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1

The mobile Army surgical hospital (MASH): a military and surgical legacy.  

PubMed Central

Operation Iraqi Freedom was perhaps the last military campaign that will ever utilize the services of a mobile Army surgical hospital (MASH). The Army has now essentially replaced the MASH with combat surgical hospitals (CSH) and forward surgical teams (FST). MASH units were designed as mobile, flexible, forward-deployed military hospitals, providing care for the wounded near the frontlines of the battlefield. These hospitals not only saved thousands of lives during war but also greatly influenced the delivery of trauma and critical care in civilian hospitals. The MASH was made popular by the television series of the 1970s, depicting the 4077th during the Korean War. Although a comical series, these television episodes provided viewers with a glimpse of life in a MASH during time of war. This article chronicles the history of the MASH from its inception during World War II to recent experiences in Operation Iraqi Freedom. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 p656-a

King, Booker; Jatoi, Ismalil

2005-01-01

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

Clinical psychology in Army hospitals  

Microsoft Academic Search

A recently established program of clinical psychological service in all general hospitals and in the major station hospitals is analyzed under the following headings: scope of the program, qualifications of clinical psychologists, administration of the hospital program, and training of professional personnel.

M. A. Seidenfeld

1944-01-01

4

Trauma experience comparison of army forward surgical team surgeons at Ben Taub Hospital and Madigan Army Medical Center 2 1 The opinions expressed in this article are those of the authors and do not reflect the official position of the Department of the Army, the Department of Defense, or the United States Government. 2 2 This article contains the opinions of the authors only and does not represent the opinion of the United States Department of Defense or the United States Army  

Microsoft Academic Search

PurposeFar forward life-saving surgical care is the mission of an army forward surgical team (FST). Trauma skill maintenance is necessary to complete that mission. A new program has been developed for FST training using the resources of a Level 1 trauma center. We sought to compare the experience of FST surgeons at a major urban trauma center with the yearly

Clifford A Porter; Kenneth Azarow; Alan L Beitler

2001-01-01

5

Knight Army Hospital: 1862-1865.  

PubMed

A cataclysmic civil war produced hundreds of thousands of sick and wounded soldiers. The Knight Army Hospital was built in New Haven to provide for returning soldiers of Connecticut suffering from disease or injury. With a 1,000-bed capacity, it became a city within a city successfully providing comprehensive health care and a variety of other services. How this hospital came to be, how it was run, and by whom, is part of this story. The sacrifices made by the soldiers in the field were matched by the sacrifices made by doctors, nurses and other paramedical personnel. The weave of politics, economics, medical science and human frailty allowed that society to provide state-of-the-art health care for its citizens under the most difficult of circumstances. PMID:19263741

Spar, Ira

2009-02-01

6

Energy Management Study for General Leonard Wood Army Community Hospital.  

National Technical Information Service (NTIS)

William Tao Associates, Inc. (WTA) was commissioned by the United States Army Corps of Engineers (COE) to perform an Energy Management Study of the General Leonard Wood Army Community Hospital (GLWACH). The Hospital is a 366,000 SF facility, with schedule...

1986-01-01

7

Tending the Army: Women and the British General Hospital in North America, 1754-1763  

Microsoft Academic Search

This essay argues that the British Army's North American general hospital and an increasingly large and diverse group of army women became not only connected but dependent on one another during the Seven Years' War. This relationship derived from the army's reorganization of its medical services in a way that intentionally predicated the hospital's operation and success on army women

Sarah Fatherly

2012-01-01

8

Ocular trauma in the United States Army: hospitalization records from 1985 through 1994  

Microsoft Academic Search

PURPOSE: To determine the incidence of hospitalized ocular injury in the United States Army and evaluate specific types and external causes of these injuries.METHODS: A US Army database that captured all hospital discharge records for Army personnel admitted to military and civilian hospitals was used to determine incident episodes of ocular injury requiring hospitalization from 1985 through 1994. Denominator data

Tien Yin Wong; Gordon S Smith; Andrew E Lincoln; James M Tielsch

2000-01-01

9

Hospitalization Associated with Traumatic Brain Injury in the Active Duty US Army: 2000-2006.  

National Technical Information Service (NTIS)

Objective: to determine the potential impacts of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) on the incidence of TBI-related hospitalization in the active duty US Army. Methods: All active duty Army personnel hospitalized with a TBI...

B. J. Ivins

2010-01-01

10

Military nursing at the forefront: the Army Forward Surgical Team.  

PubMed

From World War II to current conflicts, history has validated the need for early surgical intervention to save lives and established the need for FSTs. Historically 10% to 15% of soldiers wounded in action require surgery to control hemorrhage and to provide stabilization sufficient for evacuation to a medical treatment facility where definitive care can be provided. Undoubtedly, many lives were saved in past conflicts because resuscitative surgery and care were available a short time after being wounded. The need for surgical stabilization for patients to survive a long evacuation was well-established during military operations such as Operation Desert Storm. Resuscitative surgery capability must be present on the battlefield, and this capability must be able to move with the units the FST is supporting. These two imperatives were the driving force of the creation of the US Army's FSTs: they are light, easily transportable, and able to keep pace with the supported units. FSTs are an integral and essential element in providing surgical care to save soldiers' lives on the modem battlefield. The US military has been involved in more operations and deployments since the end of the Cold War than in the preceding years. FSTs participated in many of these operations and have performed superbly. FSTs will continue to have a critical role in providing combat health service support to soldiers on the battlefield of the twenty-first century, and FST nurses will continue to be an indispensable asset. PMID:12755185

Hough, Charlotte; Sadler, Michael; Patrician, Patricia A

2003-06-01

11

Lean Six Sigma: Optimizing Operating Room Utilization at Bayne-Jones Army Community Hospital.  

National Technical Information Service (NTIS)

Bayne-Jones Army Community Hospital secured funding to hire additional staff members to open a third operating room on a consistent basis. According to the guidelines published in the fiscal year 2006 Medical Command funding guidance, Bayne-Jones Army Com...

T. A. Peacock

2006-01-01

12

Study of the Committee Structure of Ireland Army Hospital, Fort Knox, Kentucky.  

National Technical Information Service (NTIS)

Ireland Army Hospital at Fort Knox, KY is confronted with tandem challenges of cost containment and decreased productivity, and the prospects of a continued physician shortage in the face of an increasing workload. IAH's matrix organizational structure ha...

A. R. Threet

1980-01-01

13

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

14

Maximizing Patient Thermoregulation in US Army Forward Surgical Teams.  

National Technical Information Service (NTIS)

Creating universal minimal thermoregulation standards for all Forward Surgical Teams (FST) may decrease morbidity and mortality of combat damage control patients. These standards will also decrease blood and IV fluid requirements for each individual patie...

B. Eastridge K. W. Grathwohl L. H. Blackbourne P. Barras

2008-01-01

15

ADOPTION OF HOSPITAL SURGICAL MANAGEMENT SOFTWARE  

Microsoft Academic Search

Health Information Technology (IT) is an important component of healthcare reform. Health IT holds the promise of improving quality while reducing costs. The broader IT literature frequently recognizes that IT payoffs depend on complementary investments in organization and capital. We build on this literature by evaluating the drivers of hospital surgical management software (HSMS) adoption. HSMS can improve operating room

Eli M. Snir; Jeffrey McCullough

16

CPAP Use in a Hospital or Surgical Setting  

MedlinePLUS

... 293.3650 CPAP USE IN A HOSPITAL OR SURGICAL SETTING This Patient Education Bulletin specifically addresses issues ... hospitalized for a medical condition or for a surgical procedure. Many of the items may also be ...

17

Causes, types and severity of injury among army soldiers hospitalized with alcohol comorbidity*  

PubMed Central

Aim To examine the relationship between alcohol use and the cause, type and severity of hospitalized injuries. Design/setting We used the Total Army Injury and Health Outcomes Database (TAIHOD) to conduct cross-sectional analyses of the association between alcohol comorbidity and the cause, type and severity of soldiers’ non-combat injuries requiring hospitalization. Participants Subjects were active-duty US army soldiers (n = 211 790) hospitalized with a primary diagnosis of injury between 1980 and 2002. Findings Alcohol comorbidity was positively associated with hospitalized injuries resulting from fights and falls and negatively associated with sports injuries; positively associated with hospitalized cases of head injury, open wounds and poisonings and negatively associated with musculoskeletal injury; and, overall, associated with shorter length of stay. Controlling for demographic factors did not moderate the association between alcohol and cause, type or severity of injury. Conclusion Alcohol comorbidity is specifically associated with injuries related to impairment and antisocial behavior.

Howland, Jonathan; Bell, Nicole S.; Hollander, Ilyssa E.

2007-01-01

18

Study of the Ambulatory Care Quality Assurance Program at DeWitt Army Community Hospital, Fort Belvoir, Virginia.  

National Technical Information Service (NTIS)

In 1981 at DeWitt Army Community Hospital, an insufficient amount of usable ambulatory care information was being generated. This prohibited the hospital staff from identifying problems and making intelligent decisions regarding the quality of care provid...

J. R. O'Keiff

1982-01-01

19

Survey of Infants with Neonatal Sepsis in U.S. Army Hospitals.  

National Technical Information Service (NTIS)

Data on 109,312 singleton births at U.S. Army hospitals over 3 years were examined to determine differences in perinatal risk factors between infants with a diagnosis of sepsis confirmed by blood culture and those whose cultures remained negative. The inc...

J. A. Horton V. G. Hemming D. F. Cruess M. Korper L. M. Capper

1989-01-01

20

Nurse's Influence on 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 dependents, and associated nursing organizational structures and processes in two U.S. Army hospitals. A total of 8 units in both hos...

B. J. Foley

2001-01-01

21

Continuity of Care as an Issue at a United States Army Community Hospital with a Family Practice Residency Program.  

National Technical Information Service (NTIS)

The process of ensuring continuity of care is essential to an effective DeWitt Army Community Hospital (DACH) coordinated care marketing program focused on bringing the chronic CHAMPUS and outpatient service user into the military treatment facility's man...

J. P. Kimball

1993-01-01

22

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

23

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

24

Energy engineering analysis program. Kimbrough Army Community Hospital, Ft. George G, Meade, Maryland. Final report  

SciTech Connect

Mueller Associates, Inc. (MAI) was retained by the Baltimore District of Army Corps of Engineers in September of 1985 to perform energy conservation services at Fort George G. Meade, Maryland. The contract included studies of the following buildings: number 2480 - Kimbrough Army Community Hospital (KACH), number 8472 - Dental Clinic, number 2481 - Barracks, number 2484 - Medical Supply Warehouse. The Scope of this study included the following objectives: Perform a complete energy audit and analysis of the entire Kimbrough Army Community Hospital including the attached Outpatient Clinic. Investigate the feasibility of an Energy Monitoring and Control System (EMCS) for the hospital. Investigate exhaust systems in the Dental Clinic. Investigate window replacement and chilled water temperature of the Barracks. Investigate the feasibility of infra-red heaters, loading dock door seals, and air stratification in the Medical Supply Warehouse. Identify all energy conservation opportunities, including low cost/no cost items and perform complete evaluations of each. Prepare programming documentation for all energy conservation investment program projects including DD Form 1391, a life cycle cost analysis summary sheet with backup calculations, and a Project Development Brochure. Prepare implementation documentation for all justifiable energy conservation opportunities. List and prioritize all recommended energy conservation opportunities.

NONE

1988-12-01

25

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

26

Surgical site infections in Italian Hospitals: a prospective multicenter study  

Microsoft Academic Search

BACKGROUND: Surgical site infections (SSI) remain a major clinical problem in terms of morbidity, mortality, and hospital costs. Nearly 60% of SSI diagnosis occur in the postdischarge period. However, literature provides little information on risk factors associated to in-hospital and postdischarge SSI occurrence. A national prospective multicenter study was conducted with the aim of assessing the incidence of both in-hospital

Nicola Petrosillo; Cecilia MJ Drapeau; Emanuele Nicastri; Lorena Martini; Giuseppe Ippolito; Maria Luisa Moro

2008-01-01

27

Arterial Injuries at a Surgical Hospital in Vietnam.  

National Technical Information Service (NTIS)

Experience with arterial injuries at a Surgical Hospital (MA) in Vietnam during a 15 month period included 62 patients who required an arterial repair. Cause of injury was approximately equally divided between gunshot and fragment wounds from grenades, mo...

R. L. Hewitt D. J. Collins H. F. Hamit

1968-01-01

28

Self-reported risk-taking behaviors and hospitalization for motor vehicle injury among active duty Army personnel  

Microsoft Academic Search

Background: Motor vehicle crashes are a leading cause of injury in the Army. Behaviors increasing risk for motor vehicle crashes are also prevalent, but research has not linked these behaviors directly to injury outcomes (e.g., hospitalizations).Methods: To evaluate the relationship between behavior and motor vehicle crash injuries, 99,981 Army personnel who completed Health Risk Appraisal surveys in 1992 were followed

Nicole S Bell; Paul J Amoroso; Michelle M Yore; Gordon S Smith; Bruce H Jones

2000-01-01

29

An Analysis of Surgical Cases in a Nigerian Mission Hospital  

PubMed Central

Approximately 315 major surgical cases were treated in one year in a one-doctor 80-bed mission hospital in Nigeria. The hospital serves a population of 137,000. One hundred and forty-three of the cases were herniorrhaphies: 19 of these cases were strangulated, of which seven required bowel resection. A case of a strangulated inguinal hernia containing uterus, Fallopian tubes and ovaries is reported. Other interesting surgical cases are also discussed.

Ward, Roy Vernon

1963-01-01

30

Surgical Volume and the Risk of Surgical Site Infection in Community Hospitals Size Matters  

Microsoft Academic Search

Results: Prospective surveillance identified 1434 SSIs after 132,111 surgical procedures (prevalence rate 1.09\\/100 procedures). In unadjusted analysis, the risk of SSI was almost twice as high at small hospitals prevalence rate ratio (PRR) 1.9 (95% CI 1.78-2.05) and large hospitals PRR 1.79 (95% CI 1.70-1.90) compared with medium hospitals. After adjusting for differences between hospital category and important confounders, the

Deverick J. Anderson; Matthew G. Hartwig; Theodore Pappas; Daniel J. Sexton; Zeina A. Kanafani; Grace Auten; Keith S. Kaye

31

Patterns of appendicitis at a forward-deployed United States Army Hospital: the Korea experience 2 1 The authors thank Ms. Jane Scott, RN, MSN, for invaluable technical and editorial assistance. 2 2 The opinions expressed herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense  

Microsoft Academic Search

Appendicitis is both a common surgical condition in a young military active duty population and a diagnosis that is notoriously easy to miss. We reviewed all cases of appendicitis that presented to the 121st General Hospital, which is an army facility in Seoul, South Korea, during an 18-month period. Our patient population consisted of 37,000 soldiers as well as dependants

Chet A Morrison; David L Greco; Kenneth G Torrington

2000-01-01

32

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

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Performance of listed surgical procedures on an inpatient hospital basis...MEDICARE PROGRAM (CONTINUED) AMBULATORY SURGICAL SERVICES Scope of Benefits for Services... § 416.75 Performance of listed surgical procedures on an inpatient hospital...

2012-10-01

33

Reasons for Utilization of the Emergency Room at Irwin Army Community Hospital by Patients Classified as Non-Urgent.  

National Technical Information Service (NTIS)

The primary objective for conducting this study was to identify the reasons patients categorized as having non-urgent conditions utilized the emergency room (ER) at Irwin Army Community Hospital, Fort Riley, Kansas, a 44- bed facility that serves a user p...

J. S. Hillard

1998-01-01

34

Hospital-acquired infections among surgical patients in a Brazilian hospital  

Microsoft Academic Search

A historical cohort study was conducted among surgical patients in a large general hospital in Porto Alegre, Brazil between March 1992 and May 1993. Data were collected by means of a retrospective chart review, which followed a standardized method based on the systematic review of all clinical and laboratory information available in the hospital records. The criteria for diagnosis of

M. B. Wagner; N. B. da Silva; A. R. Vinciprova; A. B. Becker; L. M. Burtet; A. J. Hall

1997-01-01

35

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

Federal Register 2010, 2011, 2012, 2013

...Training Administration [TA-W-82,137] Naugatuck Valley Surgical Center, Department of Saint Mary's Hospital, Waterbury...applicable to workers and former workers of Naugatuck Valley Surgical Center, Department of Saint Mary's Hospital,...

2013-02-12

36

Hospital admissions related to mental disorders in U.S. Army soldiers in Iraq and Afghanistan.  

PubMed

We conducted a retrospective study of 473,964 U.S. Army soldiers deployed to Iraq and Afghanistan through December 2004 using deployment and admission records. We categorized mental disorder diagnoses using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and identified attempted suicide/ self-inflicted injuries using ICD-9-CM diagnosis codes E950-E959. We estimated and evaluated relative risks (RR) using Poisson regression models. Analysis found 1,948 psychiatric hospitalizations of deployed soldiers. The most common mental problems were mood, adjustment, and anxiety disorders (including post-traumatic stress disorder [PTSD]). RR of mental disorders ranged from 1.6 to 3 for females and 2 to 6 for enlisted soldiers compared to their counterparts. Younger soldiers had 30-60% higher substance abuse disorders. Combat units in Iraq demonstrated higher risk of any mental disorder and anxiety problems compared to combat support units. Younger women had the highest incidence of attempted suicide/ self-inflicted injuries. Further mental disorders surveillance is recommended. PMID:19891211

Wojcik, Barbara E; Akhtar, Fatema Z; Hassell, L Harrison

2009-10-01

37

Study to Determine the Most Cost-Effective Method of Delivering Obstetrical Care to All Eligible Beneficiaries within the Kenner Army Community Hospital's Catchment Area.  

National Technical Information Service (NTIS)

A study was conducted to determine the most cost-effective method of delivering obstetrical care to military beneficiaries within the Kenner Army Community Hospital's (KACH) catchment area. Six options were considered with the most plausible one being a j...

P. G. Gidwani

1988-01-01

38

Re-engineering surgical services in a community teaching hospital.  

PubMed

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

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

1997-04-01

39

Investing in the Future by Learning from the Past: Developing a Survey Tool to Gather Feedback from Deployed Army Forward Surgical Team.  

National Technical Information Service (NTIS)

The purpose of this Graduate Management Project (GMP) was to develop a validated survey instrument to gather crucial feedback from deployed Forward Surgical Teams (EST) for use by the Army Medical Department Center and School (AMEDD C AND S) in the develo...

R. Morton

2004-01-01

40

Pre-Admission Patient Treatment Times in The Emergency Room Silas Beach Hays Army Community Hospital.  

National Technical Information Service (NTIS)

The author conducted a retrospective study to identify variables that influence the length of the total time needed to admit patients via the Emergency Room (ER) at an army medical treatment facility. Total time was an aggregate measurement that included ...

H. E. Schloss

1992-01-01

41

Surgical Management of Uterine Fibroids at Aminu Kano Teaching Hospital  

PubMed Central

Objective. To determine the influence of age and parity on the surgical management of uterine fibroids, clinical presentation, presence of pelvic adhesions, cadre of surgeons, and postoperative complications at the Aminu Kano Teaching Hospital, Kano, Nigeria. Methods. A retrospective analysis of 105 cases of uterine fibroids that were managed between 1st January 2003 and 31st December 2007. Results. The period prevalence of uterine fibroids was 24.7% of all major gynecological operations. The mean age was 35.8 ± 7.6 and mean parity 4.7 ± 2.8. Abdominal hysterectomy accounted for 58.1% of the cases and myomectomy 41.9%. The odd of using abdominal hysterectomy was about twice that of myomectomy. Pelvic adhesions were found in 67.6% of the cases. Menorrhagia (86.7%) was the commonest symptom, while post operative anemia and pyrexia showed significant association with myomectomy. There was no maternal mortality. Conclusion. Surgical operations for uterine fibroids are safe and common kind of gynecological operations at the Aminu Kano Teaching Hospital. Uterine fibroid is associated more with high parity and dominance of abdominal hysterectomy over myomectomy, because early girl marriage is common in our community.

Omole-Ohonsi, Abiodun; Belga, Francis

2012-01-01

42

Financial impact of surgical site infections on hospitals: the hospital management perspective.  

PubMed

IMPORTANCE Surgical site infections (SSIs) may increase health care costs, but few studies have conducted an analysis from the perspective of hospital administrators. OBJECTIVE To determine the change in hospital profit due to SSIs. DESIGN Retrospective study of data from January 1, 2007, to December 31, 2010. SETTING The study was performed at 4 of The Johns Hopkins Health System acute care hospitals in Maryland: Johns Hopkins Bayview (560 beds); Howard County General Hospital (238 beds); The Johns Hopkins Hospital (946 beds); and Suburban Hospital (229 beds). PARTICIPANTS Eligible patients for the study included those patients admitted to the 4 hospitals between January 1, 2007, and December 31, 2010, with complete data and the correct International Classification of Diseases, Ninth Revision code, as determined by the infection preventionist. Infection preventionists performed complete medical record review using National Healthcare Safety Network definitions to identify SSIs. Patients were stratified using the All Patient Refined Diagnosis Related Groups to estimate the change in hospital profit due to SSIs. EXPOSURE Surgical site infections. MAIN OUTCOMES AND MEASURES The outcomes of the study were the difference in daily total charges, length of stay (LOS), 30-day readmission rate, and profit for patients with an SSI when compared with patients without an SSI. The hypothesis, formulated prior to data collection, that patients with an SSI have higher daily total costs, a longer LOS, and higher 30-day readmission rates than patients without an SSI, was tested using a nonpaired Mann-Whitney U test, an analysis of covariance, and a Pearson ?2 test. Hospital charges were used as a proxy for hospital cost. RESULTS The daily total charges, mean LOS, and 30-day readmission rate for patients with an SSI compared with patients without an SSI were $7493 vs $7924 (P?=?.99); 10.56 days vs 5.64 days (P?hospitals have a financial incentive to reduce SSIs, but hospitals should expect to see an increase in both cost and revenue when SSIs are reduced. PMID:23965750

Shepard, John; Ward, William; Milstone, Aaron; Carlson, Taylor; Frederick, John; Hadhazy, Eric; Perl, Trish

2013-10-01

43

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

Code of Federal Regulations, 2012 CFR

...facility services related to covered ASC surgical procedures performed in hospitals on...facility services related to covered ASC surgical procedures performed in hospitals on...services related to covered ambulatory surgical center (ASC) procedures...

2012-10-01

44

Combat trauma experience with the United States Army 102nd Forward Surgical Team in Afghanistan † † This is an original work by the authors. The opinions expressed are the authors' alone. They do not necessarily reflect the opinion of the United States government, the Department of Defense, the United States Army, or Madigan Army Medical Center  

Microsoft Academic Search

BackgroundThe United States Army 102nd Forward Surgical Team (FST) was deployed to Kandahar Airfield, Afghanistan, from August 2002 to March 2003, in support of Operation Enduring Freedom. The unit's primary mission was to provide trauma surgical support to units of the 101st and 82nd Airborne Divisions, to coalition special operations units, and to allied Afghan militia forces. The FST's mission

Alec C. Beekley; David M. Watts

2004-01-01

45

Nursing Burnout: Cross-Sectional Study at a Large Army Hospital.  

National Technical Information Service (NTIS)

The purpose of this study was to examine the levels of burnout among U,S, Army and civilian nursing personnel assigned to a large military treatment facility. Using a cross-sectional design, a convenience sample of eligible participants (n = 364) complete...

E. A. Pfister G. M. Lang M. J. Siemens

2010-01-01

46

Nursing Burnout: Cross-Sectional Study at a Large Army Hospital.  

National Technical Information Service (NTIS)

The purpose of this study was to examine the levels of burnout among U.S. Army and civilian nursing personnel assigned to a large military treatment facility. Using a cross-sectional design, a convenience sample of eligible participants (n = 364) complete...

E. A. Pfister G. M. Lang M. J. Siemens

2010-01-01

47

Implementation plan for a hospital-wide recycling program at William Beaumont Army Medical Center, El Paso, Texas. Master's thesis, July 1992July 1993 (Final)  

Microsoft Academic Search

The purpose of this research project is to establish an implementation plan for a recycling program at William Beaumont Army Medical Center, implement and evaluate a pilot program, and provide a restatement of the hospital-wide recycling program plan based on the pilot study. The program will be composed of three essential components: a recycling team, data collection, and program design.

1993-01-01

48

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

49

[Structural and clinical characteristics of elderly and senile patients' treatment in regional surgical hospital].  

PubMed

Treatment results of 1219 patients of elderly and senile age, hospitalized in surgical departments of Turkestan during 2001-2008 were analyzed. Demographic characteristics, spectrum of profile pathology as well as concurrent diseases were given. Operative activity and average hospital stay, hospital lethality and complication rates were defined. PMID:21716221

Gavrilov, A O; Se?dinov, Sh M; Iusupov, A A

2011-01-01

50

Concentration and detection of SARS coronavirus in sewage from Xiao Tang Shan Hospital and the 309th Hospital of the Chinese People's Liberation Army.  

PubMed

A worldwide outbreak of severe acute respiratory syndrome (SARS) had been reported. Over 8439 SARS cases and 812 SARS-related deaths were reported to the World Health Organization from 32 countries around the world up to 5 July 2003. The mechanism of transmission of SARS-CoV has been limited only to close contacts with patients. Attention was focused on possible transmission by the sewage system because laboratory studies showed that patients excreted coronavirus RNA in their stools in Amoy Gardens in Hong Kong. To explore whether the stool of SARS patients or the sewage containing the stool of patients would transmit SARS-CoV or not, we used a style of electropositive filter media particle to concentrate the SARS-CoV from the sewage of two hospitals receiving SARS patients in Beijing, as well as cell culture, semi-nested RT-PCR and sequencing of genes to detect and identify the viruses from sewage. There was no live SARS-CoV detected in the sewage in these assays. The nucleic acid of SARS-CoV was found in the sewage before disinfection from both hospitals by PCR. After disinfection, SARS-CoV RNA could be detected from some samples from the 309th Hospital of the Chinese People's Liberation Army, but not from Xiao Tang Shan Hospital after disinfection. In this study, we found that the virus can survive for 14 days in sewage at 4 degrees C, 2 days at 20 degrees C, and its RNA can be detected for 8 days though the virus had been inactivated. In conclusion, this study demonstrates that the RNA of SARS-CoV could be detected from the concentrates of sewage of both hospitals receiving SARS patients before disinfection and occasionally after disinfection though there was no live SARS-CoV; thus much attention should be paid to the treatment of stools of patients and the sewage of hospitals receiving SARS patients. PMID:16312970

Wang, X W; Li, J; Guo, T; Zhen, B; Kong, Q; Yi, B; Li, Z; Song, N; Jin, M; Xiao, W; Zhu, X; Gu, C; Yin, J; Wei, W; Yao, W; Liu, C; Li, J; Ou, G; Wang, M; Fang, T; Wang, G; Qiu, Y; Wu, H; Chao, F; Li, J

2005-01-01

51

Nurses' use of research in practice at three US Army hospitals.  

PubMed

Translation of research into clinical nursing practice has been extensively studied with nurses in civilian institutions. However, limited examination has been made of research utilization in US military facilities. A quantitative survey approach, using Estabrooks's adapted Research Utilization Survey and Mylle's Organizational Climate Survey, was employed to determine the extent that registered nurses in selected US Army Medical Treatment Facilities (MTFs) use research findings for their own practice and to describe the factors, both professional and organizational, that enhance or hinder research utilization. This study found that nurses at the MTFs reported using research in their practice less than half the time. Variables most significantly correlated with research utilization were belief suspension and attitudes toward research. The variable of support correlated significantly with all types of research utilization except indirect. Other organizational factors influencing nurses' use of research findings in practice were time, accessibility to research and a champion to assist their efforts. Interestingly, the number of years worked in nursing and in the facilities correlated inversely with research utilization, suggesting that over time, nurses may begin to rely on past experience rather than seek out new knowledge for practice. PMID:16372787

Kenny, Deborah J

2005-01-01

52

Continuity of long-term medication use after surgical hospital stay  

Microsoft Academic Search

Objectives: To investigate changes in long- term medication during the transfer between surgical hospital and primary care. To examine differences in defined daily doses (DDDs) versus real prescribed daily doses (PDDs). Methods: During a 15-month period, patients from three surgical wards in a university-based teaching hospital were asked about their medication at admis- sion (T1), at discharge (T2), and 3

I. Hach; U. Maywald; D. Meusel; J. U. König; W. Kirch

2005-01-01

53

[Surgical treatment of nasal and paranasal sinus diseases in a day hospital].  

PubMed

Microendoscopic techniques for surgical intervention find wide application in both in-patient and out-patient settings. High efficiency of low-invasive surgical methods make them applicable to treat paranasal cavity pathology, septal deformities, and cystic-polypous processes, etc. The authors consider peculiarities of operations under endoscopic control with the use of microsurgical instruments, discuss their efficiency under conditions of a day hospital, and illustrate the possibility to avoid prolonged hospitalization of a patient based on this approach. PMID:20517279

Magomedov, M M; Butaeva, Kh M; Ibragimov, Sh I

2010-01-01

54

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

55

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

56

Estimation of increased hospital stay due to nosocomial infections in surgical patients: comparison of matched groups  

Microsoft Academic Search

An investigation, using a prospective cohort study, was performed to estimate the prolongation of hospital stay caused by nosocomial infections in surgical patients. An evaluation of the one-to-one matching method, as a model for similar studies was also undertaken. Between 1992 and 1994, 225 of 1482 surgical patients (15%) developed infection. Of these, 223 evaluable patients were compared with 1256

S. Erbaydar; A. Akgün; A. Eksik; T. Erbaydar; O. Bilge; A. Bulut

1995-01-01

57

Methods for identifying surgical wound infection after discharge from hospital: a systematic review  

Microsoft Academic Search

BACKGROUND: Wound infections are a common complication of surgery that add significantly to the morbidity of patients and costs of treatment. The global trend towards reducing length of hospital stay post-surgery and the increase in day case surgery means that surgical site infections (SSI) will increasingly occur after hospital discharge. Surveillance of SSIs is important because rates of SSI are

Emily S Petherick; Jane E Dalton; Peter J Moore; Nicky Cullum

2006-01-01

58

Impact of Hospital Characteristics on Surgical Outcomes and Length of Stay.  

National Technical Information Service (NTIS)

Two sets of data were used: an extensive study of the 1225 hospitals in the 1972 PAS of the CPHA and 559,629 patients in 17 diagnostic categories; and an intensive study of 17 randomly selected hospitals with 8,593 associated surgical patients in 15 diagn...

B. W. Brown W. H. Forrest W. R. Scott

1978-01-01

59

1 Canadian Field Hospital in Haiti: surgical experience in earthquake relief.  

PubMed

The Canadian Forces' (CF) deployable hospital, 1 Canadian Field Hospital, was deployed to Haiti after an earthquake that caused massive devastation. Two surgical teams performed 167 operations over a 39-day period starting 17 days after the index event. Most operations were unrelated to the earthquake. Replacing or supplementing the destroyed local surgical capacity for a brief period after a disaster can be a valuable contribution to relief efforts. For future humanitarian operations/disaster response missions, the CF will study the feasibility of accelerating the deployment of surgical capabilities. PMID:22854149

Talbot, Max; Meunier, Bethann; Trottier, Vincent; Christian, Michael; Hillier, Tracey; Berger, Chris; McAlister, Vivian; Taylor, Scott

2012-08-01

60

Epidemiology of Surgical Admissions to a Children’s Disability Hospital in Nepal  

Microsoft Academic Search

Background  The goal of this retrospective review was to characterize the spectrum of surgical admissions to a tertiary hospital specializing\\u000a in musculoskeletal conditions in children and adolescents in Nepal.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We reviewed hospital records from 1996 to 2006 to categorize all major surgical procedures. Additional information collected\\u000a included diagnosis, patient age, gender, and home district.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Of 7,556 major surgical procedures performed from

David A. SpiegelOm; Om P. Shrestha; Tarun Rajbhandary; Binod Bijukachhe; Prakash Sitoula; Bibek Banskota; Ashok Banskota

2010-01-01

61

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

SciTech Connect

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

NONE

1991-05-01

62

Posttraumatic stress disorder (PTSD) in the German Armed Forces: a retrospective study in inpatients of a German army hospital.  

PubMed

In 2006 and 2007, around 0.4 and 0.7% of all German soldiers involved in missions abroad were registered as suffering from PTSD. The frequency of PTSD in the German Armed Forces was assessed from army records. All soldiers admitted to the German Military Hospital in Hamburg, Germany, with PTSD (n = 117) in the years 2006 and 2007 were assessed by using questionnaires and structure interviews. Risk factors associated with PTSD were identified. Of the 117 soldiers with PTSD, 39.3% were in missions abroad, and 18.0% had participated in combat situations. Five (4.3%) were wounded in combat, and 4 of them had a serious irreversible injury. In total, 53.8% of the PTSD cases were related to injuries or physical/sexual abuse, while 46.2% were due to psychological traumatization. Among soldiers with PTSD who were not abroad, sexual or physical abuse were the most common traumas. In 35.9% of the patients, there was evidence for psychiatric disorders existing before the traumatic event. The percentage of women among sufferers from PTSD was significantly higher than the proportion of women in the armed forces (30.8% vs. 5.17%). A careful psychiatric screening before recruitment might help to identify persons at risk of PTSD. PMID:22274736

Bandelow, Borwin; Koch, Manuel; Zimmermann, Peter; Biesold, Karl-Heinz; Wedekind, Dirk; Falkai, Peter

2012-01-25

63

Readiness Evaluation of Professional Filler System and Forces Command Nurses at Darnall Army Community Hospital, Fort Hood, Texas.  

National Technical Information Service (NTIS)

The purpose of this study is to apply a psychometric tool for readiness assessment, the Readiness Estimate and Deployability Index (READI), to Army Nurse Corps (ANC) officers assigned to U.S. Army MEDDAC, Fort Hood, Texas. Because of increases in the numb...

M. K. Morris

2002-01-01

64

Surgical Outcomes in Rhegmatogenous Retinal Detachment at Srinagarind Hospital  

Microsoft Academic Search

Objectives: To evaluate the surgical outcome for patients with rhegmatogenous retinal detachment and to find out the factors influencing the anatomic reattachment and visual results. Material and Method: Retrospective review of the medical records of patients for the following details: age, sex, time to diagnosis, time to surgery, phakic status, types, numbers and locations of the retinal breaks, macular status,

Yosanan Yospaiboon; Thuss Sanguansak; Tanapat Ratanapakorn; Suthasinee Sinawat

65

[Organization of surgical work in hospitals under special conditions].  

PubMed

A check-list consisting all the importants measures in hospital care for handling all sorts of disasters is described. In those situations the management of organization is primarily more important than medical attendance. The doctor educated in individual medicine overestimates the medical problems. In every hospital a disaster plan should be step up as a precuation. The importance of triage has been confirmed, and several aspects of its planning have been stressed. Excercise and test alarm are necessary to check the set upa organization. PMID:936927

Jekic, M; Jekic, D

1976-01-01

66

Surgical interventions at field hospitals during the Iran and Iraq War (1980-1987).  

PubMed

Surgical treatment of wounded soldiers in the field began in World War II, and the care of the wounded was aided by air, ground, and marine transportation. Even with highly developed facilities, medical care should be started as soon as possible. The Islamic Republic of Iran was under an economic blockade during its war with Iraq. Field hospitals were considered a solution to the problem of transportation shortages. The aim of this study was to assess the surgical interventions of these hospitals. In a descriptive cross-sectional study, data for 7,718 patients admitted to field hospitals (among a total of 173,823 casualties) were analyzed. A checklist was used as the data-collection tool. The data were entered and analyzed by the Statistical Program for the Social Sciences. The type of surgical intervention, duration of the surgery, and frequency of the interventions in each hospital were examined. Laparotomy was the most common and tracheostomy the least common intervention. Shahid Baghaei Field Hospital had the greatest number of admissions. Of all the patients in the Southern Command District who underwent any kind of surgery, 21.53% were operated on in the complex of field hospitals. The surgery time in these hospitals was 156 +/- 69 minutes (mean +/- SD). A great number of the procedures were lifesaving (including laparotomy and chest tube insertion). It seems that these hospitals played a key role in reducing mortality and morbidity during the war. PMID:10050572

Heidarpour, A; Jahani, M R; Dabbagh, A; Khatami, M S

1999-02-01

67

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

Microsoft Academic Search

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

Farrin A. Manian; Lynn Meyer

1997-01-01

68

The evolution of a surgical liaison program in a children's hospital.  

PubMed

Surgical liaison nurses use clear communication to provide timely reports to family members about their loved one during the time the patient is in the OR. The surgical liaison program at the Children's Hospital Boston, Massachusetts, has evolved over time. It began as nurses supervising brief family member visits to the postanesthesia care unit (PACU) and has become a program in which surgical liaison nurses work with OR and PACU staff members to access and provide patient-specific information to families throughout the surgical time period and prepare families for extended visits to the PACU. In addition, we redesigned our surgical department by expanding its size, locating it closer to the OR and PACU, and providing more amenities to family members. A survey conducted to assess family member needs found that most people were satisfied with the services provided, and we were able to make improvements to services based on the survey feedback. PMID:20678605

Micheli, Anne J; Curran-Campbell, Sheila; Connor, Linda

2010-08-01

69

Preliminary data of the Surveillance of Surgical Site infections at Gaziantep University Hospital.  

PubMed

Surgical site infection (SSI) is a major surgical complication that leads to mortality, morbidity and socioeconomic losses. The objective of this study is to determine the rate of SSIs, the pathogens involved in the infections and the associated antimicrobial sensitivity patterns in the surgical clinics of our hospital. This study was conducted in all surgical departments of our hospital except ophthalmology. Patients (n = 1397) who had surgery for any reason and who stayed in the hospital for at least 48 h were enrolled in this study. The criteria issued by the Centers for Disease Control and Prevention was utilized in defining and diagnosing SSI. During the study, SSIs developed in 131 (9.4%) of 1397 patients. The development of a SSI resulted in an additional 12.8 days of hospital stay. Gram-negative microorganisms constituted 74.6% of the pathogens responsible for the SSIs. The most commonly isolated microorganisms were Escherichia coli (32.8%), Pseudomonas spp. (13.4%) and Enterococcus spp. (11.9%). Methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci was 83.3% and 100%, respectively. No vancomycin resistance was detected in the enterococci. The rates of extended spectrum beta lactamase production in E. coli and Klebsiella strains were 86.3% and 42.8%, respectively. SSI surveillance studies should be performed to decrease the rate of SSIs. PMID:23806704

Nam?duru, Mustafa; Karao?lan, Ilkay; Çam, R?za; Bo?nak, Vuslat Keçik; Mete, Ay?e Özlem

2013-03-30

70

[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

71

The current and future role of surgical physician assistants. Report of a national survey of surgical chairmen in large U.S. hospitals.  

PubMed Central

The chairman of departments of surgery in general hospitals with more than 400 beds were surveyed to assess their current and projected use of surgical physician assistants. Of the 552 institutions represented in our survey, surgical physician assistants were working in one-third, providing preoperative, intraoperative, and postoperative care. Two-thirds of the chairmen felt that the introduction of physician assistants had improved surgical patient care in their institutions. In institutions with surgical housestaff, almost half the chairmen felt that surgical physician assistants had improved the quality of residency training. During the next five years an increase of 87% in the number of surgical physician assistants is projected by respondents. We conclude that appropriately trained and supervised surgical physician assistants will play an increasingly important role in improving the care of surgical patients and, by functioning as junior housestaff, make it possible to reduce the number of surgeons being trained.

Perry, H B; Detmer, D E; Redmond, E L

1981-01-01

72

Medical care of Iraqis at a forwardly deployed U.S. Army hospital during Operation Desert Storm.  

PubMed

To evaluate the injuries and diseases and their subsequent care for both Iraqis and U.S. soldiers in the Persian Gulf War, we analyzed all 196 admissions to the 46th Combat Support Hospital during Operation Desert Storm, with primary focus on the 118 admissions during the Ground War. Admission diagnosis was used to classify injury or disease. Percentage of patients who underwent surgery for combat wounds and percentage of patients who were air-evacuated were used as measurements of quality of care. The proportion of Iraqi patients who had been wounded in action was significantly higher than the proportion for Americans (95 vs. 53% for the Ground War). The rate of surgical procedures per wounded patients admitted was the same for Iraqis (28%) as for Americans (27%). Rates of air-evacuation for Iraqis were not statistically different from those for Americans in the same category of admission diagnoses. These last two findings suggest that the quality of care given to Iraqis was the same as that given to Americans. PMID:8855063

Wintermeyer, S F; Pina, J S; Cremins, J E; Heier, J S

1996-05-01

73

[Conflicts and dilemmas of nurses who work in surgical centers of macro-regional hospitals].  

PubMed

This research aimed at describing the conflicts and ethical dilemmas experienced by twelve nurses working in Surgical Centers of macro-regional hospitals in Rio Grande do Sul, Brazil. The analysis of the interview data was carried out through the Content Analysis technique. The data were discussed through technical-deontologica base and communicative action theory. It has been found out that the nurses working at Surgical Centers face conflicts and dilemmas daily. They are related to the lack of infrastructure to meet the deman resulting in disrespect and violation of some principles of the deontology code. PMID:17025038

Duarte, Liliane Espinosa de Mello Norberto; Liana, Lautert

2006-06-01

74

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

75

Effectiveness in professional organizations: the impact of surgeons and surgical staff organizations on the quality of care in hospitals.  

PubMed Central

In this research, we examine the relative importance of different structural units in a professional organization, the hospital, as they affect organizational effectiveness. The difficulties of measuring effectiveness in a complex professional organization are discussed, and an adjusted measure of surgical outcome is developed. Data are drawn from a prospective study of over 8,000 surgical patients treated by more than 500 surgeons in 15 hospitals throughout the nation. Two different types of analyses are presented, both indicating that hospital features have more impact on surgical outcomes than do surgeon characteristics. The second analysis assesses the relative importance of specific attributes of the hospital, surgical staff organization, and surgeon characteristics on surgical outcomes.

Flood, A B; Scott, W R; Ewy, W; Forrest, W H

1982-01-01

76

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

PubMed Central

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

Blais, R

1993-01-01

77

Candida Isolation in Patients Hospitalized on a Surgical Ward: Significance and Mortality-Related Factors  

Microsoft Academic Search

Background  Infections caused by Candida are an emerging pathology on surgical wards. The aim of the present study was to evaluate the incidence, characteristics,\\u000a and predictive factors of mortality in patients colonized and\\/or infected by Candida spp. in this setting.\\u000a \\u000a \\u000a \\u000a Methods  A consecutive series of 105 patients hospitalized on a general surgery ward between 2000 and 2004 were included, and 118 positive

J. Marchena-Gomez; T. Saez-Guzman; M. Hemmersbach-Miller; A. Conde-Martel; V. Morales-Leon; A. Bordes-Benitez; M. A. Acosta-Merida

2009-01-01

78

Surgical-site infection surveillance at a small-scale community hospital  

Microsoft Academic Search

Surveillance of surgical-site infection (SSI) is becoming more important given the current situation of increasing antibiotic resistance by microorganisms. It may be difficult to carry out SSI surveillance at small-scale community hospitals because of small staff numbers. We examined whether SSI surveillance could be carried out with a system we devised. Furthermore, we investigated the SSI rateat our small-scale community

Takashi Saito; Yoji Aoki; Kazuo Ebara; Shunichi Hirai; Yasuhiro Kitamura; Yosinobu Kasaoka; Yoshihiro Mori; Yoshitsugu Iinuma; Satoshi Ichiyama; Fumikazu Kohi

2005-01-01

79

HIV Testing and Epidemiology in a Hospital-Based Surgical Cohort in Malawi  

PubMed Central

Background Despite the high prevalence of HIV in adults (11 %) in Malawi, testing among surgical patients is not routine. We examined the feasibility of universal opt-out HIV testing and counseling (HTC) on the surgical wards of Kamuzu Central Hospital in Lilongwe, Malawi, and sought to further delineate the role of HIV in surgical presentation and outcome. Methods We reviewed HTC and surgical admission records from May to October 2011 and compared these data to data collected prospectively on patients admitted from November 2011 through April 2012, after universal HTC implementation. Results Prior to universal HTC, 270 of the 2,606 (10.4 %) surgical admissions were tested; 13 % were HIV-infected. After universal HTC implementation, HTC counselors reviewed 1,961 of the 2,488 admissions (79 %): 310 (16 %) had known status (157 seropositive, 153 seronegative) and 1,651 had unknown status (81 %). Among those with unknown status, 97 % (1,598, of 64 % of all admissions) accepted testing, of whom 9 % were found to be HIV-infected. Patients with longer lengths of stay (LOS) (mean = 11 vs. 5 days, p <0.01) and those who underwent surgical intervention (odds ratio [OR] 2.5; confidence interval [CI] 2.0–3.1) were more likely to have a known status on discharge. HIV was more prevalence in patients with infection and genital/anal warts or ulcers and lower in trauma patients. HIV-positive patients received less surgical intervention (OR 0.69; CI 0.52–0.90), but there was no association between HIV status and length of stay or mortality. Conclusions Universal opt-out HTC on the surgical wards was well accepted and increased the proportion of patients tested. High HIV prevalence in this setting merits implementation of universal HTC.

Haac, Bryce E.; Matoga, Mitch; LaCourse, Sylvia M.; Nonsa, Dominic; Hosseinipour, Mina

2013-01-01

80

Virtual slide telepathology for an academic teaching hospital surgical pathology quality assurance program.  

PubMed

Virtual slide telepathology is an important potential tool for providing re-review of surgical pathology cases as part of a quality assurance program. The University of Arizona pathology faculty has implemented a quality assurance program between 2 university hospitals located 6 miles apart. The flagship hospital, University Medical Center (UMC), in Tucson, AZ, handles approximately 20 000 surgical pathology specimens per year. University Physicians Healthcare Hospital (UPHH) at Kino Campus has one tenth the volume of surgical pathology cases. Whereas UMC is staffed by 10 surgical pathologists, UPHH is staffed daily by a single part-time pathologist on a rotating basis. To provide same-day quality assurance re-reviews of cases, a DMetrix DX-40 ultrarapid virtual slide scanner (DMetrix, Inc, Tucson, AZ) was installed at the UPHH in 2005. Since then, glass slides of new cases of cancer and other difficult cases have been scanned the same day the slides are produced by the UPHH histology laboratory. The pathologist at UPHH generates a provisional written report based on light microscopic examination of the glass slides. At 2:00 pm each day, completed cases from UPHH are re-reviewed by staff pathologists, pathology residents, and medical students at the UMC using the DMetrix Iris virtual slide viewer. The virtual slides are viewed on a 50-in plasma monitor. Results are communicated with the UPHH laboratory by fax. We have analyzed the results of the first 329 consecutive quality assurance cases. There was complete concordance with the original UPHH diagnosis in 302 (91.8%) cases. There were 5 (1.5%) major discrepancies, which would have resulted in different therapy and/or management, and 10 (3.0%) minor discrepancies. In 6 cases (1.8%), the diagnosis was deferred for examination of the glass slides by the reviewing pathologists at UMC, and the diagnosis of another 6 (1.8%) cases were deferred pending additional testing, usually immunohistochemistry. Thus, the quality assurance program found a small number of significant diagnostic discrepancies. We also found that implementation of a virtual slide telepathology quality assurance service improved the job satisfaction of academic subspecialty pathologists assigned to cover on-site surgical pathology services at a small, affiliated university hospital on a rotating part-time basis. These findings should be applicable to some community hospital group practices as well. PMID:19540562

Graham, Anna R; Bhattacharyya, Achyut K; Scott, Katherine M; Lian, Fangru; Grasso, Lauren L; Richter, Lynne C; Carpenter, John B; Chiang, Sarah; Henderson, Jeffrey T; Lopez, Ana Maria; Barker, Gail P; Weinstein, Ronald S

2009-06-21

81

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

2013-03-25

82

Pattern of Thoracic Surgical Diseases in Nigeria: Experience at the University College Hospital, Ibadan  

PubMed Central

A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 13

Adebonojo, S. A.; Adebo, O.; Osinowo, O.

1978-01-01

83

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

PubMed

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

Carey, M E

1996-03-01

84

Quality improvement of surgical prophylaxis in Dutch hospitals: evaluation of a multi-site intervention by time series analysis  

Microsoft Academic Search

OBJECTIVES: Misuse of antibiotics in surgical prophylaxis is still quite common. The objectives of this study were to reduce the quantity and improve the quality of surgical prophylaxis and to reduce costs. METHODS: Prospective multi-site study of elective procedures in 13 Dutch hospitals. The quality of prophylaxis was audited before and after an intervention consisting of performance feedback and implementation

Marjo E. E. van Kasteren; Judith Mannien; Bart-Jan Kullberg; Annette S. de Boer; Nico J. Nagelkerke; Marja Ridderhof; Jan C. Wille; Inge C. Gyssens

2005-01-01

85

Long-term survival of surgically treated hip fracture in an Australian regional hospital.  

PubMed

This study was undertaken to identify factors influencing outcome in elderly patients operated for hip fracture. In particular, this study examined factors related to mortality at least 30 months post-fracture. Hospital records and death registrations were analysed for 463 patients aged 60 or more years treated for hip fracture at a Queensland regional hospital between 1997 and 2001. The overall mortality for surgically treated patients was 13.7% at 100 days and 24.9% at one year Patient factors including age, gender, health status and place of residence were the predominant influences on mortality. Non-patient and process factors including delay to surgery, type of operation and type of anaesthetic had minimal impact on mortality. No major determinants of length of hospital stay were identified. Patient health status was the main determinant for surgical delay. Our results confirm the persistently high mortality in this group of patients, and suggest that the main determinants of outcome are patient- rather than process-related. PMID:16398380

McLeod, K; Brodie, M P; Fahey, P P; Gray, R A

2005-12-01

86

Registration of surgical adverse outcomes: a reliability study in a university hospital  

PubMed Central

Objective Accurate registration of adverse surgical outcomes is essential to detect areas for improvement of surgical care quality. One reason for inaccurate adverse outcome registration may be the method to collect these outcomes. The authors compared the completeness of the national complication registry database (LHCR) as used in our hospital with relevant information from other available resources. Design Retrospective reliability analysis. Setting University hospital. Participants From the 3252 patients admitted to the surgical wards in 2010, the authors randomly selected a cohort of 180 cases, oversampling those with adverse outcomes. The LHCR contains adverse outcomes as reported during morning hand-offs or in discharge letters. The authors checked if the number and severity of adverse outcomes recorded in the LHCR agreed with those reported in morning hand-offs, discharge letters and medical and nursing files. Results In 135 of 180 patients, all resources could be retrieved completely. Fourteen per cent of the patients with adverse outcomes were not recorded in the LHCR. Missing adverse outcomes were all reversible without the need for (re)operation, for example, postoperative pain, delirium or urinary tract complications. Only 38% of these adverse outcomes were reported in the morning hand-offs and discharge letters but were best reported in the medical and nursing files. Conclusions Registration of surgical adverse outcomes appears largely depending on the reliability of the underlying sources. For a more complete adverse outcome registration, the authors advocate a better hand-off and additional consultation of the patient's dossier. This extra effort allows for improvement actions to eventually avoid ‘mild’ adverse outcomes patients perceive as important and undesirable.

Visser, Annelies; Gouma, Dirk J; Goslings, J Carel

2012-01-01

87

Severe Surgical Site Infection in Community Hospitals: Epidemiology, Key Procedures, and the Changing Prevalence of Methicillin?Resistant Staphylococcus aureus  

Microsoft Academic Search

objective. To characterize the epidemiology of severe (ie, nonsuperficial) surgical site infection (SSI) in community hospitals. methods. SSI data were collected prospectively at 26 community hospitals in the southeastern United States. Two analyses were performed: (1) a study of the overall prevalence rates of SSI and the prevalence rates of SSI due to specific pathogens in 2005 at all participating

Deverick J. Anderson; Daniel J. Sexton; Zeina A. Kanafani; Grace Auten; Keith S. Kaye

2007-01-01

88

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

89

Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital.  

PubMed

Background.?Public reporting of surgical site infections (SSIs) by hospitals is largely limited to infections detected during surgical hospitalizations or readmissions to the same facility. SSI rates may be underestimated if patients with SSIs are readmitted to other hospitals. We assessed the impact of readmissions to other facilities on hospitals' SSI rates following primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). Methods.?This was a retrospective cohort study of all patients who underwent primary THA or TKA at California hospitals between 1 January 2006 and 31 December 2009. SSIs were identified using ICD-9-CM diagnosis codes predictive of SSI assigned at any California hospital within 365 days of surgery using a statewide repository of hospital data that allowed tracking of patients between facilities. We used statewide data to estimate the fraction of each hospital's THA and TKA SSIs identified at the operative hospital versus other hospitals. Results.?A total of 91 121 THA and 121 640 TKA procedures were identified. Based on diagnosis codes, SSIs developed following 2214 (2.3%) THAs and 2465 (2.0%) TKAs. Seventeen percent of SSIs would have been missed by operative hospital surveillance alone. The proportion of hospitals' SSIs detected at nonoperative hospitals ranged from 0% to 100%. Including SSIs detected at nonoperative hospitals resulted in better relative ranking for 61% of THA hospitals and 61% of TKA hospitals. Conclusions.?Limiting SSI surveillance to the operative hospital caused varying degrees of SSI underestimation and substantially impacted hospitals' relative rankings, suggesting that alternative methods for comprehensive postdischarge surveillance are needed for accurate benchmarking. PMID:23912846

Yokoe, Deborah S; Avery, Taliser R; Platt, Richard; Huang, Susan S

2013-08-02

90

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

91

Internal quality assurance activities of a surgical pathology department in an Australian teaching hospital.  

PubMed Central

AIM: To assess the role of a quality assurance programme in improving the service provided by a surgical pathology department. METHODS: A continuous internal quality assurance study of the activities of an anatomical pathology department in an Australian teaching hospital was undertaken over a five year period. This addressed all steps involved in the production of a surgical pathology report. These were addressed in an open forum which included technical, scientific, clerical, and medical staff. Minor errors not needing immediate action were discussed and incorporated into laboratory practice. For major discrepancies with potential implications for patient management supplementary reports were issued and the relevant clinician informed of the outcome. RESULTS: Comprehensive peer review of 8.9% of the total workload of the department (3530 cases) and all the frozen sections (916 cases) over a period of five years, beginning in 1991, led to comments on some aspects of the original report by the reviewer in 19.6% of the cases. The great majority of the comments were minor, concerning issues related to the microscopic findings (4%), macroscopic description (3.1%), clerical aspects (3%), typographical errors (3%), coding errors (2.7%), technical errors including poor sections and incorrect labelling (1.7%), inadequate clinical history (1.2%), and incomplete or incomprehensible diagrams (0.9%). In two cases (0.05%) the original report did not state proximity of the tumour to surgical margins and in three of the frozen sections (0.3%) the original diagnosis was incorrect. However, in these cases the frozen section assessment did not alter the overall management of the cases. CONCLUSIONS: This study highlights the importance of a review system in detecting errors in surgical pathology reporting. Recognition of the fact that surgical pathology is not infallible has improved the end product. It has also minimised interobserver variability in the department, resulting in a uniform approach among the pathologists to macroscopic description, specimen sampling, special stains, and histological reporting.

Zardawi, I M; Bennett, G; Jain, S; Brown, M

1998-01-01

92

Surgical?Site Infection Due to Staphylococcus aureus Among Elderly Patients: Mortality, Duration of Hospitalization, and Cost  

Microsoft Academic Search

OBJECTIVES: To examine the impact of surgical-site infection (SSI) due to Staphylococcus aureus on mortality, dura- tion of hospitalization, and hospital charges among elderly surgi- cal patients and the impact of older age on these outcomes by comparing older and younger patients with S. aureus SSI. DESIGN: A nested cohort study. SETTING: A 750-bed, tertiary-care hospital and a 350-bed community

Sarah A. McGarry; John J. Engemann; Kenneth Schmader; Daniel J. Sexton; Keith S. Kaye

2004-01-01

93

Study of the Ambulatory Care Quality Assurance Program at DeWitt Army Community Hospital, Fort Belvoir, Virginia.  

National Technical Information Service (NTIS)

This study was an endeavor to develop a system to collect and display useful information on the quality of ambulatory care by which hospital staff could make intelligent decisions in the management of the Ambulatory Care Quality Assurance Program.

J. R. O'Keiff

1982-01-01

94

Hashimoto's thyroiditis: celebrating the centennial through the lens of the Johns Hopkins hospital surgical pathology records.  

PubMed

Hashimoto's thyroiditis is now considered the most prevalent autoimmune disease, as well as the most common endocrine disorder. It was initially described in 1912, but only rarely reported until the early 1950s. To celebrate this centennial, we reviewed the surgical pathology archives of the Johns Hopkins hospital for cases of Hashimoto's thyroiditis, spanning the period from May 1889 to October 2012. Approximately 15,000 thyroidectomies were performed at this hospital over 124 years. The first surgical case was reported in 1942, 30 years after the original description. Then, 867 cases of Hashimoto's thyroiditis were seen from 1942 to 2012, representing 6% of all thyroidectomies. Hashimoto's thyroiditis was the sole pathological finding in 462 cases; it accompanied other thyroid pathologies in the remaining 405 cases. The most commonly associated pathology was papillary thyroid cancer, an association that increased significantly during the last two decades. The most common indication for thyroidectomy was a thyroid nodule that was cytologically suspicious for malignancy. Hashimoto's thyroiditis remains a widespread, intriguing, and multifaceted disease of unknown etiology one century after its description. Advances in the understanding of its pathogenesis and preoperative diagnosis will improve recognition and treatment of this disorder, and may one day lead to its prevention. PMID:23151083

Caturegli, Patrizio; De Remigis, Alessandra; Chuang, Kelly; Dembele, Marieme; Iwama, Akiko; Iwama, Shintaro

2013-02-01

95

Surgical management of retrosternal goiter: Local experience at a university hospital  

PubMed Central

BACKGROUND AND OBJECTIVE: Retrosternal goiter (RSG) is a term that has been used to describe a goiter that extends beyond the thoracic inlet. Surgery plays an important role in the treatment of these patients, but whether all or selected patients with RSG should undergo this operation remains controversial. Our aim is to look into the demographics, presentation, and treatment of patients with RSG and essentially to determine the role of surgery in its treatment. SETTING AND DESIGN: Retrospective study, teaching hospital-based. METHODS: Retrospective analysis of 537 thyroidectomies performed at King Khalid University Hospital between 2003 and 2010. The twenty-six patients with RSG were analyzed further, with regard to demographics, presentation, indications, and outcome of surgical treatment. Statistical analysis was performed, where age was expressed as mean and range, and other variables were presented as numbers and percentage. RESULTS: There were 26 patients (4.8%) with RSG out of 537 thyroidectomies, who underwent an operation for removal of RSGs, in a seven-year period. The most common presentation was dyspnea (34.6%) and the surgical procedure predominantly used was total thyroidectomy. The RSGs were removed by collar incision in 96% of the cases. The final histological diagnosis revealed malignancy in 26.9% of the thyroid specimens. There was no mortality and minor complications occurred in nine patients. CONCLUSIONS: The presence of an RSG is an indication for surgery owing to the lack of effective medical treatment, the higher incidence of symptoms related to compression, low surgical morbidity, and the risk of malignancy.

Khairy, Gamal A.; Al-Saif, Abdulaziz A.; Alnassar, Sami A.; Hajjar, Waseem M.

2012-01-01

96

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

PubMed Central

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

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

2013-01-01

97

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

2012-05-30

98

The National Surgical Quality Improvement Program in Non-Veterans Administration Hospitals  

PubMed Central

Objective To assess the feasibility of implementing the National Surgical Quality Improvement Program (NSQIP) methodology in non-VA hospitals. Summary Background Data Using data adjusted for patient preoperative risk, the NSQIP compares the performance of all VA hospitals performing major surgery and anonymously compares these hospitals using the ratio of observed to expected adverse events. These results are provided to each hospital and used to identify areas for improvement. Since the NSQIP’s inception in 1994, the VA has reported consistent improvements in all surgery performance measures. Given the success of the NSQIP within the VA, as well as the lack of a comparable system in non-VA hospitals, this pilot study was undertaken to test the applicability of the NSQIP models and methodology in the nonfederal sector. Methods Beginning in 1999, three academic medical centers (Emory University, Atlanta, GA; University of Michigan, Ann Arbor, MI; University of Kentucky, Lexington, KY) volunteered the time of a dedicated surgical nurse reviewer who was trained in NSQIP methodology. At each academic center, these nurse reviewers used NSQIP protocols to abstract clinical data from general surgery and vascular surgery patients. Data were manually collected and then transmitted via the Internet to a secure web site developed by the NSQIP. These data were compared to the data for general and vascular surgery patients collected during a concurrent time period (10/99 to 9/00) within the VA by the NSQIP. Logistic regression models were developed for both non-VA and VA hospital data. To assess the models’ predictive values, C-indices (0.5 = no prediction; 1.0 = perfect prediction) were calculated after applying the models to the non-VA as well as the VA databases. Results Data from 2,747 (general surgery 2,251; vascular surgery 496) non-VA hospital cases were compared to data from 41,360 (general surgery 31,393; vascular surgery 9,967) VA cases. The bivariate relationships between individual risk factors and 30-day mortality or morbidity were similar in the non-VA and VA patient populations for over 66% of the risk variables. C-indices of 0.942 (general surgery), 0.915 (vascular surgery), and 0.934 (general plus vascular surgery) were obtained following application of the VA NSQIP mortality model to the non-VA patient data. Lower C-indices (0.778, general surgery; 0.638, vascular surgery; 0.760, general plus vascular surgery) were obtained following application of the VA NSQIP morbidity model to the non-VA patient data. Although the non-VA sample size was smaller than the VA, preliminary analysis suggested no differences in risk-adjusted mortality between the non-VA and VA cohorts. Conclusions With some adjustments, the NSQIP methodology can be implemented and generates reasonable predictive models within non-VA hospitals.

Fink, Aaron S.; Campbell, Darrell A.; Mentzer, Robert M.; Henderson, William G.; Daley, Jennifer; Bannister, Janet; Hur, Kwan; Khuri, Shukri F.

2002-01-01

99

Surgical site infection: Rates, etiology and resistance patterns to antimicrobials among strains isolated at rio de janeiro university hospital  

Microsoft Academic Search

Summary A 6-month prospective surveillance was conducted in the Department of General Surgery of the Rio de Janeiro University Hospital. Postoperative infections were classified according to CDC criteria. This study reports a significant rate (16.9%) in surgical infections detected by surveillance in a series where 45% of surgical interventions were classified as clean. The majority (52.7%) was apparent only after

K. R. N. Santos; L. S. Fonseca; G. P. Bravo Neto; P. P. Gontijo Filho

1997-01-01

100

How good is compliance with surgical antibiotic prophylaxis guidelines in a tertiary care private hospital in India? A prospective study  

Microsoft Academic Search

Purpose  There is a need to study compliance with surgical antibiotic prophylaxis guidelines in India.\\u000a \\u000a \\u000a \\u000a Methods  In this prospective study, 100 consecutive surgical procedures performed at a tertiary care private hospital in Mumbai, India\\u000a were observed. The choice of antibiotic, timing and duration of administration were recorded and compared to the hospital\\u000a guidelines.\\u000a \\u000a \\u000a \\u000a Results  Appropriateness of choice of antibiotic was seen in 68%,

Lipika Parulekar; Rajeev Soman; Tanu Singhal; Camilla Rodrigues; F. D. Dastur; Ajita Mehta

2009-01-01

101

Empirical Data Mining: Conservation of Nursing Energy and Care Capacity in Medical-Surgical Hospital Work Environments  

Microsoft Academic Search

Ann L. Hendrich\\u000aLoyola University Chicago\\u000aEMPIRICAL DATA MINING: CONSERVATION OF NURSING ENERGY AND CARE CAPACITY IN MEDICAL-SURGICAL HOSPITAL WORK ENVIRONMENTS\\u000aNurses are a critical component of the hospital care delivery system and provide essential observation and surveillance of inpatients. Mounting evidence describes an association between nurse staffing, the nurse work environment, and patient and nurse outcomes. In particular, more

Ann L. Hendrich

2011-01-01

102

78 FR 15052 - Naugatuck Valley Surgical Center, Department of Saint Mary's Hospital, Waterbury, Connecticut...  

Federal Register 2010, 2011, 2012, 2013

...TA-W-82,137] Naugatuck Valley Surgical Center, Department of Saint Mary's...and former workers of Naugatuck Valley Surgical Center, a Department of Saint Mary's...group eligibility of Naugatuck Valley Surgical Center, a Department of Saint...

2013-03-08

103

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

104

Nasal Carriage of Staphylococcus aureus and Epidemiology of Surgical-Site Infections in a Sudanese University Hospital  

Microsoft Academic Search

Surgical site infections (SSI) due to Staphylococcus aureus among 256 male and 158 female patients (mean age, 28 years) undergoing elective surgery at the Soba University Hospital (Khartoum, Sudan) were studied. During an 11-month study period all patients were analyzed for nasal carriage of S. aureus at the time of admission. Follow-up of the development of SSI proceeded until 4

ABDALLA O. A. AHMED; ALEX VAN BELKUM; AHMED H. FAHAL; A. E. ABU ELNOR

1998-01-01

105

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

PubMed Central

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

2013-01-01

106

Epidemiology and surgical management of breast cancer in gynecological department of Douala General Hospital  

PubMed Central

Introduction Breast cancer is one of the most common gynecological cancers in our environment. Douala General Hospital (DGH) is one of the two main centers in Cameroon, where the cancerous patient can receive multidisciplinary management including radiotherapy. Methods The aim of our study was to describe the epidemiological, clinical profile and surgical management of patients with breast cancer in gynecological department of DGH. Results A total of 42 patients were recruited in our department within a period of 3 years (from November 2006 to October 2009). The mean age was 46 years (range: 29-73 years). Characteristics of our study group were as followed: female sex (100%); breast feeding (95.245%); familial history of breast cancer (7.14%); 14.29% of patients were nulliparous and 19.05% primiparous. The main mode of discovering the disease was auto examination (92.86%). The clinical tumor size ranges from 2cm to 20cm with a mean of 6.83cm. Patients were then mostly diagnosed at stage III (54.76%) of the WHO classification. Only 2.38% were diagnosed at stage I. The main method of diagnosis was breast fine needle aspiration. Neo adjuvant treatment was administered in 78.57% of patients and the main surgical treatment was mastectomy (92.86%). Many patients are still followed up (59.52%), but we already had a mortality rate of 14.29% at the end of December 2010. We had no feedback for 26.19% of the study group. Conclusion Breast cancer is generally diagnosed in advanced stage in our milieu; there is therefore a need for generalized sensitization of the population.

Nguefack, Charlotte Tchente; Biwole, Martin Essomba; Massom, Annie; Kamgaing, Jacques Tsingaing; Njamen, Theophile Nana; Ekane, Gregory Halle; Obinchemti, Thomas Egbe; Priso, Eugene Belley

2012-01-01

107

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

2013-07-23

108

[Surgical services in a central regional hospital in for ballistic wounds during the armed conflicts].  

PubMed

There was effectuated an analyze of delivery of health care to 1294 patients with ballistic wounds, admitted to Gudermess central regional hospital of Chechen Republic during the armed conflict on Northern Caucasus in 1994-2002. Age of wounded was between 12 and 67 years old, among them men - 1088 (84.1%), women - 206 (15.9%) and children - 291 (22.5%). Native population - 945 persons (73%), military servicemen from different departments - 349 persons (27%). In accord with character of destructive factor all wounds were divided in following way: ballistic wounds - 419 cases (32.4%), fragment wounds - 466 cases (36%), explosive wounds - 409 cases (31.6%). 392 persons (30.3%) had isolated wounds, 340 persons (26.3%) had multiple wounds, 513 persons (39.6%) had conjoined wounds, 49 persons (3.8%) had combined (term-mechanic) wounds. In accord with localization all wounds were divided in following way: head - 93 cases (7.2%), neck - 19 cases (1.5%), sternum - 117 cases (9%), stomach - 110 (8.5%), bowl - 89 cases (6.9%), axis - 21 cases (1.6%), upper limbs - 352 (27.2%), lower limbs - 493 cases (38.1%). 1074 were operated, term from admission to operation was: for emergency operation - 2.1+/-0.3 h, for delayed operations - 12+/-0.5 h. 220 patients were not operated, 6 of them died in 30-45 minutes after admission (cause - damages, not compatible with life). 214 were not pertained for first surgical aid. Postoperation complications were 8.2%, mortality - 2.6%, postoperation lethality - 1.93%, average term of stay in hospital - 24.3+/-0.3 days. PMID:19827666

Iakhikhazhiev, S K

2009-07-01

109

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

110

The economic impact of infections. An analysis of hospital costs and charges in surgical patients with cancer.  

PubMed

We performed an economic analysis of the care provided to patients undergoing major abdominal surgical procedures to determine the effect of postoperative infection on hospital resource use. Patients' clinical and demographic characteristics and their use of medical care services were determined from a review of hospital bills and medical records. Hospital charges were obtained from the hospital billing system and costs were determined by use of Medicare cost-charge ratios obtained from the hospital's Medicare Cost Report. The care of patients with postoperative infections was significantly more expensive than that of uninfected patients (multivariate analysis indicated that a surgical infection added $12,542 to the cost of patient care). Patients with postoperative fever but without documented infection were also more expensive to care for than afebrile, uninfected patients (fever added $9145 to the cost of care). Increased costs for infected patients were found among microbiology tests, radiology services, pharmaceutical costs, and room costs. For these patients, we found that use of departmental cost-charge ratios, instead of hospital-wide cost-charge ratios, had no substantial impact on comparison of the cost of care for infected and uninfected patients. PMID:8457158

Shulkin, D J; Kinosian, B; Glick, H; Glen-Puschett, C; Daly, J; Eisenberg, J M

1993-04-01

111

Health and Economic Impact of Surgical Site Infections Diagnosed after Hospital Discharge  

PubMed Central

Although surgical site infections (SSIs) are known to cause substantial illness and costs during the index hospitalization, little information exists about the impact of infections diagnosed after discharge, which constitute the majority of SSIs. In this study, using patient questionnaire and administrative databases, we assessed the clinical outcomes and resource utilization in the 8-week postoperative period associated with SSIs recognized after discharge. SSI recognized after discharge was confirmed in 89 (1.9%) of 4,571 procedures from May 1997 to October 1998. Patients with SSI, but not controls, had a significant decline in SF-12 (Medical Outcomes Study 12-Item Short-Form Health Survey) mental health component scores after surgery (p=0.004). Patients required significantly more outpatient visits, emergency room visits, radiology services, readmissions, and home health aide services than did controls. Average total costs during the 8 weeks after discharge were US$5,155 for patients with SSI and $1,773 for controls (p<0.001).

Sands, Kenneth E.; Cosgrove, Sara E.; Guadagnoli, Edward; Meara, Ellen; Platt, Richard

2003-01-01

112

Risk factors associated with surgical site infections following vascular surgery at a German university hospital.  

PubMed

Surgical site infection (SSI) after vascular surgery is a serious complication increasing morbidity, mortality, and costs for healthcare systems. A 4-year retrospective cohort study was performed in a university hospital with patients who had undergone arterial vascular surgery below the aortic arch. Investigated variables included demographics and clinical data. Forty-four of 756 patients experienced SSI, 29 of which were superficial, five were deep, and 10 had organ/space infections. Coagulase-negative staphylococci (22%), enterococci (20%), and Staphylococcus aureus (18%) were the most common pathogens. Independent risk factors for SSIs were femoral grafting [odds ratio (OR) 6·7], peripheral atherosclerotic disease, Fontaine stages III-IV (OR 4·1), postoperative drainage >5 days (OR 3·6), immunosuppression (OR 2·8), duration of operation >214 min (OR 2·8), and body mass index >29 (OR 2·6). The application of perioperative antibiotic prophylaxis was an independent protective factor (OR 0·2). Patients with certain risk factors for SSIs warrant special attention for infection prevention. PMID:22906362

Ott, E; Bange, F-Ch; Sohr, D; Teebken, O; Mattner, F

2012-08-21

113

Adult surgical emergencies in a developing country: the experience of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.  

PubMed

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 of adult patients treated as emergencies over a 5-year period, from 7 September 1998 to 6 September 2003, were obtained. The hospital folders were then retrieved from the Records Department. From each folder, the following details about each patient were extracted: age, sex, diagnosis at presentation, causative factors, treatment given, and outcome. A total of 902 adult patients were treated during the period. The commonest emergency operation was appendectomy for acute appendicitis in 139 patients (97 women and 42 men), followed closely by road traffic accidents (RTAs) involving 137 patients (103 men and 34 women). Gunshot injuries, which resulted mainly from armed robbery attacks, accounted for 127 cases. More men (113) sustained gunshot injuries than women (14). Of the 92 cases of acute intestinal obstruction seen, 62 occurred in women and 30 in men. Some 126 men presented with acute urinary retention, and two others presented with priapism. Governments at various levels should provide modern diagnostic tools for the accurate preoperative diagnosis of surgical emergencies in hospitals. Governments should also inculcate strict discipline into drivers using the highways, particularly in relation to abuse of alcohol and drugs. Good roads and adequate security should be provided for the people. The need for Pre-Hospital Care for the efficient evacuation of accident victims is emphasized. These measures will help to improve the management and outcome of surgical emergencies, and decrease the number of surgical emergencies resulting from RTAs and gunshot wounds. PMID:15880283

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

2005-06-01

114

Surgical Site Infection in General and Thoracic Surgery: Surveillance of 2?663 Cases in a Japanese Teaching Hospital  

Microsoft Academic Search

Purpose  We conducted a prospective survey of 2?663 surgical patients in a Japanese teaching hospital to look for any risk factors\\u000a predisposing to surgical site infection (SSI) other than the National Nosocomial Infection Surveillance (NNIS) System risk\\u000a indices; namely, performance status, operative time, wound classification, and endoscopic use.\\u000a \\u000a \\u000a \\u000a Methods  Our Infection Control Team recorded data for 5 years using the Japanese SSI

Junichi Yoshida; Masahiro Shinohara; Mikimasa Ishikawa; Kenichi Matsuo

2006-01-01

115

Impact of bleeding-related complications and\\/or blood product transfusions on hospital costs in inpatient surgical patients  

Microsoft Academic Search

Background  Inadequate surgical hemostasis may lead to transfusion and\\/or other bleeding-related complications. This study examines the\\u000a incidence and costs of bleeding-related complications and\\/or blood product transfusions occurring as a consequence of surgery\\u000a in various inpatient surgical cohorts.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective analysis was conducted using Premier's Perspective™ hospital database. Patients who had an inpatient procedure\\u000a within a specialty of interest (cardiac, vascular, non-cardiac

Michael E Stokes; Xin Ye; Manan Shah; Katie Mercaldi; Matthew W Reynolds; Marcia FT Rupnow; Jeffrey Hammond

2011-01-01

116

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

Code of Federal Regulations, 2013 CFR

...result of which the disease or injury was sustained...ii) As applied to medical or surgical treatment, the physical condition prior to the disease or injury will be the condition which the specific medical or surgical...

2013-07-01

117

Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit.  

PubMed

A preoperative delay in emergency surgery for spontaneous pneumothorax is associated with a poor outcome after surgery and a prolonged hospital stay. To reduce preoperative delays, all tertiary referrals from district general hospitals to our thoracic surgery unit were processed through a 'clinical decisions unit' (CDU). Prior to the establishment of the CDU, these patients were added to a waiting list for a surgical bed. This study has reviewed the effect of this change in admission policy on the efficiency of treatment for non-elective spontaneous pneumothorax. An intergroup comparison (pre-CDU group vs. post-CDU group) was made of the following parameters: referral to transfer time, transfer to surgery time and length of inpatient stay in the referring and tertiary hospitals. There were no significant differences in gender, diagnosis, treatment in the referring hospitals, postoperative clinical outcome, or indications for or type of surgery. The total length of inpatient stay in the referring and tertiary hospitals was significantly reduced for the post-CDU group (12 vs. 15 days; P<0.001), which was attributed to the earlier transfer of patients (18 vs. 78 hours; P<0.001) hours. Allowing surgical access to a traditional medical admission unit is therefore, cost-effective and significantly improves the efficiency of non-elective pneumothorax surgery. PMID:21873367

Aslam, Muhammad I; Martin-Ucar, Antonio E; Nakas, Apostolos; Waller, David A

2011-08-26

118

Analytical methodology and assessment of potential second-hand exposure to fentanyl in the hospital surgical setting.  

PubMed

Second-hand exposure to aerosols containing fentanyl and other opiates during surgical procedures has been implicated as possibly contributing to maintenance of addiction among medical professionals, specifically anesthesiologists. This article outlines a pilot study that was conducted to verify a reported finding fentanyl in the air of operating suites. Environmental fentanyl air sampling and analysis methods were developed and evaluated for this study. Multiple sampling media and extraction solvents were evaluated for trace fentanyl air sampling. Non-specific binding losses were reduced by using silanized binder-free glass fiber sampling media with subsequent methanol extraction. Filtration air samples were then collected in surgical suites during the entire operation time from two cardiovascular surgical procedures. Both surgical procedures were conducted at the same hospital but on different days. Samples were extracted and analyzed by high-performance liquid chromatography/tandem mass spectrometry using a capillary high-performance liquid chromatography coupled to a quadrupole time-of-flight mass spectrometer. The total air volume collected per surgery was 290 to 300 L at a rate of 1 LPM giving an limit of quantification for fentanyl of 57 pg/m(3) air (17 pg/filter). No fentanyl was detected in the air during cardiovascular surgical operations from either surgical suite. PMID:20390698

Law, Brandon F; Hettick, Justin M; Hornsby-Myers, Jennifer; Siegel, Paul D

2010-01-01

119

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

120

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

121

Does patient perception of pain control affect patient satisfaction across surgical units in a tertiary teaching hospital?  

PubMed

In this study, the relationship between patients' perceptions of pain control during hospitalization and their overall satisfaction with care was examined. Satisfaction data were collected from the federally mandated Hospital Consumer Assessment of Healthcare Providers and Systems survey for 4349 adult patients admitted to any surgical unit over an 18-month period. Patients' perceptions of pain control and staff's efforts to control pain were associated with their overall satisfaction scores. These perceptions varied widely among services and nursing units. Interestingly, patient satisfaction was more strongly correlated with the perception that caregivers did everything they could to control pain than with pain actually being well controlled. The odds of a patient being satisfied were 4.86 times greater if pain was controlled and 9.92 times greater if the staff performance was appropriate. Hospitals may improve their patients' satisfaction by focusing on improving the culture of pain management. PMID:22345130

Hanna, Marie N; González-Fernández, Marlís; Barrett, Ashlea D; Williams, Kayode A; Pronovost, Peter

2012-02-16

122

Emergency room surgical workload in an inner city UK teaching hospital  

Microsoft Academic Search

BACKGROUND: Emergency admissions may account for over 50% of surgical admissions. The impact on service provision and implications for training are difficult to quantify. We performed a cohort study to analyse these workload patterns. METHODS: Data on emergency room (ER) surgical admissions over six months was collected including patient demographics, referral sources, diagnosis, operation and length of stay and analysed

Tuong A Mai-Phan; Bijendra Patel; Michael Walsh; Ajit T Abraham; Hemant M Kocher

2008-01-01

123

Spectrum of surgical trauma and associated head injuries at a university hospital in eastern Nepal  

PubMed Central

Background: Trauma is one of the common surgical emergencies presenting at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal, a tertiary referral center catering to the needs of the population of Eastern Nepal and nearby districts of India. Objective: The objective of this study is to analyze the magnitude, epidemiological, clinical profile and outcome of trauma at B P Koirala Institute of Health Sciences. Materials and Methods: This descriptive case series study includes all patients with history of trauma coming to BPKIHS emergency and referred to the surgery department. We noted the detailed clinical history and examination, demographics, mechanism of injury, nature of injury, time of reporting in emergency, treatment offered (operative or non operative management) and analyzed details of operative procedure (i.e. laparotomy, thoracotomy, craniotomy etc.), average length of hospital stay, morbidity and outcome (according to Glasgow outcome scale). Collected data were analyzed using EpiInfo 2000 statistical software. Results: There were 1848 patients eligible to be included in the study. The mean age of the patients was 28.9 ± 19.3 years. Majority of the patients (38%) belonged to the age group of 21 - 40 years and the male to female ratio was 2.7:1. Most of the trauma victims were students (30%) followed by laborers (27%) and farmers (22%) respectively. The commonest causes of injury were fall from height (39%), road traffic accident (38%) and physical assault (18%); 78% of the patients were managed conservatively and 22% underwent operative management. Postoperative complications were seen in 18%. Wound infection 7.5%, neurological deficit including cerebrospinal fluid (CSF) otrorrhea was seen in 2.2% patients. Good recovery was seen in 84%, moderate disability in 5.2% patients and severe disability in 1.4% patients. The mortally was 6.3% and most of the deaths were related to traumatic brain injuries. Conclusions: In Nepal, trauma-related injury contributes significantly to morbidity and mortality and is the third leading cause of death. There are very few studies on trauma from this country and hence this study will help in understanding the etiology and outcome particularly in the Eastern region of Nepal.

Bajracharya, A; Agrawal, A; Yam, BR; Agrawal, CS; Lewis, Owen

2010-01-01

124

Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program.  

National Technical Information Service (NTIS)

The purpose of the business case analysis was to determine what combination of Full-Time Equivalent (FTE) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management sol...

P. B. Markot

2007-01-01

125

SEROPREVALENCE OF HEPATITIS-B AND C AMONG THE PATIENTS REPORTING IN SURGICAL OPD AT FAUJI FOUNDATION HOSPITAL, RAWALPINDI: Review of 5 year literature  

Microsoft Academic Search

Objectives: To find out the seroprevalence of HbsAg and Anti HCV virus among the patients reporting in surgical OPD. Methodology: This is a prospective observational study. Patients reporting to surgical OPD of Fuji Foundation Hospital, Rawalpindi above 20 years of age, with no previous history of seropositive Hepatitis B or C of chronic liver disease were enrolled from January 2006

Ishtiaq Ahmed Chaudhary; Shah Sattar Khan; Muhammad Ashraf Majrooh; Ahsan Ahmed Alvi

126

Methodologies used in surveillance of surgical wound infections and bacteremia in Australian hospitals  

Microsoft Academic Search

Background: The prevalence of nosocomial infection in Australian hospitals is estimated to be between 5.5% and 6.3%. Since 1989, infection control professionals (ICPs) in hospitals accredited by the Australian Council on Health Care Standards (ACHS) have been encouraged to collect nosocomial infection data according to ACHS methodology. Method: In 1996, we surveyed members of the Australian Infection Control Association to

Cathryn L. Murphy; M.-L. McLaws

1999-01-01

127

Quality of life and surgical outcomes following laparoscopic surgery for refractory gastroesophageal reflux disease in a regional hospital  

PubMed Central

Background Gastroesophageal reflux disease (GERD) is a prevalent condition leading to poor quality of life (QOL) in patients with refractory symptoms. Laparoscopic antireflux (LAR) surgery has been shown to improve QOL, and I sought to examine the surgical and QOL outcomes associated with LAR surgery over a 3-year period at a regional hospital. Methods Patients were given GERD–health related quality of life (GERD-HRQL) and SF-36 questionnaires preoperatively, at 6 months and at 12 or more months after surgery. I collected data on demographic and clinical characteristics and surgical outcomes. Results Of the 342 patients referred for GERD or dysphagia, 26 received LAR surgery during the study period. All 26 patients had symptoms refractory to medications; 19 had atypical symptoms and 8 had some form of chronic pain syndrome (CPS). The mean duration of surgery was 125 minutes. There were no conversions, complications, 30-day readmissions or deaths. Three patients stayed 2 days in hospital and 23 stayed overnight. One patient required esophageal dilation for persistent dysphagia. Two patients resumed medication for recurrent symptoms and 24 remained medication free. There were significant improvements in GERD–HRQL scores in all patients. Patients with CPS had no improvements in SF-36 scores, whereas patients without CPS showed significant improvement. Conclusion Excellent surgical outcomes in LAR surgery can be obtained with careful patient selection at a nonacademic regional hospital. Although GERD-HRQL improved in all patients, patients with CPS showed no improvement in general health QOL scores after LAR surgery. Careful patient counselling should be employed when offering LAR surgery to patients with CPS.

Hwang, Hamish

2012-01-01

128

Army Helicopter Crashworthiness.  

National Technical Information Service (NTIS)

This paper discusses the evolution of crash survival design criteria, its influence on the formulation of a US Army military standard for rotary-wing aircraft crashworthiness, and its application to current and new-generation Army helicopters. Emphasis is...

C. H. Carper K. F. Smith L. T. Burrows

1983-01-01

129

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

130

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

131

The Army Mental Tests  

Microsoft Academic Search

Reviews the book, Psychological Examining in the United States Army edited by R. M. Yerkes . Much has already been written of the work of psychologists in the United States army during the recent war. Their services were manifold and psychologists were utilized in many different branches of the army. The present volume deals with the work of the group

R. Pintner

1921-01-01

132

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

133

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

134

Multi-drug-resistant gram-negative bacterial infection in surgical patients hospitalized in the ICU: a cohort study.  

PubMed

We sought to identify risk factors for postoperative infections, caused by multi-drug-resistant gram-negative bacteria (MDR-GNB) in surgical patients. This was a retrospective cohort study among patients hospitalized in the intensive care unit (ICU) for more than 5 days, following general surgical operations. Comparison of patients who developed infection caused by MDR-GNB with the remainder of the cohort showed that every minute of operative time, use of special treatments during hospitalization (antineoplastic, immunosuppressive or immunomodulating therapies), every day of metronidazole, and every day of carbapenems use, increased patients' odds to acquire an infection caused by MDR-GNB by 0.7%, 8.9 times, 9%, and 9%, respectively [OR (95% CI): 1.007 (1.003-1.011), p?=?0.001; 8.9 (1.8-17.3), p?=?0.004; 1.09 (1.04-1.18), p?=?0.039; 1.09 (1.01-1.18), p?=?0.023, respectively]. The above were adjusted in the multivariable analysis for the confounder of time distribution of infections caused by MDR-GNB. Finally, the secondary comparison, with patients that did not develop any infection, showed that patients who had received antibiotics, within 3 months prior to admission, had 3.8 times higher odds to acquire an infection caused by MDR-GNB [OR (95% CI): 3.8 (1.07-13.2), p?=?0.002]. This study depicts certain, potentially modifiable, risk factors for postoperative infections in patients hospitalized in the ICU for more than 5 days. PMID:21796346

Alexiou, V G; Michalopoulos, A; Makris, G C; Peppas, G; Samonis, G; Falagas, M E

2011-07-28

135

Four-Year Hospital Resource Utilization After Bariatric Surgery: Comparison with Clinical and Surgical Controls  

Microsoft Academic Search

Background  Consumption of healthcare has been shown to diminish after bariatric treatment, but utilization of hospital services has not\\u000a been well documented. Aiming to assess this question, a retrospective study with females was designed.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Yearly outpatient appointments, hospital admissions, emergency department visits, and total biochemical tests during 4 years\\u000a were registered and compared with the preoperative year. Population (N?=?176, all females) comprised

Silvia Yoko Hayashi; Joel Faintuch; Joao Italo Dias França; Ivan Cecconello

136

Results of the centralisation of adult emergency oral and maxillofacial surgical services at the University Hospital, Birmingham.  

PubMed

In 2001, the oral and maxillofacial surgical (OMFS) services for adults in Birmingham were centralised at the Selly Oak site of the University Hospital and the OMFS department was given access to the emergency operating theatre every day. We examined the effects of this on the emergency workload during the 6 months after centralisation and compared it with the emergency workload at the University Hospital during the 6 months before centralisation. The number of adult patients who attended the University Hospital as emergencies increased from 242 in the 6 months before centralisation to 545 in the subsequent 6 months (an increase of 127%). Of the latter 164 (30%) were admitted and operated on, 138 (84%) within 24h of admission. Despite the large increase in the number of patients, 102 (74%) were operated on during normal working hours. After centralisation, all operations were done on multidisciplinary emergency lists compared with only 55% before centralisation. Centralisation did not reduce the access of patients to the emergency service and conformed with the guidelines of the National Confidential Enquiry into Perioperative Deaths (NCEPOD). PMID:16310906

James, G J; Gibbons, A J; Srinivasan, D; Dover, M Stephen

2005-11-28

137

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

PubMed Central

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

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

2013-01-01

138

ENT surgical simulator project  

Microsoft Academic Search

This paper outlines the proposal, approved by The United States Army Medical Research and Material Command, to develop and implement an ENT surgical simulator. The proposed research aims to develop and evaluate a minimally invasive prototype surgical simulator to establish real time fidelity requirements for tactile feedback and computer image synthesis. The project will enhance Graduate Medical Education programs, as

C. V. Edmond; D. Sluis

1995-01-01

139

Complexity and Army Transformation  

NASA Astrophysics Data System (ADS)

On 12 Octther 1999, the U.S. Army began a journey down a new path to innovation, when General Eric Shinseki presented his vision of Army Transformation at the 45th annual meeting of the Association of the United States Army. In this speech, General Shinseki described the Army as an organization consisting of heavy forces with excellent staying power but poor strategic responsiveness, light forces with excellent responsiveness but poor staying power, and a logistics system with an excessively large footprint. His proposed solution, a comprehensive change of the Army resulting in full-spectrum dominance and strategic responsiveness, would occur so quickly as to "be unnerving to some." [Shinseki. 1999] While this prediction has turned out in some ways to be true, it is not necessarily the speed of change that is unnerving to many of the people studying Army Transformation.

Calhoun, Mark T.

140

The risk of seizures during the in-hospital admission for surgical or endovascular treatment of unruptured intracranial aneurysms.  

PubMed

Few studies detail the risk of in-hospital seizures following elective surgical or endovascular treatment of unruptured intracranial aneurysms (UIA). We compared the peri-procedural seizure incidence for clipping and coiling of UIA. A retrospective cohort study using the Australian National Hospital Morbidity Database from 1998 to 2008 was conducted. Treatment modalities were compared for the combined primary end point related to seizure. Putative risk factors were investigated with univariate and multivariate logistic regression analysis to identify independent predictors of outcome. A total of 5922 hospitalisations for UIA (3098 clipping, 2824 coiling) were identified. Overall, surgery was associated with a 2.7% (95% confidence interval [CI] 2.2-3.4) incidence of peri-operative seizures, compared to a 0.6% (95% CI 0.4-1.0) incidence following endovascular treatment (adjusted odds ratio [OR] 4.40; 95% CI 2.64-7.33; p<0.001). The incidences of seizures declined over the 11year study period in both treatment groups, from 4.2% to 2.0% for surgery and from 2.8% to 0.3% for endovascular. Haemorrhagic complication with intracerebral haemorrhage predicted occurrence of a seizure (OR 3.41; 95% CI 1.20-9.66; p=0.021), whereas endovascular coiling was associated with a better seizure outcome (OR 0.23; 95% CI 0.14-0.39; p<0.001). Overall, elective surgical treatment of UIA is associated with a higher risk of seizure occurrence compared to endovascular coiling. Contrary to conventional thinking, the risk of seizures following endovascular treatment is not entirely absent. Current recommendations must be considered in relation to the issue of driving after elective intracranial aneurysm treatment. PMID:23896547

Lai, Leon T; O'Donnell, Joan; Morgan, Michael K

2013-07-27

141

Surgical site infection prevention: a survey to identify the gap between evidence and practice in University of Toronto teaching hospitals  

PubMed Central

Background A gap exists between the best evidence and practice with regards to surgical site infection (SSI) prevention. Awareness of evidence is the first step in knowledge translation. Methods A web-based survey was distributed to 59 general surgeons and 68 residents at University of Toronto teaching hospitals. Five domains pertaining to SSI prevention with questions addressing knowledge of prevention strategies, efficacy of antibiotics, strategies for changing practice and barriers to implementation of SSI prevention strategies were investigated. Results Seventy-six individuals (60%) responded. More than 90% of respondents stated there was evidence for antibiotic prophylaxis and perioperative normothermia and reported use of these strategies. There was a discrepancy in the perceived evidence for and the self-reported use of perioperative hyperoxia, omission of hair removal and bowel preparation. Eighty-three percent of respondents felt that consulting published guidelines is important in making decisions regarding antibiotics. There was also a discrepancy between what respondents felt were important strategies to ensure timely administration of antibiotics and what strategies were in place. Checklists, standardized orders, protocols and formal surveillance programs were rated most highly by 75%–90% of respondents, but less than 50% stated that these strategies were in place at their institutions. Conclusion Broad-reaching initiatives that increase surgeon and trainee awareness and implementation of multifaceted hospital strategies that engage residents and attending surgeons are needed to change practice.

Eskicioglu, Cagla; Gagliardi, Anna R.; Fenech, Darlene S.; Forbes, Shawn S.; McKenzie, Marg; McLeod, Robin S.; Nathens, Avery B.

2012-01-01

142

Industry-wide studies report of an industrial-hygiene survey at the Cutler US Army Community Hospital, Fort Devens, Massachusetts, January 7-10, 1985. [Ethylene oxide exposures  

SciTech Connect

An industrial-hygiene survey of exposures to ethylene oxide at Cutler United States Army Community Hospital, Fort Devens, Massachusetts, was conducted in January 1985. Breathing-zone and general-area sampling for ethylene oxide in the Central Materials Supply (CMS) area was performed. The only personal protective equipment used by personnel in the CMS area was polyvinyl gloves to transfer sterilized items from the sterilizer to the aerator. Respiratory protective equipment was not used or provided. Breathing-zone ethylene oxide exposures ranged from below the detection limit to 0.83 part per million (ppm). Short-term exposures of 2.40 and 17.84ppm occurred. The OSHA 8-hour time-weighted average (TWA) standard for ethylene oxide is 1.0ppm. Area ethylene oxide concentrations ranged up to 58.3ppm. The author concludes that except for the short term 17.84ppm exposure, which equals 1.1ppm on a TWA basis, breathing-zone ethylene oxide concentrations did not exceed the OSHA standard. Exposure potential in the hospital could be reduced further by improving work practices and installing engineering controls.

Elliott, L.J.

1985-10-01

143

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

144

42. Post Engineer Office, Presidio of San Francisco, Letterman Army ...  

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

42. Post Engineer Office, Presidio of San Francisco, Letterman Army Hospital, X-Ray Department and Second Floor Plan, X-Ray Department Plan, Building 1006. no date. BUILDING 1006. - Presidio of San Francisco, Letterman General Hospital, Building No. 27, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

145

41. Post Engineer Office, Presidio of San Francisco, Letterman Army ...  

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

41. Post Engineer Office, Presidio of San Francisco, Letterman Army Hospital, First Floor Plan, Main Laboratory Section and Plan, Building 1006. no date BUILDING 1006. - Presidio of San Francisco, Letterman General Hospital, Building No. 27, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

146

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

147

Army Civilian Awards Study.  

National Technical Information Service (NTIS)

A study was made of the Army civilian performance awards system to determine whether the system was adequately meeting the needs of the Army and its commanders and personnel in the field. The study revealed that the program is generally well administered,...

C. E. Thomas J. M. Alward W. E. Fanelli W. M. Fennel R. A. Haisch

1977-01-01

148

Army's Wireless Communications Programs.  

National Technical Information Service (NTIS)

The Army's plans for operating its forces rely on the ability of those forces to rapidly process and exchange large amounts of information during battle. The availability of new, high-capacity radios purchased by the Army under a number of wireless commun...

2009-01-01

149

Army occupational health and AEJA (Army Environmental Hygiene Agency)  

Microsoft Academic Search

The Army Environmental Hygiene Agency (AEHA) recently celebrated 38 years of continuous service in support of occupational health programs of the Army. This report briefly reviews its historical development, examine some of its current occupational and industrial hygiene programs, and touches on future program efforts. The Army Industrial Hygiene Laboratory, conducts surveys and investigations concerning occupational health hazards in Army-owned

Kneessy

1981-01-01

150

Army G-1: The Army's National Human Resources Provider.  

National Technical Information Service (NTIS)

The Army G-1 and the Human Resources Command (HRC) serve as the Army's National Human Resources Provider (NHRP) and the key 'top of the system' management, policy formulation, and process leader of the Army's Human Resources (HR) system. Army wide-transfo...

L. Wark

2008-01-01

151

[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

152

Enhancing the Army's Strategic Deployability.  

National Technical Information Service (NTIS)

Since the end of the cold war, the US Army has become a force- projection Army with reduced forward basing. With increased overseas commitments, the Army's ability to conduct strategic deployment is more important than ever. In the next decade, the Army w...

W. A. Shoffner

2000-01-01

153

Local audit of surgical pathology. 18 month's experience of peer review-based quality assessment in an English teaching hospital.  

PubMed

In order to assess the performance of a surgical pathology laboratory in a university hospital, we have established a comprehensive system of quality audit based on peer review. Each month, 2% of cases received are selected at random and assessed retrospectively by two senior pathologists. The system, which uses semi-quantitative scoring, examines diagnostic accuracy, identifies delay at any stage in the production of reports, evaluates the overall quality of the slides, the presentation of the final report, and the accuracy of the SNOMED coding. Each of these parameters is graded as "satisfactory," "borderline," or "unsatisfactory." In 20 of 518 cases (3.9%) analyzed in 18 months, the microscopic report was unsatisfactory; in six of these cases, the error could have affected patient management. Remediable faults were detected in the macroscopic description of specimens and in the speed and accuracy of report typing by the secretarial staff. In 13 of 18 months, greater than 10% of reports were delayed because of the time taken in microscopic reporting by pathologists. Some (but not all) of this delay was attributable to the "checking out" of pathologists in training. We conclude that this audit system has uncovered substantial deficiencies in our departmental performance, some of which could affect the clinical course of patients. These surprising results suggest that a system of peer review should be adopted more widely. PMID:1599026

Ramsay, A D; Gallagher, P J

1992-05-01

154

U.S. Army Says Goodbye to MASH  

NSDL National Science Digital Library

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

2006-01-01

155

Army Aircraft Armament.  

National Technical Information Service (NTIS)

The background document provides general testing information relative to the planning and conduct of army aircraft armament engineering evaluation. This information supplements and is applied in common to test procedures which deal with the evaluation of ...

1970-01-01

156

Factors Influencing Army Accessions.  

National Technical Information Service (NTIS)

The subject of this thesis is accessions and the factors influencing a potential recruit's decision to join the Army. Six types of analysis were performed: regression analysis, data base profile analysis through SPSS Frequencies and Crosstabs, factor anal...

K. M. Kalinich D. C. Wenzel

1982-01-01

157

Army Physical Readiness Training.  

National Technical Information Service (NTIS)

The Army assesses, plans, prepares and executes training and leader development through training based on tasks, conditions and standards. Knowing the task, assessing the level of proficiency against the standard and developing a sustained or improved tra...

2010-01-01

158

Army facility energy conservation  

Microsoft Academic Search

The Army installation is similar to a small city with a population of 30,000 to 40,000 people. The Army's approach to energy conservation, energy management and control, and the use of alternate energy sources is on an installation wide or city wide basis, i.e., energy master planning. The first step in energy master planning is to perform an energy audit

J. R. Hoffman; H. D. Musselman

1978-01-01

159

PATTERN OF PATHOGENS AND THEIR SENSITIVITY ISOLATED FROM SUPERFICIAL SURGICAL SITE INFECTIONS IN A TERTIARY CARE HOSPITAL  

Microsoft Academic Search

Background: Infection is an important cause of morbidity and mortality in surgical patients. Rapidly emerging nosocomial pathogens and the problem of multi-drug resistance necessitates periodic review of isolation patterns and sensitivity in surgical practice. Surgical site infections (SSI) are defined as an infections that occurs at the incision site within thirty days after surgery. Objectives of the study were to

Syed Asad Ali; S. M. Tahir; Abdul Sattar Memon; Noshad A. Shaikh

2009-01-01

160

The Impact of Depth of Infection and Postdischarge Surveillance on Rate of Surgical-Site Infections in a Network of Community Hospitals  

PubMed Central

OBJECTIVE To describe the epidemiology of surgical-site infections (SSIs) in community hospitals and to explore the impact of depth of SSI, healthcare location at the time of diagnosis, and variations in surveillance practices on the overall rate of SSI. DESIGN Retrospective cohort study. SETTING Thirty-seven community hospitals in the southeastern United States. PATIENTS Consecutive sample of patients undergoing surgical procedures between July 1, 2007, and December 31, 2008. METHODS ANOVA was used to compare rates of SSIs, and the F test was used to compare the distribution of rates of SSIs. Wilcoxon rank-sum was used to test for differences in performance rankings of hospitals. RESULTS Following 177,706 surgical procedures, 1,919 SSIs were identified (incidence, 1.08 per 100 procedures). Sixty-four percent (1,223 of 1,919) of these were identified as complex SSIs; 87% of the complex SSIs were diagnosed in inpatient settings. The median proportion of superficial-incisional SSIs was 37% (interquartile range, 29.6%–49.5%). Postdischarge SSI surveillance was variable, with 58% of responding hospitals using surgeon letters. As reporting focus was narrowed from all SSIs to complex SSIs (incidence, 0.69 per 100 procedures) and, finally, to complex SSIs diagnosed in the inpatient setting (incidence, 0.51 per 100 procedures), variance in rates changed significantly (P =.02). Performance ranking of individual hospitals, based on rates of SSIs, differed significantly, depending on the reporting method utilized (P =.0006). CONCLUSIONS Inconsistent reporting methods focused on variable depths of infection and healthcare location at time of diagnosis significantly impact rates of SSI, distribution of rates of SSI, and hospital comparative-performance rankings. We believe that public reporting of SSI rates should be limited to complex SSIs diagnosed in the inpatient setting.

Ming, David Y.; Chen, Luke F.; Miller, Becky A.; Sexton, Daniel J.; Anderson, Deverick J.

2013-01-01

161

[Organization and contents of the specialized surgical care in multiprofile military hospitals of the 1st level during counter-terrorist operations on the northern Caucasus (report V)].  

PubMed

The principle difference of the work of multiprofile military hospitals (MMH) of the Ist level during the armed conflicts on the Northern Caucasus, particularly during the second, was rendering specialized surgical care to the primary contingent of the wounded, evacuated during the nearest hours after a wound. The incoming flow to MMH of the 1st level - in connection with the primary entering of the wounded practically from a battle field - was characterized by severity (one third of the wounded had severe and extremely severe wounds) and the significant number of the wounded with multiple and combined injuries (up to 60% of the wounded). Effective treatment of the above-mentioned wounded can only be carried by specially trained surgeons in appropriately-equipped multiprofile medical hospitals. The rendered volume of specialized surgical care in MMH of the 1st level included the following operations: neurosurgical (2,4%), thoracoabdominal (19,8%), traumatologic (17,0%), angiosurgical (8,2%), special (otorhinolaryngologic, maxillofacial, ophthalmologic, urologic) - 17,7%, general surgery (35,4%). During the armed conflict of 1999-2002 due to the introduction of the early specialized surgical care concept three MMH of the 1st level in the advanced way executed 86,4 % of all complex operations in medical units and hospitals of the combat zone. PMID:16737069

Gumanenko, E K; Samokhvalov, I M; Trusov, A A; Badalov, V I

2006-03-01

162

Impact of routine surgical ward and intensive care unit admission surveillance cultures on hospital-wide nosocomial methicillin-resistant Staphylococcus aureus infections in a university hospital: an interrupted time-series analysis  

Microsoft Academic Search

Objectives: To determine whether a routine admission screening in surgical wards and intensive care units (ICUs) was effective in reducing methicillin-resistant Staphylococcus aureus (MRSA) infections— particularly nosocomial MRSA infections—for the whole hospital. Methods: The study used a single-centre prospective quasi-experimental design to evaluate the effect of the MRSA screening policy on the incidence density of MRSA-infected\\/nosocomial MRSA-infected patients\\/1000 patient-days (pd)

Iris F. Chaberny; Frank Schwab; Stefan Ziesing; Sebastian Suerbaum; Petra Gastmeier

163

U.S. Army Custom Segmentation System.  

National Technical Information Service (NTIS)

Outline: (1) Where I work -- USAAC -- G2; (2) Understand who the Army's Target Audience is -- Explain the challenges to the Army; (3) Segmentation Overview -- Show Army Recruiting Command Geographies -- Explain Market Segmentation -- Show what Army Custom...

L. Clingan

2007-01-01

164

CBO Study. The Army's Bandwidth Bottleneck.  

National Technical Information Service (NTIS)

Partial contents: Bandwidth Supply and Demand in Today s Army, Background on the Army's Digitization Initiative, Bandwidth Supply at Army Commands Today, Bandwidth Demand at Army Commands Today, Comparing Bandwidth Supply and Demand in 2003, Operation Ira...

2003-01-01

165

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

PubMed

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

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

2011-10-01

166

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

167

Surgical treatment of intact thoracoabdominal aortic aneurysms in the United States: Hospital and surgeon volume-related outcomes  

Microsoft Academic Search

ObjectiveSurgical treatment of intact thoracoabdominal aortic aneurysm (TAAA) is crucial to prevent rupture but is associated with high perioperative mortality. We tested the hypothesis that provider volume of surgical treatment of TAAA is an important determinant of operative outcome.

John A Cowan; Justin B Dimick; Peter K Henke; Thomas S Huber; James C Stanley; Gilbert R Upchurch

2003-01-01

168

Study to Develop an Assessment Tool and Evaluate the Social Work Service Quality Assurance Plan at Walter Reed Army Medical Center, Brooke Army Medical Center, and Fitzsimons Army Medical Center. (Final Report).  

National Technical Information Service (NTIS)

The intent of this study was to develop an assessment tool to evaluate Continental United States Army Medical Center Hospital Social Work Service Quality Assurance Plans. In today's litigious and rapidly changing health care environment, quality assurance...

B. J. Nystrom

1987-01-01

169

Effects of live music therapy sessions on quality of life indicators, medications administered and hospital length of stay for patients undergoing elective surgical procedures for brain.  

PubMed

The physiological and psychological stress that brain tumor patients undergo during the entire surgical experience can considerably affect several aspects of their hospitalization. The purpose of this study was to examine the effects of live music therapy on quality of life indicators, amount of medications administered and length of stay for persons receiving elective surgical procedures of the brain. Subjects (N = 27) were patients admitted for some type of surgical procedure of the brain. Subjects were randomly assigned to either the control group receiving no music intervention (n = 13) or the experimental group receiving pre and postoperative live music therapy sessions (n = 14). Anxiety, mood, pain, perception of hospitalization or procedure, relaxation, and stress were measured using a self-report Visual Analog Scale (VAS) for each of the variables. The documented administration of postoperative pain medications; the frequency, dosage, type, and how it was given was also compared between groups. Experimental subjects live and interactive music therapy sessions, including a pre-operative session and continuing with daily sessions until the patient was discharged home. Control subjects received routine hospital care without any music therapy intervention. Differences in experimental pretest and posttest scores were analyzed using a Wilcoxon Matched-Pairs Signed-Rank test. Results indicated statistically significant differences for 4 of the 6 quality of life measures: anxiety (p = .03), perception of hospitalization (p = .03), relaxation (p = .001), and stress (p = .001). No statistically significant differences were found for mood (p > .05) or pain (p > .05) levels. Administration amounts of nausea and pain medications were compared with a Two-Way ANOVA with One Repeated Measure resulting in no significant differences between groups and medications, F(1, 51) = 0.03; p > .05. Results indicate no significant differences between groups for length of stay (t = .97, df = 25, p > .05). This research study indicates that live music therapy using patient-preferred music can be beneficial in improving quality of life indicators such as anxiety, perception of the hospitalization or procedure, relaxation, and stress in patients undergoing surgical procedures of the brain. PMID:18959455

Walworth, Darcy; Rumana, Christopher S; Nguyen, Judy; Jarred, Jennifer

2008-01-01

170

Validation of the World Health Organization Tool for Situational Analysis to Assess Emergency and Essential Surgical Care at District Hospitals in Ghana  

PubMed Central

Background The World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care (hereafter called the WHO Tool) has been used in more than 25 countries and is the largest effort to assess surgical care in the world. However, it has not yet been independently validated. Test–retest reliability is one way to validate the degree to which tests instruments are free from random error. The aim of the present field study was to determine the test–retest reliability of the WHO Tool. Methods The WHO Tool was mailed to 10 district hospitals in Ghana. Written instructions were provided along with a letter from the Ghana Health Services requesting the hospital administrator to complete the survey tool. After ensuring delivery and completion of the forms, the study team readministered the WHO Tool at the time of an on-site visit less than 1 month later. The results of the two tests were compared to calculate kappa statistics for each of the 152 questions in the WHO Tool. The kappa statistic is a statistical measure of the degree of agreement above what would be expected based on chance alone. Results Ten hospitals were surveyed twice over a short interval (i.e., less than 1 month). Weighted and unweighted kappa statistics were calculated for 152 questions. The median unweighted kappa for the entire survey was 0.43 (interquartile range 0–0.84). The infrastructure section (24 questions) had a median kappa of 0.81; the human resources section (13 questions) had a median kappa of 0.77; the surgical procedures section (67 questions) had a median kappa of 0.00; and the emergency surgical equipment section (48 questions) had a median kappa of 0.81. Conclusions Hospital capacity survey questions related to infrastructure characteristics had high reliability. However, questions related to process of care had poor reliability and may benefit from supplemental data gathered by direct observation. Limitations to the study include the small sample size: 10 district hospitals in a single country. Consistent and high correlations calculated from the field testing within the present analysis suggest that the WHO Tool for Situational Analysis is a reliable tool where it measures structure and setting, but it should be revised for measuring process of care. Electronic supplementary material The online version of this article (doi:10.1007/s00268-010-0918-1) contains supplementary material, which is available to authorized users.

Chang, David; Choo, Shelly; Perry, Henry; Hesse, Afua; Abantanga, Francis; McCord, Colin; Chrouser, Kristin; Abdullah, Fizan

2010-01-01

171

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

172

Returning to Army Leadership.  

National Technical Information Service (NTIS)

Great military leaders inspire their troops and lead them into battle. No senior officer in today's Army has risen to this level of greatness. Instead, we are led by a corps of general officers who are better described with superlatives like 'scholar,' 'd...

J. M. Riley

2011-01-01

173

Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States 1 1 Presented at the Annual Meeting of the Association for Academic Surgery, Boston, MA, November 7th–9th, 2002  

Microsoft Academic Search

BackgroundRecent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for patients of different age groups to determine whether elderly

Justin B Dimick; John A Cowan; Gilbert R Upchurch; Lisa M Colletti

2003-01-01

174

Bir Üniversite Hastanesi Cerrahi Servislerinde Antibiyotik Kullanimi ve Maliyeti: Bir Günlük Nokta Prevalansi Çali?masi Antibiotic Use and Its Cost in Surgical Clinics of a University Hospital: A One-Day Point Prevalence Survey  

Microsoft Academic Search

Objective: It has been shown in several studies that, 25-35% of hospitalized patients receive antibiotics, 40-50% of which are misused. Methods: This study investigates the trends in antibiotic use and the cost of inappropriate use by point prevalence method. The study was performed on a single day in surgical clinics of our tertiary care hospital . Results: On the day

M. Bülent; Hedef Özgün; M. Özlem Saylak; Nazmi Sayim

175

Surgical site infections in patients undergoing major operations in a university hospital: Using standardized infection ratio as a benchmarking tool  

Microsoft Academic Search

Background: Because patterns of infection acquired in patients undergoing operation are ever changing, it is an essential part of nosocomial infection surveillance programs to periodically document the epidemiologic features of infection in these patients. This study was conducted with the primary intention of describing the incidence and risk factors of the surgical site infection (SSI). Methods: We performed a prospective

Montha Na Narong; Somchit Thongpiyapoom; Nonglak Thaikul; Silom Jamulitrat; Nongyao Kasatpibal

2003-01-01

176

Outcomes of a postdischarge surveillance system for surgical site infections at a Midwestern regional referral center hospital  

Microsoft Academic Search

Background: Postdischarge surveillance has been reported in the literature as one method for detecting surgical site infections (SSIs) that more traditional methods of surveillance (review of readmission data, monitoring of microbiology, radiology, pharmacy antibiotic usage reports, and medical record review) fail to include. Methods: This article describes a postdischarge surveillance program that used surgeon questionnaires and was implemented at a

Cynthia L. Fields

1999-01-01

177

Medicare and Medicaid programs: hospital outpatient prospective payment; ambulatory surgical center payment; hospital value-based purchasing program; physician self-referral; and patient notification requirements in provider agreements. Final rule with comment period.  

PubMed

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we set forth the relative payment weights and payment amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other ratesetting information for the CY 2012 ASC payment system. We are revising the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, adding new requirements for ASC Quality Reporting System, and making additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. We also are allowing eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. Finally, we are making changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements. PMID:22145188

2011-11-30

178

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

179

Rehabilitating the Wounded: Historical Perspective on Army Policy.  

National Technical Information Service (NTIS)

This study looks at how the Army has handled long-term care for combat casualties. Policy and practice have changed over time due to (1) the availability and capability of other government hospitals to care for patients, (2) changing political climates, (...

S. Marble

2008-01-01

180

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

181

Army Recruit Health and Diet Survey.  

National Technical Information Service (NTIS)

During 1998, 200 Army recruits took part in a health and diet survey. Most (90%) were Regular Army recruits and recent high school graduates, the remainder being Army Reservists. Fourteen percent of recruits were female. Recruits completed a questionnaire...

C. Booth R. Coad

2001-01-01

182

Engineering Test of Stereoscope, Army, Multipower.  

National Technical Information Service (NTIS)

The Engineering Test of the Army Multipower Stereoscope was conducted. The Army Multipower Stereoscope is intended to provide Army image interpreters with a fast and accurate means of interpreting high resolution imagery (both opaque prints and transparen...

1964-01-01

183

Modeling the Effects of Army Advertising.  

National Technical Information Service (NTIS)

This research was performed to develop and empirically examine a set of prototype behavioral models designed to measure the effects of Army advertising on the decision to enlist in the Army. Data were taken from the Army Communications Objectives Measurem...

J. B. Wilcox R. D. Howell R. E. Wilkes

1988-01-01

184

Developing Leaders for Army 2020.  

National Technical Information Service (NTIS)

Every officer in the United States Army is required to complete a Multi-Source Assessment and Feedback survey (MSAF/360) every three years in accordance with Army Regulation 350-1, to enhance self-awareness and enable officers to be more effective leaders...

D. A. Lesperance

2012-01-01

185

Management: Total Army Quality Management.  

National Technical Information Service (NTIS)

This regulation establishes policy, procedures and responsibilities for managing U.S. Army organizations. This regulation serves as the capstone for the AR 5 series of management regulations. Army personnel will use AR-5-1 to develop and implement sound m...

2002-01-01

186

Army Design Methodology: Commander's Resource.  

National Technical Information Service (NTIS)

With the March 2010 publication of FM 5-0, The Operations Process, the U.S. Army formally introduced Design into its doctrine (Headquarters; Department of the Army, 2010). Design is defined in FM 5-0 as 'a methodology for applying critical and creative th...

A. Grome B. Crandall H. Wolters L. Rasmussen

2012-01-01

187

How the Army Resists Change.  

National Technical Information Service (NTIS)

Many authors in recent years have written about the Army's reaction to change. They have explored the topic from various perspectives; some look at bureaucracy, others at culture, and still others look at the increasing speed with which the Army's strateg...

J. M. Pape

2009-01-01

188

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

189

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

PubMed Central

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

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

2013-01-01

190

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

PubMed

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

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

2013-02-27

191

The knowledge and attitudes of surgical staff towards the use of opioids in cancer pain management: can the Hospital Palliative Care Team make a difference?  

PubMed

The principles of cancer pain management are well established, but evidence suggests that these are not incorporated into daily practice and patients are still in pain. Deficiencies in knowledge and inappropriate attitudes towards the use of opioids may partially explain why the management of cancer pain is still such a widespread problem. This study assessed the knowledge and attitudes of 135 nursing and medical staff working in a surgical unit, before and after working with a newly established Hospital Palliative Care Team. The baseline survey highlighted the existence of a number of myths and misconceptions in relation to opioid use. Results of the follow-up survey indicated that the knowledge and attitudes of doctors and nurses had improved after working with the team, but that this probably occurred as a result of good working relationships and case discussions rather than through formal teaching. The study provided a useful method of identifying deficiencies in knowledge and attitude among staff, and helped to raise awareness of the problem of cancer pain management. Our challenge now is to work with staff to ensure that positive changes in knowledge and attitudes are translated into the everyday practice of hospital nurses and doctors caring for patients with cancer. PMID:11829383

Wells, M; Dryden, H; Guild, P; Levack, P; Farrer, K; Mowat, P

2001-09-01

192

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

193

Predictors and outcome of surgical repair of obstetric fistula at a regional referral hospital, Mbarara, western Uganda  

PubMed Central

Background Obstetric fistula although virtually eliminated in high income countries, still remains a prevalent and debilitating condition in many parts of the developing world. It occurs in areas where access to care at childbirth is limited, or of poor quality and where few hospitals offer the necessary corrective surgery. Methods This was a prospective observational study where all women who attended Mbarara Regional Referral Hospital in western Uganda with obstetric fistula during the study period were assessed pre-operatively for social demographics, fistula characteristics, classification and outcomes after surgery. Assessment for fistula closure and stress incontinence after surgery was done using a dye test before discharge Results Of the 77 women who were recruited in this study, 60 (77.9%) had successful closure of their fistulae. Unsuccessful fistula closure was significantly associated with large fistula size (Odds Ratio 6 95% Confidential interval 1.46-24.63), circumferential fistulae (Odds ratio 9.33 95% Confidential interval 2.23-39.12) and moderate to severe vaginal scarring (Odds ratio 12.24 95% Confidential interval 1.52-98.30). Vaginal scarring was the only factor independently associated with unsuccessful fistula repair (Odds ratio 10 95% confidential interval 1.12-100.57). Residual stress incontinence after successful fistula closure was associated with type IIb fistulae (Odds ratio 5.56 95% Confidential interval 1.34-23.02), circumferential fistulae (Odds ratio 10.5 95% Confidential interval 1.39-79.13) and previous unsuccessful fistula repair (Odds ratio 4.8 95% Confidential interval 1.27-18.11). Independent predictors for residual stress incontinence after successful fistula closure were urethral involvement (Odds Ratio 4.024 95% Confidential interval 2.77-5.83) and previous unsuccessful fistula repair (Odds ratio 38.69 95% Confidential interval 2.13-703.88). Conclusions This study demonstrated that large fistula size, circumferential fistulae and marked vaginal scarring are predictors for unsuccessful fistula repair while predictors for residual stress incontinence after successful fistula closure were urethral involvement, circumferential fistulae and previous unsuccessful fistula repair.

2011-01-01

194

Abortion - surgical  

MedlinePLUS

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

195

Army Heart Monitor - Model I.  

National Technical Information Service (NTIS)

Model I of the Army Heart Monitor (formerly called the Cardiac Arrest Indicator) is an electronic device which accepts the electrocardiogram (ECG) and makes distinctive indications when cardiac standstill or ventricular fibrillation occurs. This model is ...

C. W. Ragsdale E. A. Wright

1968-01-01

196

Recruiting Effects of Army Advertising.  

National Technical Information Service (NTIS)

This report analyzes the effects of Army advertising on recruiting. It uses an econometric analysis of information describing advertising patterns for the three-year period from 1981 to 1984. A model that controls for economic conditions, local area chara...

A. Bamezai J. M. Polich J. N. Dertouzos T. Chesnutt

1989-01-01

197

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

PubMed

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

Bricknell, M C M

2002-09-01

198

Army Club Management Study (Reevaluation of Centralized Management of Army Clubs).  

National Technical Information Service (NTIS)

The VCSA approval of Army Club Management Study reaffirmed the validity of the current concept of centralized management of Army clubs. It directed reorganization and relocation of the Army club management organization to Washington, DC with a concomitant...

J. P. Duffy M. J. D. Santo P. E. Wise R. Belgrano P. W. Pazzano

1975-01-01

199

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

200

[Indications for cardiology consultation and management of cardiac patients who will undergo surgical or endoscopic procedures: the proposal of the University Hospital of Trieste, Italy].  

PubMed

The number of patients affected by cardiovascular disease admitted to internal medicine and geriatric wards is expanding due to the increasing prevalence of cardiovascular disease in the ageing population. This contributes to a growing demand for cardiology consult visits, with requests for perioperative risk stratification for non-cardiac surgery or endoscopy, and general clinical management. This document was jointly drafted by the Cardiology and Anesthesiology departments, medical and surgical departments, and endoscopy services of the Azienda Ospedaliero-Universitaria "Ospedali Riuniti" in Trieste (Italy). It addresses critical issues such as antiplatelet and anticoagulant therapy in non-cardiac surgery, electric device management, and prophylaxis of bacterial endocarditis. It provides general guidelines and appropriateness criteria, prompted by the Joint Commission International and approved by the Hospital Guidelines Committee. It provides a basis for periodic educational meetings, and will be periodically updated. Periodic audits will monitor its application, and critical and controversial points, in order to promote quality of health care, organizational efficiency, and appropriateness. PMID:21033337

Massa, Laura; Vitrella, Giancarlo; Zecchin, Massimo; Berlot, Giorgio; Bergamini, Pier Riccardo; Pelusi, Lucia; Lattuada, Luca; Sinagra, Gianfranco

201

Harmony of Action - Sherman as an Army Group Commander.  

National Technical Information Service (NTIS)

Major General William T. Sherman commanded three field armies under a single command all having the same operational objective. Modern doctrine states that two to five field armies constitute an army group, therefore, by definition, Sherman was an army gr...

A. C. Channels

1992-01-01

202

Protecting the Homeland. Insights from Army Wargames.  

National Technical Information Service (NTIS)

The Army After Next (AAN) Project and, more recently, the Army Transformation Study, Wargames, and Analysis Project have identified issues relating to homeland security. Over the course of five major wargames, a counterterrorism workshop, and a homeland s...

R. Brennan

2002-01-01

203

Protecting the Homeland: Insights from Army Wargames.  

National Technical Information Service (NTIS)

The Army After Next (AAN) Project and, more recently, the Army Transformation Study, Wargames, and Analysis Project have identified issues relating to homeland security. Over the course of five major wargames, a counterterrorism workshop, and a homeland s...

R. Brennan

2002-01-01

204

Army Prisoner Population Prediction Study (AP3).  

National Technical Information Service (NTIS)

The Army Prisoner Prediction Study (AP3) consists of the development of a methodology and associated model to provide the Army Correctional System proponent with an analytic managerial tool to assist in the management of the correctional system. The model...

R. M. Miller S. H. Miller

1983-01-01

205

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

206

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

207

Army High Performance Computing Research Center.  

National Technical Information Service (NTIS)

High Performance Computing (HPC) is an enabling technology for a large class of Army needs including weapon system design, simulation and modeling, intelligence, automation, advanced manufacturing, and training. Recognizing this, in 1989 Army established ...

T. Tezduyar

1995-01-01

208

Army Aviation as an Element of Airpower.  

National Technical Information Service (NTIS)

This paper demonstrates that the Army must embrace jointness to affect future employment of its attack helicopters as an element of airpower. To accommodate the joint employment of these aircraft, Army doctrine must evolve beyond dated, Cold War doctrine ...

D. L. Lawrence

2000-01-01

209

Training Readiness in the Army Reserve Components.  

National Technical Information Service (NTIS)

This report documents research on the training readiness of high-priority Army Reserve Component (RC) units that participated in the Army's training enhancement pilot program, 'Bold Shift,' in 1992. The authors seek to understand the training achievements...

R. E. Sortor T. F. Lippiatt J. M. Polich J. C. Crowley

1994-01-01

210

Army Airspace Control Program of Evaluation Report.  

National Technical Information Service (NTIS)

The purpose of the Army Airspace Control Program of Evaluation was to evaluate Army doctrine, procedures, and organization for controlling airspace and to identify materiel needed to implement the system. The program of evaluation was conducted as four se...

B. B. Powell D. J. DeLany D. L. McKee R. S. Boothe T. M. Brown

1973-01-01

211

U.S. Army Medical Department  

MedlinePLUS

... yields hope for malaria vaccine External Links Privacy & Security Notice Disclaimer Web Accessibility The appearance of hyperlinks does not constitute ... with the stated purpose of this ... & Security Notice and Army Medical Department beneficiaries. The Army ...

212

Army Study Highlights, Volume 13, December 1992.  

National Technical Information Service (NTIS)

This report discusses: Active Component Structure Reductions - Impacts on Capability and Resources --; Army Program Value Added Analysis 94-99; Army Strategic Force Architecture; Counterdrug Transportation Analysis Program; Design and Evaluation of 2+2+4 ...

1992-01-01

213

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

PubMed Central

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

2012-01-01

214

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

215

The evolution of military neurosurgery in the Turkish army.  

PubMed

The history of neurosurgery in the Turkish army is not long and complex. Neurosurgery was first practiced in the Ottoman army by Cemil Pasha, who was a general surgeon. After the fall of the Ottoman Empire, the Republic of Turkey was established and modern neurosurgical procedures were applied at the Gulhane Military Medical Academy (GMMA). Maj. Zinnur Rollas, M.D., was the founder of the Department of Neurosurgery at GMMA in 1957. A modern neurosurgical program and school was established in 1965 by Col. Hamit Ziya Gokalp, M.D., who completed his residency training in the US. Today, 26 military neurosurgeons are on active duty in 11 military hospitals in Turkey. All of these neurosurgeons work in modern clinics and operating theaters. In this paper, military neurosurgery in the Turkish army is reported in 3 parts: 1) the history of neurosurgery in the Turkish military, 2) the Department of Neurosurgery at the GMMA, and 3) the duties of a military neurosurgeon in the Turkish army. PMID:20568932

Izci, Yusuf

2010-05-01

216

Army Medical Department, 1917-1941. Army Historical Series.  

National Technical Information Service (NTIS)

Long-awaited, Mary C. Gilletts final work The Army Medical Department, 19171941, completes her four-volume study covering the years from 1775 to 1941. Although the Medical Department had improved medical standards and practices because of the latest advan...

M. C. Gillett

2009-01-01

217

Total Army Quality: TQM or Something Else.  

National Technical Information Service (NTIS)

The Army has been directed by the Department of Defense (DOD) to change corporate management philosophy and practices by adopting Total Quality Management (TQM) as espoused by W. Edwards Deming and others. Total Army Quality (TAQ) is the Army's new manage...

R. R. Murfin

1993-01-01

218

Special Forces Doctrine and Army Operations Doctrine.  

National Technical Information Service (NTIS)

This study investigates the compatibility of current Army Special Forces doctrine as enunciated in FM 31-20, February 1990, and the future Army doctrine of Army Operations as enunciated in FM 100-5, (Final Draft), 19 January 1993. For testing purposes, co...

D. E. Carroll

1993-01-01

219

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

220

Hydraulic systems performance of Army engine oils  

Microsoft Academic Search

A technical evaluation of qualified military specification lubricants was started by the U.S. Army Belvoir Research and Development Center and was performed at the U.S. Army Fuels and Lubricants Research Laboratory (AFLRL) located at Southwest Research Institute. This work was conducted to determine if such lubricants can be used as hydraulic fluids in Army Commercial Construction Equipment (CCE) and Selected

H. W. Marbach; S. J. Lestz

1984-01-01

221

32 CFR 631.14 - Army policy.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army policy. 631.14 Section 631.14...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL...Activities) and Policy § 631.14 Army policy. (a) Soldiers, military...

2013-07-01

222

Application of prophylactic gel-pads for transcutaneous pacing in patients with complete right bundle-branch block with axis deviation when surgical procedures are performed: 10-year experience from a single Japanese university hospital  

Microsoft Academic Search

This retrospective study aimed to determine whether prophylactic transcutaneous pacing is required for patients with complete\\u000a right bundle-branch block (CRBBB) and axis deviation (AD), so-called bifascicular block, when surgical procedures are performed\\u000a under general or local anesthesia. The authors reviewed 34 063 anesthesia cases that took place at Nara Medical University\\u000a Hospital during a 10-year period (1996–2005). The anesthesia records

Aki Okamoto; Satoki Inoue; Yu Tanaka; Masahiko Kawaguchi; Hitoshi Furuya

2009-01-01

223

Army Executive and the Computer.  

National Technical Information Service (NTIS)

The management of information is a critical executive responsibility. This is especially true in the public sector where information not money is the medium of exchange. For the Army executive, on the battlefield or in an office, the computer will continu...

M. F. Browning

1987-01-01

224

The Mexican Army as Cartel  

Microsoft Academic Search

This article deals with one of the least examined aspects of smuggling along the U.S.\\/Mexico border: the role of the Mexican army as a major player in the traffic of drugs into the United States. It is hoped that this study will help to eliminate a lacuna in our understanding of organized criminal activity south of the border. It will

PATRICK ODAY

2001-01-01

225

Sociology of the Army Reserves.  

National Technical Information Service (NTIS)

This report presents a conceptual framework of reserve components. The focus is on the Selected Reserves of the U.S. Army. The guiding principle of the report is that reserve components are more than just an organizational variation of active components. ...

C. C. Moskos

1990-01-01

226

Army Role in Project Argus  

Microsoft Academic Search

Argus was a code name given to a project which was to utilize atomic bursts at high altitudes to inject electrons artificially into the magnetic field of the earth, and to observe their movements by means of satellite borne instrumentation. The Army Ballistic Missile Agency (ABMA) was assigned the over-all project direction for the satellite program including development of the

R. D. Shelton; A. W. Thompson

1960-01-01

227

Battles: Intelligent Army versus Insurgency  

NASA Astrophysics Data System (ADS)

A ``simple'' battle can be thought of as a conflict between two parties, each with finite reserves, and typically fought on one side’s territory. Modern battles are often strategic, based largely on the speed of information processing and decision making and are mission oriented rather than to annex new territory. Here, we analyze such battles using a simple model in which the ``blue'' army fights a strategic battle against a ``red'' army that is well matched in combat power and in red’s territory. We assume that the blue army attacks strategically while the red army attempts to neutralize the enemy when in close enough proximity, implemented here as ``on- site,'' with randomly varying force levels to potentially confuse and drive the blue's strategies. The temporal evolution of the model battles incorporate randomness in the deployment of the reds and hence possess attendant history dependence. We show that minimizing risk exposure and making strategic moves based on local intelligence are often the deciding factors that determine the outcome of battles among well matched adversaries.

Shanahan, Linda; Sen, Surajit

2009-03-01

228

Social Structures Affecting Army Performance.  

National Technical Information Service (NTIS)

The Center for Research on Military Organization undertook a multi- year research program on the impact of social change on the performance of Army units and of Soldiers after the end of the Cold War in Europe and the first Gulf War. We were concerned wit...

D. R. Segal

2007-01-01

229

Mass Recruitment by Army Ants  

Microsoft Academic Search

A single army ant (Ecitoninae) can attract and direct scores of workers to prey by means of a chemical trail and momentary contact between the recruiter and workers on a raid column. Recruited workers, in turn, attract more ants, resulting in a continuous stream of recruits. While the recruitment mechanism is basically similar, the speed and the number of ants

Ruth Chadab; Carl W. Rettenmeyer

1975-01-01

230

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

231

Army and Multinational Force Compatibility.  

National Technical Information Service (NTIS)

As part of its Force XXI development program, the U.S. Army is 'digitizing' the force: interweaving its various levels of command with sophisticated information technologies to provide a clear and accurate shared picture of the battlespace, or area of ope...

M. Zanini J. M. Taw

2000-01-01

232

Homeopaths, surgery, and the Civil War: Edward C. Franklin and the struggle to achieve medical pluralism in the Union army.  

PubMed

An important aspect of the Union army medical corps throughout the Civil War was the clinical discord that pitted allopathic, or orthodox, physicians against sectarian, or unorthodox, physicians. Allopaths dominated the corps and its examining boards and consequently denied commissions as army surgeons to sectarian practitioners such as the homeopaths. This probably affected surgical manpower needs, since many well-trained homeopathic surgeons, like Edward C. Franklin, one of the nation's busiest and most prolific surgeons, wished to serve in the northern army but were unable to do so. PMID:15249414

Rutkow, Lainie W; Rutkow, Ira M

2004-07-01

233

Army ground robotics research program  

NASA Astrophysics Data System (ADS)

The U.S. Army is undergoing a transformation from Cold War era "heavy" forward-deployed forces arrayed against a monolithic known enemy to lighter, more flexible, U.S.-based forces able to rapidly engage in a full spectrum of military operations. Unmanned systems can potentially contribute towards achieving this goal of a highly capable and flexible ground force. To support this effort, the U.S. Army Research Laboratory has undertaken a long-term research program to support technology development for unmanned ground vehicle systems. Over the course of the past year, this multifaceted effort has made significant technical strides, demonstrating sufficient technological maturity to potentially enable incorporation of semi-autonomous unmanned vehicles into the initial fielding of Future Combat Systems (FCS), while successfully conducting additional research directed toward improved capabilities for later increments of FCS and Land Warrior systems.

Bornstein, Jonathan A.; Shoemaker, Chuck M.

2003-09-01

234

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

235

Surgical audit under scrutiny  

Microsoft Academic Search

Surgical audit must be shown to improve clinical practice and patient outcome if its widespread introduction is to be enthusiastically\\u000a embraced by surgeons. Retrospective studies on hospital activity by their nature are often incomplete and unreliable. A 12-month\\u000a prospective review (July 1990-June 1991) of the activity, morbidity and mortality that occurred within a district general\\u000a surgical unit is analysed. During

M. G. Davies; M. F. Shine; F. Lennon

1991-01-01

236

Surgical Management in Sicklemia  

PubMed Central

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

Warner, Clinton E.

1979-01-01

237

Hydraulic systems performance of Army engine oils  

SciTech Connect

A technical evaluation of qualified military specification lubricants was started by the U.S. Army Belvoir Research and Development Center and was performed at the U.S. Army Fuels and Lubricants Research Laboratory (AFLRL) located at Southwest Research Institute. This work was conducted to determine if such lubricants can be used as hydraulic fluids in Army Commercial Construction Equipment (CCE) and Selected Material Handling Equipment (SMHE). Sixteen military specification lubricants were extensively evaluated using twelve selected tests required by equipment manufacturers and one test developed by AFLRL in conjunction with John Deere. From the data developed, lubricants meeting Army specifications passed 88 percent of all the tests. It appears that the Army engine oils are good potential candidates for use as hydraulic and power transmission lubricants within the Army CCE/SMHE systems. Areas of concern include copper corrosion, wet brake/clutch frictional performance, and final drive gear wear.

Marbach, H.W.; Lestz, S.J.

1984-01-01

238

Increasing Participation in Army Continuing Education. eArmyU and Effects of Possible Program Changes.  

National Technical Information Service (NTIS)

The Army offers a continuing education program called eArmyU (an e- learning, computer-based program) that allows soldiers to earn college credits and degrees at no or low cost while on active duty. The name eArmyU was chosen to emphasize the electronic, ...

B. R. Orvis L. L. McDonald B. Raymond F. Wu

2005-01-01

239

Estimates of energy consumption by building type and end use at U.S. Army installations  

Microsoft Academic Search

This report discusses the use of LBNL`s End-use Disaggregation Alogrithm (EDA) to 12 US Army installations nationwide in order to obtain annual estimates of electricity use for all major building types and end uses. The building types include barrack, dining hall, gymnasium, administration, vehicle maintenance, hospital, residential, warehouse, and misc. Up to 8 electric end uses for each type were

S. J. Konopacki; H. Akbari

1996-01-01

240

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

241

Emergency geriatric surgical admissions  

PubMed Central

The emergency surgical work load created by patients aged 80 and over in a district hospital was assessed and the results of treatment examined. Over one year 248 patients aged 80 or over were admitted as emergencies, and the overall mortality rate was 21·8%. When terminal disease was excluded mortality rate was 12·5%. These elderly patients had an average length of stay in the acute surgical ward of 14·7 days compared with a mean of 8·4 days for all patients, and all but seven patients were discharged to their original place of referral. Elderly patients do exacerbate the bed shortage in acute surgical wards because they tend to stay longer than younger patients, but these elderly surgical patients imposed only a small load on the inpatient geriatric services, as 78% were discharged straight to their own homes and a further 17% went home after a period on the surgical convalescent wards.

Salem, R; Devitt, P; Johnson, J; Firmin, R

1978-01-01

242

Historic Properties Report: Savanna Army Depot Activity, Savanna, Illinois.  

National Technical Information Service (NTIS)

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

W. Shank J. Mecum D. Wolfe

1984-01-01

243

Harmony of Action - Sherman as an Army Group Commander.  

National Technical Information Service (NTIS)

Major General William T. Sherman commanded three field under a single command all having the same operational objective. Modern doctrine states that two to five field armies constitute an army group, therefore, by definition, Sherman was an army group com...

A. C. Channels

1992-01-01

244

Historic Properties Report: Badger Army Ammunition Plant, Baraboo, Wisconsin.  

National Technical Information Service (NTIS)

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

D. A. Fey

1984-01-01

245

Decline of African American Enlistment in the United States Army.  

National Technical Information Service (NTIS)

This monograph will argue that Black Americans, who have historically enlisted in the Army in overwhelming proportions with respect to national populations, are now pursuing other opportunities outside of the Army. The U.S. Army and African Americans have...

A. A. Neal

2008-01-01

246

Historic Properties Report: Letterkenny Army Depot, Chambersburg, Pennsylvania.  

National Technical Information Service (NTIS)

This report presents the results of an historic properties survey of Letterkenny Army Depot. Prepared for the United States Army Materiel Development and Readiness Command (DARCOM), the report is intended to assist the Army in bringing this installation i...

R. Hatheway H. B. Sugaya

1984-01-01

247

32 CFR 644.326 - Army military real property.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army military real property. 644.326 ...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE...Property in Excess Status § 644.326 Army military real property....

2013-07-01

248

32 CFR 644.517 - Clearance of Army lands.  

Code of Federal Regulations, 2013 CFR

... 2013-07-01 false Clearance of Army lands. 644.517 Section 644.517...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE...Improvements § 644.517 Clearance of Army lands. The responsibility for...

2013-07-01

249

32 CFR 581.2 - Army Discharge Review Board.  

Code of Federal Regulations, 2013 CFR

... 2013-07-01 2013-07-01 false Army Discharge Review Board. 581.2 Section...of Defense (Continued) DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD § 581.2 Army Discharge Review Board. (a)...

2013-07-01

250

32 CFR 536.14 - Commanders of major Army commands.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Commanders of major Army commands. 536.14 Section 536.14...Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.14...

2013-07-01

251

Improving Army Planning for Future Multinational Coalition Operations.  

National Technical Information Service (NTIS)

The Army Vision recognizes explicitly that in future operations, Army forces will perform missions as part of a larger joint-combined- multinational force. Given the importance that Army doctrine places on coalition operations, and the capability gap betw...

F. M. Lussler K. Magras M. Zanini O. Oliker T. S. Szayna

2001-01-01

252

The use of artificial neural networks methodology in the assessment of "vulnerability" to heroin use among army corps soldiers: a preliminary study of 170 cases inside the Military Hospital of Legal Medicine of Verona.  

PubMed

This article describes a preliminary study of screening/diagnostic instruments for prediction for large-scale application in the military field at the Neuropsychiatric Department of the Military Hospital of Legal Medicine of Verona and for the prevention of self-destructive behaviors, particularly through the use of drugs. 170 subjects divided into three subsamples were examined. The first subsample was characterized by a strong tendency towards normalcy, the second by a strong tendency towards pathology, and the third by a great variety of expressions of psychological and social problems, which were not necessarily related to drug use. These subjects were administered a questionnaire designed according to Squashing Theory principles (Buscema, 1994a). Answers were processed by an Artificial Neural Network created by Semeion in Rome (Buscema, 1996) and were compared with a standard clinical psychiatric assessment report and with the results of psychodiagnostic tests. Results document ANNs' remarkable ability to recognize subjects with declared, in exordium and "at risk" pathological behaviors. Blind results on learning and trial samples show a very high predictive capacity (over 90%). A comparison with the examined subjects' clinical report and the results of the first follow-up also document very high agreements. The broad variation of answers obtained in the third subsample allows further methodological reflections on the contribution of Artificial Neural Networks and Squashing Theory to the study of deviance, for both sociologists and clinicians, and not only for those in the field of drug addiction. PMID:9533731

Speri, L; Schilirò, G; Bezzetto, A; Cifelli, G; De Battisti, L; Marchi, S; Modenese, M; Varalta, F; Consigliere, F

1998-02-01

253

Soldiers' dental complaints compared with clinical findings in the Military Hospital in Bologna, Italy.  

PubMed

There is no previous data published on the frequency and reasons for dental emergencies in the Italian Army. In this study, all the 329 soldiers who sought dental help during a 5-month period in the Military Hospital in Bologna were investigated. Prior to clinical examination, the soldiers filled out a questionnaire concerning their subjective perception about their dental treatment needs. Data from the questionnaire were then compared with the actual status findings. The results showed that endodontic problems comprised the majority of the cases (37.1%), followed by surgical problems as the second most frequent emergency (33.1%). The subjects' own perceptions showed good agreement with the clinical record in cases with endodontal or surgical problems, excluding problems related to wisdom teeth, while those related to caries and periodontal disease were less frequently correctly assessed by the soldiers. PMID:1454179

Calderara, P C; Zuccari, A; Wahlman, T; Meurman, J H

1992-10-01

254

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

National Technical Information Service (NTIS)

Aptitude area scores of the Army Classification Battery (ACB) are part of the Army selection and classification procedure to determine which applicants for enlistment are accepted and which Army job training programs are open to them. The validity of the ...

M. H. Maler E. F. Fuchs

1978-01-01

255

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

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Reserve component, U.S. Army Reserve, and Army National Guard personnel. 635.22 Section 635...Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL...

2013-07-01

256

Department of the Army Agency Specific Requirements (Federal Demonstration Partnership)  

NSF Publications Database

... fdparmya -- DEPARTMENT OF ARMY - Agency Specific Requirements - ModType : Grant Conditions NSF Org ... fdparmya DEPARTMENT OF ARMY Agency Specific Requirements Modifications to the General Terms and ...

257

Automation impact study of Army Training Management  

Microsoft Academic Search

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

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

1988-01-01

258

Army Representativeness: The National Longitudinal Study.  

National Technical Information Service (NTIS)

This report provides graphical comparisons among four Army-relevant groups as to thirteen indices of representativeness. The four groups break the 1972 high school seniors down according to whether or not they planned to enter the Army and again according...

A. C. Purcell R. L. Eisenman M. J. Eitelberg J. M. Hicks

1976-01-01

259

Career Intentions of Army Officers: Educational Factors.  

National Technical Information Service (NTIS)

This report examines the relationship between the college major and the career intentions of company-grade Army officers. The research tests a simple regression model that predicts expected years of service in the Army from college major and a composite g...

T. J. Guthrie

1992-01-01

260

Counter-Drug: Mandate for the Army.  

National Technical Information Service (NTIS)

This study identified policy options, analyzed the options, and provided observations for the short- and long-term direction of Army support to the national counter-drug effort. It will provide a basis for responding to initiatives assigned to the Army by...

H. Golding

1991-01-01

261

Determining an Army Installation's Critical Requirements (CORE).  

National Technical Information Service (NTIS)

Many circumstances have combined to force a re-evaluation of the traditional idea of how the Army manages its installations and how it accomplishes its mission. The Army has traditionally required a heavy investment in a broadly-based installation infrast...

P. V. Reddy J. Baird S. Ariaratnam V. McCleary B. Mahi

1995-01-01

262

Chaplaincy in the Army After Next.  

National Technical Information Service (NTIS)

This paper looks at several issues that will face the Army Chaplaincy in the future. It deals with concepts and ideas that flow from the ideas arising from the discussion about the Army After Next. Issues discussed in this paper included mission, training...

J. A. Haberek

1998-01-01

263

Embracing cultural geography: an army imperative  

Microsoft Academic Search

As an instrument of national strategy, the United States Army has served the American people well for more than two centuries. Its fundamental mission has always been to ‘fight and win America's Wars’. As we have moved from the bi-polar nature of world dynamics to that of the new global neighborhood, the American Army has seen an increase in missions

Dennis M. Thompson; John H. Grubbs

1998-01-01

264

THE BREAKING OF THE JAPANESE ARMY'S CODES  

Microsoft Academic Search

This memoir relates the writer's experience as a Signal Corps cryptanalyst in World War II. The major foci are the efforts of the Signal Intelligence Service in Australia and at Arlington Hall to solve the Japanese Army's codes. The initial entries into the codes and some of the later efforts to keep these entries going as the Japanese Army made

Joseph E. Richard

2004-01-01

265

Continuum of Capability - Army's Force Structure Transformation.  

National Technical Information Service (NTIS)

The Army is in the midst of a 'Transformation,' a transformation into the Army of the future, abandoning 20th Century concepts. We are molding a military force that's capabilities based and responsive to new enemies but still maintains the ability to succ...

L. E. McCabe

2003-01-01

266

Army's Stake in Emerging Space Technologies.  

National Technical Information Service (NTIS)

On 29 May 1940 in Washington, D.C., Robert A. Goddard, the father of American rocketry, briefed representatives of the Army Air Corps, Army Ordnance, and the Navy. He urged that unmanned rockets could deliver more explosives, more accurately than manned b...

J. P. Robblee

1988-01-01

267

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

268

Army Reserve: Relevant Today, More Relevant Tomorrow.  

National Technical Information Service (NTIS)

Since the creation of the Army Reserve in 1908 it has been a key component of the National Military Strategy of the United States. When called upon in times of crisis, many perceived it was not ready. This paper will review the evolution of the Army Reser...

M. A. Phipps

2006-01-01

269

Ultrahigh reliability US Army missiles and munitions  

Microsoft Academic Search

Provides an overview of U.S. Army requirements necessary for missiles and munitions to survive and operate in extreme environments with ultrahigh reliability. Long-term storage of assets, exposure to harsh environments, and requirements for high reliability with minimum field checks are significant concerns for Army missiles and munitions. These concerns warrant investigation into new and advanced techniques that provide health monitoring

T. G. Erickson; Wyatt E. Shankle; Stephen A. Marotta

2002-01-01

270

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

271

Race and Injury Among Army Basic Trainees.  

National Technical Information Service (NTIS)

Injuries due to exercise and training are cammon, particularly in Army populations. Few studies have examined the relationship between race and such injuries. Eight-hundred and sixty-one male and female Army trainees were followed over their 8 week Basic ...

N. Bell P. Amoroso D. Hemenway T. Mangione B. Jones

1994-01-01

272

Surgical site infection surveillance  

Microsoft Academic Search

Surgical site infection (SSI) is the third most commonly reported nosocomial infection and accounts for 14–16% of all nosocomial infections among hospital inpatients. A successful SSI surveillance programme includes standardized definitions of infection, effective surveillance methods and stratification of the SSI rates according to risk factors associated with the development of SSI. Surveillance with feedback of information to surgeons and

E. T. M. Smyth; A. M. Emmerson

2000-01-01

273

Crucible of fire: the Boer War and the birth of the Canadian Army Medical Corps.  

PubMed Central

Although Canada's military physicians didn't come to prominence until WW I and WW II, the Canadian Army Medical Corps (CAMC), the forerunner of the Royal Canadian Army Medical Corps and the current Canadian Forces Medical Service, actually had its origins in the Boer War. During that turn-of-the-century conflict, field hospitals accompanied Canadian troops to South Africa. Ian McCulloch discusses that early type of medical service and the steps that led to the creation of the CAMC. Images p1495-a p1496-a

McCulloch, I

1995-01-01

274

African-American dentists in the U.S. Army: the origins.  

PubMed

The majority of the dentists mentioned in this work are unknown both to dental and military historians. However, the contributions of Dr. William T. Jefferson, the first African-American dentist to treat U.S. Army soldiers in Cuba, Dr. William A. Birch, the first black hospital steward/dentist to serve unofficially (as a dentist) overseas in the Philippine campaign, and the dental veterans of 1917-1918, deserve recognition. They were among the early pioneers in the U.S. Army's dental history. PMID:8754709

Hyson, J M

1996-07-01

275

Trends in Department of Defense hospital efficiency  

Microsoft Academic Search

This study employs a simple cross sectional design using longitudinal data to explore the underlying factors associated with differences in hospital technical efficiency using data envelopment analysis (DEA) in the Department of Defense (DOD) sector across three service components, the Army, Air Force and Navy. The results suggest that the services do not differ significantly in hospital efficiency. Nor does

Yasar A. Ozcan; Richard R. Bannick

1994-01-01

276

The Impact of Surgical?Site Infections Following Orthopedic Surgery at a Community Hospital and a University Hospital: Adverse Quality of Life, Excess Length of Stay, and Extra Cost  

Microsoft Academic Search

OBJECTIVE: To measure the impact of orthopedic surgi- cal-site infections (SSIs) on quality of life, length of hospitalization, and cost. DESIGN: A pairwise-matched (1:1) case-control study within a cohort. SETTING: A tertiary-care university medical center and a community hospital. PATIENTS: Cases of orthopedic SSIs were prospectively identified by infection control professionals. Matched controls were selected from the entire cohort of

James D. Whitehouse; N. Deborah Friedman; Kathryn B. Kirkland; William J. Richardson; Daniel J. Sexton

2002-01-01

277

Cysticercosis of the central nervous system. I. Surgical treatment of cerebral cysticercosis: a 23 years experience in the Hospital das Clínicas of Ribeirão Preto Medical School.  

PubMed

Cysticercosis is the most frequent parasitosis of the nervous system and nowadays it is widespread through the world. Despite the development of anticysticercal drugs (praziquantel and albendazole), their efficacy is more marked in cases with parenchymal active cysts and they do not prevent complications such as hydrocephalus. Thus, many patients with neurocysticercosis require surgical intervention, generally of palliative nature, but that may occasionally produce a cure. The clinical outcome of 180 patients with cerebral cysticercosis who underwent surgical treatment form 1970 to 1993 was analyzed. Surgical treatment was performed to control increased ICP in 177 patients and due to local compression of cranial nerves or brainstem in five. Some patients had more than one surgical procedure, totalizing 287 interventions. Increased intracranial pressure (ICP) was caused by hydrocephalus in 91%, by intracranial mass lesion (tumoral form) in 6.2% and by pseudotumor cerebri (pseudotumoral form) in 2.8% of the case. Based on the pathophysiological mechanisms of intracranial hypertension identified through conventional CT-scan, ventriculography, cysternotomography, ventriculotomography and MRI, different surgical approaches were indicated. Patients with tumoral form were submitted to direct approach and cyst removal and generally they had benefits from this procedure. Patients with pseudotumoral form whose clinical treatment failure underwent decompressive craniectomies and had a poor outcome (40% of good results). Direct removal of ventricular/cisternal cysts and/or ventriculoatrial/peritoneal shunting (VA/VPS) was performed in patients with hydrocephalus. Removal of free ventricular cysts in patients who had no ependimitis/arachnoiditis generally allowed a good outcome. Patients with adherent cysts and inflammatory process needed a VA/VPS posteriorly and the outcome was not so good. One hundred thirty-two patients were submitted to VA/VPS (109 as the first procedure and 23 after another surgical treatment). The VA/VPS was effective to control increased ICP, despite many complications observed mainly during the two first postoperative years. After this period the surviving patients generally had a better outcome. The patients submitted to cyst removal due to local compression of cranial nerves/brainstem generally had good results. Based on the experience acquired with the management of these patients we present our recent policy for the treatment of patients with neurocisticercosis. PMID:7826245

Colli, B O; Martelli, N; Assirati Júnior, J A; Machado, H R; Salvarani, C P; Sassoli, V P; Forjaz, S V

1994-06-01

278

Medicare program: hospital outpatient prospective payment system and CY 2011 payment rates; ambulatory surgical center payment system and CY 2011 payment rates; payments to hospitals for graduate medical education costs; physician self-referral rules and related changes to provider agreement regulations; payment for certified registered nurse anesthetist services furnished in rural hospitals and critical access hospitals. Final rule with comment period; final rules; and interim final rule with comment period.  

PubMed

The final rule with comment period in this document revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2011. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011. In this document, we also are including two final rules that implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest. In the interim final rule with comment period that is included in this document, we are changing the effective date for otherwise eligible hospitals and critical access hospitals that have been reclassified from urban to rural under section 1886(d)(8)(E) of the Social Security Act and 42 CFR 412.103 to receive reasonable cost payments for anesthesia services and related care furnished by nonphysician anesthetists from cost reporting periods beginning on or after October 1, 2010, to December 2, 2010. PMID:21121180

2010-11-24

279

Correcting for bias when estimating the cost of hospital-acquired infection: an analysis of lower respiratory tract infections in non-surgical patients  

Microsoft Academic Search

Hospital acquired infections (HAI) are costly but many are avoidable. Evaluating prevention programmes requires data on their costs and benefits. Estimating the actual costs of HAI (a measure of the cost savings due to prevention) is difficult as HAI changes cost by extending patient length of stay, yet, length of stay is a major risk factor for HAI. This endogeneity

Nicholas Graves; Diana Weinhold; Jennifer A. Roberts

2005-01-01

280

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

281

Surgical Options  

MedlinePLUS

... have significant memory problems and patients who have unstable medical conditions that would increase surgical risk are ... to patients with severe tremor who because of unstable medical conditions are not candidates for DBS. Surgical ...

282

77 FR 40030 - Army Science Board Summer Study Meeting  

Federal Register 2010, 2011, 2012, 2013

...Department of the Army Army Science Board Summer Study Meeting...amended), the Sunshine in the Government Act of 1976 (U.S.C. 552b...Name of Committee: Army Science Board (ASB). Date(s...Strategic Direction for Army Science and Technology and Small...

2012-07-06

283

77 FR 21977 - Army Science Board Summer Study Meeting  

Federal Register 2010, 2011, 2012, 2013

...Department of the Army Army Science Board Summer Study Meeting...amended), the Sunshine in the Government Act of 1976 (U.S.C. 552b...Name of Committee: Army Science Board (ASB). Date(s...Strategic Directions for Army Science and Technology and vote...

2012-04-12

284

Hand to Hand Combatives in the US Army.  

National Technical Information Service (NTIS)

The Modern Army Combatives Program was adopted by the U.S. Army in 2000. The program is the culmination of a 1995 directive by the Commander of 2nd Battalion, 75th Ranger Regiment, to improve the Army's old and unused combatives program. Modern Army Comba...

J. F. Blanton

2008-01-01

285

Army Family Research Program. Second Annual Work Plan  

National Technical Information Service (NTIS)

The Army Family Research Program (AFRP) is a 5-year integrated research program that supports the Chief of Staff of the Army (CSA) White Paper 1983: The Army Family and the Army Family Action Plans (1984-1990) by developing databases, models, program eval...

A. M. Cruze

1990-01-01

286

Army Family Research Program: Origin, Purpose, and Accomplishments.  

National Technical Information Service (NTIS)

The U.S. Army Research Institute for the Behavioral and Social Sciences Army Family Research Program (AFRP) has provided research support for our sponsor, the U.S. Army Community and Family Support Center (CFSC), and for the Army Chief of Staff's (CSA) Ar...

B. Quigley D. B. Bell J. Scarville

1991-01-01

287

Key Trends That Will Shape Army Installations of Tomorrow.  

National Technical Information Service (NTIS)

Given growing external pressures on Army installations, the U.S. Army asked RAND Arroyo Center to examine how external trends might affect Army installations out to the year 2025. The Army s Office of Assistant Chief of Staff for Installation Management (...

A. G. Schaefer B. E. Lachmann K. C. Hall N. Kalra S. Hassell

2013-01-01

288

Army Recruiters: "Counseling" High-Schoolers to Death  

ERIC Educational Resources Information Center

|This article deals with Army recruitment in high schools. Students get to ask questions and hear stories about life In the Army from a soldier of the year, officers, and recruiters. Some brave students will even get a physical taste of life in the Army. According to an Army officer, the primary reason why recruiters go on high school campuses is…

Merrow, John

2005-01-01

289

32 CFR 536.6 - The Army claims mission.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false The Army claims mission. 536.6 Section 536...Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.6 The Army...

2013-07-01

290

Army Basic Skills Provision: Whole Organisation Approach/Lessons Learnt  

ERIC Educational Resources Information Center

|The Army began working in partnership with the Basic Skills Agency in 2000. This was formalised with the establishment of the Basic Skills Agency's National Support Project for the Army (2001) that contributes to the raising of basic skills standards in the Army by advising on, and assisting with, the development of the Army's basic skills policy…

Basic Skills Agency, 2007

2007-01-01

291

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

292

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

Code of Federal Regulations, 2013 CFR

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

2013-07-01

293

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

294

Reporting Requirements for the Army Library.  

National Technical Information Service (NTIS)

The reports described in this document have been developed specifically for the Army Library, Pentagon. They constitute a subset of the general reports developed for the circulation module of the National Library of Medicine, Lister Hill National Center f...

J. S. Lovelace

1978-01-01

295

Microelectronics availability for the Army's missiles  

NASA Astrophysics Data System (ADS)

Our modern Army is critically dependent on high technology and in particular sophisticated electronics. Microcircuit technology is the "brain-trust" of our advanced weapon systems. Because of the central role that microelectronics plays in the total acquisition, and maintenance of the Army's weapon systems, it is extremely important that the Army have ready access to this technology. However, the semiconductor industry is not motivated toward serving this need and therefore potential supply problems exist in this area. The Army's requirements cannot be satisfied with off-the-shelf standard products produced by the large semiconductor manufacturers. Rather, they are typically low volume, high reliability, military standard components -- some of which have the added requirement of radiation hardening. In this report the many facets and ramifications which impact the cause/effect relationships among the various factors of this very timely problem will be discussed.

Riley, C. E.

1980-09-01

296

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

297

REALTRAIN Improves Soldier Attitudes Toward the Army.  

National Technical Information Service (NTIS)

Although the Army is concerned primarily with improving the combat readiness of its units, there is a growing orientation toward enhancing the job motivation and satisfaction of soldiers. To improve the psychological rewards that are derived from training...

P. R. Bleda

1979-01-01

298

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

299

Role Conflict and Army Public Affairs Officers.  

National Technical Information Service (NTIS)

A field study discusses whether role conflict was present in the professional lives of Army Public Affairs Officers (PAOs). Role conflict is defined as the drive state resulting from simultaneous perception of differing expectations, legitimately held by ...

P. E. Soucy

1978-01-01

300

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

301

Effects of Multiple Deployments on Army Adolescents.  

National Technical Information Service (NTIS)

This monograph examines the effects of multiple deployments on adolescent children of a deployed Army parent through the perspectives of the Soldiers, their spouses, and the adolescents themselves. The authors sought to identify factors that predict the l...

L. Wong S. Gerras

2010-01-01

302

Army Robotics Technology: Evolution of Autonomy.  

National Technical Information Service (NTIS)

Army Robotics Mission/Task: Develop an innovative, affordable, and integrated portfolio of robotics technology (air, ground, unattended sensors, ...) programs and demonstrations that will: -Assess and guide the execution, integration, and transition of ro...

C. Shoemaker

2003-01-01

303

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

304

Management: Army Management of the Electromagnetic Spectrum.  

National Technical Information Service (NTIS)

This revision updates and consolidates several regulations regarding policies and responsibilities for Army management of the electromagnetic spectrum. It covers the coordination and integration of the research, development, test, acquisition, fielding an...

1997-01-01

305

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

306

Strategy, Change and the Democratic Army.  

National Technical Information Service (NTIS)

This study is composed of four essays that address contemporary contradictions that reduce or have constrained the effectiveness of the US Army. The first essay addresses the contradiction between existing strategic theory and the role of the military pro...

A. P. O'Meara

1978-01-01

307

Energy Design Guides for Army Barracks: Preprint  

SciTech Connect

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

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

2008-08-01

308

Treatment of Landfill Leachate at Army Facilities.  

National Technical Information Service (NTIS)

The overall objectives of this research are (1) to supply information allowing Facility Engineers (FEs) at Army installations both to recognize potential or actual leachate problems and to gauge the magnitude of the problems, (2) to provide guidance on sh...

R. A. Shafer E. D. Smith J. T. Bandy P. G. Malone D. A. Moore

1983-01-01

309

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

310

Alternative Aviation Fuels and the Army.  

National Technical Information Service (NTIS)

Core Characteristics defining the Energy Security necessary for the full range of Army missions: Surety: Preventing loss of access to power and fuel sources. Survivability: Ensuring resilience in energy systems. Supply: Accessing alternative and renewable...

E. Sattler

2010-01-01

311

78 FR 18473 - Army Privacy Act Program  

Federal Register 2010, 2011, 2012, 2013

...District Court has changed. DATES: Effective Date: This rule is effective March 27, 2013. FOR FURTHER INFORMATION CONTACT: MAJ Lisa R. Bloom, 703-693-1009, email: lisa.bloom@us.army.mil. SUPPLEMENTARY INFORMATION: A. Background In...

2013-03-27

312

32 CFR 651.5 - Army policies.  

Code of Federal Regulations, 2011 CFR

...returned with comment in those cases where additional work is required. Cases where these policies are violated...resolution. (e) Army leadership and commanders at all levels...monitoring, and other required studies as part of the MILCON...

2013-07-01

313

Transformation: Effectively Marketing Change in the Army.  

National Technical Information Service (NTIS)

Transformation reform modernization change - whatever one calls it - is not a new phenomenon in the Army. Change is an ongoing dynamic associated with practically all modern institutions regardless of the label. The recent controversy surrounding the U.S....

J. M. Waring

2004-01-01

314

Hypermedia Applications for Army Installation Master Planning.  

National Technical Information Service (NTIS)

Army installation master planning involves a wide range of technical, economic, environmental, and social issues. Planning decisions are often formulated by groups whose members have varying degrees and areas of expertise, and their information is drawn f...

B. E. Aley M. J. Shiffer M. A. Shiffer R. I. Adiguzel C. J. Neal

1993-01-01

315

United States Army Weapon Systems 2010.  

National Technical Information Service (NTIS)

This handbook describes how the Army is accomplishing its mission. It is designed to promote greater understanding of major acquisition programs. It describes what each is designed to achieve; summarizes program schedules; and offers information regarding...

2009-01-01

316

United States Army Aviation Crash Survival Research.  

National Technical Information Service (NTIS)

Analysis of U. S. Army aircraft accidents has revealed that accelerative loads on impact have been well within the limits of human tolerance in the majority of cases. Personnel involved in these accidents, however, have frequently suffered serious or fata...

1966-01-01

317

Current strategy for surgical management of bronchiectasis  

Microsoft Academic Search

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

Toshio Fujimoto; Ludger Hillejan; Georgios Stamatis

2001-01-01

318

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

319

The actuarial survival analysis of the surgical and non-surgical therapy regimen for chronic thromboembolic pulmonary hypertension  

Microsoft Academic Search

Aim To characterize the in-hospital mortality and the actuarial survival of surgical and non-surgical therapy regimen in the\\u000a treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Methods A retrospective cohort study was conducted in 504 patients with CTEPH, who were treated surgically (n = 360), or non-surgically (n = 144) in Anzhen Hospital from February 1989 to August 2007. The patients in surgical group received

Hui-Li Gan; Jian-Qun Zhang; Ping Bo; Qi-Wen Zhou; Sheng-Xun Wang

2010-01-01

320

Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; electronic reporting pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; revision to Quality Improvement Organization regulations. Final rule with comment period.  

PubMed

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011). PMID:23155551

2012-11-15

321

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.

322

Assessing the effectiveness of the British Army's mental health service.  

PubMed

The Ministry of Defence's commitment to modernizing and improving mental health (MH) care for Armed Forces personnel has resulted in considerable changes to frontline services. The last remaining United Kingdom (UK) military psychiatric hospital closed on 1 April 2004 with the move to a clear, integrated care pathway between primary healthcare, military departments of community mental health (DCMHs) and secondary healthcare. The Army's eight UK DCMHs provide a patient-centred, occupational MH service grounded in the military MH philosophy of local, easily accessible, effective treatment (O'Brien, 1998). These MH services have been exposed to significant media interest and this article will attempt to quantify the correct state of affairs through patient, customer and staff satisfaction surveys. Clinical groups in the customer survey recorded a satisfaction rate of 87%, the staff survey 72% and the patient survey 94%. The Army has excellent access to specialist MH support and a common theme emerging in these surveys is the perception that the MH teams provide a high quality of service. The three surveys provide valuable direction to improve patient care and highlight strengths such as 97% of patients receiving appointments compatible with their duties. PMID:17851361

Finnegan, Alan; Finnegan, Sarah

323

Traumatic Brain Injury in the US Army: Behavioral Sequelae and Medical Disability. Abstract, Executive Summary and Dissertation.  

National Technical Information Service (NTIS)

This study examined the behavioral and medical consequences of hospital admissions during fiscal years 1992 and 1993 for traumatic brain injury (TBI n = 1,617), orthopedic/internal injury (n = 4,626), and a random sample of the active duty Army population...

A. K. Ommaya

1996-01-01

324

38 CFR 3.361 - Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical...  

Code of Federal Regulations, 2010 CFR

...additional disability or death due to hospital care, medical or surgical treatment...additional disability or death due to hospital care, medical or surgical treatment...immediately before the beginning of the hospital care, medical or surgical...

2010-07-01

325

38 CFR 3.361 - Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical...  

Code of Federal Regulations, 2010 CFR

...additional disability or death due to hospital care, medical or surgical treatment...additional disability or death due to hospital care, medical or surgical treatment...immediately before the beginning of the hospital care, medical or surgical...

2009-07-01

326

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

327

Efficient or Effective. An Assessment of the Army Lessons Leaned Program.  

National Technical Information Service (NTIS)

The Army recently revised the Army Lessons Learned regulation to centralize the collection, analysis and dissemination of lessons learned. Historically, the Army has not sustained an effective lessons learned process. TRADOC has the lead for the Army in m...

A. C. Funkhouser

2007-01-01

328

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

329

Training Program in Army International Logistics Operations and Procedures.  

National Technical Information Service (NTIS)

This study addresses International Logistics (IL) training requirements within the Army, with emphasis on the U.S. Army Materiel Development and Readiness Command (DARCOM). Data was collected by interviews with 124 persons performing IL tasks at all level...

J. G. Holland J. R. Lenassi

1977-01-01

330

Knowledge Management Officers: Necessary or Redundant within Army Tactical Units.  

National Technical Information Service (NTIS)

The project examined the necessity, and value in assigning knowledge management officers to Army tactical units. Ancillary, supporting research, focused on decision-making, battle command and Army knowledge management. A qualitative methodology, with quan...

C. Hartline

2008-01-01

331

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

332

Automation Management Study, Director of Army Automation (DAA).  

National Technical Information Service (NTIS)

The Automation Management Study was a 7-month study effort which produced the Charter and implementing documents for the central manager of Army Automation, the Director of Army Automation (DAA). The DAA organizationally and functionally replaced the Dire...

M. F. Levine

1977-01-01

333

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

334

Military Corrections and Justice in a Volunteer Army.  

National Technical Information Service (NTIS)

The basic question is whether or not the Army should be operating a Correctional (Confinement) System as well as the 'Criminal' aspects of the current Military Justice System in view of the current 'peacetime volunteer army' environment and drastic manpow...

P. M. Suess

1974-01-01

335

Army Food and Nutrition Survey, 1995-97.  

National Technical Information Service (NTIS)

This technical report contains data on nutrition attitudes, nutrition knowledge, and dietary practices of over 3,000 Army soldiers. This survey included soldiers from 32 Army installations across the continental United States, Alaska, Hawaii, Germany, Hun...

F. M. Kramer J. Warber L. Lesher S. McGraw W. Johnson

1997-01-01

336

Army Hyperspectral R&D Consortium The Way Forward.  

National Technical Information Service (NTIS)

In early 2001 four Army laboratories signed a memorandum of understanding that signifies the Army's interest in focusing research interests on practical tactical applications of hyperspectral technology. The result of the focusing of these research intere...

C. Gray P. Gillespie C. Simi A. Aberle T. Colandene

2002-01-01

337

Archaeological Collections Summary for Savanna Army Depot, Illinois.  

National Technical Information Service (NTIS)

The U.S. Army Environmental Center tasked the Mandatory Center of Expertise for the Curation and Management of Archaeological Collections (MCX) with the job of assisting the Army in complying with the Native American Graves Protection and Repatriation Act...

1995-01-01

338

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

339

Army Preliminary Evaluation I. Model 200 CEFLY LANCER.  

National Technical Information Service (NTIS)

The United States Army Aviation Engineering Flight Activity conducted an Army Preliminary Evaluation of the Model 200 CEFLY LANCER aircraft, manufactured by Beech Aircraft Corporation, from 20 February to 6 March 1974 at the Beech facility in Wichita, Kan...

G. M. Yamakawa T. P. Benson L. K. Brewer M. A. Hawley

1974-01-01

340

Army Preliminary Evaluation II. Model 200 CEFLY LANCER.  

National Technical Information Service (NTIS)

The United States Army Aviation Engineering Flight Activity conducted Army Preliminary Evaluation (APE) 2 of the Model 200 CEFLY LANCER aircraft, manufactured by Beech Aircraft Corporation, from 27 April to 15 May 1974 at the Beech facility in Wichita, Ka...

G. M. Yamakawa T. P. Benson L. K. Brewer

1974-01-01

341

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

342

32 CFR 636.10 - Hunter Army Airfield vehicle registration.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Hunter Army Airfield vehicle registration. 636.10 Section 636...ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION (SPECIFIC INSTALLATIONS...Georgia § 636.10 Hunter Army Airfield vehicle registration. Personnel...

2013-07-01

343

Recruitment of Physicians for the Active Army, 1970-1980.  

National Technical Information Service (NTIS)

The Army Medical Department method of procuring physicians is examined from the following aspects: (1) An historical review of physician procurement during the 1940-1973 draft period; (2) the Army procurement plan as a forecast of anticipated requirements...

W. M. Vance

1975-01-01

344

Total Army Injury and Health Outcomes Database: Description and Capabilities.  

National Technical Information Service (NTIS)

The impact of injuries on the mission of the Armed Forces is unacceptably high. To determine the complete spectrum of injury and disease outcomes among Army service members, USARIEM developed the Total Army Injury and Health Outcomes Database (TAIHOD). Th...

P. J. Amoroso W. G. Swartz F. A. Hoin M. M. Yore

1997-01-01

345

Chemical Weapon's: Army's Emergency Preparedness Program Has Financial Management Weaknesses.  

National Technical Information Service (NTIS)

As requested, we reviewed how the Army's Chemical Stockpile Emergency Preparedness Program (CSEPP) funds about $281 million appropriated in fiscal years 1988 to 1994 were spent. We have previously reported problems the Army experienced in improving the em...

1995-01-01

346

Personnel Policies for an Operational Army National Guard.  

National Technical Information Service (NTIS)

The Army recognizes that the Army National Guard (ARNG) must transition to an operational reserve to meet current and future demands. Yet, current policies surrounding enlisted accessions, unit stabilization, mobilizations, and medical and dental benefits...

B. K. Vincent

2008-01-01

347

Creativity and Strategic Vision: The Key to the Army's Future.  

National Technical Information Service (NTIS)

Creativity is important for the Army because it is so essential to strategic leadership. The Army, like all institutions, is dependent on strategic leadership, but like most institutions distrusts creativity. A large degree of that distrust is caused by v...

R. D. Daniel

1993-01-01

348

United States Army Medical Materiel Center Europe: Organizational Analysis.  

National Technical Information Service (NTIS)

The Army relies on the United States Army Medical Materiel Center Europe (USAMMCE) to support units stationed and deployed overseas. To provide the best medical materiel support possible, USAMMCE must develop an organizational plan that considers current ...

H. I. Ritchey J. B. Schamburg

2004-01-01

349

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

350

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.

351

Spouse Abuse and Child Abuse by Army Soldiers  

Microsoft Academic Search

This study analyzed data collected by the U.S. Army’s Family Advocacy Program, the group primarily responsible for family\\u000a violence prevention, identification, evaluation, treatment, and follow-up on Army installations. Patterns of spouse abuse\\u000a and child abuse perpetrated within a five year period (2000–2004) were examined in a sample of 10,864 Army Soldiers who were\\u000a substantiated for family violence offenses. Three groups

Sandra L. Martin; Deborah A. Gibbs; Ruby E. Johnson; E. Danielle Rentz; Monique Clinton-Sherrod; Jennifer Hardison

2007-01-01

352

Russia's New Look Army Reforms and Russian Foreign Policy  

Microsoft Academic Search

In December 2009 the first stage of an ambitious military reform of the Russian Federation's army was implemented: the former Soviet, and post-Soviet, four-tiered command structure: military district-army-division-regiment, was replaced with a three tiered command structure: military district-army-brigade. In this process, the brigade replaced the division as the primary tactical unit in the Russian army, and most “cadre-strength” units, partially

Gregory P. Lannon

2011-01-01

353

Urgent Reform Required: Army Expeditionary Contracting. Report of the Commission on Army Acquisition and Program Management in Expeditionary Operations.  

National Technical Information Service (NTIS)

The Secretary of the Army established an independent Commission on Army Acquisition and Program Management in Expeditionary Operations to review the lessons learned in recent operations and provide forward-looking recommendations to ensure that future mil...

D. J. Berteau D. M. Maddox J. D. Oliver J. S. Gansler L. E. Salomon

2007-01-01

354

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

355

32 CFR 636.10 - Hunter Army Airfield vehicle registration.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 true Hunter Army Airfield vehicle registration...Stewart, Georgia § 636.10 Hunter Army Airfield vehicle registration...Personnel assigned or employed at Hunter Army Airfield are required...personnel requiring decals. (1) Temporary passes will...

2010-07-01

356

32 CFR 636.10 - Hunter Army Airfield vehicle registration.  

Code of Federal Regulations, 2010 CFR

...2009-07-01 2009-07-01 false Hunter Army Airfield vehicle registration...Stewart, Georgia § 636.10 Hunter Army Airfield vehicle registration...Personnel assigned or employed at Hunter Army Airfield are required...personnel requiring decals. (1) Temporary passes will...

2009-07-01

357

Army's Future Combat System (FCS): Background and Issues for Congress.  

National Technical Information Service (NTIS)

The Future Combat System (FCS) is the U.S. Army's multiyear, multibilliondollar program at the heart of the Army's transformation efforts. It is to be the Army's major research, development, and acquisition program consisting of 14 manned and unmanned sys...

A. Felckert

2007-01-01

358

United States Army Medical Department Journal. October-December 2011.  

National Technical Information Service (NTIS)

The Army Medical Department Journal is published quarterly for The Surgeon General by the US Army Medical Dept Center & School, Journal Office, AHS CDD Bldg 4011, 2377 Greeley RD STE T, Fort Sam Houston, TX 78234-7584. Articles published in The Army Medic...

2011-01-01

359

Designing Relevant Religious Support for a Transforming Army.  

National Technical Information Service (NTIS)

The Chief of Staff of the Army has declared that the Army will transform to a full-spectrum combat force that is strategically responsive and dominant at every point on the spectrum of conflict, resulting in the Objective Force. How should the Army Chapla...

C. L. McGriff

2002-01-01

360

U.S. Army Advertising from the Recruits' Viewpoint.  

National Technical Information Service (NTIS)

This paper focuses on the recruits' self-reported media habits, recall of Army advertising by media, and reported response to Army advertising. This paper examines the media habits of Army recruits and profiles the media that are most likely to draw an au...

A. Hertzbach M. M. Weltin P. A. Gade R. M. Johnson T. W. Elig

1985-01-01

361

History of U.S. (United States) Army Corrections.  

National Technical Information Service (NTIS)

U.S. Army Corrections has progressed a long way from the use of physical punishment as a means of correcting behavior. This paper examines that history, starting in 1784 with the establishment of the first Federal Army, and concluding with the Army Correc...

R. R. Youngs

1983-01-01

362

Specifications for Version 1. 0 of the Army Data Encyclopedia  

Microsoft Academic Search

This document provides a more detailed description of the Army Data Encyclopedia (ADE) Version 1.0, in accordance with the Data Encyclopedia Architecture for Army Information Management. The software and contents of the ADE are key mechanisms that are necessary to achieve interoperability, integration and synchronization of Army information systems. The ADE architecture is intended to provide a global view, long-term

F. Gey; H. Holmes

1988-01-01

363

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

364

Impact of Revising the Army's Female Assignment Policy.  

National Technical Information Service (NTIS)

Current Army policy excludes females from serving in a number of units and positions. Due to the new Army Modular design and the change in the type of warfare the Army is likely to face in the coming years, this policy no longer adequately supports the Ar...

M. R. Lindon

2007-01-01

365

US Army battery needs-present and future  

Microsoft Academic Search

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

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

1995-01-01

366

Operational Test and Evaluation in the Army: An Evaluation.  

National Technical Information Service (NTIS)

This study traces the evolution of the Army's current OT/E effort and examines how well it is satisfying some of its major objectives. First, the history and evolution of the Army's current OT/E structure are traced. The organization of the US Army Operat...

B. F. Stout

1976-01-01

367

United States Army Medical Materiel Development Activity 1993 Annual Report.  

National Technical Information Service (NTIS)

The Annual report, Calendar Year 1993, summarizes development projects managed by the U.S. Army Medical Materiel Development Activity as authorized by The Surgeon General, the Army, and the Commander, U.S. Army Medical Research and Development Command, an...

G. E. Lewis

1993-01-01

368

Using Venture Capital to Improve Army Research and Development.  

National Technical Information Service (NTIS)

The U.S. Army is having difficulty balancing its need for new technologies with the resources available to develop them. Since it is unlikely that the Army will devote substantially greater resources to its research and development (R&D), the Army must fi...

B. Held I. Chang

2000-01-01

369

32 CFR 644.416 - Army civil works lands.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army civil works lands. 644.416 Section...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE...Property and Easement Interests § 644.416 Army civil works lands. The Secretary...

2013-07-01

370

32 CFR 644.328 - Army military leased property.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army military leased property. 644.328...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE...Property in Excess Status § 644.328 Army military leased property. (a)...

2013-07-01

371

32 CFR 643.112 - Army exchange activities.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army exchange activities. 643.112 Section...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE...Authority of Commanders § 643.112 Army exchange activities. Use of space...

2013-07-01

372

32 CFR 508.1 - Utilization of Army bands.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Utilization of Army bands. 508.1 Section 508.1 National...Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS...CIVILIAN BANDS § 508.1 Utilization of Army bands. (a) General....

2013-07-01

373

32 CFR 644.329 - Army civil works real property.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army civil works real property. 644.329...Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE...Property in Excess Status § 644.329 Army civil works real property. (a)...

2013-07-01

374

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

375

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

376

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

377

32 CFR 581.1 - Army Disability Review Board.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 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...

2013-07-01

378

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

379

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

380

Poor Design and Management Hamper Army's Basic Skills Education Program. Report to the Secretary of the Army.  

ERIC Educational Resources Information Center

|The Army's Basic Skills Education Program (BSEP) was studied to consider whether it was properly designed to determine the basic skills needed in Army jobs and to be effectively implemented. Information and reports on BSEP were reviewed, and three major commands were selected for evaluation. In designing the program, the Army did not identify the…

General Accounting Office, Washington, DC.

381

Effect of the Army Oral Health Maintenance Program on the Dental Health Status of Army Personnel (AOHMP Evaluation) Executive Summary.  

National Technical Information Service (NTIS)

The Army Oral Health Maintenance Program is a Department Of Army approved dental program which serves as the primary patient input device for the Army dental care system. This study was designed to determine how effectively the program is working. The stu...

W. A. Parker R. V. Mayotte T. M. Rauch

1979-01-01

382

Attrition of Army Nurse Corps Officers: Looking at Factors that Affect Retention and Recruitment of Army Nurse Corps Officers.  

National Technical Information Service (NTIS)

The nursing shortage has been a challenge for the U.S. Army Nurse Corps. Currently, it is short of its budgeted end strength and continues to have an increasing number of nurses leaving the Army. Additionally, the U.S. Army Recruiting Command (USAREC) and...

P. R. Gahol

2005-01-01

383

Ideals of Today's Modernizing People's Liberation Army.  

National Technical Information Service (NTIS)

As China emerges as a major world power, the Chinese Communist Party (CCP) has adjusted its ideology to maintain national spirit and power. Elements of this adjustment can be seen in changes within the People's Liberation Army (PLA). As the PLA aggressive...

D. P. Kisby

2010-01-01

384

Sowing Seeds to Cultivate Future Army Leaders.  

National Technical Information Service (NTIS)

With the continuous deployment of units over the past nine years and before that, to a lesser extent, the peace operations in Bosnia and Kosovo, the U.S. Army has lost many of its core competencies and training skills. One of those degraded skills is offi...

R. Nussio

2010-01-01

385

Red Army Faction: Four Generations of Terror.  

National Technical Information Service (NTIS)

The year 1985 began with the reemergence of one of the most notorious and violent terrorist organizations in Europe, The Red Army Faction (RAF) of West Germany. The RAF, whose demise has been pronounced on numerous occasions by West German authorities, ha...

C. N. Bay

1986-01-01

386

Initial Result of the Army Background Experiment.  

National Technical Information Service (NTIS)

The Army Background Experiment was commissioned in April 1987 to measure the space neutron background near the Earth. It was launched aboard the LACE spacecraft in February 1990 and has operated flawlessly since turn on. All overview of the experiment and...

W. C. Feldman G. F. Auchampaugh E. R. Shunk

1985-01-01

387

Homosexuality, Manliness, and the United States Army.  

National Technical Information Service (NTIS)

This monograph investigates the following: (1) the nature of the resistance within the United States Army to the inclusion of openly homosexual service members into the force, and (2) the preparation for social change that would be necessary at the macro ...

J. C. Dayhoff

2010-01-01

388

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

389

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

390

Paradigm for the US Army Transformation.  

National Technical Information Service (NTIS)

This monograph analyzes the Revolution in Military Affairs of early modem Europe to develop a paradigm for the current posited RMA and or the U.S. Army Transformation. Michael Roberts introduced the concept of a 'military revolution' during a lecture pres...

V. R. Sikorsky

2000-01-01

391

Army Pathology Service in Viet Nam.  

National Technical Information Service (NTIS)

With the increased troop build-up in Vietnam, Army medical facilities have been sent to that country in order to provide American servicemen with the highest quality of medical care possible. Laboratory units have been necessary to enable clinicians to pr...

F. W. Kiel

1966-01-01

392

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

393

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

394

US Army working group on aircraft noise  

Microsoft Academic Search

The research carried out by a U.S. Army working group on the internal noise of helicopters is discussed. A new noise standard is felt to be needed because the standard used to date has never been considered adequate for helicopters and because of the Surgeon General's hearing conservation program. Attention is given to the preliminary considerations of the working group,

S. Moreland

1980-01-01

395

Marketing Program: Tripler Army Medical Center, Hawaii.  

National Technical Information Service (NTIS)

The purpose of this study was to develop the initial framework upon which to build an effective marketing program for improving patient satisfaction with outpatient care at Tripler Army Medical Center. The market research instrument for this study was a P...

M. R. Williams

1990-01-01

396

Army Energy and Water Reporting System Assessment  

Microsoft Academic Search

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

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

2011-01-01

397

Solar Energy Applications at Army Ammunition Plants.  

National Technical Information Service (NTIS)

The Army Ammunition Plants use significant quantities of fossil fuels. To reduce dependence on these scarce, costly, and non-renewable fuels, a study was conducted to investigate potential solar energy applications at the AAPs. Solar energy is a low-level...

A. P. Lowry S. M. Moy

1982-01-01

398

Solar energy applications at Army ammunition plants  

Microsoft Academic Search

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

A. P. Lowry; S. M. Moy

1982-01-01

399

‘Coxey's Army’ as a millennial movement  

Microsoft Academic Search

'Coxey's Army' was the popular name for a march of unemployed workers which left Massillon, Ohio, on Easter Sunday 1894, and arrived in Washington, D.C., on May Day. It was the first nationally reported protest march on Washington and as an example of protest against economic conditions is usually classified as a form of Populism. Careful analysis, however, reveals that

Michael Barkun

1988-01-01

400

British army aviation in the 1990s  

Microsoft Academic Search

The Army Air Corps has gone from strength to strength since its formation in 1957 with the increased need for and recognition of the roles of helicopter support by commanders on the ground. As technology has advanced, so has the ability of the helicopter to perform a under range of tasks and this has come to fruition with the new

S W StJ Lytle

1994-01-01

401

Army Aviation's Role In Peace Operations.  

National Technical Information Service (NTIS)

The end of the Cold War and the demise of the Soviet Union has resulted in increased regional conflicts and instability throughout the world. In areas where U.S. national interests have been threatened, we employed our Army to protect our interests or ass...

G. D. Walker

1996-01-01

402

Army Physicians' Attitudes Towards Physicians' Assistants.  

National Technical Information Service (NTIS)

In Februrary 1972 the US 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 ...

J. H. Bair R. B. Stuart

1971-01-01

403

Path Taken...Army Space Technology Beginnings.  

National Technical Information Service (NTIS)

Department of Defense (DoD) Space efforts can be divided into four basic areas: Space support, force enhancements, Space control, and Space applications. In each of these key areas, the Army has a rich history and has made significant contributions. Space...

B. Kerstiens

2003-01-01

404

Army Library Conversion: Cost Assessment Plan.  

National Technical Information Service (NTIS)

The paper is a work plan for gathering cost data at the Army Library during conversion of its manual circulation system to the automated circulation module of the Integrated Library System (ILS). The plan describes the activities to be studied, discusses ...

J. S. Lovelace

1981-01-01

405

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

406

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

407

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

408

Surgical Management of Intractable Epilepsy  

Microsoft Academic Search

Cortical resective surgery (including amygdalohippocampectomy) and corpus callosotomy are the most widely accepted modes of surgical treatment for intractable epilepsy. Between July 1989 and May 1996, 146 surgeries for epilepsy were done at Severance Hospital, Yonsei University. Resective surgery was performed in 126 patients and corpus callosotomy in 20 patients. Of the 126 patients who underwent resective surgery, surgery for

Yong Gou Park

1998-01-01

409

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

410

'We did the best we could'--the United States Army nurses of Ie Shima.  

PubMed

During World War II, Army Nurses of the 156th Army Evacuation Hospital delivered care while under attack, demonstrated incredible bravery, endured extreme hardships, and unknowingly defined advanced nursing practice as we know it today. First Lieutenant Edythe (Goldstein) Pallin, BS, RN, was a 23-year old registered nurse who served in the Pacific and was stationed near the front lines on the remote island of Ie Shima in the Ryukyu Island Chain near Okinawa. This article, as told to Edythe's daughter, draws heavily on her memories and her military photo album stored in the attic of her home for over 50 years. Edythe only acknowledges her military experience by saying, "We did the best we could." Yes, these nurses not only did the best they could, they also changed nursing from a subservient position to an independent practice long before nurses even understood their professional possibilities. Edythe passed away October 26, 2012. PMID:23734553

Bernier, Francie

411

Surgical complications of typhoid fever: Enteric perforation  

Microsoft Academic Search

Typhoid fever remains a prevalent disease in developing nations as the result of adverse socioeconomic factors. The most frequent complication, and principal cause of mortality, is perforation of the terminal ileum. This report presents our experience with 96 patients surgically treated at Cayetano Heredia University Hospital in Lima, Peru from 1972 to 1986. The clinical characteristics and the diverse surgical

Miguel Santillana

1991-01-01

412

Safety with surgical lasers.  

PubMed

As the sales of surgical lasers continue to grow, the problem of laser safety in hospitals becomes increasingly more urgent. This article considers both the principles and the practice of laser safety, and indicates how safety codes should be organized within a hospital. Eye safety is of paramount importance, and the effects of different wavelengths of laser radiation on the eye are described, both for intrabeam and extended-source exposure. An account is given of the concept of Maximum Permissible Exposure (MPE) and how it depends upon wavelength and exposure duration. The standard laser classification is developed in relation to MPE. The use of laser protective eyewear is discussed for the surgeon, other theatre staff and the patient. Finally, the role of the Laser Protection Supervisor and of the Laser Protection Adviser are explained in the context of establishing a local laser safety code. PMID:6527370

McKenzie, A L

413

U.S. Army Corps of Engineers  

NSDL National Science Digital Library

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

414

Robotic technology integration for Army ground vehicles  

Microsoft Academic Search

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

J. J. Jaczkowski

2001-01-01

415

ARMI: an adaptive, platform independent communication library  

Microsoft Academic Search

ARMI is a communication library that provides a framework for expressing fine-grain parallelism and mapping it to a particular machine using shared-memory and message passing library calls. The library is an advanced implementation of the RMI protocol and handles low-level details such as scheduling incoming communication and aggregating outgoing communication to coarsen parallelism when necessary. These details can be tuned

Steven Saunders; Lawrence Rauchwerger

2003-01-01

416

Army nurses in wartime: distinction and pride.  

PubMed

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

Higgins, L P

1996-08-01

417

Amphibian Research and Monitoring Initiative (ARMI)  

Microsoft Academic Search

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

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

418

Surgical morbidity in obese children.  

PubMed

In recent years, there has been a worldwide increase in childhood obesity. At present, pediatric surgeons manage a greater number of pediatric patients who are significantly overweight. Little data exist regarding the surgical challenges of obese children. This review study was designed to examine the relationship of obesity to surgical comorbidities, postoperative complications, and perioperative outcome in children, and to pediatric trauma. Obesity seems to be an independent risk factor in surgical-related pediatric morbidity and should be considered an important variable when looking at surgical outcomes in the pediatric population. Identification by and awareness among pediatric surgeons, of increased risk factors for peri/postoperative complications, will be crucial in optimizing the hospital stay and outcome of these children. PMID:22884265

Roupakias, Stylianos; Mitsakou, Paraskevi

2012-07-17

419

Risk factors for spinal surgical site infection  

Microsoft Academic Search

Background. Surgical site infections (SSI) are one of the most common nosocomial infections in the United States. This study was conducted following an increase in the rate of SSI following spinal procedures at the study hospital. ^ Methods. This study examined patient and hospital associated risk factors for SSI using existing data on patients who had spinal surgery performed at

Kelley M Boston

2007-01-01

420

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

421

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

ERIC Educational Resources Information Center

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

Gall, Joseph A.

2009-01-01

422

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

NASA Astrophysics Data System (ADS)

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

Sen, Surajit; Shanahan, Linda

2008-03-01

423

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

424

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.

425

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

426

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

427

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

PubMed

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

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

2008-10-15

428

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

429

The Effectiveness of the Recent Army Captain Retention Program  

Microsoft Academic Search

The United States Army recently implemented a policy aimed at quelling a large-scale exodus of captains. This policy included the provision of a Menu of Incentives Program targeting officers in year groups 1999—2005. This study details the captain attrition problem, evaluates literature regarding retention options, analyzes the efficacy of the Army’s interventions by branch and by year group, and draws

Hunter R. Coates; Teresa S. Silvernail; Lawrence V. Fulton; Lana Ivanitskaya

2011-01-01

430

Balancing Army and Endangered Species Concerns: Green vs. Green  

Microsoft Academic Search

A number of endangered, threatened, or at-risk species have been identified on US Army training bases. Before further training\\u000a is restricted or curtailed under provisions of the US Endangered Species Act (ESA), the Army can explore available proactive\\u000a options for providing habitat protection and mitigation. This paper investigates the possibility of an Army habitat acquisition\\u000a program to acquire (by lease

Michael McKee; Robert P. Berrens

2001-01-01

431

Quality of Surgical Instruments  

PubMed Central

INTRODUCTION Many surgeons will have encountered the scissors that would not cut, and the artery clip that comes off in a deep difficult location, but it would be reasonable to assume that new instruments should be of assured quality. This study reports the surprising findings of a local quality control exercise for new instruments supplied to a single trust. MATERIALS AND METHODS Between January 2004 and June 2004, all batches of new surgical instruments ordered by the Central Sterile Supplies Department of St Bartholomew's and the Royal London Hospitals were assessed by three clinical engineers, with reference to British Standards (BS) requirements. RESULTS Of 4800 instruments examined, 15% had potential problems. These included 116 with machining burrs and debris in the teeth of the tissue-holding regions, 71 defects of ratcheted instruments, 34 scissors with deficient cutting action, and 35 tissue forceps protruding guide pins. In addition, 254 instruments did not have a visible manufacturer's mark. CONCLUSIONS This study demonstrates the value of local quality control for surgical instruments. This is of importance in an increasingly hazard-conscious environment, where there are concerns over instrument sterilisation, surgical glove puncture and the potential for transmission of blood-borne and prion diseases.

Brophy, T; Srodon, PD; Briggs, C; Barry, P; Steatham, J; Birch, MJ

2006-01-01

432

Porridge and peas: C. Stanton Hicks and Australian army rations.  

PubMed

In 1942 Australian troops came back from fighting the Japanese in New Guinea exhausted and malnourished. The army rations of bully beef and biscuits were insufficiently rich in vitamins to sustain men in combat in tropical conditions. The nutritionist C. Stanton Hicks was one of a vast army of scientists who worked behind the scenes to maximize the war effort. He made it his mission to improve the army diet. He set up the Australian Army Catering Corps, invented combat ration packs and tried to introduce vitamin-rich foods into the soldiers' diet. Two of his more idiosyncratic innovations were wheat porridge and Tasmanian blue peas. PMID:19539373

Collingham, Lizzie

2009-06-17

433

Life and death in the US Army. In Corpore sano.  

PubMed

Using standardized mortality ratios, this study compares the sex- and race-specific, age-adjusted death rates for all US Army soldiers with those for the entire US population. Results show that soldiers are currently dying at a rate that is only half that of their civilian counterparts. The most striking difference in death rates by cause is a markedly lower homicide death rate for Army black men; homicides among the civilian black male population are 12 times more frequent than in the Army. Some factors that might account for these lower mortality rates in the Army are discussed. PMID:2214102

Rothberg, J M; Bartone, P T; Holloway, H C; Marlowe, D H

1990-11-01

434

Pediatric Care as Part of the US Army Medical Mission in the Global War on Terrorism in Afghanistan and Iraq December 2001 to December 2004  

Microsoft Academic Search

ABSTRACT OBJECTIVE. Our objective in this report was to describe the epidemiologic,features of and workload,associated with pediatric admissions,to 12 US Army,military hospitals deployed,to Iraq and Afghanistan. METHODS. The Patient Administration Systems and Biostatistics Activity database was

Mark W. Burnett; Philip C. Spinella; Kenneth S. Azarow; Charles W. Callahan

435

Primary Prophylaxis of Venous Thromboembolism in Surgical Patients  

Microsoft Academic Search

The following article is the first in a series addressing the important topic of improving the quality and safety of surgical care. To promote awareness, Hospital Physician is publishing a series of clinical review articles focused on recent evidence-based recom- mendations for lowering the incidence of perioperative complications and general approaches to improving surgical quality of care. Some surgical complications

Eric K. Peden; Peter H. Lin

436

[The physician in the Roman Army in the early period and at the height of the empire].  

PubMed

This article deals with the organization of health care in the Roman army, especially in the garrisons stationed in the more remote provinces of the Roman empire. A system of military healthcare was first created during the reign of Augustus. It consisted of various ranks of military physicians (milites medici) and assistants (capsarii and marsi) as well as military hospitals (valetudinaria). These played a major part in the spread of rational medicine over the less civilized parts of the Roman empire. PMID:7705041

Wilmanns, J C

1995-01-01

437

Comorbidities and Health Outcomes of African American Men With Prostate Cancer: Analysis of Outpatient Claims and Hospital Discharge Data.  

National Technical Information Service (NTIS)

A study was funded by the US Army Medical Research and Material Command titled, 'Comorbidities and Health Outcomes of African American Men with Prostate Cancer: An Analysis of Outpatient and Hospital Discharge Data'. The primary data source that was used ...

G. P. Hoke

1999-01-01

438

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

439

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

440

32 CFR 623.3 - Submission of requests for loan of Army materiel.  

Code of Federal Regulations, 2010 CFR

...Continued) DEPARTMENT OF THE ARMY SUPPLIES AND EQUIPMENT LOAN OF ARMY MATERIEL...identify the items needed by type, model, size, capacity, caliber, etc. ...Commander, US Army Communications Security Logistics Agency (para 24, app B) for...

2009-07-01

441

32 CFR 623.3 - Submission of requests for loan of Army materiel.  

Code of Federal Regulations, 2010 CFR

...Continued) DEPARTMENT OF THE ARMY SUPPLIES AND EQUIPMENT LOAN OF ARMY MATERIEL...identify the items needed by type, model, size, capacity, caliber, etc. ...Commander, US Army Communications Security Logistics Agency (para 24, app B) for...

2010-07-01

442

AHPCRC (Army High Performance Computing Research Center) Bulletin. Volume 1, Issue 4.  

National Technical Information Service (NTIS)

The Army High Performance Computing Research Center, a collaboration between the U.S. Army and a consortium of university and industry partners, develops and applies high performance computing capabilities to address the Army s most difficult scientific a...

2011-01-01

443

Operational, Social, and Religious Influences upon the Army Chaplain Field Manual, 1926-1952.  

National Technical Information Service (NTIS)

The early formulation of the Army Chaplain Field Manual reveals the Army Chaplaincy struggling with individuals using the Army Chaplain Field Manual to further their social and religious beliefs upon other chaplains. The research is to determine what were...

R. Nay

2008-01-01

444

75 FR 22756 - Federal Advisory Committee; United States Army Science Board; Charter Renewal  

Federal Register 2010, 2011, 2012, 2013

...United States Army Science Board; Charter Renewal...C. Appendix), the Government in the Sunshine Act...the United States Army Science Board (hereafter referred...shall serve as special government employees, shall be...designated ``Senior Army Science Board...

2010-04-30

445

78 FR 21919 - Finding of No Significant Impact and Final Programmatic Environmental Assessment for Army 2020...  

Federal Register 2010, 2011, 2012, 2013

...Environmental Assessment for Army 2020 Force Structure Realignment AGENCY: Department of the...FNSI) for implementation of force structure realignment to reduce the Army active...Environmental Assessment for Army 2020 Force Structure Realignment (PEA), supporting...

2013-04-12

446

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.  

Code of Federal Regulations, 2010 CFR

...Commanding General, U.S. Army Medical Command. ...Commander of the U.S. Army MEDCOM, the European...malpractice claims arising at Army medical centers under...agreement between TJAG and The Surgeon General, such personnel...

2009-07-01

447

32 CFR 536.12 - Commanding General, U.S. Army Medical Command.  

Code of Federal Regulations, 2010 CFR

...Commanding General, U.S. Army Medical Command. ...Commander of the U.S. Army MEDCOM, the European...malpractice claims arising at Army medical centers under...agreement between TJAG and The Surgeon General, such personnel...

2010-07-01

448

32 CFR 552.38 - Acquisition of maneuver agreements for Army commanders.  

Code of Federal Regulations, 2013 CFR

... Acquisition of maneuver agreements for Army commanders. 552.38 Section 552...Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES... Acquisition of maneuver agreements for Army commanders. (a) Authorization....

2013-07-01

449

32 CFR 562.8 - Army Advisory Panel on ROTC Affairs.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Army Advisory Panel on ROTC Affairs. 562...Defense (Continued) DEPARTMENT OF THE ARMY ORGANIZED RESERVES RESERVE OFFICERS' TRAINING CORPS § 562.8 Army Advisory Panel on ROTC Affairs....

2013-07-01

450

32 CFR 581.3 - Army Board for Correction of Military Records.  

Code of Federal Regulations, 2010 CFR

... 2010-07-01 2010-07-01 true Army Board for Correction of Military Records...of Defense (Continued) DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD § 581.3 Army Board for Correction of Military...

2010-07-01

451

75 FR 59235 - Federal Advisory Committee; Army National Cemeteries Advisory Commission  

Federal Register 2010, 2011, 2012, 2013

...Secretary Federal Advisory Committee; Army National Cemeteries Advisory Commission...it is establishing the charter for the Army National Cemeteries Advisory Commission...Defense, through the Under Secretary of the Army, independent advice and...

2010-09-27

452

32 CFR 581.3 - Army Board for Correction of Military Records.  

Code of Federal Regulations, 2010 CFR

... 2009-07-01 2009-07-01 false Army Board for Correction of Military Records...of Defense (Continued) DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD § 581.3 Army Board for Correction of Military...

2009-07-01

453

32 CFR 536.1 - Purpose of the Army Claims System.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Purpose of the Army Claims System. 536.1 Section 536...Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.1 Purpose...

2013-07-01

454

32 CFR 553.7 - Design and layout of Army national cemeteries.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Design and layout of Army national cemeteries. 553.7 Section...of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES ARMY NATIONAL CEMETERIES § 553.7 Design...

2013-07-01

455

33 CFR 211.16 - Scope and application of Army Regulations.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Scope and application of Army Regulations. 211.16 Section 211... CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REAL ESTATE... § 211.16 Scope and application of Army Regulations. (a) AR...

2013-07-01

456

32 CFR 581.3 - Army Board for Correction of Military Records.  

Code of Federal Regulations, 2013 CFR

... 2013-07-01 2013-07-01 false Army Board for Correction of Military Records...of Defense (Continued) DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD § 581.3 Army Board for Correction of Military...

2013-07-01

457

U.S. Army Professional Development of Officers Study: A Critique.  

National Technical Information Service (NTIS)

Recent media reports and internal Army officer preference surveys cast a shadow on the quality, timeliness, scope and substance of Army professional education and training. A new Army study, Professional Development of Officers (PDOS), provides a structur...

J. J. McLeskey

1986-01-01

458

42 CFR 413.124 - Reduction to hospital outpatient operating costs.  

Code of Federal Regulations, 2012 CFR

...this chapter is implemented. (b) For purposes of determining the blended payment amounts of ambulatory surgical center approved surgical procedures performed in the hospital outpatient setting under § 413.118 and hospital outpatient...

2012-10-01

459

Army as a Repository of National Values: The Army McCarthy Hearings of 1954.  

National Technical Information Service (NTIS)

This monograph explores the concept of the Army as a repository for national values, and the government's periodic use of this vessel as a tool in the peacetime protection of the Constitution. Most of the social mechanisms which shape the professional eth...

K. B. Smith

1993-01-01

460

Typology of Army Families. Coping Styles of Successful, Career Army Families.  

National Technical Information Service (NTIS)

This is a qualitative study of the coping styles of 18 healthy families. Healthy army families are defined as those who are without overt clinical sypmtoms of pathology, who enjoy military life, and who have chosen the military as a career. Data were gath...

R. C. Smith

1988-01-01

461

Army Posts in American Culture: A Historical Geography of Army Posts in the United States.  

National Technical Information Service (NTIS)

Army posts in the United States can be divided into three distinct groups. Stone and masonry coastal forts came to America from Europe. They reflected the close cultural ties between the United States and Europe, while at the same time they reflected effo...

D. W. Rhyne

1979-01-01

462

[Hospital infections at an oncology hospital].  

PubMed

During 23 months, the authors analyzed 8122 records of cancer patients admitted to the National Institute of Cancer of Rio de Janeiro, Brazil. The rate of hospital infection was of 18.4 infection episodes per 100 admissions. Hospital infections were detected in 556 patients (57.7%) of the surgical department. The overall rate of purulence seen in 4194 surgeries was 10.1%, and among 2153 clean surgeries, the authors found 95 (4.4%) suppurated surgeries. The surgical wound (28.2%), the respiratory tract (19.2%), and the urinary tract (18.7%) were the major sites involved during infections episodes. Of the 319 ICU patients evaluated, 154 acquired infection after the first 72 hours, with a mortality rate of 48.7%. The hospital microbial flora was made-up mostly of gram-negative aerobic bacteria, with a high incidence of micro-organisms that resist to major antibiotics of hospital use. The percentage of positive results in blood culture tests requested was of 23.7%, with a predominance of gram-negative bacteria (50.9%) and a high percentage of gentamicin-resistant micro-organisms. Antibiotics of greater use in surgical interventions were amikacin, first generation cephalosporins, and chloramphenicol, whereas amikacin, carbenicillin, and first and third generation cephalosporins prevailed in nonsurgical treatments. The authors' experience and findings re-emphasize the need and the importance of a broad multidisciplinary understanding and suggest the need of strict action for an effective control and prevention in hospitals of developing countries. PMID:2259822

Velasco, E D; Martins, C A; Vidal, E; Carvalho, A D; Gaglianone, T C

463

[Financing and control of surgical training].  

PubMed

The present analyses of different surgical training systems show that training of surgical residents significantly contributes to hospital costs. These are predominantly caused by prolonged operation times of residents with increased work load for other staff members in the operating room. In addition, the productivity of surgical residents is less compared to experienced surgeons. On the other hand, hospital managements save money by the lower standard wages paid to the residents. The amount of educational costs is difficult to determine because surgical training takes place as on the job training. Therefore, from an economic point of view, the two products patient care and surgical training are difficult to separate. There are no reliable cost analyses available for the German training system. At present surgical training is indirectly financed by the DRG (diagnosis-related groups) flat rates of the health insurance. Possible options of financing the surgical training are additional funding from the health department or redistribution with supplemental payment for those surgical departments which contribute significantly more to the residents' training. Statements of medical associations, health departments and health insurances demonstrate the difficulty to come to an agreement concerning the finances of the training system. Despite this controversial discussion it should be taken into consideration that there is no alternative to a high quality surgical training as this is the basis for an effective health system. PMID:19949765

Schröder, W; Welcker, K

2010-01-01

464

Obstructive sleep apnea in loudly snoring army conscripts.  

PubMed

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

Mäkelä, Jyrki P; Savolainen, Seppo

2007-08-01

465

A common architecture prototype for army tactical and FCS UAVS  

Microsoft Academic Search

The U.S. Army is fielding several unmanned air vehicles (UAV) within the Tactical, Light Attack, and Future Combat Systems (FCS) Command, Control, Communication, Computers, Intelligence Surveillance and Reconnaissance (C4ISR) classes over the next several years. Each UAV program will develop its own mission processing architecture unless the Army implements a common approach that is responsive to a broad set of

L. Olson; L. Burns

2005-01-01

466

Schooling, Child Labor, and Reserve Army Evidences from India  

Microsoft Academic Search

It is accepted that working from an early age causes physical, moral and psychological trauma for the children and loss of childhood. This article contends that apart from working children, those out of school but not working constitute a reserve army of child workers and policies must focus on them as well. Incidence of schooling, work and the reserve army

Dipa Mukherjee

2012-01-01

467

Waste Stream Analysis of Two United States Army Dining Facilities.  

National Technical Information Service (NTIS)

The purposes of this study were to characterize the waste stream at two United States Army dining facilities at Fort Riley, Kansas and to recommend policies and procedures to effectively manage solid waste at U.S. Army dining facilities. A waste stream an...

M. K. King

1993-01-01

468

United States Army Functional Concept for Intelligence, 2016-2028.  

National Technical Information Service (NTIS)

The U.S. Army continues to answer the Nation's call, as it has since its inception over 235 years ago. As we look to the future, our Army faces a complex and uncertain operational environment that will challenge our Soldiers, leaders, and organizations in...

2010-01-01

469

Relationship Between Army CRNA Job Satisfaction and Turnover.  

National Technical Information Service (NTIS)

The purpose of this study was to identify components of job satisfaction of Army CRNAs and their relationship to turnover. There is a shortage of Certified Registered Nurse Anesthetists (CRNAs) in the Army. Presently, only 80% of the allocated CRNA slots ...

D. P. Grasso

1998-01-01

470

Solid Waste Incineration at Lima Army Tank Plant, OH.  

National Technical Information Service (NTIS)

Due to the shortage of landfill space for solid waste disposal and the escalating cost of using commercial landfills, Lima Army Tank Plant, OH, asked the U.S. Army Construction Engineering Research Laboratory (USACERL) to investigate the technical and eco...

K. E. Griggs

1992-01-01

471

Dental Fitness of Army War College Students, Class of 1985.  

National Technical Information Service (NTIS)

The purpose of the study was to determine the dental fitness of the Army War College military students, Class of 1985. The information is intended to be used to provide information to help motivate the senior Army leadership in support of the proposed Arm...

R. C. Webster

1985-01-01

472

Army's Light Infantry Divisions: An Analysis of Advocacy and Opposition.  

National Technical Information Service (NTIS)

In October 1983 the Army Chief of Staff, General John Wickham, announced his decision to create light infantry divisions. In the ten years since the American withdrawal from Vietnam, the general trend of US Army force structure development had been toward...

T. A. Wray

2005-01-01

473

Survey of army mobile power plant pollution requirements. Final report  

Microsoft Academic Search

This report reviews and summarizes the past work that has been done by the Army to relate emissions to fuel composition, the hardware performance factors, the emissions regualtions as they vary from state to state, the relation of those regulations to Army operations and the areas where additional action is warranted. (Author)

1977-01-01

474

Army and the Drug War: Politics or National Security.  

National Technical Information Service (NTIS)

On 15 July 1986, six US Army Blackhawk helicopters from the 210th Combat Aviation Battalion, 193d Infantry Brigade (Panama), deployed to Bolivia to conduct an operation never before attempted on a large scale by a US Army combat unit. Called Task Force Ja...

M. H. Abbott

1988-01-01

475

Army Facility Energy Demand and the Impact on National Security.  

National Technical Information Service (NTIS)

Sustaining the Army base ensures soldiers and their families have adequate resources to live and work. The focus of this paper is current and future energy demand for Army facilities and how demand will be met in the face of global resource shortages. Uti...

I. Clapp

2007-01-01

476

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

477

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 article 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 exploring and exploiting food resources. The raid patterns of three army ant species,

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

2000-01-01

478

Stress/Fatigue and the ARNG (Army National Guard) Aviator.  

National Technical Information Service (NTIS)

As a result of national policy, Army National Guard (ARNG) aviation units contain thirty-three percent of today's United States Army aviation program. In the event of a national emergency requiring military force, Guard aviation is scheduled to be mobiliz...

K. D. Rhoades

1988-01-01

479

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

480

U.S. Army Engineer Support to Expeditionary Warfare.  

National Technical Information Service (NTIS)

The Army's efforts to project power from the continental United States is dependent on the Army's ability to deploy a full-spectrum land force capable of engaging future asymmetrical threats. Studies have shown that current airlift assets are incapable of...

D. J. Sentinella

2004-01-01

481

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

482

Simulation of the Initial Movement Phase of Army Units.  

National Technical Information Service (NTIS)

An analysis of the movement of Army units from their home station to their designated Airport of Embarkation (APOE) or Seaport of Embarkation (SPOE) is performed. It is intended to be used in the overall deployment of Army units to areas where contingenci...

F. D. Ortman E. L. Parkinson

1968-01-01

483

U.S. Army and the New National Security Strategy.  

National Technical Information Service (NTIS)

In this book, 14 RAND analysts with broad experience in strategic and Army planning have undertaken to answer the following questions: How is the U.S. Army changing to fulfill its role in light of the new national security strategy; How must it change fur...

B. R. Nardulli J. Shapiro L. E. Davis N. Bensahel R. Cliff

2003-01-01

484

Smart isolation mount for army guns: I. Preliminary results  

Microsoft Academic Search

The work reported in this paper is focused on an effective and efficient solution, namely Smart Isolation Mount for Army Guns (SIMAG), to the weapon stabilization and fire control issues facing US Army guns. SIMAG is composed of the optimum integration of two innovative technologies. Vibration Control by Confinement and smart senor\\/actuator\\/active control systems. The combined approach may also be

Daryoush Allaei; David J. Tarnowski; Michael S. Mattice; Robert C. Testa

2000-01-01

485

Maintaining a Trained and Ready Army from an Environmental Perspective.  

National Technical Information Service (NTIS)

Environmental factors strike at the very heart of the Army's training and readiness mission. As proud environmental stewards, the Army strives to minimize the long-term effects and permanent damage to all facets of the environment that may result of pursu...

R. Cardarelli

2002-01-01

486

Road to Abu Ghraib: US Army Detainee Doctrine and Experience.  

National Technical Information Service (NTIS)

The 2004 revelations of detainee maltreatment at the Abu Ghraib prison outside of Baghdad, Iraq have led to an exhaustive overhaul of Army doctrine and training with respect to this topic. The Army has identified disconnects in its individual, leader, and...

J. F. Gebhardt

2005-01-01

487

National Nursing Shortage: Recruitment and Retention Challenges for the Army.  

National Technical Information Service (NTIS)

Like the country at large, the Army has been challenged by a national imbalance between the supply of professional nurses and the demand for their services. This shortage, known as the nursing shortage, poses special problems for the Army Medical Departme...

S. E. Kading

1991-01-01

488

Medical Materiel Support to the Army of the Potomac.  

National Technical Information Service (NTIS)

At the beginning of the Civil War in 1861, the Union army found itself in dire straits logistically. War materiel was in short supply in every category, from uniforms to arms to wagons. The Army Medical Department was ill-prepared to serve, with an incumb...

A. E. Rhodes

1991-01-01

489

Soldier Education in the British Army, 1920-2007  

ERIC Educational Resources Information Center

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

Beach, Jim

2008-01-01

490

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

491

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

492

Emergency response concept plan for Tooele Army Depot and vicinity  

Microsoft Academic Search

The continued storage and disposal of the United States' unitary chemical stockpile, including that portion stored at Tooele Army Depot (TEAD) near Tooele, Utah, have the potential for accidental releases that could escape installation boundaries and pose a threat to civilian populations. The US Army, in conjunction with the Federal Emergency Management Agency and other federal agencies, is committed to

S. A. Carnes; J. H. Sorensen; G. O. Rogers; B. L. Shumpert; R. L. Miller; A. P. Watson; C. V. Chester

1989-01-01

493

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

494

Land Management Panel: Army's Net Zero Installation Initiative.  

National Technical Information Service (NTIS)

A Net Zero ENERGY Installation is an installation that produces as much energy on site as it uses, over the course of a year. Goals: Contribute to the Army Campaign Plan s objective of energy security for the Army. Address energy efficiency and conservati...

K. Kingery

2012-01-01

495

External Support for the Army in the Persian Gulf War.  

National Technical Information Service (NTIS)

This study provides a history of the Army's use of External Support assets (host nation support and contractors) during the Persian Gulf War (Operation Desert Shield and Desert Storm) in 1990 and 1991. The study details the Army's extensive reliance on ex...

J. R. Brinkerhoff

1997-01-01

496

Army IO is PSYOP: Influencing More with Less.  

National Technical Information Service (NTIS)

The purpose of this article is to briefly examine some of the root causes of the ongoing fracture of Army information operations (IO) in general and the dysfunctional friction between IO and the various Army agents of influence, in particular psychologica...

C. D. Boyd

2007-01-01

497

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

498

Essential Surgery at the District Hospital: A Retrospective Descriptive Analysis in Three African Countries  

Microsoft Academic Search

In the first of two papers investigating surgical provision in eight district hospitals in Saharan African countries, Margaret Kruk and colleagues find low levels of surgical care provision suggesting unmet need for surgical services.

Moses Galukande; Johan von Schreeb; Andreas Wladis; Naboth Mbembati; Helder de Miranda; Margaret E. Kruk; Sam Luboga; Alphonsus Matovu; Colin McCord; S. Khady Ndao-Brumblay; Doruk Ozgediz; Peter C. Rockers; Ana Romàn Quiñones; Fernando Vaz; Haile T. Debas; Sarah B. Macfarlane

2010-01-01

499

[Surgical metabolism].  

PubMed

Trauma, operative interventions, infection and other disturbances of homeostasis lead to a uniform reaction of the body, namely release and activation of hormones and cytokines. Profound alterations of substrate flow result, with mobilization of energy stores and degradation of structural and functional proteins of vital organs like the gut mucosa. Due to these reactions the energy demands of the organs are met and energy-consuming synthesis of substrates is indicated. Clinically, hypermetabolism, hyperglycemia, lipolysis and increased urea production with negative nitrogen balance can be observed. The metabolic reactivity is reached by an increased substrate cycling. To avoid negative consequences such as organ dysfunction, a rational situation-adapted substrate supply is warranted as well as reduction of catabolic stimuli and stimulation of anabolic factors. The metabolic care of the surgical patient is still a basic and important task. PMID:9324431

Jauch, K W

1997-06-01

500

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