineer District, ...  

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

20. Photocopy of original drawing by US Army Engineer District, Corps of Engineers, 1964 (original in possession of NYC Economic Development Corp.) REPAIRS OF SPALLED CONCRETE-PIERS 2,3, AND 4 - Brooklyn Army Supply Base, Pier 2, Brooklyn, Kings County, NY

424

Mentoring: A Useful Concept for Leader Development in the Army.  

National Technical Information Service (NTIS)

Mentoring became part of the Army's lexicon in 1985, when the Chief of Staff of the Army, General John C. Wickman, Jr., challenged every leader to be a mentor to his or her subordinates. Mentoring soon emerged as a primary concept in the doctrine for prof...

G. W. Wood

1990-01-01

425

Women in the Army: Experiences of a Battalion Commander.  

National Technical Information Service (NTIS)

There have been numerous studies, papers, and articles written about women in the Army or about women in the armed services, one of the most recent of which is by Martin Blumenson and appeared in the May 1979 issue of Army. However, there are few records ...

J. G. McKnight

1979-01-01

426

U.S. Army Corps of Engineers: A History.  

National Technical Information Service (NTIS)

This illustrated history of the U.S. Army Corps of Engineers provides an overview of many of the missions that engineers have performed in support of the U.S. Army and the Nation since the early days of the American Revolution. A permanent institution sin...

2008-01-01

427

Showdown: An interactive exercise bike for the army  

Microsoft Academic Search

In this paper we describe the design and implementation of Showdown, which is a game-like application for army soldiers. The application uses an exercise bike for the interaction with the user. The goal of the application is to create an activity which allows soldiers to train themselves physically and mentally. It was designed to fit into the army environment in

Amine Rhor; Naveen Sethi; Steven Fokkinga

428

Evolution of Instrument Flying in the U.S. Army.  

National Technical Information Service (NTIS)

This study describes how the U.S. Army developed training programs and management systems for instrument flying between 1981 and 1948. The study addresses the factors, such as attitudes, people and events that influenced the Army's development of an instr...

D. M. McIntosh

1988-01-01

429

Army Budget: Potential Reductions to Aircraft Procurement Budgets.  

National Technical Information Service (NTIS)

The study reviews selected aircraft procurement line items in the Army's fiscal year 1988 budget request. Specifically, it reviews the Army's requests of about $1.6 billion for seven helicopter systems--the AH-64A Apache, the UH-60A Black Hawk, the CH-47D...

1987-01-01

430

An Evaluation of Drug Education in the United States Army.  

ERIC Educational Resources Information Center

In an attempt to prevent drug abuse, the U.S. Army developed drug education programs (DEP) at all its installations to inform soldiers about the dynamics and consequences of drug use. This paper presents the findings of the recently completed evaluation of Army DEP. The study surveyed 1,716 enlisted men at 16 posts about exposure to the DEP and…

Morton, Anton S.; And Others

431

Army Unit Cohesion in Vietnam: A Bum Rap.  

National Technical Information Service (NTIS)

The recently implemented program of the Army regimental system perhaps best typifies the current perception of the linkage between primary group cohesion and fighting power. Curiously, the U.S. Army decided on this program based on one of the very factors...

R. Kaplan

1987-01-01

432

United States Army Reserve Support to Peace Operations.  

National Technical Information Service (NTIS)

The United States must be prepared to respond to smaller-scale contingency operations as the Army continues to integrate the Active and Reserve components into a Total Force. Currently, the Army has too much to do and given the necessity for USAR involvem...

C. V. Anderson

2001-01-01

433

Discourses of Gender in the Contemporary British Army  

Microsoft Academic Search

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

Rachel Woodward; Patricia Winter

2004-01-01

434

Energy Sustainability and the Army: The Current Transformation.  

National Technical Information Service (NTIS)

The purpose of this paper is to examine the U.S. Army's use of conservation and renewable energy systems (RES) for the purposes of sustainability and national security. Initiatives in these areas will allow the U.S. Army to transform itself into a more bu...

N. D. Northern

2009-01-01

435

Pattern Formation and Optimization in Army Ant Raids  

Microsoft Academic Search

Army ant colonies display complex foraging raid patterns involving thousands of individuals communicating through chemical trails. In this paper we explore, by means of a simple search algorithm, the properties of these trails in order to test the hypothesis that their structure reflects an optimized mechanism for exporing and exploiting food resources. The raid patterns of three army ant species,

Ricard V. Solé; Eric Bonabeau; Jordi Delgado; Pau Fernández; Jesus Marín

1999-01-01

436

Explaining Recent Army and Navy Minority Recruiting Trends. Research Brief  

ERIC Educational Resources Information Center

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…

Steinberg, Paul

2009-01-01

437

Space Support Elements: Embedded Space Expertise in Army Modular Forces  

Microsoft Academic Search

The Army's Future Force, serving as part of the Joint Force, will be adaptable and lethal, leveraging the extraordinary capabilities of space. Army Modular Forces will routinely exploit the overhead constellations of national, commercial and military space and near-space platforms. They will rely on knowledge-based networks that are vertically and horizontally integrated from strategic to tactical levels. Warfighters will have

2005-01-01

438

Army and Franklin Covey Leadership Models: A Comparison.  

National Technical Information Service (NTIS)

This Strategy Research Project compares and contrasts the Army Leadership Model, as presented in FM 22-100, Army Leadership: Be, Know, Do, with the Franklin Covey Leadership Model as described in The 7 Habits of Highly Effective People. Principle-Centered...

D. J. Smith

2000-01-01

439

Army Finance Organizational Support of Force Projection Operations.  

National Technical Information Service (NTIS)

This study investigates the role of U.S. Army financial organizations and their ability to adequately provide finance operations in support of force projection operations. Two significant events brought about a change to the U.S. Army's finance organizati...

D. G. Murch

1996-01-01

440

Army Total Quality Management (TQM) Implementation Plan for Acquisition.  

National Technical Information Service (NTIS)

The Army TQM (Total Quality Management) Acquisition Plan contains four parts. Part 1 is the introduction; Part 2 presents the strategy for achieving TQM within the Army acquisition community; Part 3 describes the tasks that will be pursued to implement th...

1988-01-01

441

77 FR 4026 - Army Education Advisory Subcommittee Meeting Notice  

Federal Register 2010, 2011, 2012, 2013

...members of the public to present their issues for review and discussion by the U.S. Army War College Subcommittee. Brenda S. Bowen, Army Federal Register Liaison Officer. [FR Doc. 2012-1650 Filed 1-25-12; 8:45 am] BILLING CODE...

2012-01-26

442

Achieving Competence: Army-VOTEC School Partnership Pilot Studies.  

ERIC Educational Resources Information Center

To reduce Army training costs, the Training and Doctrine Command (TRADOC) investigated use of training at civilian secondary and postsecondary vocational-technical (VOTEC) institutions as an alternative to initial job training in Army service schools. Three models were used in the pilot study: the preservice training model in which…

Stout, Mary W.

443

Groundwater modeling in the Army environmental restoration programs. Final report  

Microsoft Academic Search

This is the report of the findings and recommendations of a ground water study panel convened by the Army Science Board's Infrastructure Environment (IE) Issue Group to evaluate the role and practice of ground water modeling (GWM) in the Army's environmental restoration programs and to assess future research program needs. Cleaning up contaminated ground water and soils is an exceptionally

G. Charnley; C. C. Campbell; K. Green; J. Sculley; G. Piegari

1994-01-01

444

U.S. Army Annual Injury Epidemiology Report 2007.  

National Technical Information Service (NTIS)

Injuries are a leading cause of death, disability, and medical encounters among active duty U.S. Army personnel. Medical surveillance data provide a useful tool for defining the magnitude of the Army injury problem, injury rates and trends, and causes of ...

B. H. Jones E. Dada-Laseinde M. Canham-Chervak N. Clemmons

2009-01-01

445

U.S. Army Annual Injury Epidemiology Report 2008.  

National Technical Information Service (NTIS)

Injuries are a leading cause of death, disability, and medical encounters among Active Duty U.S. Army personnel. Medical surveillance data provide a useful tool for defining the magnitude of the Army injury problem, injury rates and trends, and causes of ...

B. H. Jones E. Dada-Laseinde M. Canham-Chervak

2009-01-01

446

Unmanned systems initiative: supporting immediate warfighter needs and army transformation  

Microsoft Academic Search

Unmanned systems have emerged as a critical warfighting capability for operation Iraqi freedom (OIF) and operation enduring freedom (OEF) and form a cornerstone of the Army's transformational flagship program, future combat systems (FCS). The unmanned systems initiative (USI), a congressionally supported program managed by the US Army Aviation and Missile Research, Development and Engineering Center (AMRDEC), is responding to these

P. B. DiNardo; S. B. Andrews

2005-01-01

447

Posttraumatic Stress Disorder Among Army Nurse Corps Vietnam Veterans.  

ERIC Educational Resources Information Center

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.…

Stretch, Robert H.; And Others

1985-01-01

448

Army Pre-Positioned Stocks (APS) Ready for Action.  

National Technical Information Service (NTIS)

Our expeditionary Army is designed to move fast and hit hard. To speed our forces to the fight, the Army Sustainment Command (ASC) maintains combat-ready equipment and materiel, strategically prepositioned around the world and ready for issue to Soldiers ...

L. K. Theis

2008-01-01

449

Quality of local guidelines for surgical antimicrobial prophylaxis  

Microsoft Academic Search

Surgical antimicrobial prophylaxis (AMP) is an effective measure to prevent surgical site infections. To determine the quality and availability of local guidelines for AMP, a survey was conducted in the public hospitals of a Northern Italian region. The guidelines for “Antimicrobial Prophylaxis in Surgery” by the Scottish Intercollegiate Guidelines Network (SIGN) were used as a standard by which the quality

C Gagliotti; F Ravaglia; D Resi; M. L Moro

2004-01-01

450

Surgical emergencies in general practice  

PubMed Central

Two thousand and thirty patients were seen in their own homes between 19.00 hours and 07.00 hours during a 14-month period. Twenty-nine per cent of these visits were for surgical conditions and a detailed analysis of this group is presented. An attempt to assess the necessity of the visit by grading them into minor, intermediate, and severe is also made. No attempt is made to discuss the treatment of individual conditions. The high admission rate to hospital probably reflects the uncertainty of further home follow-up.

Scurr, John H.

1979-01-01

451

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.

1996-01-01

452

ARI (Army Research Institute for the Behavioral and Social Sciences) Survey of Army Recruits, 1985: Tabular Description of NPS Army Reserve Accessions. Volume 1.  

National Technical Information Service (NTIS)

This is one of eight reports that provide background information, descriptions of survey approach, assessments of data quality, and preliminary results from the 1985 summer administration of the ARI Survey of Army Recruits, familiarly known as the New Rec...

J. F. Celeste V. F. Ramsey B. F. Allen J. B. Davis D. C. Garver

1987-01-01

453

ARI (Army Research Institute for the Behavioral Social Sciences) Survey of Army Recruits, 1985: Tabular Description of Army National Guard Accessions.  

National Technical Information Service (NTIS)

This is one of eight reports that provide background information, descriptions of survey approach, assessments of data quality, and preliminary results from the 1985 summer administration of the ARI Survey of Army Recruits, familiarly known as the New Rec...

J. F. Celeste V. F. Ramsey B. F. Allen J. B. Davis D. C. Garver

1987-01-01

454

ARI (Army Research Institute for the Behavioral and Social Sciences) Survey of Army Recruits, 1985: Tabular Description of NPS Army Reserve Accessions. Volume 2.  

National Technical Information Service (NTIS)

This is one of eight reports that provide background information, descriptions of survey approach, assessments of data quality, and preliminary results form the 1985 summer administration of the ARI Survey of Army Recruits, familiarly known as the New Rec...

J. F. Celeste M. J. Wilson V. F. Ramsey B. F. Allen J. B. Davis

1987-01-01

455

ARI (Army Research Institute for the Behavioral and Social Sciences) Survey of Army Recruits, 1985: Tabular Description of NPS (Active) Army Accessions. Volume 1.  

National Technical Information Service (NTIS)

This is one of eight reports that provide background information, descriptions of survey approach, assessments of data quality, and preliminary results from the 1985 summer administration of the ARI Survey of Army Recruits, familiarly known as the New Rec...

J. F. Celeste M. J. Wilson V. F. Ramsey B. F. Allen J. B. Davis

1987-01-01

456

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

PubMed Central

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.

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

2010-01-01

457

Army Working Capital Fund: Army Faces in Challenges in Managing Working Capital Fund Cash Balance during Wartime Environment.  

National Technical Information Service (NTIS)

The Army Working Capital Fund (AWCF) collected over $16 billion for goods and services provided to customers in fiscal year 2009. Cash generated from sales is used by AWCF to cover its expenses such as paying employees. In light of the Army's changing rol...

2010-01-01

458

Differential Validity of the Army Aptitude Areas for Predicting Army Job Training Performance of Blacks and Whites. Technical Paper 312.  

ERIC Educational Resources Information Center

Validation studies were conducted on nine revised aptitude areas of the Army Classification Battery (ACB) to determine whether ACB scores provided an equitable indication of the qualifications of blacks and whites for training in major groups of Army jobs. The aptitude areas were: combat, field artillery, electronics repair, operators and food,…

Maier, Milton H.; Fuchs, Edmund F.

459

Retained surgical swabs in 13 dogs.  

PubMed

To report the signalment, history, clinical signs, diagnostic and surgical findings and outcome in dogs and cats with retained swabs, medical records of dogs and cats that were referred to four referral centres were reviewed. Cases in which a retained surgical swab was identified during surgery at the referral hospital were selected for further study. The signalment, history, clinical signs, diagnostic and surgical findings and outcome in these cases were reviewed. Thirteen dogs with retained surgical swabs were included in the study. Bodyweight ranged from 9 to 45 kg. The initial surgery was a 'non-routine' abdominal procedure in seven dogs, ovariohysterectomy in five dogs and perineal hernia repair in one dog. Time from initial surgery to presentation at the referral centre ranged from four days to seven years. Treatment involved major surgery in eight of the 13 dogs. Outcome was excellent in 12 of 13 cases, one dog was euthanased. PMID:21846684

Forster, K; Anderson, D; Yool, D A; Wright, C; Burrow, R

2011-09-24

460

Intraoperative nursing activities performed by surgical technologists.  

PubMed

In this study of delegated intraoperative nursing activities performed by surgical technologists (STs) in low-risk and high-risk surgical procedures, 343 OR directors, perioperative nurses, and STs from rural, community, and medical center hospitals reported that STs frequently perform activities related to surgical counts, the sterile field, and equipment and supplies. Surgical technologists do not frequently perform tasks related to patient transportation, teaching, medication administration, OR environment, patient monitoring, and patients' rights. The investigator used nine competency statements of intraoperative nursing as a framework for the research instrument. Data analysis determined that the levels of risk in patient situations affects how frequently STs perform transportation, teaching, sterile field, OR environment, and patients' rights activities. PMID:7979325

Abbott, C A

1994-09-01

461

Compare Hospitals  

MedlinePLUS

... to making information about the safety, quality, and efficiency of their hospital available to the public. We ... Hospitals that implement these quality, safety, and/or efficiency practices have reported that their internal processes of ...

462

Designing and implementing the Army Nursing Leader Academy.  

PubMed

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

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

2011-01-01

463

American Pediatric Surgical Association  

MedlinePLUS

... May 2014 issue Stay current with APSA and pediatric surgery news. Read current issue | Archives Locum Tenens ... for Children’s Surgical Care Assuring Access to Quality Pediatric Surgical Subspecialty Care in the Accountable Care Organization ( ...

464

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 ...

465

System, apparatuses and methods to increase supply of specialty care surgical-medical treatments  

US Patent & Trademark Office Database

System, apparatuses and methods for treating specialty care surgical-medical patients (10) who are medically-stable. A specialty care surgical-medical hospital-clinic (40) is sited on a quasi-sovereign geographic area, including federally-recognized American Indian/Alaskan Native tribal nations. Surgical-medical treatments by provider group (42) who are citizens of countries worldwide. Transportation (30) of patients to hospital-clinic (40) by non-emergency vehicles. Treatment of patients (10) maximized via surgical-medical expertise from other hospital-clinics (60) provided via information technology systems (50) connected by global wide-area network linkages (62).

2014-04-01

466

The Professional Environment in Army Laboratories and Its Effect on Scientific and Engineering Performance.  

ERIC Educational Resources Information Center

In response to a 1982 request by the U.S. Department of the Army, the National Research Council's Board on Army Science and Technology established the Committee on Army Manpower to investigate the professional environments and use of civilian and military scientists/engineers in Army laboratories. The committee's primary objective was to identify…

National Academy of Sciences - National Research Council, Washington, DC. Board on Army Science and Technology.

467

Surgical evacuation of acute subdural hematoma improves cerebral hemodynamics in children: a transcranial Doppler evaluation  

Microsoft Academic Search

Objective The objective was to evaluate cerebral hemodynamics in young children with acute subdural hematoma (SDH) and the impact of surgical treatment using transcranial Doppler (TCD). Design The design was a prospective study of infants with SDH requiring surgical evacuation. Setting The setting was the neuro intensive care unit of a university hospital. Interventions Indications for surgical evacuation were based

Philippe Gabriel Meyer; Sarah Ducrocq; Thibault Rackelbom; Gilles Orliaguet; Dominique Renier; Pierre Carli

2005-01-01

468

Lower Mortality in Magnet Hospitals  

PubMed Central

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 to 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 vs. 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 (OR 0.86, 95% CI 0.76-0.98, p=0.02) and 12% lower odds of failure-to-rescue (OR 0.88, 95% CI 0.77-1.01, p=0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions Magnet hospitals have lower mortality than is fully accounted for by measured characteristics of nursing. Magnet recognition likely both identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes.

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

2012-01-01

469

Malignant pleural mesothelioma: outcome of limited surgical management.  

PubMed

This study presents data on limited surgical management of malignant pleural mesothelioma. We reviewed retrospectively 70 cases of the disease managed surgically over a 10 year period. Fifteen patients received only diagnostic direct pleural biopsy, 40 had video-assisted thoracoscopic, pleural biopsy and talc pleurodesis while 15 patients underwent thoracotomy and pleurectomy for disease confined to the pleura. There were two in-hospital deaths. Actuarial survival was significantly longer in the thoracotomy group (median 14 months vs. 6 months in the other two groups, P < 0.03). Survival after limited surgical management of malignant mesothelioma is comparable to a previously reported more radical surgical approach. PMID:17669981

Phillips, Peter G; Asimakopoulos, George; Maiwand, M Omar

2003-03-01

470

Study of the Reproductive Effects in Rats Surgically Implanted With Depleted Uranium for Up to 90 Days  

Microsoft Academic Search

In 2001, the Naval Health Research Center Toxicology Detachment was funded by the U.S. Army Medical Research Acquisition Activity (USAMRAA) to conduct a study of the effects of surgically implanted depleted uranium (DU) pellets on adult rat reproductive success and development across two successive generations. This article presents some of the findings for the group of offspring from adult rats

D. P. Arfsten; M. Bekkedal; E. R. Wilfong; J. Rossi III; K. A. Grasman; L. B. Healey; J. M. Rutkiewicz; E. W. Johnson; A. R. Thitoff; A. E. Jung; S. R. Lohrke; D. J. Schaeffer; K. R. Still

2005-01-01

471

Determine the Influence of Time Held in Knockdown Anesthesia on Survival and Stress of Surgically Implanted Juvenile Salmonids  

Microsoft Academic Search

The Juvenile Salmon Acoustic Telemetry System (JSATS) was developed for the U.S. Army Corp of Engineers Portland District (USACE) to address questions related to survival and performance measures of juvenile salmonids as they pass through the Federal Columbia River Power System (FCRPS). Researchers using JSATS acoustic transmitters (ATs) were tasked with standardizing the surgical implantation procedure to ensure that the

Christa M. Woodley; Katie A. Wagner; Kasey M. Knox

2012-01-01

472

The surgical treatment of regional enteritis  

Microsoft Academic Search

Summary  A review of the significant contributions to the literature on the surgical management of regional enteritis has been made.\\u000a \\u000a Eight cases from the experience with this disease at the Meriden Hospital and from the author's experience have been presented\\u000a from the standpoint of their surgical management and the results.\\u000a \\u000a \\u000a \\u000a An analysis of the claims made for the greater efficacy of

Allan J. Ryan

1951-01-01

473

Design of Waste Heat Boiler for Scranton Army Ammunition Plant.  

National Technical Information Service (NTIS)

The Army Ammunition Plant at Scranton, Pennsylvania, has rotary hearth furnaces to heat billets for the forging operation. Mechanical Technology Incorporated established the economic and operational feasibility of waste heat recovery from the most used fu...

R. J. Krowech G. Scullin

1980-01-01

474

78 FR 23759 - Army Education Advisory Subcommittee Meeting Notice  

Federal Register 2010, 2011, 2012, 2013

...16, 2013. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall...Designated Federal Officer, Dept. of Academic Affairs, 122 Forbes Avenue, Carlisle, PA 17013. At any point, however, if...

2013-04-22

475

77 FR 27209 - Army Education Advisory Subcommittee Meeting Notice  

Federal Register 2010, 2011, 2012, 2013

...31, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall...Designated Federal Officer, Dept, of Academic Affairs, 122 Forbes Avenue, Carlisle, PA 17013. At any point, however, if...

2012-05-09

476

Amphibian Research and Monitoring Initiative (ARMI), 5-Year Report.  

National Technical Information Service (NTIS)

This report is a 5-year retrospective of the structure, methodology, progress, and contributions to the broader scientific community that have resulted from this national USGS program. We evaluate ARMIs success to date, with regard to the challenges faced...

A. L. Gallant D. E. Green E. Muths E. H. Campbell Grant W. A. Battaglin

2006-01-01

477

Environmental Trends - Policy Implications for the U.S. Army.  

National Technical Information Service (NTIS)

This paper provides a compilation of the environmental trends expected to most significantly influence U.S. Army mission and environmental program management in this decade, and beyond. This document reflects information gathered in mid-1991. It is a stat...

J. Stratta R. Jarrett R. Reuter R. K. Jan

1992-01-01

478

Development of an Operations Research Software Package for Army Divisions.  

National Technical Information Service (NTIS)

There exists great potential for applying operations research techniques to solve specific problems in the areas of operations, installation support, and training at the Army division level. Because of the operational tempo of today's active-duty and rese...

B. C. Wilson

1998-01-01

479

Micro-Electro-Mechanical Systems: A Catalyst for Army Transformation.  

National Technical Information Service (NTIS)

If global force projection through rapid deployability is the Army Transformation vision, then Micro-electro Mechanical Systems (MEMS) are one of the key technological building blocks for the Objective Force. Size and weight are the fundamental characteri...

S. G. Bianco

2001-01-01

480

Overcoming the Cultural Barriers to TQM in the Army.  

National Technical Information Service (NTIS)

The Army is in the process of considering a change to its leadership and management philosophy to the concepts of Total Quality Management (TQM). TQM is an organizational philosophy which focuses on customer orientation, statistical thinking, and continuo...

R. M. Zimmerman

1992-01-01

481

Needs Assessment for the Army Education Information System.  

National Technical Information Service (NTIS)

The purpose of this effort was to identify the specific kinds and quantity of information provided to enlisted personnel by Army Education Center counselors and to determine the feasibility of providing this information by computer. The attitudes of Educa...

J. Harris-Bowlsbey C. M. Rabush

1979-01-01

482

Functional Specifications: The Army Education Information System (AREIS).  

National Technical Information Service (NTIS)

This document provides the details and specifications for the completion and implementation of the Army Education Information System (AREIS). AREIS is a computer-based educational and vocational guidance system. A plan for a field tryout of the completed ...

J. H. Bowlsbey C. Rabush

1980-01-01

483

Nonverbal Communication and Aircrew Coordination in Army Aviation: Annotated Bibliography.  

National Technical Information Service (NTIS)

The Army's Aircrew Coordination Training (ACT) programs emphasize the importance of verbal communications between crewmembers during mission execution. While this is a critical component of effective crew coordination, little attention has been directed t...

L. C. Katz G. Kambe K. F. Kline G. N. Grubb

2006-01-01

484

Combating Tobacco Use in the United States Army.  

National Technical Information Service (NTIS)

This study will test the effectiveness of a computer-based cigarette smoking and smokeless tobacco prevention and cessation video game among active Army personnel stationed at Fort Hood, Texas. The study has been designed to permit analyses sensitive enou...

A. Prokhorov L. A. Gatus S. Reese

2010-01-01

485

Human Systems Integration Analysis of the Army Suicide Prevention Program.  

National Technical Information Service (NTIS)

A Human Systems Integration (HSI) analysis of the Army Suicide Prevention Program (ASPP) was conducted to gain feedback from soldiers and leaders. The scope of the study limited analysis to the prevention activities associated with the ASPP system. A retr...

B. R. Bell

2013-01-01

486

Funding for Army Facility Maintenance and Repair Projects in Europe.  

National Technical Information Service (NTIS)

The audit objective was to determine whether funds for the Amelia Earhart facility construction project and other U.S. Army Europe maintenance and repair projects had been made available through improper fund substitutions. The audit also assessed the ade...

1996-01-01

487

The Army Stock Fund--Friend or Foe.  

National Technical Information Service (NTIS)

The study examines whether or not the current method of operating the Wholesale Stock Fund System at the National Inventory Control Points (NICP) impacts on the Army's operational readiness and stock availability. The growing emphasis on unit readiness an...

J. R. Brinton

1975-01-01

488

US Army's Delay Entry Program: A Survival Study.  

National Technical Information Service (NTIS)

This thesis studies the phenomena of Delayed Entry Program (DEP) survival. Specifically, this study attempts to provide a method for estimating the number of DEP accessions from a pool of recruits in DEP contracts. When providing recruiter goals, the Army...

J. S. Vales

1994-01-01

489

Validating a Network Simulation Testbed for Army UAVs.  

National Technical Information Service (NTIS)

Auburn University, through the Army's Aviation and Missile Research, Development and Engineering Center (AMRDEC) has been supporting the Unmanned Systems Initiative (USI) program in three research areas related to unmanned aerial vehicle (UAV). A major el...

J. J. Hamilton S. S. Hamilton T. Schmoyer

2007-01-01

490

Army's Flexible Display Center (FDC) at Arizona State University (ASU).  

National Technical Information Service (NTIS)

As Army transformation unfolds through the Future Combat Systems (FCS) program, the ability to perform essential command, control, communications, computers, intelligence, surveillance, reconnaissance/mobility (C4ISR/M) functions for combat vehicles and d...

D. Morton G. B. Raupp

2007-01-01

491

Army Reserve Meeting Homeland Security Obligations Amidst Transformation.  

National Technical Information Service (NTIS)

The United States Army Reserve is undergoing tremendous change during transformation to include Base Closure and Realignment (BRAC). It is closing 176 reserve centers, occupying 125 new joint reserve centers; disestablishing ten Regional Readiness Command...

S. H. Brown

2008-01-01

492

Systems Analysis of Army Field Bread and Bakery Requirements.  

National Technical Information Service (NTIS)

The systems analysis addresses alternatives to satisfy the Army's field bread product requirement, including fresh bread from mobile bakeries and host nation support, shelf-stable end products (canned bread, crackers, British-type biscuits), and shelf-sta...

H. J. Kirejczyk W. Chevalier B. Edelman R. V. Decareau

1985-01-01

493

Study of Job Satisfaction at Eisenhower Army Medical Center.  

National Technical Information Service (NTIS)

This study was conducted to determine the level of job satisfaction among administrative employees at Eisenhower Army Medical Center. The Job Descriptive Index (a widely used survey instrument) was used to evaluate the satisfaction of EAMC employees. The ...

S. C. Schmid

1987-01-01

494

Finding 'The Right Way': Toward an Army Institutional Ethic.  

National Technical Information Service (NTIS)

The ethical lapses exemplified by Abu Ghraib, Mahmudiyah (Blackhearts), and Maywand (5/2 Stryker) are distressing symptoms of an even bigger, and potentially devastating, cultural shortcoming. The U.S. Army profession lacks an institutional ethical framew...

C. C. Barrett

2012-01-01

495

Finding 'The Right Way': Towards an Army Institutional Ethic.  

National Technical Information Service (NTIS)

The ethical lapses exemplified by Abu Ghraib, Mahmudiyah (Blackhearts), and Maywand (5/2 Stryker) are distressing symptoms of an even bigger, and potentially devastating, cultural shortcoming. The U.S. Army profession lacks an institutional ethical framew...

C. C. Barrett

2012-01-01

496

77 FR 40030 - Army Science Board Summer Study Meeting  

Federal Register 2010, 2011, 2012, 2013

...Committee: Army Science Board (ASB). Date(s) of Meeting: July 26, 2012. Time(s) of Meeting: 1530-1630. Location: MIT Endicott House, 80 Haven Street, Dedham, MA 02026. Purpose: Adopt the findings and recommendations for the following...

2012-07-06

497

History of the U.S. Army Medical Service Corps.  

National Technical Information Service (NTIS)

The United States Army Medical Service Corps is an important national resource with a long and distinguished history. Many thousands of officers have proudly served in its ranks, selflessly prosecuting the nation's defense missions in peace and war throug...

R. V. N. Ginn

1997-01-01

498

Use of Army School Samples in Estimating ACB Test Validity.  

National Technical Information Service (NTIS)

Results are reported of the reexamination of the statistical method currently employed in estimating the predictive effectiveness of the tests of the Army Classification Battery (ACB) when validity data are restricted to a segment of the entering populati...

P. T. Olson

1968-01-01

499

Integrating Language and Cultural Knowledge into the Army Officer Corps.  

National Technical Information Service (NTIS)

As the Contemporary Operating Environment (COE) has shifted away from a necessity to apply conventional tactics towards a counterinsurgency fight, culture has become increasingly important to the U.S. Army. In the wake of such a tremendous tactical policy...

J. L. Purser

2008-01-01

500

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

NASA Astrophysics Data System (ADS)

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 solid state laser technologies, advances in beam control technology, and conducting major demonstrations. The High Energy Laser Mobile Demonstrator (HELMD) will be a major step toward demonstrating HEL weapon capability to the soldier. The US Army will continue to pursue technologies that enable more compact systems compatible with, for example, a Stryker tactical vehicle as a crucial part of our strategy to provide a capability to the warfighter that can maneuver with the force.

Lavan, Michael J.; Wachs, John J.

2011-10-01