Science.gov

Sample records for central service prise

  1. Super Kitchen Centralizes Food Service

    ERIC Educational Resources Information Center

    Modern Schools, 1975

    1975-01-01

    To centralize food service within the entire Pittsburgh school district, a 90,000-square-foot food service preparation building contains cranes and monorails to move 500-pound capacity vats throughout the kitchen. (Author/MLF)

  2. Evolution in a centralized transfusion service.

    PubMed

    AuBuchon, James P; Linauts, Sandra; Vaughan, Mimi; Wagner, Jeffrey; Delaney, Meghan; Nester, Theresa

    2011-12-01

    The metropolitan Seattle area has utilized a centralized transfusion service model throughout the modern era of blood banking. This approach has used four laboratories to serve over 20 hospitals and clinics, providing greater capabilities for all at a lower consumption of resources than if each depended on its own laboratory and staff for these functions. In addition, this centralized model has facilitated wider use of the medical capabilities of the blood center's physicians, and a county-wide network of transfusion safety officers is now being developed to increase the impact of the blood center's transfusion expertise at the patient's bedside. Medical expectations and traffic have led the blood center to evolve the centralized model to include on-site laboratories at facilities with complex transfusion requirements (e.g., a children's hospital) and to implement in all the others a system of remote allocation. This new capability places a refrigerator stocked with uncrossmatched units in the hospital but retains control over the dispensing of these through the blood center's computer system; the correct unit can be electronically cross-matched and released on demand, obviating the need for transportation to the hospital and thus speeding transfusion. This centralized transfusion model has withstood the test of time and continues to evolve to meet new situations and ensure optimal patient care. PMID:22150685

  3. Developing a Performance Measurement System for University Central Administrative Services

    ERIC Educational Resources Information Center

    Arena, Marika; Arnaboldi, Michela; Azzone, Giovanni; Carlucci, Paola

    2009-01-01

    Central administrative services have recently received increasing attention from practitioners and academics due to the challenging need to both manage scarce resources and provide high-quality services. In this context, performance measurement systems (PMSs) may assume a central role, although an unresolved debate remains on the claimed benefits…

  4. Health and health services in Central America.

    PubMed

    Garfield, R M; Rodriguez, P F

    1985-08-16

    Despite rapid economic growth since World War II, health conditions improved only slowly in most of Central America. This is a result of poor medical, social, and economic infrastructure, income maldistribution, and the poor utilization of health investments. The economic crisis of the 1980s and civil strife have further endangered health in the region. Life expectancy has fallen among men in El Salvador and civil strife has become the most common cause of death in Guatemala, Nicaragua, and El Salvador. Large-scale US assistance has done little to improve conditions, and refugees continue to pour into North America. It is estimated that there are more than a million refugees within Central America, while a million have fled to the United States. Costa Rica and Nicaragua are partial exceptions to this dismal health picture. An effective approach to the many health problems in Central America will require joint planning and cooperation among all countries in the region. PMID:4021026

  5. PRISE Reporter. Volume 12, 1980-81.

    ERIC Educational Resources Information Center

    PRISE Reporter, 1981

    1981-01-01

    The document consists of six issues of the "PRISE (Pennsylvania Resources and Information Center for Special Education) Reporter" which cover issues and happenings in the education of the mentally retarded, learning disabled, emotionally disturbed, physically handicapped, visually handicapped, and speech/hearing impaired. Lead articles include the…

  6. Coaching the new central service employee to success.

    PubMed

    Robinson, V M

    1990-01-01

    Many benefits can be reaped by the central service department that provides an effective coaching program for new employees. A smooth transition into the department will increase new employee satisfaction and, in the long term, should have a positive impact on employee retention. In addition, well-trained employees project a positive image of your department and increase department productivity. Experienced central service personnel possess extensive knowledge and skill and when they coach, they are excellent resources for new employees. An additional benefit is that coaches experience greater job satisfaction and feel like a valuable part of the team. By utilizing the coaching process, coaches can ensure that new employees become effectively oriented to central service and satisfied, productive members of your department. PMID:10104859

  7. Centralization of a regional clinical microbiology service: The Calgary experience

    PubMed Central

    Church, Deirdre L; Hall, Paula

    1999-01-01

    Diagnostic laboratory services in Alberta have been dramatically restructured over the past five years. In 1994, Alberta Health embarked on an aggressive laboratory restructuring that cut back approximately 30% of the overall monies previously paid to the laboratory service sector in Calgary. A unique service delivery model consolidated all institutional and community-based diagnostic testing in a company called Calgary Laboratory Services (CLS) in late 1996. CLS was formed by a public/private partnership between the Calgary Regional Health Care Authority (CRHA) and MDS-Kasper Laboratories. By virtue of its customer service base and scope of testing, CLS provides comprehensive regional laboratory services to the entire populace. Regional microbiology services within CLS have been successfully consolidated over the past three years into a centralized high volume laboratory (HVL). Because the HVL is not located in a hospital, rapid response laboratories (RRLs) are operated at each acute care site. Although the initial principle behind the proposed test menus for the RRLs was that only procedures requiring a clinical turnaround time of more than 2 h stay on-site, many other principles had to be used to develop and implement an efficient and clinically relevant RRL model for microbiology. From these guiding principles, a detailed assessment of the needs of each institution and extensive networking with user groups, the functions of the microbiology RRLs were established and a detailed implementation plan drawn up. The experience at CLS with regards to restructuring a regional microbiology service is described herein. A post-hoc analysis provides the pros and cons of directing and operating a regionalized microbiology service. PMID:22346397

  8. Prise en charge des traumatismes graves du rein

    PubMed Central

    Lakmichi, Mohamed Amine; Jarir, Redouane; Sadiki, Bader; Zehraoui; Bentani; Wakrim, Bader; Dahami, Zakaria; Moudouni; Sarf, Ismail

    2015-01-01

    Les traumatismes graves du rein de grade III, IV et V selon la classification de l'Amercan Society for Surgery For Trauma (ASST) sont plus rares et se retrouvent dans 5% des cas en moyenne. Leur prise en charge est souvent délicate, nécessitant alors des centres expérimentés dotés de moyen adéquats d'imagerie (scanner spiralé). Cependant, durant ces dernières années, la prise en charge de ces traumatismes a évolué vers une attitude de moins en moins chirurgicale grâce à l’évolution des techniques de la radiologie interventionnelle, de l'endourologie et des moyens de surveillance aux urgences et de réanimation. L'objectif de cette étude est d’évaluer notre expérience dans la prise en charge des traumatismes rénaux de haut grade. Notre étude rétrospective porte sur 25 cas de traumatismes grave du rein de grade III, IV et V selon la classification de l'ASST, colligés entre Janvier 2002 et Juin 2009 au service d'urologie du centre Hospitalier Universitaire Mohammed VI, Université Cadi Ayyad de Marrakech, Maroc. Nous avons étudié les données épidémiologiques, les signes cliniques et biologiques à l'admission (état de choc hémorragique, taux d'hémoglobine), les données radiologiques (échographie et scanner), les lésions associées, la prise en charge thérapeutique et les complications. L’âge moyen de nos patients était de 24,9 ans 15 et 58 ans, avec une prédominance masculine (sex-ratio = 7, 3). Le rein droit était intéressé dans 15 cas (60%). Le traumatisme rénal était fermé dans 15 cas, et ouvert par arme blanche dans 10 cas. Huit patients se sont présentés en état de choc hémorragique (32%). Une anémie inférieur à 10g /100ml a été observée dans 10 cas (40%). L'uroscanner fait systématiquement à l'admission a retrouvé un grade III (10 cas), grade IV (13 cas) et grade V (2 cas). La prise en charge a consisté en une exploration chirurgicale avec néphrectomie chez 2 cas de Grade IV pour une instabilité h

  9. Centralized Authorization Using a Direct Service, Part II

    SciTech Connect

    Wachsmann, A

    2004-06-09

    Authorization is the process of deciding if entity X is allowed to have access to resource Y. Determining the identity of X is the job of the authentication process. One task of authorization in computer networks is to define and determine which user has access to which computers in the network. On Linux, the tendency exists to create a local account for each single user who should be allowed to logon to a computer. This is typically the case because a user not only needs login privileges to a computer but also additional resources like a home directory to actually do some work. Creating a local account on every computer takes care of all this. The problem with this approach is that these local accounts can be inconsistent with each other. The same user name could have a different user ID and/or group ID on different computers. Even more problematic is when two different accounts share the same user ID and group ID on different computers: User joe on computer1 could have user ID 1234 and group ID 56 and user jane on computer2 could have the same user ID 1234 and group ID 56. This is a big security risk in case shared resources like NFS are used. These two different accounts are the same for an NFS server so that these users can wipe out each other's files. The solution to this inconsistency problem is to have only one central, authoritative data source for this kind of information and a means of providing all your computers with access to this central source. This is what a ''Directory Service'' is. The two directory services most widely used for centralizing authorization data are the Network Information Service (NIS, formerly known as Yellow Pages or YP) and Lightweight Directory Access Protocol (LDAP).

  10. La Prise en Charge des Brulures Electriques: a Propos de 30 Cas

    PubMed Central

    Bakkali, H.; Ababou, K.; Bellamari, H.; Ennouhi, A.; Nassim Sabah, T.; Achbouk, A.; Moussaoui, A.; Fouadi, F.Z.; Siah, S.; Ihrai, H.

    2009-01-01

    Summary Les brûlures électriques sont rares mais graves nécessitant une prise en charge urgente et adéquate car l'évolution peut être émaillée de complications graves, notamment cardiaques, neurologiques et rénales, et les séquelles sont importantes. A travers une étude analytique et rétrospective de janvier 2000 à novembre 2007 ayant inclus 30 patients admis au Service des Brûlés de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Maroc, pour prise en charge de brûlures électriques, il a été relaté les mécanismes des brûlures électriques, comme aussi les complications, la morbidité et la mortalité, dues aux brûlures électriques, tout en insistant sur les modalités de prise en charge initiale chez ces patients. La prévention reste le point capital pour réduire l'incidence de ces accidents. Cette prévention se base sur la surveillance des enfants et l'élimination de facteurs de risque à la maison, par la maintenance des installations électriques et par l'information et l'éducation du public. PMID:21991148

  11. Forecasting the Future Food Service World of Work. Final Report. Volume II. Centralized Food Service Systems. Service Management Reports.

    ERIC Educational Resources Information Center

    Powers, Thomas F., Ed.; Swinton, John R., Ed.

    Volume II of a three-volume study on the future of the food service industry considers the effects that centralized food production will have on the future of food production systems. Based on information from the Fair Acres Project and the Michigan State University Vegetable Processing Center, the authors describe the operations of a centralized…

  12. 76 FR 72697 - Central Vermont Public Service Corporation; Notice of License Application Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-25

    ... license transfer from Vermont Marble Power Division of Omya Inc., to Central Vermont Public Service... opportunities with interpretive signage for public education about the historic Vermont Marble buildings...

  13. 17 CFR 256.01-4 - Construction or service contracts, and centralized procurement accounting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... service company and charged directly by the vendor or supplier to the construction project. (c) Service... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Construction or service... § 256.01-4 Construction or service contracts, and centralized procurement accounting. (a)...

  14. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Apply: Basic Principles and Individual Coverage Employees Engaged in Commerce Or in the Production of Goods for Commerce § 779.118 Employees providing central services for multi-unit organizations. Employees providing central services for a multiunit organization may be engaged both “in commerce” and...

  15. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Apply: Basic Principles and Individual Coverage Employees Engaged in Commerce Or in the Production of Goods for Commerce § 779.118 Employees providing central services for multi-unit organizations. Employees providing central services for a multiunit organization may be engaged both “in commerce” and...

  16. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Apply: Basic Principles and Individual Coverage Employees Engaged in Commerce Or in the Production of Goods for Commerce § 779.118 Employees providing central services for multi-unit organizations. Employees providing central services for a multiunit organization may be engaged both “in commerce” and...

  17. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Economic feasibility of centralized services. 101-5.104 Section 101-5.104 Public Contracts and Property Management Federal Property... FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.104 Economic feasibility of centralized services....

  18. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Economic feasibility of centralized services. 101-5.104 Section 101-5.104 Public Contracts and Property Management Federal Property... FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.104 Economic feasibility of centralized services....

  19. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Economic feasibility of centralized services. 101-5.104 Section 101-5.104 Public Contracts and Property Management Federal Property... FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.104 Economic feasibility of centralized services....

  20. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Economic feasibility of centralized services. 101-5.104 Section 101-5.104 Public Contracts and Property Management Federal Property... FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.104 Economic feasibility of centralized services....

  1. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Economic feasibility of centralized services. 101-5.104 Section 101-5.104 Public Contracts and Property Management Federal Property... FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.104 Economic feasibility of centralized services....

  2. The myth of patient centrality in integrated care: the case of back pain services

    PubMed Central

    Louise Howarth, Michelle; Haigh, Carol

    2007-01-01

    Purpose The purpose of this paper is to critically examine the extent of patient centrality within integrated chronic back pain management services and compare policy rhetoric with practice reality. Context Integrated chronic back pain management services. Data sources We have drawn on theories of integration and context specific journals related to integration and pain management between 1966 and 2006 to identify evidence of patient centrality within integrated chronic pain management services. Discussions Despite policy rhetoric and guidelines which promote ‘patient centrality’ within multidisciplinary services, we argue that evaluations of these services are scant. Many papers have focussed on the assessment of pain in multidisciplinary services as opposed to the patients' experience of these services. Conclusions A latent measure of the reality of its magnitude needs to be captured through analysis of the patient's perspectives. Capturing patients' thoughts about integrated services will promote patient centrality and support the reality rather than endorse the rhetoric. PMID:17786176

  3. Centralizing and Focusing Roles: The Student Services Committee.

    ERIC Educational Resources Information Center

    Hicks, Anna T.

    1995-01-01

    To eliminate duplication and underutilization of student services, a South Carolina high school formed a student services committee composed of all service providers (principal, assistant principals, guidance counselors, psychologists, at-risk coordinator, computer specialist, and nurse). The group focused on needs assessment and team-building,…

  4. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... cost allocations or billings for are allowable in accordance with the requirements of 2 CFR Part 225... Plans A. General. 1. Most governmental units provide certain services, such as motor pools, computer... basis. Typical examples of billed central services include computer services, transportation...

  5. A Study of University of Central Texas Student Opinions Concerning Academic and Service Programs.

    ERIC Educational Resources Information Center

    Dixon, Terry P.

    As part of a larger campus-wide study, a student survey was developed to assess student perceptions of programs and services at the University of Central Texas (UCT) in Killeen. The survey focused on: (1) student financial needs, (2) student perceptions of academic and service programs, (3) student attitudes towards programs and services, and (4)…

  6. Enhancing Experiment Central Service Reliability: from delivery to security and virtualization

    NASA Astrophysics Data System (ADS)

    Donno, F.; Baranov, S.; Buzykaev, S.; Saiz Santos, M. D.

    2011-12-01

    The four LHC experiments rely on experiment specific services running on machines mainly located at CERN. Some of these services have been rated by the experiments as very critical: any loss or degradation of performance has a major impact on the experiment's production and analysis activities. It is therefore important to provide a reliable and robust operational environment. In this work we describe the strategy based on service deployment, security and virtualization adopted to enhance the reliability of ATLAS and CMS central services.

  7. How Did States in the Central Region Evaluate Supplemental Educational Services in 2007?

    ERIC Educational Resources Information Center

    Barley, Zoe; Wegner, Sandra K.

    2009-01-01

    In state needs assessment meetings held in late June 2008, the leadership of two Central Region state departments of education, South Dakota and Missouri, asked Regional Educational Laboratory (REL) Central to determine how the states in the region evaluate their supplemental educational service (SES) providers. Specifically, these SEA staff…

  8. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cost allocations or billings for are allowable in accordance with the requirements of 2 CFR Part 225... motor pools, computer centers, purchasing, accounting, etc., to operating agencies on a centralized... include computer services, transportation services, insurance, and fringe benefits. 2. “Allocated...

  9. Alternative Models of Service, Centralized Machine Operations. Phase II Report. Volume II.

    ERIC Educational Resources Information Center

    Technology Management Corp., Alexandria, VA.

    A study was conducted to determine if the centralization of playback machine operations for the national free library program would be feasible, economical, and desirable. An alternative model of playback machine services was constructed and compared with existing network operations considering both cost and service. The alternative model was…

  10. Lessons for major system change: centralization of stroke services in two metropolitan areas of England

    PubMed Central

    Ramsay, Angus; Perry, Catherine; Boaden, Ruth; McKevitt, Christopher; Morris, Stephen; Pursani, Nanik; Rudd, Anthony; Tyrrell, Pippa; Wolfe, Charles; Fulop, Naomi

    2016-01-01

    Objectives Our aim was to identify the factors influencing the selection of a model of acute stroke service centralization to create fewer high-volume specialist units in two metropolitan areas of England (London and Greater Manchester). It considers the reasons why services were more fully centralized in London than in Greater Manchester. Methods In both areas, we analysed 316 documents and conducted 45 interviews with people leading transformation, service user organizations, providers and commissioners. Inductive and deductive analyses were used to compare the processes underpinning change in each area, with reference to propositions for achieving major system change taken from a realist review of the existing literature (the Best framework), which we critique and develop further. Results In London, system leadership was used to overcome resistance to centralization and align stakeholders to implement a centralized service model. In Greater Manchester, programme leaders relied on achieving change by consensus and, lacking decision-making authority over providers, accommodated rather than challenged resistance by implementing a less radical transformation of services. Conclusions A combination of system (top-down) and distributed (bottom-up) leadership is important in enabling change. System leadership provides the political authority required to coordinate stakeholders and to capitalize on clinical leadership by aligning it with transformation goals. Policy makers should examine how the structures of system authority, with performance management and financial levers, can be employed to coordinate transformation by aligning the disparate interests of providers and commissioners. PMID:26811375

  11. Factors that determine use of breeding services by smallholder dairy farmers in Central Kenya.

    PubMed

    Murage, Alice W; Ilatsia, Evans D

    2011-01-01

    This study examined the determinants of smallholder dairy farmers' use of breeding services in Nyandarua and Kiambu districts, Central Kenya. Data was collected through semi-structured interviews with 140 randomly selected respondents. The breeding services considered were artificial insemination (AI), natural bull service, or a combination of AI and bull services. A multinomial logit econometric model was used fitting AI as the base category. There was a negative relationship between higher levels of education, herd size, and location and the use of bull service. However, education, herd size, and credit were positively related to the combined option. The results indicate that uptake of AI services after the liberalization of the sector is influenced by other factors besides cost-related factors. Factors such as accessibility to breeding services and product markets had influence on the farmer decision to choose among the available breeding services. The effectiveness of the breeding services in terms of successful conception also plays a big role in the choice. A need for concerted efforts to increase farmer's knowledge base on utilization and effectiveness of available breeding services is imperative. Furthermore, smallholder dairy farming could be made more sustainable and economically viable by implementing initiatives geared towards enhancing access to breeding services that would guarantee access to quality genetic material. PMID:20703810

  12. 76 FR 63921 - Central Vermont Public Service Corporation; Notice of Proposed Restricted Service List for a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

    ... Energy Regulatory Commission [Project No. 2558-029--Illinois Otter Creek Hydroelectric Project Central... properties included in, or eligible for inclusion in, the National Register of Historic Places at the Otter Creek Hydroelectric Project (Otter Creek Project). \\2\\ 16 USC section 470 (2006) et seq. \\3\\ 36 CFR...

  13. 75 FR 55317 - Central Vermont Public Service Corporation; Notice of Application for Amendment of License and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... for public inspection: a. Application Type: Amendment of License. b. Project No.: 11475-013. c. Date Filed: June 17, 2010. d. Applicant: Central Vermont Public Service Corporation. e. Name of Project: Carver Falls Hydroelectric Project. f. Location: On the Poultney River, in Washington County, New...

  14. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2 Grants and Agreements 1 2013-01-01 2013-01-01 false State/Local-Wide Central Service Cost Allocation Plans C Appendix C to Part 225 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved COST PRINCIPLES FOR STATE, LOCAL, AND INDIAN...

  15. Central Services PREP (A Curriculum for Sterilization Technicians in the Workplace). Final Report.

    ERIC Educational Resources Information Center

    Tri-County Opportunities Industrialization Center, Inc., Harrisburg, PA.

    A workplace literacy curriculum for entry-level hospital workers who sterilize medical equipment for doctors and nurses was developed, tested, and published in Harrisburg, Pennsylvania. An assessment was conducted to identify the needs of the hospital's management and the literacy skills needed by its central services prep department, and…

  16. 75 FR 64303 - Vermont Marble Power, Division of Omya Inc.; Central Vermont Public Service Corporation; Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... Relicensing Regulations Under the Federal Power Act (54 FR 23,756 FERC Stats. and Regs., Regs. Preambles 1986... Energy Regulatory Commission Vermont Marble Power, Division of Omya Inc.; Central Vermont Public Service... Soliciting Comments and Motions To Intervene October 12, 2010. On August 31, 2010, Vermont Marble...

  17. A Community Assessment Survey Conducted Throughout the Central Florida Community College Service District.

    ERIC Educational Resources Information Center

    Pealer, Casius H., Jr.

    During fall 1977, Central Florida Community College conducted a community assessment survey throughout its three-county service district in order to access residents' knowledge, perceptions, and opinions about the college. Seven objectives were identified: what information the community already has about the college; how people learn about the…

  18. "Feed from the Service": Corruption and Coercion in State-University Relations in Central Eurasia

    ERIC Educational Resources Information Center

    Osipian, Ararat L.

    2009-01-01

    Education in Central Eurasia has become one of the services most affected by corruption. Corruption in academia, including bribery, extortion, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region's media and addressed in a few scholarly works. This article considers corruption in higher education as a product of…

  19. Access to Supplemental Educational Services in the Central Region States. Issues & Answers. REL 2007-No. 007

    ERIC Educational Resources Information Center

    Barley, Zoe; Wegner, Sandra K.

    2007-01-01

    The Central Region states (Colorado, Kansas, Missouri, Nebraska, North Dakota, South Dakota, and Wyoming) lag behind the nation in the rate of participation in supplemental educational services that schools failing to make adequate progress for three consecutive years must offer to eligible students under the No Child Left Behind Act. This study…

  20. 78 FR 57922 - American Energy Production, Inc., Best Energy Services, Inc., Community Central Bank Corporation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION American Energy Production, Inc., Best Energy Services, Inc., Community Central Bank Corporation, Explortex Energy, Inc., HemoBioTech, Inc., Larrea Biosciences Corporation, MBI Financial, Inc., and Million Dollar Saloon, Inc.; Order...

  1. 18 CFR 369.1 - FERC Form No. 60, Annual report of centralized service company.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false FERC Form No. 60, Annual report of centralized service company. 369.1 Section 369.1 Conservation of Power and Water... HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT STATEMENTS AND REPORTS...

  2. 18 CFR 369.1 - FERC Form No. 60, Annual report of centralized service company.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false FERC Form No. 60, Annual report of centralized service company. 369.1 Section 369.1 Conservation of Power and Water... HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT STATEMENTS AND REPORTS...

  3. 18 CFR 369.1 - FERC Form No. 60, Annual report of centralized service company.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false FERC Form No. 60, Annual report of centralized service company. 369.1 Section 369.1 Conservation of Power and Water... HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT STATEMENTS AND REPORTS...

  4. 18 CFR 369.1 - FERC Form No. 60, Annual report of centralized service company.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false FERC Form No. 60, Annual report of centralized service company. 369.1 Section 369.1 Conservation of Power and Water... HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT STATEMENTS AND REPORTS...

  5. 18 CFR 369.1 - FERC Form No. 60, Annual report of centralized service company.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false FERC Form No. 60, Annual report of centralized service company. 369.1 Section 369.1 Conservation of Power and Water... HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT STATEMENTS AND REPORTS...

  6. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... organizations. 779.118 Section 779.118 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION... Apply: Basic Principles and Individual Coverage Employees Engaged in Commerce Or in the Production of.... Employees providing central services for a multiunit organization may be engaged both “in commerce” and...

  7. Computerized satellite delivery service: redefines central service and promotes nursing satisfaction.

    PubMed

    Haney, W

    1989-01-01

    Since its implementation in 1986, the Computerized Satellite Delivery Service at Saint Anthony's has contributed to improved efficiency in both the nursing and supply staffs. The system is easily modified, and has influenced other departments such as dietary to develop mechanisms to provide greater support to nursing service. Since the floor technician's role crosses many departmental boundaries, and this job function necessitates communication and facilitates interaction, thereby encouraging a team approach to health care. The implementation of programs which allow nursing staff to devote more time to patient care should be the basis on which any hospital service department operates. By providing a more efficient handling of support services, a closer working relationship between nursing and ancillary departments can be developed. Given the restrictions and limitations that surround many aspects of providing health care in today's society, it is inevitable that a "high tech", "high touch" approach to our efforts will prove not only financially viable, but will also support the basics for networking job satisfaction into the hospital environment. PMID:10293356

  8. 78 FR 41954 - TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ... Employment and Training Administration TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher, Pennsylvania; TA-W-82,634A, Prudential Global Business Technology Solutions Central Security Services Iselin, New Jersey; TA-W-82,634B, Prudential Global Business...

  9. Centralized automated cataloging of health science materials in the MLC/SUNY/OCLC shared cataloging service.

    PubMed Central

    Raper, J E

    1977-01-01

    Since February 1976, The Medical Library Center of New York, with the assistance of the SUNY/OCLC Network, has offered, on a subscription basis, a centralized automated cataloging service to health science libraries in the greater metropolitan New York area. By using workforms and prints of OCLC record (amended by the subscribing participants), technical services personnel at the center have fed cataloging data, via a CRT terminal, into the OCLC system, which provides (1) catalog cards, received in computer filing order; (2) book card, spine, and pocket labels; (3) accessions lists; and (4) data for eventual production of book catalogs and union catalogs. The experience of the center in the development, implementation, operation, and budgeting of its shared cataloging service is discussed. PMID:843650

  10. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia

    NASA Astrophysics Data System (ADS)

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2016-02-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support environmental management. This study assesses and analyzes how the monetary benefits of seven ecosystem services are generated in Central Kalimantan Province, Indonesia, are distributed to different types of beneficiaries. We analyze the following ecosystem services: (1) timber production; (2) rattan collection; (3) jelutong resin collection; (4) rubber production (based on permanent agroforestry systems); (5) oil palm production on three management scales (company, plasma farmer, and independent smallholder); (6) paddy production; and (7) carbon sequestration. Our study shows that the benefits generated from these services differ markedly between the stakeholders, which we grouped into private, public, and household entities. The distribution of these benefits is strongly influenced by government policies and in particular benefit sharing mechanisms. Hence, land-use change and policies influencing land-use change can be expected to have different impacts on different stakeholders. Our study also shows that the benefits generated by oil palm conversion, a main driver for land-use change in the province, are almost exclusively accrued by companies and at this point in time are shared unequally with local stakeholders.

  11. Interactive distance education service (IDES) using the Centralized Access Node System (CANS)

    NASA Astrophysics Data System (ADS)

    Moon, Phil J.; Choi, Mun K.; Jun, Mun S.; Lee, Chul H.

    1995-02-01

    The successes of B-ISDN project depend on attractive application services. Thus, it is very important to analyze application services which users desire, and to study the customer access network for applications. Especially, because the cost of the constructions for the customer access network need high, it is very important to configure this network economically and effectively. We recognize the importance how to provide B-ISDN application services and to configure the customer access network. This paper describes the Interactive Distance Education Service (IDES) requirements in the user and network aspects. The requirements include the service definition, reference configuration, procedure and Quality Of Service. And also this paper proposes the configuration of customer access network for providing IDES using the Centralized Access Node system which is a kind of the B-NT system. There are many applications area in IDES, we describe the three scenarios--for rural area, between the major and minor campus and for joint education including the university, research institute and enterprise.

  12. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia.

    PubMed

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2016-02-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support environmental management. This study assesses and analyzes how the monetary benefits of seven ecosystem services are generated in Central Kalimantan Province, Indonesia, are distributed to different types of beneficiaries. We analyze the following ecosystem services: (1) timber production; (2) rattan collection; (3) jelutong resin collection; (4) rubber production (based on permanent agroforestry systems); (5) oil palm production on three management scales (company, plasma farmer, and independent smallholder); (6) paddy production; and (7) carbon sequestration. Our study shows that the benefits generated from these services differ markedly between the stakeholders, which we grouped into private, public, and household entities. The distribution of these benefits is strongly influenced by government policies and in particular benefit sharing mechanisms. Hence, land-use change and policies influencing land-use change can be expected to have different impacts on different stakeholders. Our study also shows that the benefits generated by oil palm conversion, a main driver for land-use change in the province, are almost exclusively accrued by companies and at this point in time are shared unequally with local stakeholders. PMID:26467675

  13. Prise en Charge du Syndrome de Lyell ou Necrolyse Epidermique Toxique

    PubMed Central

    Siah, S.; Baite, A.; Bakkali, H.; Atmani, M.; Ababou, K.; Ihrai, H.

    2009-01-01

    Summary Le syndrome de Lyell ou nécrolyse épidermique toxique (NET) est une pathologie très grave des dermatoses bulleuses d'étiologie médicamenteuse. Il se caractérise par une nécrose aiguë de l'épiderme sur toute la hauteur du corps muqueux. L'aspect clinique de la NET est celui d'une brûlure étendue du deuxième degré profond. A ce tableau s'associent constamment des lésions muqueuses et une atteinte multiviscérale qui aggrave le pronostic. Nous rapportons deux cas de NET qui illustrent l'importance d'une prise en charge précoce et multidisciplinaire de ces patients atteints au sein d'un service de réanimation des brûlés, dont les fondements reposent sur l'asepsie rigoureuse, l'apport hydroélectrolytique et nutritionnel, la prévention de l'infection et son traitement par une antibiothérapie adaptée, et un nursing et des soins locaux. L'efficacité supposée des immunoglobulines intraveineuses ne repose que sur des cas isolés et il n'y a pas encore d'études randomisées. PMID:21991170

  14. Ecosystem services from a degraded peatland of Central Kalimantan: implications for policy, planning, and management.

    PubMed

    Law, Elizabeth A; Bryan, Bretr A; Meijaard, Erik; Mallawaarachchi, Thilak; Struebig, Matthew; Wilson, Kerrie A

    2015-01-01

    Increasingly, landscapes are managed for multiple objectives to balance social, economic, and environmental goals. The Ex-Mega Rice Project (EMRP) peatland in Central Kalimantan, Indonesia provides a timely example with globally significant development, carbon, and biodiversity concerns. To inform future policy, planning, and management in the EMRP, we quantified and mapped ecosystem service values, assessed their spatial interactions, and evaluated the potential provision of ecosystem services under future land-use scenarios. We focus on key policy-relevant regulating (carbon stocks and the potential for emissions reduction), provisioning (timber, crops from smallholder agriculture, palm oil), and supporting (biodiversity) services. We found that implementation of existing land-use plans has the potential to improve total ecosystem service provision. We identify a number of significant inefficiencies, trade-offs, and unintended outcomes that may arise. For example, the potential development of existing palm oil concessions over one-third of the region may shift smallholder agriculture into low-productivity regions and substantially impact carbon and biodiversity outcomes. While improved management of conservation zones may enhance the protection of carbon stocks, not all biodiversity features will be represented, and there will be a reduction in timber harvesting and agricultural production. This study highlights how ecosystem service analyses can be structured to better inform policy, planning, and management in globally significant but data-poor regions. PMID:26255358

  15. Breeding Services and the Factors Influencing Their Use on Smallholder Dairy Farms in Central Uganda

    PubMed Central

    Kayiizi, Vincent; Owiny, David; Mburu, John

    2014-01-01

    Dairy cattle breeding is an important technology in the enhancement and promotion of dairy production in Uganda. The introduction of germplasm through AI is crucial to enhance the production potential of the local breeds. A study was conducted in six districts of Uganda in the central region using a questionnaire survey involving 450 randomly selected households to profile the dairy breeding services in use and investigate the factors that affect the success of dairy breeding focusing on AI. Adoption of the AI service was highly (P < 0.05) dependent on ava ilability of extension services, record keeping practice (P < 0.05), and availability of milk markets (P < 0.05). On the other hand AI adoption was independent of formal education, age of farmer, labor availability, and feed/water availability (P > 0.05). Use or nonuse of AI did not significantly (P > 0.05) influence the sex of the calf born. While preference for AI was marked, very few farmers actually used it. This implies that focus should be put on improved AI service delivery alongside improved extension services. PMID:24782940

  16. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

    PubMed Central

    Pandey, Srijana; Karki, Supendra

    2014-01-01

    Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

  17. La prise en charge des troubles de santé mentale par les omnipraticiens du Québec

    PubMed Central

    Fleury, Marie-Josée; Farand, Lambert; Aubé, Denise; Imboua, Armelle

    2012-01-01

    services (ressources; coordination formalisée) et l’environnement (politiques). Conclusion Le rôle clé des omnipraticiens et leur soutien à la prise en charge des TM ont été démontrés, spécifiquement pour les TMC. Pour une prise en charge optimale des soins primaires de santé mentale, des stratégies à composantes multiples, dont les soins partagés, devraient être davantage déployées.

  18. Characteristics of Students Receiving Special Education Services in a Central Minnesota School District According to Setting, Classification, and Level of Service.

    ERIC Educational Resources Information Center

    Ittenbach, Richard F.; And Others

    The records of 1,231 preschool, elementary, and secondary students receiving special education services in a central Minnesota school district were evaluated to provide information on differences according to setting, classification, and level of service. Data were analyzed within the context of four broad domains: demographics (age, race, gender,…

  19. Willingness and ability to pay for physician services in six Central and Eastern European countries.

    PubMed

    Danyliv, Andriy; Groot, Wim; Gryga, Irena; Pavlova, Milena

    2014-07-01

    Patient charges for physician services are implemented in high-income countries and often are considered in the Central and Eastern Europe (CEE). However, there is no evidence on the potential consumption effects of service charges in these countries. This study provides evidence on the potential impact of patient charges on the consumption of specialized physician services in six CEE countries: Bulgaria, Hungary, Lithuania, Poland, Romania, and Ukraine. We apply a semi-parametric survival analysis to stated willingness and ability to pay (WATP) in order to identify potential demand pools and their price, income and age semi-elasticity. Data are collected through a survey held in 2010 among representative samples of about 1000 respondents in each country. Our results suggest that median WATP in the studied countries is comparable to the cost of the services. The obtained demand pools appear to be theoretically valid and externally consistent. They provide information on the shares of population that would be WATP certain fee levels, and their heterogeneity across socio-demographic groups gives an idea about the population groups that will need to be exempted. PMID:24630780

  20. A centralized cardiovascular risk service to improve guideline adherence in private primary care offices

    PubMed Central

    Carter, Barry L.; Levy, Barcey T.; Gryzlak, Brian; Chrischilles, Elizabeth A.; Weg, Mark W. Vander; Christensen, Alan J.; James, Paul A.; Moss, Carol A.; Parker, Christopher P.; Gums, Tyler; Finkelstein, Rachel J; Xu, Yinghui; Dawson, Jeffrey D.; Polgreen, Linnea A.

    2015-01-01

    Background Many large health systems now employ clinical pharmacists in team-based care to assist patients and physicians with management of cardiovascular (CV) diseases. However, small private offices often lack the resources to hire a clinical pharmacist for their office. The purpose of this study is to evaluate whether a centralized, web-based CV risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in primary care medical offices in rural and small communities. Methods This study is a cluster randomized prospective trial in 12 primary care offices. Medical offices were randomized to either the CVRS intervention or usual care. The intervention will last for 12 months and all subjects will have research visits at baseline and 12 months. Primary outcomes will include adherence to treatment guidelines and control of key CV risk factors. Data will also be abstracted from the medical record at 30 months to determine if the intervention effect is sustained after it is discontinued. Conclusions This study will enroll subjects through 2015 and results will be available in 2018. This study will provide information on whether a distant, centralized CV risk service can improve guideline adherence in medical offices that lack the resources to employ clinical pharmacists. PMID:25952471

  1. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative description of service company functions. 366.23 Section 366.23 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS...

  2. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative description of service company functions. 366.23 Section 366.23 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS...

  3. A Climate Information Portal for Copernicus: a central portal for European climate services?

    NASA Astrophysics Data System (ADS)

    Juckes, Martin; Swart, Rob; Thysse, Peter; Som de Cerff, Wim; Groot, Annemarie; Bennett, Victoria; Costa, Luis; Lückenkötter, Johannes; Callaghan, Sarah

    2015-04-01

    The FP7 project "Climate Information Portal for Copernicus" (CLIPC) is developing a demonstration portal for the Copernicus Climate Change Service (C3S). This project is one of a suite of FP7 research activities which are administratively independent of Copernicus, focussed on creating the technical and scientific building blocks needed for the service. It is to be expected that at EGU 2015 there will be many presentations describing portals delivering new and innovative ranges of services. It would be unwise to seek to replace all this creative activity with a single portal -- instead CLIPC is designing a portal to make distributed resources more accessible through flexible discovery systems. CLIPC needs to deliver more than a directory of resources: resources need to be presented in common protocols so that users can access multiple datasets. More information about the project objectives is available at www.clipc.eu. The gulf between the climate science communities and the end user communities is a central challenge being addressed in the project. It is important to understand that there is significant diversity and multiple communication barriers within these two sets of communities as well as between them. The CLIPC services must presentation will provide a review of progress towards this ambitious goal, through a discussion of user requirements activities, an overview of the proposed architecture, work on assessing and adjusting model biasses, and a discussion of the climate impact indicators which will be provided through the portal. When looking at the usability of data for the various users, CLIPC will implement a set of services functioning as a "knowledge base" supplying information to users about the data, including definitions of terminology used, quality of datasets, versioning, and user annotations.

  4. La prise en charge de la douleur chez l'enfant cancéreux

    PubMed Central

    Moukhlissi, Mohamed; Aitidir, Malika; Bouamama, Imane; Maani, Khadija; Hachim, Jamila

    2015-01-01

    C'est une étude prospective étalée sur une année (Juin 2007 à Mai 2008) portant sur une série de 140 malades (84 garçons et 56 filles), hospitalisés à l'unité d'hémato-oncologie du service de pédiatrie III à l'hôpital d'enfant de Casablanca. L'objectif de l’étude est de reconnaître la douleur chez l'enfant, l’évaluer en fonction des échelles internationales, et d’ assurer sa prise en charge globale en rapportant l'expérience du service. L’évaluation de la douleur a concerné différentes pathologies cancéreuses: quatre vingt enfants avaient des leucémies aigues lymphoblastiques (57%), 24 enfants présentaient des lymphomes (17%), 10 enfants avaient des neuroblastomes (7%) et 10 autres des néphroblastomes (7%). Parmi les 140 malades évalués, 100 présentaient des douleurs et qui ont fait l'objet de notre étude, donc on peut estimer la prévalence de la douleur ressentie au cours de l'hospitalisation à 71,4%. Plusieurs types d’échelles en fonction de l’âge de l'enfant, et de sa capacité à exprimer par lui-même, ou non, sa douleur, ont été mises à la disposition pour une mesure chiffrée et reproductible mais aussi une base à l'adaptation du traitement antalgique et pour assurer un suivi évolutif sous traitement. Le Traitement anticancéreux reçu par les malades à but curatif: dix malades soit 7,2% ont bénéficié d'une chirurgie curative et une chimiothérapie, cent vingt cinq enfants (89,2%) ont reçu une chimiothérapie seule et cinq malades (3,6%) ont bénéficié d'une association chirurgie, chimiothérapie et radiothérapie. La douleur ressentie avait en lien direct avec la maladie cancéreuse chez 30% des cas (30 enfants), secondaire au traitement anticancéreux chez 30% (30 enfants), et elle était surtout induite par des actes invasifs à visée diagnostique ou thérapeutique chez 40% des cas (40 enfants). Le traitement antalgique a été instauré en fonction de l’évaluation clinique: 67% des patients

  5. Exploring the potential offered by legacy soil databases for ecosystem services mapping of Central African soils

    NASA Astrophysics Data System (ADS)

    Verdoodt, Ann; Baert, Geert; Van Ranst, Eric

    2014-05-01

    Central African soil resources are characterised by a large variability, ranging from stony, shallow or sandy soils with poor life-sustaining capabilities to highly weathered soils that recycle and support large amounts of biomass. Socio-economic drivers within this largely rural region foster inappropriate land use and management, threaten soil quality and finally culminate into a declining soil productivity and increasing food insecurity. For the development of sustainable land use strategies targeting development planning and natural hazard mitigation, decision makers often rely on legacy soil maps and soil profile databases. Recent development cooperation financed projects led to the design of soil information systems for Rwanda, D.R. Congo, and (ongoing) Burundi. A major challenge is to exploit these existing soil databases and convert them into soil inference systems through an optimal combination of digital soil mapping techniques, land evaluation tools, and biogeochemical models. This presentation aims at (1) highlighting some key characteristics of typical Central African soils, (2) assessing the positional, geographic and semantic quality of the soil information systems, and (3) revealing its potential impacts on the use of these datasets for thematic mapping of soil ecosystem services (e.g. organic carbon storage, pH buffering capacity). Soil map quality is assessed considering positional and semantic quality, as well as geographic completeness. Descriptive statistics, decision tree classification and linear regression techniques are used to mine the soil profile databases. Geo-matching as well as class-matching approaches are considered when developing thematic maps. Variability in inherent as well as dynamic soil properties within the soil taxonomic units is highlighted. It is hypothesized that within-unit variation in soil properties highly affects the use and interpretation of thematic maps for ecosystem services mapping. Results will mainly be based

  6. Principal factors of soil spatial heterogeneity and ecosystem services at the Central Chernozemic Region of Russia

    NASA Astrophysics Data System (ADS)

    Vasenev, Ivan; Valentini, Riccardo

    2013-04-01

    The essential spatial heterogeneity is mutual feature for most natural and man-changed soils at the Central Chernozemic Region of Russia which is not only one of the biggest «food baskets» in RF but very important regulator of ecosystem principal services at the European territory of Russia. The original spatial heterogeneity of dominated here forest-steppe and steppe Chernozems and the other soils has been further complicated by a specific land-use history and different-direction soil successions due to environmental changes and more than 1000-year history of human impacts. The carried out long-term researches of representative natural, rural and urban landscapes in Kursk, Orel, Tambov and Voronezh oblasts give us the regional multi-factorial matrix of elementary soil cover patterns (ESCP) with different land-use practices and history, soil-geomorphologic features, environmental and microclimate conditions. The validation and ranging of the limiting factors of ESCP regulation and development, ecosystem principal services, land functional qualities and agroecological state have been done for dominating and most dynamical components of ESCP regional-typological forms - with application of regional and local GIS, soil spatial patterns mapping, traditional regression kriging, correlation tree models. The outcomes of statistical modeling show the essential amplification of erosion, dehumification and CO2 emission, acidification and alkalization, disaggregation and overcompaction processes due to violation of agroecologically sound land-use systems and traditional balances of organic matter, nutrients, Ca and Na in agrolandscapes. Due to long-term intensive and out-of-balance land-use practices the famous Russian Chernozems begin to lose not only their unique natural features of (around 1 m of humus horizon, 4-6% of Corg and favorable agrophysical features), but traditional soil cover patterns, ecosystem services and agroecological functions. Key-site monitoring

  7. Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study

    PubMed Central

    2010-01-01

    Background Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms. Methods A review of literature was conducted. A conceptual framework was developed to guide the review, which focused on the two traditional core public health functions of the san-epid system: communicable disease surveillance, prevention and control and environmental health. The review included twenty-two former communist countries in the former Soviet Union (fSU) and in Central and Eastern Europe (CEE). Results The countries studied fall into two broad groups. Reforms were more extensive in the CEE countries than in the fSU. The CEE countries have moved away from the former centrally managed san-epid system, adopting a variety of models of decentralization. The reformed systems remain mainly funded centrally level, but in some countries there are contributions by local government. In almost all countries, epidemiological surveillance and environmental monitoring remained together under a single organizational umbrella but in a few responsibilities for environmental health have been divided among different ministries. Conclusions Progress in reform of public health services has varied considerably. There is considerable scope to learn from the differing experiences but also a need for rigorous evaluation of how public health functions are provided. PMID:20663198

  8. JAliEn - A new interface between the AliEn jobs and the central services

    NASA Astrophysics Data System (ADS)

    Grigoras, A. G.; Grigoras, C.; Pedreira, M. M.; Saiz, P.; Schreiner, S.

    2014-06-01

    Since the ALICE experiment began data taking in early 2010, the amount of end user jobs on the AliEn Grid has increased significantly. Presently 1/3 of the 40K CPU cores available to ALICE are occupied by jobs submitted by about 400 distinct users, individually or in organized analysis trains. The overall stability of the AliEn middleware has been excellent throughout the 3 years of running, but the massive amount of end-user analysis and its specific requirements and load has revealed few components which can be improved. One of them is the interface between users and central AliEn services (catalogue, job submission system) which we are currently re-implementing in Java. The interface provides persistent connection with enhanced data and job submission authenticity. In this paper we will describe the architecture of the new interface, the ROOT binding which enables the use of a single interface in addition to the standard UNIX-like access shell and the new security-related features.

  9. Assessing the value of the Central Everglades Planning Project (CEPP) in Everglades restoration: an ecosystem service approach

    USGS Publications Warehouse

    Richardson, Leslie A.; Keefe, Kelly; Huber, Christopher C.; Racevskis, Laila; Gregg, Reynolds; Thourot, Scott; Miller, Ian

    2014-01-01

    This study identifies a full range of ecosystem services that could be affected by a restoration project in the central Everglades and monetizes the economic value of a subset of these services using existing data. Findings suggest that the project will potentially increase many ecosystem services that have considerable economic value to society. The ecosystem services monetized within the scope of this study are a subset of the difference between the future-with the Central Everglades Planning Project (CEPP) and the future-without CEPP, and they totaled ~ $1.8 billion USD at a 2.5% discount rate. Findings suggest that the use of ecosystem services in project planning and communications may require acknowledgment of the difficulty of monetizing important services and the limitations associated with using only existing data and models. Results of this study highlight the need for additional valuation efforts in this region, focused on those services that are likely to be impacted by restoration activities but were notably challenging to value in this assessment due to shortages of data.

  10. Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

    PubMed Central

    Wagenaar, Bradley H.; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Gloyd, Stephen; Lambdin, Barrot H.; Micek, Mark A.; Porthé, Victoria; Sherr, Kenneth

    2016-01-01

    Background We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. Design We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. Results Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. Discussion The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness. PMID:27580822

  11. 2 CFR Appendix V to Part 200 - State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans V Appendix V to Part 200 Grants and Agreements Office of Management..., App. V Appendix V to Part 200—State/Local Government and Indian Tribe-Wide Central Service...

  12. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... Operations in Afghanistan 225.7704 Acquisitions of products and services from South Caucasus/Central...

  13. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... Operations in Afghanistan 225.7704 Acquisitions of products and services from South Caucasus/Central...

  14. La prise en charge d’une clientèle

    PubMed Central

    Roy, Andréanne; Breton, Mylaine; Loslier, Julie

    2016-01-01

    Résumé Objectif Analyser les facteurs qui incitent les médecins de famille nouvellement autorisés à faire de la prise en charge d’une clientèle en première ligne. Type d’étude Devis mixte séquentiel : questionnaire en ligne auto-administré auprès de médecins de famille, suivi d’entrevues individuelles. Contexte La Montérégie, qui est la deuxième région la plus populeuse du Québec, et qui présente des zones rurales et urbaines. Participants Tous les médecins de famille détenant un poste en Montérégie et ayant moins de 10 années d’expérience ont été sollicités, soit 366 médecins. Parmi eux, 118 ont complété le questionnaire en ligne (taux de réponse de 32,2 %). Parmi les répondants, 10 médecins ayant des profils de prise en charge variés ont été sélectionnés pour les entrevues individuelles. Principaux paramètres à l’étude Le pourcentage de temps de travail consacré à la prise en charge, analysé en parallèle avec différents facteurs facilitants et barrières à la prise en charge aux niveaux contextuel, organisationnel, du médecin de famille et de la clientèle. Résultats Les principaux facteurs facilitant la prise en charge sont la relation médecin-patient, l’intérêt pour les activités cliniques liées à la prise en charge, les modèles de rôles positifs, la collaboration avec une infirmière et l’accès adéquat aux ressources, notamment en santé mentale. Les principales barrières sont l’ampleur des tâches administratives, l’intérêt pour une pratique polyvalente, l’expérience négative de la prise en charge lors de la formation, un sentiment n’inaptitude à l’égard de la prise en charge, la lourdeur de la clientèle et le manque de soutien en début de pratique. Conclusion Certaines pistes de solution pour inciter les nouveaux médecins de famille à prendre en charge une clientèle sont proposées. Des points d’amélioration au niveau de la formation médicale, du soutien

  15. Performance Enhancing Diets and the PRISE Protocol to Optimize Athletic Performance

    PubMed Central

    Arciero, Paul J.; Ward, Emery

    2015-01-01

    The training regimens of modern-day athletes have evolved from the sole emphasis on a single fitness component (e.g., endurance athlete or resistance/strength athlete) to an integrative, multimode approach encompassing all four of the major fitness components: resistance (R), interval sprints (I), stretching (S), and endurance (E) training. Athletes rarely, if ever, focus their training on only one mode of exercise but instead routinely engage in a multimode training program. In addition, timed-daily protein (P) intake has become a hallmark for all athletes. Recent studies, including from our laboratory, have validated the effectiveness of this multimode paradigm (RISE) and protein-feeding regimen, which we have collectively termed PRISE. Unfortunately, sports nutrition recommendations and guidelines have lagged behind the PRISE integrative nutrition and training model and therefore limit an athletes' ability to succeed. Thus, it is the purpose of this review to provide a clearly defined roadmap linking specific performance enhancing diets (PEDs) with each PRISE component to facilitate optimal nourishment and ultimately optimal athletic performance. PMID:25949823

  16. Approche de prise en charge du trouble du spectre de l’autisme

    PubMed Central

    Lee, Patrick F.; Thomas, Roger E.; Lee, Patricia A.

    2015-01-01

    Résumé Objectif Se pencher sur les critères diagnostiques du trouble du spectre de l’autisme (TSA) comme les définit le Manuel diagnostique et statistique des troubles mentaux, cinquième édition (DSM-V), et concevoir une approche de prise en charge du TSA à l’aide du cadre CanMEDS–Médecine familiale (CanMEDS-MF). Sources d’information Le DSM-V, publié par l’American Psychiatric Association en mai 2013, énonce de nouveaux critères diagnostiques du TSA. Le cadre CanMEDS-MF du Collège des médecins de famille du Canada fournit un plan d’orientation pour la prise en charge complexe du TSA. Nous avons utilisé des données recueillies par le Centers for Disease Control and Prevention afin de déterminer la prévalence du TSA, ainsi que la revue systématique et méta-analyse détaillée effectuée par le National Institute for Health and Care Excellence du R.-U. pour ses lignes directrices sur le TSA dans le but d’évaluer les données probantes issues de plus de 100 interventions. Message principal Selon les données du Centers for Disease Control and Prevention, la prévalence du TSA se chiffrait à 1 sur 88 en 2008 aux États-Unis. La classification du TSA dans la quatrième édition du DSM incluait l’autisme, le syndrome d’Asperger, le trouble envahissant du développement et le trouble désintégratif de l’enfance. La dernière révision du DSM-V réunit tous ces troubles sous la mention TSA, avec différents niveaux de sévérité. La prise en charge du TSA est complexe; elle exige les efforts d’une équipe multidisciplinaire ainsi que des soins continus. Les rôles CanMEDS-MF fournissent un cadre de prise en charge. Conclusion Les médecins de famille sont au cœur de l’équipe de soins multidisciplinaire pour le TSA, et le cadre CanMEDS-MF tient lieu de plan détaillé pour guider la prise en charge d’un enfant atteint de TSA et aider la famille de cet enfant.

  17. Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria

    PubMed Central

    Al-Mujtaba, Maryam; Cornelius, Llewellyn J.; Galadanci, Hadiza; Erekaha, Salome; Okundaye, Joshua N.; Adeyemi, Olusegun A.; Sam-Agudu, Nadia A.

    2016-01-01

    Introduction. Uptake of antenatal services is low in Nigeria; however, indicators in the Christian-dominated South have been better than in the Muslim-dominated North. This study evaluated religious influences on utilization of general and HIV-related maternal health services among women in rural and periurban North-Central Nigeria. Materials and Methods. Targeted participants were HIV-positive, pregnant, or of reproductive age in the Federal Capital Territory and Nasarawa. Themes explored were utilization of facility-based services, provider gender preferences, and Mentor Mother acceptability. Thematic and content approaches were applied to manual data analysis. Results. Sixty-eight (68) women were recruited, 72% Christian and 28% Muslim. There were no significant religious influences identified among barriers to maternal service uptake. All participants stated preference for facility-based services. Uptake limitations were mainly distance from clinic and socioeconomic dependence on male partners rather than religious restrictions. Neither Muslim nor Christian women had provider gender preferences; competence and positive attitude were more important. All women found Mentor Mothers highly acceptable. Conclusion. Barriers to uptake of maternal health services appear to be minimally influenced by religion. ANC/PMTCT uptake interventions should target male partner buy-in and support, healthcare provider training to improve attitudes, and Mentor Mother program strengthening and impact assessment. PMID:27006944

  18. Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria.

    PubMed

    Al-Mujtaba, Maryam; Cornelius, Llewellyn J; Galadanci, Hadiza; Erekaha, Salome; Okundaye, Joshua N; Adeyemi, Olusegun A; Sam-Agudu, Nadia A

    2016-01-01

    Introduction. Uptake of antenatal services is low in Nigeria; however, indicators in the Christian-dominated South have been better than in the Muslim-dominated North. This study evaluated religious influences on utilization of general and HIV-related maternal health services among women in rural and periurban North-Central Nigeria. Materials and Methods. Targeted participants were HIV-positive, pregnant, or of reproductive age in the Federal Capital Territory and Nasarawa. Themes explored were utilization of facility-based services, provider gender preferences, and Mentor Mother acceptability. Thematic and content approaches were applied to manual data analysis. Results. Sixty-eight (68) women were recruited, 72% Christian and 28% Muslim. There were no significant religious influences identified among barriers to maternal service uptake. All participants stated preference for facility-based services. Uptake limitations were mainly distance from clinic and socioeconomic dependence on male partners rather than religious restrictions. Neither Muslim nor Christian women had provider gender preferences; competence and positive attitude were more important. All women found Mentor Mothers highly acceptable. Conclusion. Barriers to uptake of maternal health services appear to be minimally influenced by religion. ANC/PMTCT uptake interventions should target male partner buy-in and support, healthcare provider training to improve attitudes, and Mentor Mother program strengthening and impact assessment. PMID:27006944

  19. Soil and water related forest ecosystem services and resilience of social ecological system in the Central Highlands of Ethiopia

    NASA Astrophysics Data System (ADS)

    Tekalign, Meron; Muys, Bart; Nyssen, Jan; Poesen, Jean

    2014-05-01

    In the central highlands of Ethiopia, deforestation and forest degradation are occurring and accelerating during the last century. The high population pressure is the most repeatedly mentioned reason. However, in the past 30 years researchers agreed that the absence of institutions, which could define the access rights to particular forest resources, is another underlying cause of forest depletion and loss. Changing forest areas into different land use types is affecting the biodiversity, which is manifested through not proper functioning of ecosystem services. Menagesha Suba forest, the focus of this study has been explored from various perspectives. However the social dimension and its interaction with the ecology have been addressed rarely. This research uses a combined theoretical framework of Ecosystem Services and that of Resilience thinking for understanding the complex social-ecological interactions in the forest and its influence on ecosystem services. For understanding the history and extent of land use land cover changes, in-depth literature review and a GIS and remote sensing analysis will be made. The effect of forest conversion into plantation and agricultural lands on soil and above ground carbon sequestration, fuel wood and timber products delivery will be analyzed with the accounting of the services on five land use types. The four ecosystem services to be considered are Supporting, Provisioning, Regulating, and Cultural services as set by the Millennium Ecosystem Assessment. A resilience based participatory framework approach will be used to analyze how the social and ecological systems responded towards the drivers of change that occurred in the past. The framework also will be applied to predict future uncertainties. Finally this study will focus on the possible interventions that could contribute to the sustainable management and conservation of the forest. An ecosystem services trade-off analysis and an environmental valuation of the water

  20. Effects of Drought and Water Resource Management on Biophysical and Sociocultural Ecosystem Services in South-Central United States

    NASA Astrophysics Data System (ADS)

    Julian, J.; Castro, A.; Vaughn, C.; Atkinson, C.

    2014-12-01

    South-Central United States is one of the fastest growing regions in the nation; however, it is experiencing water supply limitations. In response, multiple interests have focused on the Kiamichi River watershed in southeast Oklahoma as a future inter-basin water supply. The Kiamichi River provides many ecosystem services, including freshwater provision to 19 cities/towns, outdoor recreation hub for the South-Central U.S., cultural capital of the Choctaw Indian Nation, and a national biodiversity hotspot. With multiple recent stressors, these ecosystem services are highly threatened. Here we present how drought and water management have impacted these benefits over the past 20 years. First, we assessed the river's sensitivity to drought (which is cyclical) and water regulation (which has increased over the past three decades). Second, we analyzed how these hydrologic changes have impacted freshwater habitat, focusing on mussels because of their sensitivity to flow alterations and because they provide additional ecosystem services such as biofiltration, nutrient recycling/storage, and cultural resources. Third, we performed a sociocultural valuation for a suite of ecosystem services provided by the Kiamichi River watershed, including 505 interviews of five different ecosystem services beneficiary (ESB) groups. We obtained ESB perceptions on how ecosystem services changed with different flow conditions and water management strategies. Analyses revealed that increased regulation (fewer dam releases) has caused the Kiamichi River to have long no flow periods during droughts (e.g. 176 days with no flow in 2006). These long dry periods have been the main culprit for a 60% decline in mussel biomass over the past 20 years, and subsequent large losses in biofiltration and nutrient recycling. Interestingly, ESBs perceived similar losses of ecosystem services. Without being provided any information on flow, more than half of the ESBs believed that water supply, freshwater

  1. Transmission of OFDM wired-wireless quintuple-play services along WDM LR-PONs using centralized broadband impairment compensation.

    PubMed

    Alves, Tiago M F; Morant, Maria; Cartaxo, Adolfo V T; Llorente, Roberto

    2012-06-18

    The simultaneous transmission of four orthogonal frequency-division multiplexing (OFDM)-based signals used to provide quintuple-play services along wavelength division multiplexing (WDM) long-reach passive optical networks (LR-PONs) is demonstrated experimentally. Particularly, the transmission performance of custom signal bearing Gigabit Ethernet data, Worldwide Interoperability for Microwave Access, Long Term Evolution and Ultra Wideband (sub-bands 2 and 3) signals is evaluated for different LR-PONs reaches, considering single-wavelength and WDM transmission, and using a centralized impairment compensation technique at the central office that is transparent to the services provided.It is shown that error vector magnitude-compliant levels are obtained for all the OFDM-based signals in WDM LR-PONs reaching 100 km and that negligible inter-channel crosstalk is obtained for a channel spacing of 100 GHz regardless the OFDM-based signal considered. The successful multi-format OFDM transmission along the 100 km-long WDM LR-PON is achieved in the absence of optical dispersion compensation or single sideband modulation, and it is enabled by the performance improvement provided by the centralized impairment compensation realized. PMID:22714440

  2. 77 FR 41975 - Central Vermont Public Service Corporation; Green Mountain Power Corporation; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-17

    ... Public Service Corporation; Green Mountain Power Corporation; Notice of Application for Transfer of... Corporation (transferor or CVPSC) and Green Mountain Power Corporation (transferee or GMPC) filed an... name Location 2205 Lamoille River Lamoille River in Chittenden, Hydroelectric. Franklin, and...

  3. Academic Library Centrality: User Success through Service, Access, and Tradition. ACRL Publications in Librarianship No. 50.

    ERIC Educational Resources Information Center

    Grimes, Deborah J.

    The purpose of this book is to report the findings of one study of the centrality of the academic library and to suggest specific ways in which the library can fulfill its mission. The book aims to improve librarians' understanding of how to help their users succeed and seeks a new metaphor for the academic library that is appropriate for the…

  4. Institutional Innovation and Public Extension Services Provision: The Marche Regional Administration Reform in Central Italy

    ERIC Educational Resources Information Center

    Pascucci, Stefano; De Magistris, Tiziana

    2011-01-01

    This paper describes how Marche Regional Administration (MRA) introduced an innovative institutional reform of an Agricultural Knowledge and Information System (AKIS) in central Italy. In order to study the main features of the MRA reform we used a methodological approach based on three steps: (i) first we applied a desk analysis to sketch the…

  5. "Feed from the Service": Corruption and Coercion in the State--University Relations in Central Eurasia

    ERIC Educational Resources Information Center

    Osipian, Ararat L.

    2007-01-01

    Education in Central Eurasia has become one of the industries, most affected by corruption. Corruption in academia, including bribery, extortions, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region's media and addressed in few scholarly works. This paper considers corruption in higher education as a product of…

  6. Recidivism at the Kumasi Central Prison: A Look into Guidance and Counselling Services

    ERIC Educational Resources Information Center

    Afari, Sarah Aba; Osei, Mavis; Adu-Agyem, Joe

    2015-01-01

    Recidivism is on the increase as ex-convicts who are expected by the society to be reformed in prison and reintegrated to lead meaningful lives, only return to crime shortly after their release and find themselves back into prison in spite of the harsh punishment and counselling services received while incarcerated. The study aimed to identify the…

  7. Marketing Informal Education Institutions in Israel: The Centrality of Customers' Active Involvement in Service Development

    ERIC Educational Resources Information Center

    Oplatka, Izhar

    2004-01-01

    The current paper outlines a unique marketing perspective that prevails in some informal education institutions in Israel parallel with "traditional modes of marketing", such as promotion, public relations and the like. Based on a case study research in five community centres, a service development based on active participation of the potential…

  8. A Cluster-randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence

    PubMed Central

    Carter, Barry L.; Coffey, Christopher S.; Chrischilles, Elizabeth A.; Ardery, Gail; Ecklund, Dixie; Gryzlak, Brian; Vander Weg, Mark W.; James, Paul A.; Christensen, Alan J.; Parker, Christopher P.; Gums, Tyler; Finkelstein, Rachel J; Uribe, Liz; Polgreen, Linnea A.

    2015-01-01

    Background Numerous studies have demonstrated the value of including pharmacists in team-based care to improve adherence to cardiovascular (CV) guidelines, medication adherence and risk factor control but there is limited information on whether these models can be successfully implemented more widely in diverse settings and populations. The purpose of this study is to evaluate whether a centralized, web-based CV risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in multiple primary care medical offices with diverse geographic and patient characteristics. Methods This study is a prospective trial in 20 primary care offices stratified by the percent of under-represented minorities and then randomized to either the CVRS intervention or usual care. The intervention will last for 12 months and all subjects will have research visits at baseline and 12 months. The primary outcome is the difference in guideline adherence between groups. Data will also be abstracted from the medical record at 24 months to determine if the intervention effect is sustained after it is discontinued. Conclusions This study expects to enroll subjects through 2016 with results expected in 2019. This study will provide information on whether a distant, centralized CV risk service can be implemented in large numbers of medical offices, if it is effective in diverse populations, and if the effect can be sustained long-term. PMID:26111939

  9. A long-reach WDM passive optical network enabling broadcasting service with centralized light source

    NASA Astrophysics Data System (ADS)

    Liu, D.; Tang, M.; Fu, S.; Liu, D.; Shum, P.

    2012-02-01

    We propose a long-reach wavelength-division-multiplexed (WDM) passive optical network (PON) to provide conventional point-to-point (P2P) data and downstream broadcasting service simultaneously by superimposing, for each WDM channel, the differential-phase-shift-keying (DPSK) broadcasting signal with the subcarrier multiplexing (SCM) modulated downstream P2P signal, at the optical line terminal (OLT). In the optical network units (ONUs), by re-modulating part of the downstream signal with a reflective semiconductor optical amplifier (RSOA), we realize color-less ONUs for upstream data transmission. The proposed scheme is numerically verified with a 5 Gb/s downstream P2P signal and broadcasting services, as well as 2.5 Gb/s upstream data through a 60 km bidirectional fiber link. In particular, the influence of the downstream lightwave's optical carrier-subcarrier ratio (OCSR) on the system performance is also investigated.

  10. Stand hazard rating for central idaho forests. Forest Service general technical report

    SciTech Connect

    Steele, R.; Williams, R.E.; Weatherby, J.C.; Reinhardt, E.D.; Hoffman, J.T.

    1996-03-01

    Growing concern over sustainability of central Idaho forests has created a need to assess the health of forest stands on a relative basis. A stand hazard rating was developed as a composite of 11 individual ratings to compare the health hazards of different stands. The composite rating includes Douglas-fire bettle, mountain pine beetle, western pine beetle, spruce beetle, Douglas-fire tussock moth, western spruce budworm, dwarf mistletoes, annosus root disease, Swhweinitzii root and butt rot, and wildfire. The interacting effects of these agents were also considered.

  11. Natural regeneration in two central Idaho grand fir habitat types. Forest Service research paper

    SciTech Connect

    Geier-Hayes, K.

    1994-03-01

    Natural regeneration of five conifer species was surveyed in two central Idaho grand fir habitat types. The habitat types range from warm, dry (grand fir/white spirea) to mesic (Grand fir/Mountain Maple). Four harvest-regeneration methods and four site preparation techniques were sampled. Recommendations for obtaining natural regeneration vary primarily by habitat type. Conifer seedlings in the warm, dry grand fir white spirea habitat type require site protection for establishment. In the mesic grand fir/mountain maple habitat type, tall shrub potential can reduce the opportunity to establish early seral conifer species.

  12. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... Operations in Iraq or Afghanistan 225.7704 Acquisitions of products and services from South...

  13. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... Operations in Iraq or Afghanistan 225.7704 Acquisitions of products and services from South...

  14. Applying an ecosystem service approach to unravel links between ecosystems and society in the coast of central Chile.

    PubMed

    de Juan, Silvia; Gelcich, Stefan; Ospina-Alvarez, Andres; Perez-Matus, Alejandro; Fernandez, Miriam

    2015-11-15

    Ecosystem-based management implies understanding feedbacks between ecosystems and society. Such understanding can be approached with the Drivers-Pressures-State change-Impacts-Response framework (DPSIR), incorporating stakeholders' preferences for ecosystem services to assess impacts on society. This framework was adapted to six locations in the central coast of Chile, where artisanal fisheries coexist with an increasing influx of tourists, and a set of fisheries management areas alternate with open access areas and a no-take Marine Protected Area (MPA). The ecosystem services in the study area were quantified using biomass and species richness in intertidal and subtidal areas as biological indicators. The demand for ecosystem services was elicited by interviews to the principal groups of users. Our results evidenced decreasing landings and a negative perception of fishermen on temporal trends of catches. The occurrence of recreational fishing was negligible, although the consumption of seafood by tourists was relatively high. Nevertheless, the consumption of organisms associated to the study system was low, which could be linked, amongst other factors, to decreasing catches. The comparison of biological indicators between management regimens provided variable results, but a positive effect of management areas and the MPA on some of the metrics was observed. The prioritising of ecosystem attributes by tourists was highly homogenous across the six locations, with "scenic beauty" consistently selected as the preferred attribute, followed by "diversity". The DPSIR framework illustrated the complex interactions existing in these locations, with weak linkages between society's priorities, existing management objectives and the state of biological communities. Overall, this work improved our knowledge on relations between components of coastal areas in central Chile, of paramount importance to advance towards an ecosystem-based management in the area. PMID:26151656

  15. Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder.

    PubMed

    Cameron, Sharon; Glyde, Helen; Dillon, Harvey; King, Alison; Gillies, Karin

    2015-11-01

    This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed. PMID:27587910

  16. Timberland and woodland resources of central and west Oklahoma. Forest Service resource bulletin

    SciTech Connect

    Rosson, J.F.

    1995-09-01

    The first forest survey of 44 central and west Oklahoma counties shows 1,338,100 acres of timberland and 908,700 acres of woodland. Total live-tree volume was 1,476.8 million cubic feet (cubic feet), 65 percent of which was in timberland. Post oak is the predominant species, making up 20 percent of live-tree volume on timberland and 75 percent of live-tree volume on woodland. There were 2,865 million board feet (fbm) of sawtimber, 76 percent of which was in timberland. Net growth for growing stock was 18.7 and 7.6 million cubic feed/year for timberland and woodland, respectively.

  17. PRISE Reporter. Issues and Happenings in the Education of the Mentally Retarded. Volumes 13-15, November 1981-May 1984.

    ERIC Educational Resources Information Center

    PRISE Reporter, 1982

    1982-01-01

    The "PRISE Reporter" newsletter is issued six times a school year, generally from November through May. This collection of 18 issues examines the following special education topics: "Chronological Age in the Design of Educational Programs for Severely and Profoundly Impaired Students" (L. A. Larsen and L. B. Jackson); "Beyond Reading Skills:…

  18. Where have all the autopsies gone? A proposal for a centralized autopsy service.

    PubMed

    Mitchell, E K; Prior, J T

    1995-10-01

    A litany of reasons have been advanced to account for the decrease in hospital autopsy rates. Increased attention has recently been centered on the difficulty hospital and medical examiner morgues are encountering in controlling infectious disease and attempting to comply with federal and state environmental regulatory agencies. The problem has been highlighted by autopsy examinations upon increased numbers of immuno-compromised patients harboring both the HIV and secondary drug resistant tuberculosis organisms. These developments occur at a time when there are budgetary restraints on hospitals and medical examiners' offices facing large expenditures involving morgue reconstruction to comply with ventilatory and infection control procedures mandated by state and federal agencies. Challenging, also, are the liability aspects, as patients and staff are potentially exposed to a variety of infectious agents. A possible solution is presented involving central off-hospital site facilities to which hospital autopsies can be funneled. A community morgue meeting the strict standards of infection control would allow economy of scale from daily use with a full time support staff trained in the protocol of infectious disease control. PMID:8550871

  19. Complications of central venous catheter in patients transplanted with hematopoietic stem cells in a specialized service

    PubMed Central

    Barretta, Lidiane Miotto; Beccaria, Lúcia Marinilza; Cesarino, Cláudia Bernardi; Pinto, Maria Helena

    2016-01-01

    Abstract Objective: to identify the model, average length of stay on site and complications of central venous catheter in patients undergoing transplant of hematopoietic stem cells and verify the corresponding relationship between the variables: age, gender, medical diagnosis, type of transplant, implanted catheter and insertion site. Method: a retrospective and quantitative study with a sample of 188 patients transplanted records between 2007 and 2011. Results: the majority of patients used Hickman catheter with an average length of stay on site of 47.6 days. The complication fever/bacteremia was significant in young males with non-Hodgkin's lymphoma undergoing autologous transplant, which remained with the device for a long period in the subclavian vein. Conclusion: nurses should plan with their team the minimum waiting time, recommended between the catheter insertion and start of the conditioning regimen, as well as not to extend the length of time that catheter should be on site and undertake their continuing education, focusing on the prevention of complications. PMID:27276021

  20. Prise en charge de l’infection gonococcique chez les adultes et les jeunes

    PubMed Central

    Pogany, Lisa; Romanowski, Barbara; Robinson, Joan; Gale-Rowe, Margaret; Latham-Carmanico, Cathy; Weir, Christine; Wong, Tom

    2015-01-01

    Résumé Objectif Présenter des recommandations sur la prise en charge de l’infection gonococcique chez les adultes et les jeunes. Qualité des données Les recommandations thérapeutiques des lignes directrices canadiennes sur les infections transmissibles sexuellement reposent sur une recherche documentaire de même que sur des catégories de recommandations et des niveaux de qualité de données déterminés par au moins 2 évaluateurs. Les recommandations ont été revues par des pairs et sont en instance d’approbation par le groupe de travail d’experts. Message principal Les nouvelles recommandations portant sur la prise en charge de l’infection gonococcique chez les adultes et les jeunes préconisent les cultures à titre d’outil diagnostique lorsqu’elles sont pratiques, le traitement par antibiothérapie combinée (ceftriaxone associée à l’azithromycine) et le signalement sans délai de tous les cas dont le traitement a échoué aux autorités de santé publique. Conclusion Si elles sont suivies, ces nouvelles recommandations pourraient réduire l’échec thérapeutique, contribuer à une surveillance plus étroite des tendances à la résistance de Neisseria gonorrhoeae aux antibiotiques et contribuer à prévenir la transmission de gonorrhée résistante à plusieurs médicaments.

  1. Assessment of the benefits of distributed fuel cell generators in the service areas of Central and South West Services, Inc.. Final report

    SciTech Connect

    El-Gasseir, M.M.

    1993-10-01

    A framework and methodology for assessing the cost effectiveness of 2-MW molten-carbonate fuel cell (MCFC) generators have been developed and used for a number of specific applications and sites within the service territories of the four operating companies of Central and South West Corporation (CSW). The analyses indicate that the MCFC`s relatively small size and its other design and operating characteristics create an opportunity for securing a number of benefits in addition to its capacity and energy values. The combined levelized values of the identified non-traditional or distributed benefits range from 6 to 71 mills/kWh (in 1991 currency) for a 1997 market-entry unit, and from 16 to 67 mills/kWh for a commercial facility in the Year 2000. Because of such savings, the projected total levelized benefits of MCFC generation varied from approximately 63 to 125 and 72 to 127 mills/kWh for the 1997 and 2000 units, respectively. These values correspond to benefit-to-cost ratios of 0.69--1.3 for the market entry fuel cell and 1.1--1.9 for the commercial unit. These estimates are indicative of the competitiveness of MCFC generation in comparison with current technology, including combined cycle plants. Although the results are not accurate projections of future benefit values and are contingent upon satisfactory performance of the MCFC facility, they are indicative of the potential opportunities and challenges that distributed generation poses for CSW and its operating companies. The new technology could be used to lower the cost of service for all customers in the future. It might also provide an additional instrument for the competition to make in-roads into operating companies` markets. The development of MCFC generators along with current cost and performance projections could have far reaching impacts on the electric utility industry.

  2. An Institutional Research for the Purpose of Measuring the Effectiveness of Instructional, Curricular, and Personnel Services to the Transfer Students at Olney Central College.

    ERIC Educational Resources Information Center

    Emrick, Raymond T.

    During 1971-72, graduates of Olney Central College (OCC) who had transferred to a four-year school were asked to rate OCC's instructional, curricular, and personnel services, to determine how adequately the college meets the needs of its students. Students' reactions to thirty-eight statements about the college were registered on a Likert-type…

  3. Utilization of institutional delivery service at Wukro and Butajera districts in the Northern and South Central Ethiopia

    PubMed Central

    2014-01-01

    Background Ethiopia has one of the highest maternal mortality in the world. Institutional delivery is the key intervention in reducing maternal mortality and complications. However, the uptake of the service has remained low and the factors which contribute to this low uptake appear to vary widely. Our study aims to determine the magnitude and identify factors affecting delivery at health institution in two districts in Ethiopia. Methods A community based cross sectional household survey was conducted from January to February 2012 in 12 randomly selected villages of Wukro and Butajera districts in the northern and south central parts of Ethiopia, respectively. Data were collected using a pretested questionnaire from 4949 women who delivered in the two years preceding the survey. Results One in four women delivered the index child at a health facility. Among women who delivered at health facility, 16.1% deliveries were in government hospitals and 7.8% were in health centers. The factors that significantly affected institutional delivery in this study were district in which the women lived (AOR: 2.21, 95% CI: 1.28, 3.82), women age at interview (AOR: 1.96, 95% CI: 1.05, 3.62), women’s education (AOR: 3.53, 95% CI: 1.22, 10.20), wealth status (AOR: 16.82, 95% CI: 7.96, 35.54), women’s occupation (AOR: 1.50, 95% CI: 1.01, 2.24), antenatal care (4+) use (AOR: 1.77, 95% CI: 1.42, 2.20), and number of pregnancies (AOR: 0.25, 95% CI: 0.18,0.35). We found that women who were autonomous in decision making about place of delivery were less likely to deliver in health facility (AOR: 0.38, 95% CI: 0.23,0.63). Conclusions Institutional delivery is still low in the Ethiopia. The most important factors that determine use of institutional delivery appear to be women education and household economic status. Women’s autonomy in decision making on place of delivery did not improve health facility delivery in our study population. Actions targeting the disadvantaged, improving

  4. [Modern referral-information service in the Central Medical Library of the University of Zagreb Medical School].

    PubMed

    Hadjina, G; Granić, D; Bekavac, A

    1990-01-01

    New technologies in information and retrieval services of the Central Medical Library are presented, as well as comparison between traditional search of biomedical literature and search of biomedical bases available on CD-ROM and on-line. MeSH thesaurus represents the basis for all modes of searches, either through published indexes (Index Medicus, Biomedicina Iugoslavica), searches through on-line, or via CD-ROM technology. Experience in indexing according to MeSH structure helps us to search and retrieve biomedical literature on new media too. Great interest in new media for search and retrieval of biomedical literature among our users (100%) justifies their introduction into the Library. In the period of four months, 75% of our users chose CD-ROM technology in their search, 25% chose on-line search, and both technologies were combined by 33% of the users. Having these new media in our library we have reached the point from which we join the world biomedical information network and successfully meet the growing need for information in the field of biomedicine. PMID:2233118

  5. Major Douglas-fir habitat types of central Idaho: A summary of succession and management. Forest Service general technical report

    SciTech Connect

    Steele, R.; Geier-Hayes, K.

    1995-12-01

    The report summarizes important successional aspects of seven central Idaho Douglas-fir habitat types. The habitat types and phases are grouped geographically into west-central and east-central Idaho to differentiate site potential based on ponderosa pine occurrence. The role of fire and other management activities and their influence on common seral shrubs and herbs are discussed. Common seral tree species are included with discussions of natural and planted conifer regeneration and tree growth capability.

  6. Towards secondary use of heterogeneous radio-oncological data for retrospective clinical trials: service-oriented connection of a central research database with image analysis tools

    NASA Astrophysics Data System (ADS)

    Bougatf, Nina; Bendl, Rolf; Debus, Jürgen

    2015-03-01

    Our overall objective is the utilization of heterogeneous and distributed radio-oncological data in retrospective clinical trials. Previously, we have successfully introduced a central research database for collection of heterogeneous data from distributed systems. The next step is the integration of image analysis tools in the standard retrieval process. Hence, analyses for complex medical questions can be processed automatically and facilitated immensely. In radiation oncology recurrence analysis is a central approach for the evaluation of therapeutic concepts. However, various analysis steps have to be performed like image registration, dose transformation and dose statistics. In this paper we show the integration of image analysis tools in the standard retrieval process by connecting them with our central research database using a service-oriented approach. A concrete problem from recurrence analysis has been selected to prove our concept exemplarily. We implemented service-oriented data collection and analysis tools to use them in a central analysis platform, which is based on a work flow management system. An analysis work flow has been designed that, at first, identifies patients in the research database fulfilling the inclusion criteria. Then the relevant imaging data is collected. Finally the imaging data is analyzed automatically. After the successful work flow execution, the results are available for further evaluation by a physician. As a result, the central research database has been connected successfully with automatic data collection and image analysis tools and the feasibility of our service-oriented approach has been demonstrated. In conclusion, our approach will simplify retrospective clinical trials in our department in future.

  7. The National Oceanic and Atmospheric Administration (NOAA) Climate Services Portal: A New Centralized Resource for Distributed Climate Information

    NASA Astrophysics Data System (ADS)

    Burroughs, J.; Baldwin, R.; Herring, D.; Lott, N.; Boyd, J.; Handel, S.; Niepold, F.; Shea, E.

    2010-09-01

    With the rapid rise in the development of Web technologies and climate services across NOAA, there has been an increasing need for greater collaboration regarding NOAA's online climate services. The drivers include the need to enhance NOAA's Web presence in response to customer requirements, emerging needs for improved decision-making capabilities across all sectors of society facing impacts from climate variability and change, and the importance of leveraging climate data and services to support research and public education. To address these needs, NOAA (during fiscal year 2009) embarked upon an ambitious program to develop a NOAA Climate Services Portal (NCS Portal). Four NOAA offices are leading the effort: 1) the NOAA Climate Program Office (CPO), 2) the National Ocean Service's Coastal Services Center (CSC), 3) the National Weather Service's Climate Prediction Center (CPC), and 4) the National Environmental Satellite, Data, and Information Service's (NESDIS) National Climatic Data Center (NCDC). Other offices and programs are also contributing in many ways to the effort. A prototype NCS Portal is being placed online for public access in January 2010, http://www.climate.gov. This website only scratches the surface of the many climate services across NOAA, but this effort, via direct user engagement, will gradually expand the scope and breadth of the NCS Portal to greatly enhance the accessibility and usefulness of NOAA's climate data and services.

  8. Implementing a multifaceted intervention to decrease central line-associated bloodstream infections in SEHA (Abu Dhabi Health Services Company) intensive care units: the Abu Dhabi experience.

    PubMed

    Latif, Asad; Kelly, Bernadette; Edrees, Hanan; Kent, Paula S; Weaver, Sallie J; Jovanovic, Branislava; Attallah, Hadeel; de Grouchy, Kristin K; Al-Obaidli, Ali; Goeschel, Christine A; Berenholtz, Sean M

    2015-07-01

    OBJECTIVE To determine whether implementation of a multifaceted intervention would significantly reduce the incidence of central line-associated bloodstream infections. DESIGN Prospective cohort collaborative. SETTING AND PARTICIPANTS Intensive care units of the Abu Dhabi Health Services Company hospitals in the Emirate of Abu Dhabi. INTERVENTIONS A bundled intervention consisting of 3 components was implemented as part of the program. It consisted of a multifaceted approach that targeted clinician use of evidence-based infection prevention recommendations, tools that supported the identification of local barriers to these practices, and implementation ideas to help ensure patients received the practices. Comprehensive unit-based safety teams were created to improve safety culture and teamwork. Finally, the measurement and feedback of monthly infection rate data to safety teams, senior leaders, and staff in participating intensive care units was encouraged. The main outcome measure was the quarterly rate of central line-associated bloodstream infections. RESULTS Eighteen intensive care units from 7 hospitals in Abu Dhabi implemented the program and achieved an overall 38% reduction in their central line-associated bloodstream infection rate, adjusted at the hospital and unit level. The number of units with a quarterly central line-associated bloodstream infection rate of less than 1 infection per 1,000 catheter-days increased by almost 40% between the baseline and postintervention periods. CONCLUSION A significant reduction in the global morbidity and mortality associated with central line-associated bloodstream infections is possible across intensive care units in disparate settings using a multifaceted intervention. PMID:25871927

  9. La place de la thoracoscopie dans la prise en charge des pathologies thoraciques: à propos de 104 cas

    PubMed Central

    Lakranbi, Marwane; Rabiou, Sani; Ghalimi, Jamal; Issoufou, Ibrahim; Ouadnouni, Yassine; Smahi, Mohamed

    2015-01-01

    Introduction La thoracoscopie est l'exploration endoscopique de la cavité pleurale, des organes avoisinants (diaphragme, péricarde, médiastin) et du poumon. Le but de ce travail se veut d'abord didactique; décrivant la thoracoscopie, ses techniques ainsi que sa place dans la prise en charge de la pathologie thoracique (indications et perspectives thérapeutiques) et informatif en rapportant l'expérience de notre équipe. Méthodes Il s'agit d'une étude rétrospective intéressant 104 thoracoscopies à visée diagnostique et/ou thérapeutique réalisées au service de chirurgie thoracique du Centre Hospitalier Universitaire Hassan II de Fès, sur une période de 04 ans (Août 2008-décembre 2012). Nous avons exclu de notre étude les cas ayant bénéficié d'une médiastinoscopie ainsi que les cas ayant bénéficié d'une thoracoscopie dans le cadre des traumatismes fermés du thorax ou des plaies thoraciques. Résultats L’ âge moyen des patients est de 47 ans, avec des extrêmes allant de 18 à 80 ans, et une légère prédominance masculine à 54%. La thoracoscopie est d'ordre pleural chez 86 patients, pulmonaire chez 10 patients et médiastinale chez 8 patients. La thoracoscopie avait une indication à visée diagnostique chez 87 cas et thérapeutique chez 52 patients (talcage dans 45 cas, décortication pleuropulmonaire dans 2 cas, résection de kystepleuro-péricardique dans 2 cas, cure de pneumothorax dans 2 cas et une fenêtre péricardique). L’évolution post opératoire etait marquée par une amélioration clinico-radiologique chez 40 malades, 11 ont présenté une amélioration clinique seule, 6 ont présenté une persistance ou une récidive de l’épanchement. Conclusion La thoracoscopie représente un réel gain en matière de diagnostic de certaines pathologies intra-thoraciques. Son intérêt thérapeutique limité doit être éventuellement étendu grâce à la chirurgie thoracique vidéo assistée, qui est une technique récente fiable

  10. Prise en charge diagnostique et thérapeutique de la tuberculose ganglionnaire en Tunisie

    PubMed Central

    Ben Brahim, Hajer; Kooli, Ikbel; Aouam, Abir; Toumi, Adnene; Loussaief, Chawki; Koubaa, Jamel; Chakroun, Mohamed

    2014-01-01

    La tuberculose ganglionnaire est la localisation extra-pulmonaire la plus fréquente de la tuberculose. Nous nous proposons dans ce travail d’étudier les modalités diagnostiques, thérapeutiques et évolutives de cette localisation. Il s'agit d'une étude rétrospective portant sur 100 cas de tuberculose ganglionnaire. L’âge moyen était de 35 ± 15 ans (15-85 ans). Aucun malade n’était VIH positif. L'aire cervicale était la plus touchée (93 cas). L'intradermo-réaction à la tuberculine était positive dans 76/91 cas (83,5%). L'examen bactériologique des prélèvements au niveau des ganglions atteints avait mis en évidence des bacilles acido-alcoolo-résistants à l'examen direct dans 2/31 cas (6,4%) et la culture avait isolé Mycobacteruim tuberculosis dans 1/31 cas (3,2%). La cytoponction ganglionnaire (FNAC) était évocatrice de tuberculose dans 35/42 cas (83,3%). La biopsie ganglionnaire était réalisée dans 69 cas et avait permis de retenir le diagnostic de tuberculose dans tous les cas. La FNAC, comparativement à la biopsie, avait permis de raccourcir significativement le délai de la prise en charge (15,1 vs 22,8 jours; p=0,001) et la durée d'hospitalisation (17,3 vs 24,6; p=0,004). La durée moyenne du traitement antituberculeux était de 9,8 ± 4,6 mois (7 à 44 mois). Le traitement chirurgical initial avait raccourci significativement la durée du traitement médical. Il n'avait pas d'impact sur le taux de guérison. Nous avons noté 10 cas de réponse paradoxale aux antituberculeux, quatre cas de résistance clinique et une rechute dans deux cas. La tuberculose ganglionnaire pose un problème diagnostique et thérapeutique. La microbiologie est d'un faible apport. La FNAC est un moyen diagnostique très utiles dans les pays endémiques et à faibles ressources. Un traitement médical seul permet d’éviter les inconvénients de la chirurgie. PMID:25829976

  11. Prise en charge d’un afflux massif de brûles lors d’une situation de catastrophe par incendie au Maroc

    PubMed Central

    Siah, S.; Hatimi, E.M.; Ihrai, H.; Drissi Kamili, N.

    2012-01-01

    Summary La brûlure est l’une des lésions les plus fréquemment rencontrées lors de catastrophes naturelles ou lors de catastrophes d’origine humaine (incendies de lieux publics d’origine accidentelle, ou en temps de guerre ou encore lors d’attentats terroristes). La prise en charge et le triage de brûlés en nombre reste un problème difficile; ceci souligne la nécessité d’une réflexion et de prévisions de ces crises en insistant sur la formation des médecins et des soignants. Les défis à relever sont multiples: les soins aux brûlés requièrent un nombre important de personnel qualifié; les évacuations doivent être planifiées en fonction de la gravité de la brûlure et des lésions associées; les stocks et lots de dotation (en particulier en topiques anti-infectieux et en cristalloïdes) doivent être suffisants et adéquats. Les services hospitaliers de l’Hôpital Militaire d’Instruction Mohammed V de Rabat doivent pouvoir être rapidement adaptés pour accueillir et surtout isoler ces patients. L’hypothèse d’une catastrophe par incendie avec afflux massif de brûlés à l’hôpital militaire d’instruction Mohammed V de Rabat ne doit laisser place à aucune improvisation. PMID:23467075

  12. Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens

    PubMed Central

    Jat, Tej Ram; Deo, Prakash R.; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

    2015-01-01

    Background Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery–related dimensions of maternal deaths in rural central India using a human rights lens. Design Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using thematic analysis. The factors associated with maternal deaths were classified by using the ‘three delays’ framework and were examined by using a human rights lens. Results All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. Conclusions The study highlighted various socio-cultural and service delivery–related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their

  13. Calculating the ecosystem service of water storage in isolated wetlands using LiDAR in north central Florida, USA (presentation)

    EPA Science Inventory

    This study used remotely-sensed Light Detection and Ranging (LiDAR) data to estimate potential water storage capacity of isolated wetlands in north central Florida. The data were used to calculate the water storage potential of >8500 polygons identified as isolated wetlands. We f...

  14. Calculating the ecosystem service of water storage in isolated wetlands using LIDAR in north central Florida, USA

    EPA Science Inventory

    This study used remotely-sensed Light Detection and Ranging (LiDAR) data to estimate potential water storage capacity of isolated wetlands in north central Florida. The data were used to calculate the water storage potential of >8500 polygons identified as isolated wetlands. We ...

  15. Superfund Record of Decision (EPA Region 5): Central Illinois Public Service, Taylorville Manufactured Gas Plant Site, Christian County, IL. (First remedial action), September 1992. Final report

    SciTech Connect

    Not Available

    1992-09-30

    The 1-acre Central Illinois Public Service (CIPS) site is a former manufactured gas plant in Taylorville, Christian County, Illinois. The plant produced a low-quality gas from coal, which was used for lighting and heating. Onsite contamination by coal tar was discovered in 1985 during site construction. The ROD addressesses a final remedy for the remaining principal threat posed by ground water contamination at the site, and also documents the prior 1987 removal action. The primary contaminants of concern affecting the soil, sediment, debris, and ground water at the site are VOCs, including benzene, toluene, and xylenes; and other organics, including PAHs and phenols.

  16. Optimizing PMTCT service delivery in rural North-Central Nigeria: protocol and design for a cluster randomized study.

    PubMed

    Aliyu, Muktar H; Blevins, Meridith; Audet, Carolyn; Shepherd, Bryan E; Hassan, Adiba; Onwujekwe, Obinna; Gebi, Usman I; Kalish, Marcia; Lindegren, Mary Lou; Vermund, Sten H; Wester, C William

    2013-09-01

    Nigeria has more HIV-infected women who do not receive needed services for the prevention of mother-to-child transmission of HIV (PMTCT) than any other nation in the world. To meet the UNAIDS/WHO goal of eliminating mother-to-child HIV transmission by 2015, multiple interventions will be required to scale up PMTCT services, especially to lower-level, rural health facilities. To address this, we are conducting a cluster-randomized controlled study to evaluate the impact and cost-effectiveness of a novel, family-focused integrated package of PMTCT services. A systematic re-assignment of patient care responsibilities coupled with the adoption of point-of-care CD4 + cell count testing could facilitate the ability of lower-cadre health providers to manage PMTCT care, including the provision and scale-up of antiretroviral therapy (ART) to pregnant women in rural settings. Additionally, as influential community members, male partners could support their partners' uptake of and adherence to PMTCT care. We describe an innovative approach to scaling up PMTCT service provision that incorporates considerations of where and from whom women can access services (task-shifting), ease of obtaining a CD4 + cell count result (point-of-care testing), the degree of HIV service integration for HIV-infected women and their infants, and the level of family and community involvement (specifically male partner involvement). This systematic approach, if proven feasible and effective, could be scaled up in Nigeria and similar resource-limited settings as a means to accelerate progress toward eliminating mother-to-child transmission of HIV and help women with HIV infection take ART and live long, healthy lives (Trial registration: NCT01805752). PMID:23816493

  17. Optimizing PMTCT Service Delivery in Rural North Central Nigeria: Protocol and Design for a Cluster Randomized Study

    PubMed Central

    Aliyu, Muktar H; Blevins, Meridith; Audet, Carolyn M; Shepherd, Bryan E; Hassan, Adiba; Onwujekwe, Obinna; Gebi, Usman I; Kalish, Marcia L; Lindegren, Mary Lou; Vermund, Sten H; Wester, C. William

    2013-01-01

    More HIV-infected women in need of services for the prevention of mother-to-child transmission of HIV (PMTCT) give birth in Nigeria than in any other nation in the world. To meet the UNAIDS/WHO goal of eliminating mother-to-child HIV transmission by 2015, multiple interventions will be required to scale up PMTCT services, especially to lower-level, rural health facilities. To address this, we are conducting a cluster-randomized controlled study to evaluate the impact and cost-effectiveness of a novel, family-focused integrated package of services for PMTCT. A systematic reassignment of patient care responsibilities coupled with the adoption of point-of-care CD4+ cell count testing could facilitate the ability of lower-cadre health providers to manage PMTCT care, including the provision and scale-up of antiretroviral therapy to pregnant women in rural settings. Additionally, as influential community members, male partners could support their partners’ uptake of and adherence to PMTCT care. We describe an innovative approach to scaling up PMTCT service provision that incorporates considerations of where and from whom women can access services (task-shifting), ease of obtaining a CD4 result (point-of-care testing), the degree of HIV service integration for HIV-infected women and their infants, and the level of family and community involvement (specifically male partner involvement). This systematic approach, if proven feasible and effective, could be scaled up in Nigeria and similar resource-limited settings as a means to accelerate progress toward eliminating mother-to-child transmission of HIV and help women with HIV infection live long, healthy lives (Trial registration: NCT01805752). PMID:23816493

  18. Biomass and nutrient distributions in central Oregon second-growth ponderosa pine ecosystems. Forest Service research paper

    SciTech Connect

    Little, S.N.; Shainsky, L.J.

    1995-03-01

    We investigated the distributioin of biomass and nurtrients in second-growth ponderosa pine (Pinus ponderosa Dougl. ex Laws.) ecosystems in central Oregon. Destructive sampling of aboveground and belowground tree biomass was carried out at six sites in the Deschutes National Forest; three of these sites also were intensively sampled for biomass and nutrient concentrations of the soil, forest floor, residue, and shrub components. Tree biomass equations were developed that related component biomass to diameter at breast height and total tree height.

  19. Effects of Centralizing Acute Stroke Services on Stroke Care Provision in Two Large Metropolitan Areas in England

    PubMed Central

    Morris, Stephen; Hoffman, Alex; Hunter, Rachael M.; Boaden, Ruth; McKevitt, Christopher; Perry, Catherine; Pursani, Nanik; Rudd, Anthony G.; Turner, Simon J.; Tyrrell, Pippa J.; Wolfe, Charles D.A.; Fulop, Naomi J.

    2015-01-01

    Background and Purpose— In 2010, Greater Manchester and London centralized acute stroke care into hyperacute units (Greater Manchester=3, London=8), with additional units providing ongoing specialist stroke care nearer patients’ homes. Greater Manchester patients presenting within 4 hours of symptom onset were eligible for hyperacute unit admission; all London patients were eligible. Research indicates that postcentralization, only London’s stroke mortality fell significantly more than elsewhere in England. This article attempts to explain this difference by analyzing how centralization affects provision of evidence-based clinical interventions. Methods— Controlled before and after analysis was conducted, using national audit data covering Greater Manchester, London, and a noncentralized urban comparator (38 623 adult stroke patients, April 2008 to December 2012). Likelihood of receiving all interventions measured reliably in pre- and postcentralization audits (brain scan; stroke unit admission; receiving antiplatelet; physiotherapist, nutrition, and swallow assessments) was calculated, adjusting for age, sex, stroke-type, consciousness, and whether stroke occurred in-hospital. Results— Postcentralization, likelihood of receiving interventions increased in all areas. London patients were overall significantly more likely to receive interventions, for example, brain scan within 3 hours: Greater Manchester=65.2% (95% confidence interval=64.3–66.2); London=72.1% (71.4–72.8); comparator=55.5% (54.8–56.3). Hyperacute units were significantly more likely to provide interventions, but fewer Greater Manchester patients were admitted to these (Greater Manchester=39%; London=93%). Differences resulted from contrasting hyperacute unit referral criteria and how reliably they were followed. Conclusions— Centralized systems admitting all stroke patients to hyperacute units, as in London, are significantly more likely to provide evidence-based clinical

  20. An Analysis of Minimum Service Standards (MSS) in Basic Education: A Case Study at Magelang Municipality, Central Java, Indonesia

    ERIC Educational Resources Information Center

    Haryati, Sri

    2014-01-01

    The study aims at analyzing the achievement of Minimum Service Standards (MSS) in Basic Education through a case study at Magelang Municipality. The findings shall be used as a starting point to predict the needs to meet MMS by 2015 and to provide strategies for achievement. Both primary and secondary data were used in the study investigating the…

  1. Willingness to pay for public health services in rural Central Java, Indonesia: methodological considerations when using the contingent valuation method.

    PubMed

    Shono, Aiko; Kondo, Masahide; Ohmae, Hiroshi; Okubo, Ichiro

    2014-06-01

    In the health sectors of low- and middle-income countries, contingent valuation method (CVM) studies on willingness to pay (WTP) have been used to gather information on demand variation or financial perspectives alongside price setting, such as the introduction of user fees and valuation of quality improvements. However, WTP found in most CVM studies have only explored the preferences that consumers express through their WTP without exploring whether they are actually able to pay for it. Therefore, this study examines the issues pertaining to WTP estimation for health services using the conventional CVM. We conducted 202 household interviews in 2008, in which we asked respondents about three types of public health services in Indonesia and assessed WTP estimated by the conventional CVM as well as in the scenario of "resorting to debt" to recognize their budget constraints. We find that all the demand curves for both WTP scenarios show gaps. Furthermore, the gap for midwife services is negatively affected by household income and is larger for the poor. These results prove that CVM studies on WTP do not always reveal WTP in the latter scenario. Those findings suggest that WTP elicited by the conventional CVM is different to that from the maximum price that prevents respondents from resorting to debt as their WTP. In order to bridge this gap in the body of knowledge on this topic, studies should improve the scenarios that CVM analyses use to explore WTP. Furthermore, because valuing or pricing health services based on the results of CVM studies on WTP alone can exacerbate the inequity of access to these services, information provided by such studies requires careful interpretation when used for this purpose, especially for the poor and vulnerable sections of society. PMID:24713191

  2. Protein-Pacing and Multi-Component Exercise Training Improves Physical Performance Outcomes in Exercise-Trained Women: The PRISE 3 Study.

    PubMed

    Arciero, Paul J; Ives, Stephen J; Norton, Chelsea; Escudero, Daniela; Minicucci, Olivia; O'Brien, Gabe; Paul, Maia; Ormsbee, Michael J; Miller, Vincent; Sheridan, Caitlin; He, Feng

    2016-01-01

    The beneficial cardiometabolic and body composition effects of combined protein-pacing (P; 5-6 meals/day at 2.0 g/kg BW/day) and multi-mode exercise (resistance, interval, stretching, endurance; RISE) training (PRISE) in obese adults has previously been established. The current study examines PRISE on physical performance (endurance, strength and power) outcomes in healthy, physically active women. Thirty exercise-trained women (>4 days exercise/week) were randomized to either PRISE (n = 15) or a control (CON, 5-6 meals/day at 1.0 g/kg BW/day; n = 15) for 12 weeks. Muscular strength (1-RM bench press, 1-RM BP) endurance (sit-ups, SUs; push-ups, PUs), power (bench throws, BTs), blood pressure (BP), augmentation index, (AIx), and abdominal fat mass were assessed at Weeks 0 (pre) and 13 (post). At baseline, no differences existed between groups. Following the 12-week intervention, PRISE had greater gains (p < 0.05) in SUs, PUs (6 ± 7 vs. 10 ± 7, 40%; 8 ± 13 vs. 14 ± 12, 43% ∆reps, respectively), BTs (11 ± 35 vs. 44 ± 34, 75% ∆watts), AIx (1 ± 9 vs. -5 ± 11, 120%), and DBP (-5 ± 9 vs. -11 ± 11, 55% ∆mmHg). These findings suggest that combined protein-pacing (P; 5-6 meals/day at 2.0 g/kg BW/day) diet and multi-component exercise (RISE) training (PRISE) enhances muscular endurance, strength, power, and cardiovascular health in exercise-trained, active women. PMID:27258301

  3. Protein-Pacing and Multi-Component Exercise Training Improves Physical Performance Outcomes in Exercise-Trained Women: The PRISE 3 Study †

    PubMed Central

    Arciero, Paul J.; Ives, Stephen J.; Norton, Chelsea; Escudero, Daniela; Minicucci, Olivia; O’Brien, Gabe; Paul, Maia; Ormsbee, Michael J.; Miller, Vincent; Sheridan, Caitlin; He, Feng

    2016-01-01

    The beneficial cardiometabolic and body composition effects of combined protein-pacing (P; 5–6 meals/day at 2.0 g/kg BW/day) and multi-mode exercise (resistance, interval, stretching, endurance; RISE) training (PRISE) in obese adults has previously been established. The current study examines PRISE on physical performance (endurance, strength and power) outcomes in healthy, physically active women. Thirty exercise-trained women (>4 days exercise/week) were randomized to either PRISE (n = 15) or a control (CON, 5–6 meals/day at 1.0 g/kg BW/day; n = 15) for 12 weeks. Muscular strength (1-RM bench press, 1-RM BP) endurance (sit-ups, SUs; push-ups, PUs), power (bench throws, BTs), blood pressure (BP), augmentation index, (AIx), and abdominal fat mass were assessed at Weeks 0 (pre) and 13 (post). At baseline, no differences existed between groups. Following the 12-week intervention, PRISE had greater gains (p < 0.05) in SUs, PUs (6 ± 7 vs. 10 ± 7, 40%; 8 ± 13 vs. 14 ± 12, 43% ∆reps, respectively), BTs (11 ± 35 vs. 44 ± 34, 75% ∆watts), AIx (1 ± 9 vs. −5 ± 11, 120%), and DBP (−5 ± 9 vs. −11 ± 11, 55% ∆mmHg). These findings suggest that combined protein-pacing (P; 5–6 meals/day at 2.0 g/kg BW/day) diet and multi-component exercise (RISE) training (PRISE) enhances muscular endurance, strength, power, and cardiovascular health in exercise-trained, active women. PMID:27258301

  4. Evaluation and demonstration of decentralized space and water heating versus centralized services for new and rehabilitated multifamily buildings. Final report

    SciTech Connect

    Belkus, P.; Tuluca, A.

    1993-06-01

    The general objective of this research was aimed at developing sufficient technical and economic know-how to convince the building and design communities of the appropriateness and energy advantages of decentralized space and water heating for multifamily buildings. Two main goals were established to guide this research. First, the research sought to determine the cost-benefit advantages of decentralized space and water heating versus centralized systems for multifamily applications based on innovative gas piping and appliance technologies. The second goal was to ensure that this information is made available to the design community.

  5. Douglas-fir/pinegrass habitat type in central Idaho: Succession and management. Forest Service general technical report

    SciTech Connect

    Steele, R.; Geier-Hayes, K.

    1993-05-01

    The report includes a taxonomic system for classifying plant succession in the Douglas-fir/Pinegrass habitat type in central Idaho. A total of 10 potential tree layer types, 32 shrub layer types, and 60 herbaceous layer types are categorized. Diagnostic keys based on indicator species provide for field identification of the types. The discussion of management implications includes pocket gopher populations, success of planted and natural tree seedlings, big-game and livestock forage preferences, and responses of major shrub and herb layer species to disturbance.

  6. Douglas-fir/white spirea habitat type in central Idaho: Succession and management. Forest Service general technical report

    SciTech Connect

    Steele, R.; Geier-Hayes, K.

    1994-04-01

    The report describes a taxonomic system for classifying plant succession in the Douglas-fir/white spirea habitat type in central Idaho. A total of 10 potential tree layer types, 35 shrub types, and 45 herb layer types are categorized. Diagonostic keys based on indicator species assist field identification of the types. Discussion of management implications includes pocket gopher populations, success of planted and natural tree seedlings, big-game and livestock forage preferences, and responses of major shrub and herb layer species to disturbances.

  7. Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique

    PubMed Central

    Mamouni, Nisrine; Ghazal, Nabil; Erraghay, Sanaa; Bouchikhi, Chahrazed; Banani, Abdelaziz

    2016-01-01

    La survenue d'une grossesse dans une corne utérine rudimentaire est une situation obstétricale extrêmement rare et potentiellement grave, menaçant le pronostic materno-fœtal. Les auteurs rapportent cinq observations de grossesse dans une corne utérine rudimentaire, à travers lesquelles, ils relatent les difficultés sur le plan diagnostique ainsi que la prise en charge thérapeutique de cette entité pathologique, soulignant l'intérêt de l’échographie endovaginale, de l'IRM pelvienne et de la cœlioscopie dans le diagnostic précoce de ce type de malformation uterine.

  8. Willingness to pay for publicly financed health care services in Central and Eastern Europe: evidence from six countries based on a contingent valuation method.

    PubMed

    Tambor, Marzena; Pavlova, Milena; Rechel, Bernd; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

    2014-09-01

    The increased interest in patient cost-sharing as a measure for sustainable health care financing calls for evidence to support the development of effective patient payment policies. In this paper, we present an application of a stated willingness-to-pay technique, i.e. contingent valuation method, to investigate the consumer's willingness and ability to pay for publicly financed health care services, specifically hospitalisations and consultations with specialists. Contingent valuation data were collected in nationally representative population-based surveys conducted in 2010 in six Central and Eastern European (CEE) countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine) using an identical survey methodology. The results indicate that the majority of health care consumers in the six CEE countries are willing to pay an official fee for publicly financed health care services that are of good quality and quick access. The consumers' willingness to pay is limited by the lack of financial ability to pay for services, and to a lesser extent by objection to pay. Significant differences across the six countries are observed, though. The results illustrate that the contingent valuation method can provide decision-makers with a broad range of information to facilitate cost-sharing policies. Nevertheless, the intrinsic limitations of the method (i.e. its hypothetical nature) and the context of CEE countries call for caution when applying its results. PMID:25016327

  9. Distribution of biomass and nutrients in lodgepole pine/bitterbrush ecosystems in central Oregon. Forest Service research paper

    SciTech Connect

    Little, S.N.; Shainsky, L.J.

    1992-09-01

    The authors investigated the distribution of biomass and nutrients in lodgepole pine (Pinus contorta var. murryana Dougl.) ecosystems on pumice soils in south-central Oregon. Sixty-three trees were sampled to develop equations for estimating dry weights of tree crowns, boles, bark, and coarse roots from diameter at breast height and height. The concentrations of total carbon, nitrogen, phosphorus, and sulfur were determined for each of these components. Biomass, nutrient concentrations, and nutrient contents of the associated vegetation, forest floor, woody debris, fine roots, and soil horizons also were determined. An example stand illustrates the use of these data for determining the effects of bole versus whole-tree harvesting on nutrient capital in a lodgepole pine ecosystem.

  10. Coordination and establishment of centralized facilities and services of the University of Alaska ERTS survey of the Alaskan environment

    NASA Technical Reports Server (NTRS)

    Belon, A. E. (Principal Investigator); Miller, J. M.

    1973-01-01

    The author has identified the following significant results. The objective of this project is to provide a focus for the entire University of Alaska ERTS-1 effort (12 projects covering 10 disciplines and involving 8 research institutes and science departments). Activities have been concentrated on the implementation of the project's three primary functions: (1) coordination and management of the U of A ERTS-1 program, including management of the flow of data and data products; (2) acquisition, installation, test, operation, and maintanence of centralized facilities for processing ERTS-1, aircraft, and ground truth data; and (3) development of photographic and digital techniques for processing and interpreting ERTS-1 and aircraft data. With minor exceptions these three functions are now well-established and working smoothly.

  11. Progesterone 5β-reductases/iridoid synthases (PRISE): gatekeeper role of highly conserved phenylalanines in substrate preference and trapping is supported by molecular dynamics simulations.

    PubMed

    Petersen, Jan; Lanig, Harald; Munkert, Jennifer; Bauer, Peter; Müller-Uri, Frieder; Kreis, Wolfgang

    2016-08-01

    Vein Patterning 1 (VEP1)-encoded progesterone 5β-reductases/iridoid synthases (PRISE) belong to the short-chain dehydrogenase/reductase superfamily of proteins. They are characterized by a set of highly conserved amino acids in the substrate-binding pocket. All PRISEs are capable of reducing the activated C=C double bond of various enones enantioselectively and therefore have a potential as biocatalysts in bioorganic synthesis. Here, recombinant forms of PRISEs of Arabidopsis thaliana and Digitalis lanata were modified using site-directed mutagenesis (SDM). In rDlP5βR, a set of highly conserved amino acids in the vicinity of the catalytic center was individually substituted for alanine resulting in considerable to complete loss of enone reductase activity. F153 and F343, which can be found in most PRISEs known, are located at the outer rim of the catalytic cavity and seem to be involved in substrate binding and their role was addressed in a series of SDM experiments. The wild-type PRISE accepted progesterone (large hydrophobic 1,4-enone) as well as 2-cyclohexen-1-one (small hydrophilic 1,4-enone), whereas the double mutant rAtP5βR_F153A_F343A converted progesterone much better than the wild-type enzyme but almost lost its capability of reducing 2-cyclohexen-1-one. Recombinant Draba aizoides P5βR (rDaP5βR) has a second pair of phenylalanines at position 156 and 345 at the rim of the binding site. These two phenylalanines were introduced into rAtP5βR_F153A_F343A and the resulting quadruple mutant rAtP5βR_F153A_F343A_V156F_V345F partly recovered the ability to reduce 2-cyclohexen-1-one. These results can best be explained by assuming a trapping mechanism in which phenylalanines at the rim of the substrate-binding pocket are involved. The dynamic behavior of individual P5βRs and mutants thereof was investigated by molecular dynamics simulations and all calculations supported the 'gatekeeper' role of phenylalanines at the periphery of the substrate

  12. Timed-daily ingestion of whey protein and exercise training reduces visceral adipose tissue mass and improves insulin resistance: the PRISE study.

    PubMed

    Arciero, Paul J; Baur, Daniel; Connelly, Scott; Ormsbee, Michael J

    2014-07-01

    The present study examined the effects of timed ingestion of supplemental protein (20-g servings of whey protein, 3×/day), added to the habitual diet of free-living overweight/obese adults and subsequently randomized to either whey protein only (P; n = 24), whey protein and resistance exercise (P + RT; n = 27), or a whey protein and multimode exercise training program [protein and resistance exercise, intervals, stretching/yoga/Pilates, endurance exercise (PRISE); n = 28]. Total and regional body composition and visceral adipose tissue (VAT) mass (dual-energy X-ray absorptiometry), insulin sensitivity [homeostasis model assessment-estimated insulin resistance (HOMA-IR)], plasma lipids and adipokines, and feelings of hunger and satiety (visual analog scales) were measured before and after the 16-wk intervention. All groups lost body weight, fat mass (FM), and abdominal fat; however, PRISE lost significantly (P < 0.01) more body weight (3.3 ± 0.7 vs. 1.1 ± 0.7 kg, P + RT) and FM (2.8 ± 0.7 vs. 0.9 ± 0.5 kg, P + RT) and gained (P < 0.05) a greater percentage of lean body mass (2 ± 0.5 vs. 0.9 ± 0.3 and 0.6 ± 0.4%, P + RT and P, respectively). Only P + RT (0.1 ± 0.04 kg) and PRISE (0.21 ± 0.07 kg) lost VAT mass (P < 0.05). Fasting glucose decreased only in P + RT (5.1 ± 2.5 mg/dl) and PRISE (15.3 ± 2.1 mg/dl), with the greatest decline occurring in PRISE (P < 0.05). Similarly, HOMA-IR improved (0.6 ± 0.3, 0.6 ± 0.4 units), and leptin decreased (4.7 ± 2.2, 4.7 ± 3.1 ng/dl), and adiponectin increased (3.8 ± 1.1, 2.4 ± 1.1 μg/ml) only in P + RT and PRISE, respectively, with no change in P. In conclusion, we find evidence to support exercise training and timed ingestion of whey protein added to the habitual diet of free-living overweight/obese adults, independent of caloric restriction on total and regional body fat distribution, insulin resistance, and adipokines. PMID:24833780

  13. Prise en charge en soins primaires des troubles liés à l’usage d’alcool et de la consommation à risque

    PubMed Central

    Spithoff, Sheryl; Kahan, Meldon

    2015-01-01

    Résumé Objectif Présenter aux médecins de soins primaires des renseignements et des conseils fondés sur des données probantes concernant la prise en charge de la consommation à risque et des troubles liés à l’usage d’alcool (TUA). Sources des données Nous avons entrepris une recherche documentaire non systématique à l’aide d’expressions de recherche en anglais, notamment primary care; screening, interventions, management et treatment; et at-risk drinking, alcohol use disorders, alcohol dependence et alcohol abuse; ainsi que des interventions spécifiques en médecine et en counseling pertinentes aux soins primaires. Principaux messages Dans le cas de patients ayant une consommation à risque ou un TUA, les médecins devraient offrir du counseling et, au besoin (p. ex. les patients dont le TUA est de modéré à grave), prescrire et connecter. Counseling : Offrir à tous les patients ayant une consommation à risque une brève séance de counseling et un suivi. Offrir à tous les patients ayant un TUA des séances de counseling et un suivi constant (fréquent et régulier). Prescrire : Offrir des médicaments (disulfiram, naltrexone, acamprosate) à tous les patients ayant un TUA de modéré à grave. Connecter : Encourager les patients souffrant d’un TUA à suivre des programmes de counseling de jour ou en résidence et d’adhérer à des groupes d’entraide. S’il est indiqué de le faire, demander une consultation pour le patient auprès d’un spécialiste en médecine des dépendances, de services concurrents en santé mentale et en toxicomanie ou une thérapie spécialisée pour traumatisme. Conclusion Les médecins de famille peuvent prendre en charge efficacement les patients qui ont une consommation à risque ou des TUA.

  14. Les fractures luxations du cotyle: prise en charge et pronostic à long terme; étude rétrospective portant sur 40 cas

    PubMed Central

    Chagou, Aniss; Hmouri, Ismail; Rhanim, Abdelkarim; Lahlou, Abdou; Berrada, Mohammed Saleh; Yaacoubi, Moradh

    2014-01-01

    Les fractures luxations du cotyle sont le plus souvent dues à des traumatismes de haute énergie. Elles constituent une urgence thérapeutique, l'association de la luxation à une fracture du cotyle fait apparaître la question du choix thérapeutique entre traitement orthopédique et traitement médical. L'objectif de l’étude est de mettre le point sur l'aspect thérapeutique dans ces lésions mais aussi leurs pronostics à long terme. Nous rapportons une étude rétrospective portant sur 40 cas colligés au service d'orthopédie du centre hospitalier universitaire de Rabat. Nous avons évalué les résultats de notre prise en charge mais aussi le pronostic à court et à long terme. Dans notre série, vingt cinq patients ont bénéficié d'un traitement orthopédique alors que les quinze restants ont été opérés, la voie d'abord la plus utilisée est la voie postérieure. Les résultats fonctionnels ont été évalués, après un recul de 3 à 8 ans, selon la cotation de Merle d'Aubigné. Nous avons obtenu 90% de résultats satisfaisants. La comparaison de nos résultats à ceux de la littérature montre que le résultat des traitements orthopédiques et chirurgicaux dépend essentiellement du type de fracture. Le pronostic à long terme reste imprévisible. La survenue des complications tardives telle que la nécrose céphalique et de l'arthrose reste toujours imprévisible, ce qui impose un suivi régulier et prolongé des patients. PMID:25722763

  15. Place de la chirurgie dans la prise en charge des cancers du sein chez la femme au Centre Hospitalier Universitaire Yalgado Ouedraogo: à propos de 81 cas

    PubMed Central

    Zongo, Nayi; Millogo-Traore, Timonga Françoise Danielle; Bagre, Sidpawalmdé Carine; Bagué, Abdoul-Halim; Ouangre, Edgar; Zida, Maurice; Bambara, Aboubacar; Bambara, Tozoula Augustin; Traoré, Si Simon

    2015-01-01

    Etudier la place de la chirurgie dans la prise en charge des cancers du sein au centre hospitalier universitaire Yalgado Ouédraogo. Nous avons réalisé une étude prospective et descriptive sur dix (10) mois portant sur la place de la chirurgie dans le cancer du sein. Elle a eu pour cadre les services de gynécologie-obstétrique et de chirurgie viscérale et digestive du centre hospitalier universitaire Yalgado Ouédraogo. Ont été pris en compte les indications, les gestes et les résultats de la chirurgie. Nous avons colligé 81 cancers mammaires. Le délai moyen de consultation a été de 14,26 mois. Les tumeurs T3 à T4 représentaient 82,71% des cas. Trente-huit patientes (46,91%) ont été opérées. La chimiothérapie néo adjuvante a été réalisée dans 29,63% des cas. Trente-quatre patientes (41,97%) étaient opérables d'emblée. Il s'agissait de mastectomie selon Madden dans 94,74% des cas et de chirurgie de propreté dans 2 cas (5,26% des cas). Une chimiothérapie adjuvante a été réalisée chez 52,63% des patientes opérées. Des complications à type de lymphocèle ont été notées dans 23,68% des cas. Leur traitement a consisté en des ponctions évacuatrices. Les indications de la chirurgie sont limitées par le retard diagnostique corollaire de stades avancés des cancers du sein. L'absence de la radiothérapie rend délicate la pratique de la chirurgie conservatrice et la mastectomie occupe toujours une place importante. Un diagnostic précoce permettrait d'augmenter les indications chirurgicales. PMID:26848364

  16. Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study

    PubMed Central

    2014-01-01

    Background Among Millennium Development Goals, achieving the fifth goal (MDG-5) of reducing maternal mortality poses the greatest challenge in Sub-Saharan Africa. Ethiopia has one of the highest maternal mortality ratios in the world with unacceptably low maternal health service utilization. The Government of Ethiopia introduced an innovative community-based intervention as a national strategy under the Health Sector Development Program. This new approach, known as the Health Extension Program, aims to improve access to and equity in essential health services through community based Health Extension Workers. Objective The objective of the study is to assess the role of Health Extension Workers in improving women’s utilization of antenatal care, delivery at health facility and postnatal care services. Methods A cross sectional household survey was conducted in early 2012 in two districts of northern and south central parts of Ethiopia. Data were collected from 4949 women who had delivered in the two years preceding the survey. Logistic regression analysis was performed to determine the association between visit by Health Extension Workers during pregnancy and use of maternal health services, controlling for the effect of other confounding factors. Results The non–adjusted analysis showed that antenatal care attendance at least four times during pregnancy was significantly associated with visit by Health Extension Workers [Odds Ratio 3.46(95% CI 3.07,3.91)], whereas health facility delivery (skilled attendance at birth) was not significantly associated with visit by Health Extension Workers during pregnancy [Odds Ratio 0.87(95% CI 0.25,2.96)]. When adjusted for other factors the association of HEWs visit during pregnancy was weaker for antenatal care attendance [Adjusted Odds Ratio: 1.35(95% CI: 1.05, 1.72)] but positively and significantly associated with health facility delivery [Adjusted Odds Ratio 1.96(1.25,3.06)]. Conclusion In general HEWs visit during

  17. Place de la laparoscopie dans la prise en charge des anomalies de différenciation sexuelle: à propos de 4 cas

    PubMed Central

    Goultaiene, Aissam; Elmortaji, Khalid; Sentissi, Reda; Moataz, Amine; Rabii, Redouane; Aboutaib, Rachid; Dakir, Mohammed; Debbagh, Adil; Meziane, Fethi

    2016-01-01

    Les troubles de la différenciation sexuelle sont à l'origine d'une discordance entre le sexe proprement dit (phénotypique) et le sexe génétique (génotypique) ce qui pose un problème de détermination du sexe. Dans les pays de faible niveau socio-économique où le diagnostic anténatal est souvent absent et les plateaux techniques insuffisants, la prise en charge médico-chirurgicale est difficile. Le but de ce travail est de préciser la place de la laparoscopie dans la prise en charge de l'ambiguïté sexuelle à travers l'observation de 4 cas et une revue de la littérature. PMID:27303583

  18. Prise en charge conservatrice des hématomes puerpéraux de gros volume: à propos de 3 cas

    PubMed Central

    Kehila, Mehdi; Khedher, Sonia Ben; Zeghal, Dorra; Mahjoub, Sami

    2013-01-01

    L'hématome puerpéral est une complication rare parfois grave du post-partum. Sa prise en charge reste encore non consensuelle. L'objectif de notre travail est de discuter la possibilité et l'intérêt d'une prise en charge conservatrice en cas d'hématome de gros volume sous couvert de certaines conditions. Ainsi nous rapportons 3 cas d'hématomes péri- génitaux de taille supérieure à 8cm pour lesquels un traitement conservateur a été préconisé. L'évolution était favorable pour les 3 patientes. PMID:24570780

  19. Epidémiologie et prise en charge des infections du per-partum à la maternité du centre hospitalier départemental de l'Ouémé-Plateau au Bénin

    PubMed Central

    Saizonou, Jacques; Ouédraogo, Laurent; Paraiso, Moussiliou Noël; Ayélo, Paul; Kpozèhouen, Alphonse; Daraté, René; Traoré, Esther

    2014-01-01

    Introduction La présente étude avait pour objectif de mesurer l'ampleur des infections du per-partum à la maternité du Centre Hospitalier Départemental de l'Ouémé-Plateau d'analyser les conditions de survenue et de prise en charge dans la perspective de l'amélioration des soins et services maternels et néonataux. Méthodes Une étude descriptive et analytique a été conduite de Août 2009 à Février 2010 et a impliqué 110 mères victimes d'infections du per-partum; elles ont été soumises à un questionnaire durant tout leur séjour hospitalier; des observations des pratiques de prise en charge des prestataires de soins ont été menées et des registres et autres supports de données sanitaires ont été exploités. L'analyse des données a été effectuée à l'aide du logiciel Epi Info 6.4 dans sa version française. Résultats L'incidence des infections du per-partum était de 5,9 pour 100 accouchements (110/ 1875); les types d'infections les plus incriminés étaient les endométrites (27,3%), les chorioamniotites (18,2%), les infections du site opératoire (12,7%) et les infections urinaires (2,7%). Les examens cliniques ont été relativement acceptables. En revanche, les examens biologiques ont été très insuffisants expliquant l'imprécision importante au niveau des diagnostics. L'antibiothérapie a été instaurée systématiquement. Le taux de mortinaissance était de 25,6% et les enfants de petit poids représentaient 23,2%. Conclusion L'incidence des infections du per-partum dans la présente étude était assez élevée. Des efforts de préventions et de dépistage de ces infections sont nécessaire afin d'améliorer la qualité des soins PMID:25120854

  20. Difficultes de Prise en Charge des Brulures Electriques par Haut Voltage: a propos d’un cas

    PubMed Central

    Mejjati, H.; Tourabi, K.; Arrob, A.; Moussaoui, A.; Ihrai, H.

    2010-01-01

    Summary Les brûlures électriques à haut voltage sont caractérisées par leur potentialité évolutive avec une extension en profondeur et une destruction tissulaire étendue dont les conséquences fonctionnelles sont considérables. La prise en charge de ces brûlures électriques se trouve toujours compliquée par un problème essentiel représenté par la difficulté diagnostique qui sous-évalue régulièrement la profondeur et l’étendue de ces lésions: en effet la nécrose cutanée s’étend progressivement jusqu’au quatrième jour à cause des thromboses vasculaires extensives, et par conséquent le diagnostic d’étendue et de profondeur de ces brûlures est difficile avant le quatrième jour. Nous présentons le cas illustré d’un jeune patient admis dans notre formation pour des brûlures à haut voltage ayant bénéficié d’un traitement chirurgical à la phase aiguë et une réparation secondaire. PMID:21991228

  1. Soil cover patterns and SOC dynamics impacts on the soil processes, land management and ecosystem services in Central Region of Russia

    NASA Astrophysics Data System (ADS)

    Vasenev, Ivan; Chernikov, Vladimir; Yashin, Ivan; Geraskin, Mikhail; Morev, Dmitriy

    2014-05-01

    In the Central Region of Russia (CRR) the soil cover patterns usually play the very important role in the soil forming and degradation processes (SFP & SDP) potential and current rates, soil organic carbon (SOC) dynamics and pools, greenhouse gases (GHG) emissions and soluble SOC fluxes that we need take into attention for better assessment of the natural and especially man-changed ecosystems' services and for best land-use practices development. Central Region of Russia is the biggest one in RF according to its population and role in the economy. CRR is characterized by high spatial variability of soil cover due to as original landscape heterogeneity as complicated history of land-use practices during last 700 years. Our long-term researches include the wide zonal-provincial set of representative ecosystems and soil cover patterns with different types and history of land-use (forest, meadow-steppe and agricultural ones) from middle-taiga to steppe zones with different level of continentality. The carried out more than 30-years region- and local-scale researches of representative natural and rural landscapes in Tver', Yaroslavl', Kaluga, Moscow, Vladimir, Saransk (Mordovia), Kursk, Orel, Tambov, Voronezh and Saratov oblasts give us the interregional multi-factorial matrix of elementary soil cover patterns (ESCP) with different soil forming and degradation processes rates and soil organic carbon dynamics due to regionally specific soil-geomorphologic features, environmental and dominated microclimate conditions, land-use current practices and history. The validation and ranging of the limiting factors of SFP and SDP develop¬ment, soil carbon dynamics and sequestration potential, ecosystem (agroecosystem) principal services, land functional qualities and agroecological state have been done for dominating and most dynamical components of ESCP regional-typological forms - with application of SOC structure analysis, regional and local GIS, soil spatial patterns detail

  2. Analyse de la prise en charge du nouveau-né dans le cadre de la stratégie nationale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou (Burkina Faso)

    PubMed Central

    Ouédraogo, Solange Odile Yugbaré; Yougbaré, Nestor; Kouéta, Fla; Dao; Ouédraogo, Moussa; Lougué, Claudine; Ludovic, Kam; Traoré, Ramata Ouédraogo; Yé, Diarra

    2015-01-01

    Introduction Il s'agit d'analyser la prise en charge du nouveau-né dans le cadre de la stratégie na-tionale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence mis en place par le gouvernement du Burkina Faso en 2006. Méthodes Nous avons menée une étude à visée descriptive et analytique comportant un volet ré-trospectif du 01 janvier 2006 au 31 décembre 2010 portant sur les paramètres épidémiologiques, cliniques des nouveau-nés hospitalisés et un volet prospectif du 3 octobre 2011 au 29 février 2012 par une entrevue des accompagnateurs des nouveau-nés et des prestataires des services de santé. Résultats Les hospitalisations ont augmenté de 43,65% entre 2006 à 2010 Le taux de mortalité néo-natale hospitalière qui était de 11,04% a connu une réduction moyenne annuelle de 3,95%. L'entrevue a porté sur 110 accompagnateurs et 76 prestataires. La majorité des prestataires (97,44%) et des ac-compagnateurs (88,18%) étaient informés de la stratégie mais n'avait pas une connaissance exacte de sa définition. Les prestataires (94,74%) ont signalé des ruptures de médicaments, consommables médicaux et des pannes d’ appareils de laboratoire et d'imagerie. Parmi les accompagnateurs (89%) disaient être satisfaits des services offerts et (72,89%) trouvaient les coûts abordables mais évoquaient les difficultés du transport. Conclusion: La subvention a amélioré la prise en charge du nou-veau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. Conclusion La subvention a amélioré la prise en charge du nouveau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. PMID:26161166

  3. Preferences for Expansion of Public Services in Five West Central Wisconsin Counties. Report No. 8 of a Series on Quality of Life and Development in Northwestern Wisconsin, February 1976.

    ERIC Educational Resources Information Center

    Lambert, Virginia

    As part of a study of the quality of life in northwestern Wisconsin, 1974 sample populations (N=150 residents per county) from each of 4 west central counties (Dunn, Clark, Eau Claire, and Polk) were presented with a list of public service programs and asked if they should be "expanded", "kept the same", or "cut back". Percentages on comparable…

  4. Hymenoptera of Afghanistan and the central command area of operations: assessing the threat to deployed U.S. service members with insect venom hypersensitivity.

    PubMed

    Turbyville, Joseph C; Dunford, James C; Nelson, Michael R

    2013-01-01

    Insect venom hypersensitivity can pose a threat to personnel deployed to a combat zone but the exposure risk in Afghanistan is currently unknown. This study was designed to assess the threat of Hymenoptera stings and associated allergic reactions in Afghanistan. Hymenoptera species were collected during a deployment to southern Afghanistan from June 2010 through January 2011. The literature was also reviewed to determine species of medically important Hymenoptera recorded in the region. The U.S. Army theater electronic medical data system was mined for ICD-9 codes associated with insect stings to determine the number of theater medical clinic encounters addressing insect sting reactions. Three species of flying hymenoptera were commonly encountered during the study period: Vespa orientalis L., Polistes wattii Cameron, and Vespula germanica (F.). A literature review also confirms the presence of honeybees (Apidae), numerous velvet ant (Mutillidae) species, and various ant (Formicidae) species all capable of stinging. No evidence was identified to suggest that fire ants (Solenopsis ssp.) are a threat in the region. Based on electronic medical records from the U.S. Central Command area of operations over a 2-year period, roughly 1 in 500 clinic visits involved a patient with a diagnosis of insect bite or sting. Cross-reactive members of all five flying Hymenoptera species commonly assessed for in Hymenoptera allergy evaluations are present in Afghanistan. The review of in-theater medical records confirms that insect stings pose an environmental threat to deployed service members. PMID:23484895

  5. Le syndrome des brides amniotiques et ses difficultés diagnostiques et de prise en charge au Burkina Faso

    PubMed Central

    Nagalo, Kisito; Badiel, Roger; Kouéta, Fla; Tall, François Housséini; Yé, Diarra

    2015-01-01

    Le syndrome des brides amniotiques est une embryo-foetopathie rare, d’étiopathogénie encore inconnue, caractérisé par des malformations crânio-faciales, thoraco-abdominales, des membres et des extrémités. Afin de discuter des difficultés diagnostiques et thérapeutiques du syndrome des brides amniotiques, nous rapportons cinq cas de ce syndrome. Ces cas représentaient autant de phénotypes de la maladie mais avec quelques singularités. Les deux premiers étaient des cas de maladie des brides amniotiques caractérisés l'un par une amputation d'un membre inférieur associée à des lésions cutanées et à une surdité, l'autre par des strictions avec amputation des doigts associées à une fente labio-palatine, une cataracte congénitale et un strabisme. Les trois autres cas correspondaient à des formes létales du Limb Body Wall Complex dont deux avec attache placento-crânienne et un avec attache placento-abdominale. Le renforcement du diagnostic anténatal, l'instauration du conseil génétique et la mise en place d'un registre national des malformations devraient permettre d'améliorer la prise en charge des cas du syndrome des brides amniotiques. PMID:26113939

  6. Détection et prise en charge efficace à l’urgence d’une luxation de Lisfranc à faible vélocité

    PubMed Central

    Mayich, D. Joshua; Mayich, Michael S.; Daniels, Timothy R.

    2012-01-01

    Résumé Objectif Améliorer la capacité des médecins de soins primaires de reconnaître les mécanismes et les présentations courantes des luxations de Lisfranc à basse vélocité (LLF) et mieux faire comprendre le rôle de l’imagerie et les principes des soins primaires dans les cas de LLF à basse vélocité. Sources des données Une recension des ouvrages spécialisés dans MEDLINE a été effectuée et les résultats ont été résumés, concernant notamment l’anatomie et les mécanismes, les diagnostics cliniques et par imagerie et les principes de la prise en charge en milieu de soins primaires. Message principal Les LLF à basse vélocité sont le résultat de divers mécanismes et, à l’examen clinique et à l’imagerie, les signes révélateurs sont très peu perceptibles. Il faut donc un fort degré de suspicion et de prudence dans la prise en charge de ce type de blessure. Conclusion Si on met en pratique quelques principes thérapeutiques dans la prise en charge des LLF à basse vélocité, qui sont potentiellement dévastatrices si elles ne sont pas reconnues, et ce, dès leur présentation, il est possible d’optimiser l’issue de telles blessures.

  7. La place de la double arthrodèse dans la prise en charge du pied bot varus équin invétéré

    PubMed Central

    Atarraf, Karima; Arroud, Mounir; Chater, Lamiae; Afifi, My Abderrahmane

    2014-01-01

    La prise en charge du pied bot varus équin invétéré ( PBVEI) pose d’énormes problèmes thérapeutiques. La double arthrodèse sous-talienne et médio-tarsienne longtemps considérée comme la solution de sécurité pour ces déformations est encore couramment utilisée. Nous rapportons une série de 13 enfants opérés pour un pied bot varus équin invétérés (16 pieds) par Arthrodèse sous-talienne et médio tarsienne réalisée au service d'orthopédie pédiatrique du CHU Hassan II; de Fès au Maroc sur une période de 4 ans; étalée de janvier 2009 à décembre 2012. L’âge moyen de nos patients était de 12,6 ans avec prédominance féminine. L'origine congénitale était retrouvée chez 10 patients. L'atteinte était gauche chez 8 patients avec une localisation bilatérale chez 3 patients. La radiographie standard du pied de face et de profil a révélée une divergence talo-calcanéenne qui variait entre 5 et 20°, l'angle talus-1er métatarsien entre 20 et 40° (avec une moyenne de 28°) et l'angle calcanéus-5ème métatarsien entre 15° et 45° (avec une moyenne de 30°). Tous les patients ont bénéficiés d'une arthrodèse sous-talienne et médio tarsienne. Les résultats étaient satisfaisants dans 98% des cas. Le pied était plantigrade dans 9 cas, le varus de l'arrière pied persistait dans 4 pieds alors que l’équin et le varus de l'avant pied étaient notés chez 2 cas. La double arthrodèse est l'intervention idéale pour stabiliser et corriger les déformations rencontrées dans le PBVE invétéré, elle assure totalement le verrouillage du couple de torsion. Elle permet outre une correction des diverses déformations et une ré-axation de l'arrière-pied dans les 3 plans de l'espace. PMID:25829977

  8. Prise en charge en soins primaires des troubles liés à l’usage d’alcool et de la consommation à risque

    PubMed Central

    Spithoff, Sheryl; Kahan, Meldon

    2015-01-01

    Résumé Objectif Fournir aux médecins de soins primaires de l’information et des conseils fondés sur des données probantes sur le dépistage et l’évaluation de la consommation d’alcool à risque et des troubles liés à l’usage d’alcool (TUA). Sources des données Nous avons effectué une recherche documentaire non systématique en utilisant des expressions de recherche portant sur les soins primaires, les TUA, la dépendance à l’alcool, l’abus d’alcool, l’usage abusif d’alcool, la consommation d’alcool néfaste pour la santé, ainsi que le dépistage, la détermination et l’évaluation dans le contexte des soins primaires. Principaux messages Les médecins de famille devraient faire passer un test validé de dépistage de l’abus d’alcool à tous les patients, au moins une fois par année. Dépister les patients qui se présentent avec des problèmes médicaux ou psychosociaux pouvant être reliés à l’usage d’alcool. Déterminer si les patients qui obtiennent des résultats positifs lors du dépistage sont des consommateurs d’alcool à risque ou s’ils ont des TUA. Si les patients ont des TUA, déterminer si les troubles sont légers, modérés ou sévères en utilisant les critères de la 5e édition du Manuel diagnostique et statistique des troubles mentaux. Communiquer le diagnostic aux patients et leur offrir de l’aide. Effectuer une évaluation plus approfondie des patients ayant des TUA. Procéder à un dépistage de la consommation d’autres substances, des troubles concomitants et des traumatismes. Déterminer s’il est nécessaire de rapporter le cas aux services de protection de l’enfance ou au ministère des Transports. Déterminer les besoins en matière de prise en charge médicale du sevrage alcoolique. Effectuer un bref examen physique et prescrire l’exécution de tests de laboratoire pour évaluer la formule sanguine complète et les taux de transaminases hépatiques, comprenant les

  9. Profil épidémiologique et prise en charge de l’éclampsie au Sénégal: à propos de 62 cas

    PubMed Central

    Diouf, Abdoul Aziz; Diallo, Moussa; Mbaye, Magatte; Sarr, Sokhna Diarra; Faye-Diémé, Marie Edouard; Moreau, Jean Charles; Diouf, Alassane

    2013-01-01

    Introduction L'objectif de cette étude etait d'apprécier les caractéristiques épidémiologiques et cliniques de l’éclampsie et d’évaluer la prise en charge et le pronostic maternel et périnatal. Méthodes Étude descriptive rétrospective sur 3 années (2007-2010) dans un service de Gynécologie Obstétrique de Dakar (Sénégal). Le critère d'inclusion était toute crise convulsive en période gravido-puerpérale dans un contexte de prééclampsie. Résultats Sur un total de 4587 accouchements, 62 cas d’éclampsie étaient enregistrés représentant une incidence de 1,35%. Le profil retrouvé était celui d'une jeune femme (24 ans), primipare (58.1%), habitant la banlieue dakaroise (83.8%), porteuse d'une grossesse à terme (56.5%), mal suivie (82.3%) et référée par un poste de santé environnant (82.3%). La crise était survenue en antépartum et en post-partum dans 72.5 et 27,5% respectivement. Toutes les patientes présentaient une HTA ; l’‘dème et la protéinurie étaient retrouvés dans 72.5 et 84% respectivement. La majorité des patientes (88%) avait présenté plus de deux crises et l’état de mal éclamptique concernait 14.5% des cas. Le sulfate de magnésium était utilisé chez toutes les patientes. La césarienne était le mode d'accouchement largement adopté (75.5%) pour les patientes reçues en antépartum. Le pronostic maternel était marqué par un cas de décès. La mortalité périnatale était de 130%. Conclusion L’éclampsie est un problème de santé publique dans les pays en développement. Les principaux facteurs de risque sont la primiparité et l’âge jeûne. L'administration du sulfate de magnésium et la césarienne permettent d'améliorer le pronostic maternel et foetal. La prévention passe nécessairement par un suivi prénatal de qualité. PMID:24711873

  10. Report of a Study to Determine the Feasibility of Establishing a Central Foreign Credential Evaluation Service Under Non-Governmental Auspices.

    ERIC Educational Resources Information Center

    Frey, James F.

    The study was conducted to determine whether a non-governmental Foreign Credential Evaluation Service (FCES) should be established and if so, what services it would provide, what the demand for these services would be, and what financial resources it would require. A survey of admissions officers at 223 educational institutions and representatives…

  11. Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la lombalgie aiguë du patient africain

    PubMed Central

    Elleuch, Mohamed; El Maghraoui, Abdellah; Griene, Brahim; Nejmi, Mati; Ndongo, Souhaibou; Serrie, Alain

    2015-01-01

    La lombalgie aiguë est la pathologie rhumatismale la plus fréquente en Afrique. L’épidémiologie et la présentation clinique ne diffèrent pas de celles observées sur les autres continents. En revanche, les aspects psycho-sociaux, la disponibilité des traitements, l'accès aux soins et le poids culturel des médecines traditionnelles sont autant de spécificités qui ont conduit à la réalisation du 1er consensus d'experts en rhumatologie pour la prise en charge du patient africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 11 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. Leur ambition est d'améliorer la prise en charge de la lombalgie aigue par une évaluation initiale clinique pertinente, une diminution des examens radiologiques inutiles, une prescription médicamenteuse adéquate et l'abandon de procédures invasives inappropriées. PMID:26955427

  12. Faculty Perspectives on the Challenges and Benefits of Providing Service-Learning Pedagogy in Higher Education: An Historical Study of Ten Diverse Central Maryland Colleges and Universities

    ERIC Educational Resources Information Center

    MacKenzie, Diane E.

    2013-01-01

    Although service-learning is considered to be a fairly new pedagogy in U.S. institutions of higher education, its origins can be traced back to the mid-nineteenth century philosopher John Dewey and his "learn by doing" approach to education. Service-learning has gained popularity as a form of applied learning that helps increase…

  13. The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

    PubMed

    Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

    2014-05-01

    Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries. PMID:24742299

  14. Les conseils et la prise en charge en prévision d’une très grande prématurité

    PubMed Central

    Jefferies, Ann L; Kirpalani, Haresh M

    2012-01-01

    RÉSUMÉ En cas de très grande prématurité (accouchement entre la 220/7 et la 256/7 semaine d’âge gestationnel [AG]), les parents doivent souvent faire des choix complexes sur les soins de leur nourrisson. Les professionnels de la santé ont un rôle important à jouer en matière d’information, d’orientation et de soutien. Les parents qui font face à la naissance d’un très grand prématuré doivent avoir la possibilité de rencontrer les dispensateurs de soins obstétricaux et pédiatriques ou néonatals pour recevoir de l’information exacte sur le pronostic de leur nourrisson, transmise avec clarté et compassion. La prise de décision entre les parents et les professionnels de la santé doit découler d’un processus éclairé et partagé, et toutes les décisions de prise en charge doivent être consignées. Il est important de consulter un centre périnatal de soins tertiaires et d’y prévoir le transfert de la mère et du fœtus afin d’assurer leurs soins. Puisque la survie des nourrissons venus au monde avant 22 semaines complètes d’AG demeure rare, il est recommandé de ne pas intervenir, mais à 23, 24 et 25 semaines d’AG, il faut adapter les conseils sur les issues et la prise de décision à chaque nourrisson et à sa famille, compte tenu des facteurs qui influent sur le pronostic. Il faut prodiguer des soins palliatifs compatissants à tous les grands prématurés qui ne sont pas réanimés ou qui ne répondent pas à la réanimation.

  15. La prévention et la prise en charge de la douleur et du stress chez le nouveau-né

    PubMed Central

    2000-01-01

    Le présent énoncé est destiné aux professionnels de la santé qui s’occupent de nouveau-nés (prématurés ou à terme, jusqu’à un mois de vie). Il vise à sensibiliser les professionnels au fait que les nouveau-nés ressentent de la douleur, à fournir les assises physiologiques de la douleur néonatale ainsi que de l’examen et de la prise en charge du stress par les professionnels de la santé, à faire des recommandations pour réduire l’exposition des nouveau-nés aux stimulus nuisibles et pour réduire au minimum les résultats indésirables associés, ainsi qu’à recommander des interventions efficaces et sécuritaires qui soulagent la douleur et le stress.

  16. Comparison of Central Appalachian In-Service Elementary and Middle School Teachers' Understanding of Selected Light and Force and Motion Concepts

    ERIC Educational Resources Information Center

    Krall, Rebecca McNall; Christopher, John E.; Atwood, Ronald K.

    2009-01-01

    This descriptive study investigated whether elementary and middle school teachers in the Central Appalachian region were prepared to teach selected standards-based light, force and motion concepts they could reasonably be expected to teach. The study also sought to compare their preparedness for teaching these concepts. (Contains 7 figures and 7…

  17. Geographic variation in speed of seed germination in central Oregon ponderosa pine ( pinus ponderosa' dougl. ex laws). Forest Service research paper

    SciTech Connect

    Weber, J.C.; Sorensen, F.C.

    1992-03-01

    Variation in speed of seed germination was investigated among ponderosa pine trees representing 225 locations in central Oregon. Results suggested that at least some of the geographic variation is related to the severity of summer drought. In general, germination speed was greater in locations with short, drought-limited growing seasons. Levels of geographic variation were highest in the region having the steepest precipitation gradients. Most of the variation occurred, however, within locations.

  18. 36 CFR 200.1 - Central organization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Central organization. 200.1 Section 200.1 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE ORGANIZATION, FUNCTIONS, AND PROCEDURES Organization § 200.1 Central organization. (a) Central office. The national office of the Forest Service,...

  19. To designate the facility of the United States Postal Service located at 787 State Route 17M in Monroe, New York, as the "National Clandestine Service of the Central Intelligence Agency NCS Officer Gregg David Wenzel Memorial Post Office".

    THOMAS, 112th Congress

    Rep. Hayworth, Nan A. S. [R-NY-19

    2011-12-07

    08/29/2012 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  20. Establishment and maintenance of regulating ecosystem services in a dryland area of Central Asia: the Kökyar Protection Forest, Aksu, NW China, as an example

    NASA Astrophysics Data System (ADS)

    Missall, S.; Welp, M.; Thevs, N.; Abliz, A.; Halik, Ü.

    2014-12-01

    The city of Aksu, situated at the northern fringe of the Taklimakan Desert in the northwest of China, is exposed to periodic severe dust and sand storms. In 1986, local authorities decided to establish a peri-urban shelterbelt plantation, the so-called Kökyar Protection Forest. It was realised as a patchwork of poplar shelterbelts and orchards. The total area of the plantation reached 3800 ha in 2005. This endeavour was made possible by the annual mass mobilisation of Aksu citizens, based on the Chinese regulation of the "National Compulsory Afforestation Campaigns". Establishment costs amounted to ca. CNY 60 000 ha-1 (ca. USD 10 000 ha-1). The regulating ecosystem services provided by Kökyar Protection Forest clearly reduce dust and sand storm impacts on Aksu City. Permanent maintenance of the plantation is facilitated by leasing orchard plots to private fruit farmers. This system ensures forest tending, reduces government expenses, and provides incomes to farmers. From the perspective of the local economy, annual farming net benefits generated by Kökyar fruit farmers more than compensate annual government grants for maintenance, resulting in an overall monetary net benefit of at least CNY 10 500 ha-1 (ca. USD 1600 ha-1) on the long-term average. The intended regulating ecosystem services can thus be provided to the citizens of Aksu without payments for ecosystem services or other financial burdens. For a more complete understanding of Kökyar Protection Forest, future research should be directed towards quantifying the effect of its regulating ecosystem services, and on investigating the negative downstream consequences of its water consumption.

  1. Health workers sensitization: effects on perceived quality of immunization services among mothers of under five children in Ilorin, North Central Nigeria.

    PubMed

    Goodman, O O; Aderibigbe, S A; Sekoni, O O; Osagbemi, G K; Akande, T M

    2013-09-01

    Clients' satisfaction with services received is an important dimension of evaluation that is examined only rarely in developing countries. Health care professionals have always acknowledged that satisfying the consumers at some level is essential to providing services of high quality. This is a quasi-experimental study. The study group included 150 mothers bringing their children for immunization at Alanamu Health Centre, Ilorin. The control group included 150 mothers bringing their children for immunization at Okelele Health Centre. Total population of mothers bringing their children for vaccines against tuberculosis/poliomyelitis/hepatitis B (BCG/ OPV/HBV) and against diphterite-pertussis-tetanus (DPT)/OPV/ HBV were recruited sequentially until sample size was attained. Mean waiting time at pre-intervention was 82.7 +/- 32.5 and 90.4 +/- 41.7 minutes for the study and control groups respectively. Post intervention, there was a significant decrease (p < 0.05) in the estimated waiting time in the study group (mean = 48.0 +/- 24.4 minutes) while there was no observed difference in the control p > 0.05 (mean = 88.4 +/- 40.6 minutes). Perceived adequacy of information on services being provided by the health facility was low (58%) in the study group while it was relatively higher in the control group (80%) but there was a significant increase in proportion of those that felt information was adequate only in the study group (p < 0.05) at post intervention. Waiting time in health facilities by clients should be reduced as this may give clients a positive perception of the service they have come to access. Information dissemination to clients should be encouraged among health workers as this would affect clients' knowledge and also quality of health care delivery. PMID:24783892

  2. De l'hémoglobine SS à SF: intérêt de l'hydroxyurée dans la prise en charge de la drépanocytose chez 2 enfants congolais et revue de la literature

    PubMed Central

    Nkashama, Gayllord Mutoke; Wakamb, Gray Kanteng A; Mulangu, Augustin Mutombo; Nkashama, Georges Mutoke; Kupa, Boniface Kabeya; Numbi, Oscar Luboya

    2015-01-01

    La drépanocytose est une maladie grave par ses complications et par les difficultés liées à sa prise en charge, notamment en milieu sous-équipé. Les auteurs rapportent l'effet bénéfique de l'hydroxyurée dans la prise en charge de deux patients drépanocytaires, au prix cependant d'une surveillance hématologique rigoureuse. Une revue de la littérature étaye par ailleurs les modalités d'administration de ce médicament et les perspectives ultérieures d'un tel traitement dans la drépanocytose. PMID:26327961

  3. FASTER (Face, Arm, Speech, Time, Emergency Response): experience of Central Coast Stroke Services implementation of a pre-hospital notification system for expedient management of acute stroke.

    PubMed

    O'Brien, W; Crimmins, D; Donaldson, W; Risti, R; Clarke, T A; Whyte, S; Sturm, J

    2012-02-01

    Despite benefit in acute ischaemic stroke, less than 3% of patients receive tissue plasminogen activator (tPA) in Australia. The FASTER (Face, Arm, Speech, Time, Emergency Response) protocol was constructed to reduce pre-hospital and Emergency Department (ED) delays and improve access to thrombolysis. This study aimed to determine if introduction of the FASTER protocol increases use of tPA using a prospective pre- and post-intervention cohort design in a metropolitan hospital. A pre-hospital assessment tool was used by ambulance services to screen potential tPA candidates. The acute stroke team was contacted, hospital bypass allowed, triage and CT radiology alerted, and the patient rapidly assessed on arrival to ED. Data were collected prospectively during the first 6 months of the new pathway and compared to a 6-month period 12 months prior to protocol initiation. In the 6 months following protocol introduction, 115 patients presented within 24 hours of onset of an ischaemic stroke: 22 (19%) received thrombolysis, significantly greater than five (7%) of 67 patients over the control period, p=0.03. Overall, 42 patients were referred via the FASTER pathway, with 21 of these receiving tPA (50%). One inpatient stroke was also treated. Only two referrals (<5%) were stroke mimics. Introduction of the FASTER pathway also significantly reduced time to thrombolysis and time to admission to the stroke unit. Therefore, fast-track referral of potential tPA patients involving the ambulance services and streamlined hospital assessment is effective and efficient in improving patient access to thrombolysis. PMID:22118794

  4. Establishment and maintenance of regulating ecosystem services in a dryland area of central Asia, illustrated using the Kökyar Protection Forest, Aksu, NW China, as an example

    NASA Astrophysics Data System (ADS)

    Missall, S.; Welp, M.; Thevs, N.; Abliz, A.; Halik, Ü.

    2015-06-01

    The city of Aksu, situated at the northern fringe of the Taklimakan Desert in northwest China, is exposed to severe periodic dust and sand storms. In 1986, local authorities decided to establish a peri-urban shelterbelt plantation, the so-called Kökyar Protection Forest, with the aim of reducing dust and sand storm impacts on Aksu City by the regulating ecosystem services provided by the plantation. It was realised as a patchwork of poplar shelterbelts and orchards. The total area of the plantation reached 3800 ha in 2005. The Kökyar Protection Forest is used as a case study to answer the following question: under which institutional frameworks and to which financial conditions can peri-urban shelterbelts be established and maintained? The endeavour of planting the shelterbelt was made possible by the annual mass mobilisation of Aksu citizens, based on the Chinese regulation of the "National Compulsory Afforestation Campaigns". Establishment costs amounted to ca. CNY 60 000 ha-1 (ca. USD 10 000 ha-1). Permanent maintenance of the plantation is facilitated by leasing orchard plots to private fruit farmers. From the perspective of the local economy, annual farming net benefits generated by Kökyar fruit farmers more than compensate for annual government grants for maintenance, resulting in an average overall monetary net benefit of at least CNY 10 500 ha-1 (ca. USD 1600 ha-1) in the long term. For a more complete understanding of Kökyar Protection Forest, future research should be directed towards quantifying the effect of its regulating ecosystem services and on investigating the negative downstream consequences of its water consumption.

  5. 47 CFR 22.1005 - Priority of service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Offshore Radiotelephone Service § 22.1005 Priority of service. Facilities in the Offshore Radiotelephone Service are intended primarily for rendition of public message service between offshore subscriber and... subsequently requesting public message service from an offshore central station....

  6. Estimates of future water demand for selected water-service areas in the Upper Duck River basin, central Tennessee; with a section on Methodology used to develop population forecasts for Bedford, Marshall, and Maury counties, Tennessee, from 1993 through 2050

    USGS Publications Warehouse

    Hutson, S.S.; Schwarz, G.E.

    1996-01-01

    Estimates of future water demand were determined for selected water-service areas in the upper Duck River basin in central Tennessee through the year 2050. The Duck River is the principal source of publicly-supplied water in the study area providing a total of 15.6 million gallons per day (Mgal/d) in 1993 to the cities of Columbia, Lewisburg, Shelbyville, part of southern Williamson County, and several smaller communities. Municipal water use increased 19 percent from 1980 to 1993 (from 14.5 to 17.2 Mgal/d). Based on certain assumptions about socioeconomic conditions and future development in the basin, water demand should continue to increase through 2050. Projections of municipal water demand for the study area from 1993 to 2015 were made using econometric and single- coefficient (unit-use) requirement models of the per capita type. The models are part of the Institute for Water Resources-Municipal and Industrial Needs System, IWR-MAIN. Socioeconomic data for 1993 were utilized to calibrate the models. Projections of water demand in the study area from 2015 to 2050 were made using a single- coefficient requirement model. A gross per capita use value (unit-requirement) was estimated for each water-service area based on the results generated by IWR-MAIN for year 2015. The gross per capita estimate for 2015 was applied to population projections for year 2050 to calculate water demand. Population was projected using the log-linear form of the Box-Cox regression model. Water demand was simulated for two scenarios. The scenarios were suggested by various planning agencies associated with the study area. The first scenario reflects a steady growth pattern based on present demographic and socioeconomic conditions in the Bedford, Marshall, and Maury/southern Williamson water-service areas. The second scenario considers steady growth in the Bedford and Marshall water-service areas and additional industrial and residential development in the Maury/southern Williamson water-service

  7. 78 FR 21401 - Notice of Inventory Completion: Central Washington University, Ellensburg, WA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Notice of Inventory Completion: Central Washington University, Ellensburg, WA AGENCY: National Park Service, Interior. ACTION: Notice. ] SUMMARY: Central Washington University has completed an... remains should submit a written request to Central Washington University. If no additional requestors...

  8. Central line infections - hospitals

    MedlinePlus

    ... infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired infection - central line infection; Patient safety - central ...

  9. Epithéliomas basocellulaires de la face: prise en charge chirurgicale, à propos de 45 cas et revue de la literature

    PubMed Central

    Ennouhi, Mohamed Amine; Moussaoui, Abdenacer

    2014-01-01

    L’épithélioma basocellulaire est de loin la tumeur épithéliale maligne la plus répandue. L'atteinte faciale représente plus de 65% des cas et constitue un facteur de risque de récidive. L'objectif de notre travail est de rappeler les principes et modalités du traitement chirurgical. Sur une période de douze mois, nous avons pris en charge quarante-cinq patients atteints de carcinomes basocellulaires de la face. Le traitement chirurgical comprend deux volets: -carcinologique: emportant la tumeur et une marge de tissu sain; -et une chirurgie réparatrice faisant appel à la suture cutanée directe; greffes ou lambeaux loco -régionaux. L'examen histologique systématique des pièces opératoires permet la confirmation du diagnostic, le typage histologique et l'appréciation de la qualité de l'exérèse chirurgicale. Les résultats esthétiques sont jugés satisfaisants. Quant aux résultats carcinologiques, nous déplorons quatre récidives. Le traitement chirurgical des épithéliomas basocellulaires est le seul garant de la guérison. Au niveau de la face, il faut trouver le meilleur compromis entre impératifs carcinologiques et esthétiques. L'amélioration des résultats passe par: la prévention, le dépistage précoce des lésions, la collaboration étroite des anatomo-pathologistes et la création de comités de concertation pluri -disciplinaire pour la prise en charge des cas difficiles. PMID:25709738

  10. Lignes directrices sur la prise en charge en soins primaires des céphalées chez l’adulte

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Résumé Objectif Accroître l’utilisation d’approches éclairées par des données probantes pour diagnostiquer, investiguer et traiter en soins primaires les céphalées des patients. Qualité des données Une recherche documentaire exhaustive a été effectuée pour trouver des lignes directrices et des révisions systématiques publiées entre janvier 2000 et mai 2011. La grille d’évaluation de la qualité des recommandations pour la pratique clinique AGREE a servi à l’analyse critique des lignes directrices. Les 6 guides de pratique clinique de la plus grande qualité ont servi de base dans le processus d’adaptation. Message principal Un groupe d’élaboration multidisciplinaire de professionnels des soins primaires ont formulé 91 recommandations précises à l’aide d’un processus consensuel. Les recommandations portent sur le diagnostic, l’investigation et la prise en charge de la migraine, de la céphalée de tension, de la céphalée due à une surmédication et de la céphalée vasculaire de Horton. Conclusion Un guide de pratique clinique adapté au contexte des soins de santé au Canada a été produit en suivant un processus d’adaptation de lignes directrices dans le but d’aider les professionnels de toutes les disciplines des soins primaires à dispenser des soins éclairés par des données probantes aux patients souffrant de céphalées.

  11. Prise en charge en cabinet des lésions cérébrales traumatiques légères chez les enfants et les adolescents

    PubMed Central

    Garcia-Rodriguez, Juan Antonio; Thomas, Roger E.

    2014-01-01

    Résumé Objectif Fournir aux médecins de famille de l’information à jour, pratique et factuelle sur les lésions cérébrales traumatiques légères et les commotions cérébrales dans la population pédiatrique. Sources d’information Une recherche a été effectuée dans MEDLINE (de 1950 à février 2013), la base de données des revues systématiques Cochrane (de 2005 à 2013), le registre central Cochrane des essais contrôlés (de 2005 à 2013) et DARE (2005 à 2013) à l’aide de mots-clés liés aux commotions cérébrales et aux traumatismes crâniens. Des lignes directrices, énoncés de position, articles et rapports de recherche originaux pertinents aux lésions cérébrales traumatiques légères ont été sélectionnés. Message principal Le traumatisme est la cause principale de décès chez les enfants de plus d’un an et, dans ce groupe, le traumatisme crânien est la cause la plus fréquente d’incapacité et de décès. Neuf pour cent des blessures sportives rapportées chez les élèves du secondaire sont associées à une lésion cérébrale traumatique légère. Les médecins de famille doivent effectuer une anamnèse ciblée et un examen physique et neurologique, utiliser les instruments d’évaluation standardisés (Échelle de Glasgow; Outil d’évaluation des commotions cérébrales dans le sport, version 3; version pédiatrique de l’Outil d’évaluation des commotions cérébrales dans le sport; et échelle BESS [Balance Error Scoring System]), expliquer aux parents comment surveiller leurs enfants, décider des circonstances où les soignants ne sont pas une ressource dûment responsable, faire un suivi prompt auprès des patients, guider le retour sécuritaire au jeu ou à l’école et décider dans quelles circonstances un test neuropsychologique est nécessaire au suivi à long terme. Conclusion La prise en charge par le médecin de famille des lésions cérébrales traumatiques légères chez les enfants repose sur une

  12. Prise en charge des complications des fistules artério-veineuses pour hémodialyse chronique

    PubMed Central

    Jiber, Hamid; Zrihni, Youssef; Zaghloul, Rachid; Hajji, Rita; Zizi, Othman; Bouarhroum, Abdellatif

    2015-01-01

    La fistule artério-veineuse native est l'accès vasculaire de choix pour l'hémodialyse chronique en raison de sa longévité, son taux faible de complication et de mortalité par rapport aux pontages artério-veineux et aux cathéters. Cependant, il arrive assez souvent que l'on assiste à des complications qui sont dominées par la sténose et la thrombose. C'est une étude rétrospective des complications ayants survenues pour 31 fistules artério-veineuses pour hémodialyse chronique des 200 fistules réalisées chez 200 patients au sein du service de chirurgie vasculaire du CHU Hassan II de Fès sur une période de trois ans, étendue de Janvier 2007 à Décembre 2009. Ces complications ont été présentés par les thromboses dans 14 cas soit 45,15% de l'ensemble des complications, les sténoses dans 4 cas (12,90%,) les anévrismes dans 4 cas (12,90%), les complications ischémiques dans 3 cas (9,67%), l'infection dans 3 cas (9,67%), l'hémorragie dans 2 cas (6,45%) et l’ hyperdébit dans un seul cas soit 3,22%. On a pu conserver 22 fistules soit 70,96% par traitement chirurgical ou endovasculaire, on a confectionné une nouvelle fistule dans 8 cas soit 25,80%, et on a adressé une patiente (3,22%) pour pose d'un cathéter veineux tunnelisé permanent. Les complications des fistules artério-veineuses pour l'hémodialyse chronique sont la principale cause de morbidité chez les patients hémodialysés, il est donc important de s'impliquer lors de leur création, et de donner un maximum d'attention quand ils sont manipulés. Ceci suggère la mise en place d'un programme de surveillance de ces fistules en raison de l'impact des complications sur la morbi-mortalité du patient hémodialysé et sur le plan financier. PMID:26113933

  13. Prise de suppléments multivitaminiques pour la prévention primaire des anomalies congénitalies

    PubMed Central

    Morin, Pascale; Demers, Karine; Giguère, Christine; Tribble, Denise St-Cyr; Lane, Julie

    2007-01-01

    RÉSUMÉ OBJECTIF Déterminer si les recommandations véhiculées par les professionnels de la santé sur l’importance de l’acide folique encouragent les femmes susceptibles de procréer de prendre les suppléments d’acide folique. CONCEPTION Enquête. CONTEXTE Centre de santé et de services sociaux, Institut universitaire de gériatrie de Sherbrooke, à Sherbrooke, Qué. PARTICIPANTS 323 femmes francophones âgées entre 18 et 45 ans. PRINCIPALES MESURES DES RÉSULTATS La consommation de suppléments de vitamines et de minéraux au cours de la dernière année. Des analyses statistiques descriptives et bivariées et une modélisation par régression logistique ont été effectuées pour déterminer si l’association observée entre la recommandation d’un professionnel de la santé et la consommation de vitamines et de minéraux persistait après avoir tenu compte de l’effet des variables de contrôle (consultation de documentation, connaissances, sources d’information, perception, âge, scolarité, revenu, état matrimonial, intention de devenir enceinte). RÉSULTATS Environ 41% des femmes rapportent que leur médecin leur avait recommandé de consommer un supplément de vitamines et de minéraux. Après avoir ajusté toutes les variables dans le modèle, il est apparu que le fait de se faire recommander par un professionnel de la santé de prendre un supplément de vitamines et de minéraux était significativement associé à la consommation de vitamines et de minéraux par les femmes susceptibles de devenir enceintes. CONCLUSION Les professionnels peuvent améliorer la santé de la population par une pratique clinique préventive. Nous soulignons l’importance de soutenir ces derniers dans leurs efforts d’intégrer puis d’appliquer des connaissances scientifiques dans leur pratique. PMID:18077754

  14. Evaluation de la qualité de la prise en charge de la dyspnée par les médecins généralistes à Parakou en 2013

    PubMed Central

    Codjo, Léopold Houétondji; Dohou, Serge Hugues; Agbodandé, Anthèlme; Karimou, Bastu Mohamed; Wanvoegbe, Armand Finangnon; Attinsounon, Angelo Cossi; Alassani, Adébayo Cossi; Houénassi, Martin Dèdonougbo

    2015-01-01

    Introduction La dyspnée est un symptôme qui peut être l'expression de pathologies potentiellement grave et urgentes. Notre objectif était d’évaluer la qualité de la prise en charge de la dyspnée en milieu hospitalier à Parakou. Méthodes Il s'agissait d’étude rétrospective portant sur tous les patients admis dans les centres hospitaliers de Parakou pour dyspnée non traumatique entre le 1er Février 2012 et le 31 Mai 2013. Les recommandations tunisiennes sur la prise en charge de la dyspnée aux urgences ont été utilisées comme référentiel d’évaluation. Chaque étape de la démarche médicale a été notée et la prise en charge était bonne lorsque la note obtenue au score était entre 51 et 100. Les autres variables utilisées étaient la qualification du soignant principal, les antécédents du patient et les données cliniques et paracliniques. Résultats Sur les 11101 patients reçus aux urgences on a dénombré 328 cas de dyspnée (2,9%). La PEC était assuré principalement par les cardiologues (55,9%) et les médecins généralistes (29,2%). La qualité de la prise en charge par les généralistes était bonne chez 73,2%. Les facteurs associés à la bonne qualité de PEC étaient: la recherche des antécédents médicaux (84,4% vs 15,6%; p < 10-4), la description des caractéristiques cliniques de la dyspnée (94,1% vs 5,9%; p < 10-4) et la réalisation de l'examen physique complet (86,8% vs 13,2%; p < 10-4). Conclusion A Parakou en 2013 près d'un généraliste sur trois gère mal la dyspnée. Cette mauvaise gestion est liée à une mauvaise démarche médicale. PMID:26985268

  15. Options for Braille Centralization. Study I--Implementation Study of Centralized Braille Book Storage and Distribution System. Part 1--Options for Braille Centralization. Final Report.

    ERIC Educational Resources Information Center

    ManTech Technical Services Corp., Fairfax, VA.

    This final report presents results of the first phase of an effort to develop in detail the resource requirements, operating procedures, and estimated costs for several centralized braille service options at the Library of Congress. Existing procedures and services were analyzed, and three models for centralized braille services were formulated.…

  16. Central Italy

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Clouds and haze cover most of the Italian peninsula in this view of central Italy (41.5N, 14.0E) but the Bay of Naples region with Mt. Vesuvius and the island of Capri are clear. The Adriatic Sea in the background separates Italy from the cloud covered Balkans of eastern Europe and the Tyrrhenian Sea in the foreground lies between the Italian mainland and the off scene islands of Corsica and Sardinia. Several aircraft contrails can also be seen.

  17. 76 FR 20624 - Central Montana Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... Forest Service Central Montana Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Montana Resource Advisory Committee will meet in Stanford, Montana... committee members, replacement members and Forest Service personnel; (2) Selection of a chairperson by...

  18. Maximizing Financial and Operating Benefits of a Comprehensive Central Plant.

    ERIC Educational Resources Information Center

    Bhan, Chander

    2001-01-01

    Discusses the organizational and contractual concepts behind making a school's central plant's production more reliable and cost effective. A description of the Energy Services Coalition's contribution to the process and its services are highlighted. (GR)

  19. Les recommandations de prise en charge des complications métaboliques associées aux antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Ho, Josephine; Panagiotopoulos, Constadina; McCrindle, Brian; Grisaru, Silviu; Pringsheim, Tamara

    2012-01-01

    HISTORIQUE : Les antipsychotiques de deuxième génération s’associent souvent à des complications métaboliques. Ces médicaments sont utilisés plus souvent pour le traitement des troubles de santé mentale chez les enfants, ce qui a requis l’élaboration de lignes directrices officielles sur la surveillance de leur innocuité et de leur efficacité. Des lignes directrices ont déjà été élaborées pour surveiller les complications métaboliques et neurologiques. Afin d’aider les praticiens qui effectuent ces interventions de surveillance, une série de recommandations thérapeutiques complémentaires a été élaborée pour les cas où l’on observe des mesures ou des résultats anormaux. OBJECTIF : Créer des recommandations probantes afin de contribuer à la prise en charge des complications métaboliques chez les enfants traités au moyen d’antipsychotiques de deuxième génération. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des publications sur les complications métaboliques des antipsychotiques de deuxième génération chez les enfants. Les membres du groupe consensuel ont évalué l’information recueillie grâce à l’analyse bibliographique systématique et ont fait appel à un processus de groupe nominal pour parvenir à un consensus à l’égard de recommandations thérapeutiques. Dans la mesure du possible, ils se sont reportés aux lignes directrices existantes sur l’évaluation et le traitement des anomalies métaboliques chez les enfants. RÉSULTATS : Des recommandations probantes sont présentées pour contribuer à la prise en charge des complications métaboliques, y compris la prise de poids, l’augmentation du tour de taille, l’élévation des taux de prolactine, de cholestérol, de triglycérides et de glucose, les épreuves de fonction hépatique anormales et les études thyroïdiennes anormales. CONCLUSION : Il faut recourir à des mesures de surveillance convenables lorsqu’on prescrit

  20. The Preparation of Human Service Professionals.

    ERIC Educational Resources Information Center

    Gartner, Alan

    New forms of preparing workers in the human services have the potential of changing and improving those services. A central feature of the new forms of preparation is that they must both be preparatory for the services and be characteristic of them (for example, if the services are participatory in nature, the training should also be so). There is…

  1. Texas State Library Centralized Processing Center. Manual.

    ERIC Educational Resources Information Center

    Texas State Library, Austin.

    This manual of the Centralized Processing Center (CPC) was published in 1966 by the Texas State Library as an introduction to, and explanation of, its services. The CPC is defined as a service center which receives requests for material from member libraries, then orders, receives, classifies, catalogs, prepares catalog and shelf list cards, and…

  2. Hématome vulvaire massif du post-partum: à propos d'un cas à l'Hôpital Central de Yaoundé (Cameroun)

    PubMed Central

    Fouelifack, Florent Ymele; Fouogue, Jovanny Tsuala; Fouedjio, Jeanne Hortence; Sando, Zacharie; Mbu, Robinson Enow

    2014-01-01

    Les hématomes puerpéraux sont une cause rare d'hémorragie du post partum. Leur prise en charge adéquate nécessite une compétence et un plateau technique particulier. A notre connaissance, aucun cas n'a été publié au Cameroun. Nous rapportons le cas d'une femme de 37 ans, G3P2013, référée d'un dispensaire vers la maternité de l'hôpital Central de Yaoundé, en état de choc hémorragique survenu une heure après un accouchement facilité par des manœuvres digitales de dilatation vaginale. Elle a été prise en charge chirurgicalement pour un hématome vulvaire expansif. Ce cas nous permet d'attirer l'attention des praticiens sur la gravité et la singularité de cette pathologie hautement morbide qui pourrait être due à des manœuvres de dilatation digitale du vagin pendant le travail. PMID:25810803

  3. The EMBRACE web service collection

    PubMed Central

    Pettifer, Steve; Ison, Jon; Kalaš, Matúš; Thorne, Dave; McDermott, Philip; Jonassen, Inge; Liaquat, Ali; Fernández, José M.; Rodriguez, Jose M.; Partners, INB-; Pisano, David G.; Blanchet, Christophe; Uludag, Mahmut; Rice, Peter; Bartaseviciute, Edita; Rapacki, Kristoffer; Hekkelman, Maarten; Sand, Olivier; Stockinger, Heinz; Clegg, Andrew B.; Bongcam-Rudloff, Erik; Salzemann, Jean; Breton, Vincent; Attwood, Teresa K.; Cameron, Graham; Vriend, Gert

    2010-01-01

    The EMBRACE (European Model for Bioinformatics Research and Community Education) web service collection is the culmination of a 5-year project that set out to investigate issues involved in developing and deploying web services for use in the life sciences. The project concluded that in order for web services to achieve widespread adoption, standards must be defined for the choice of web service technology, for semantically annotating both service function and the data exchanged, and a mechanism for discovering services must be provided. Building on this, the project developed: EDAM, an ontology for describing life science web services; BioXSD, a schema for exchanging data between services; and a centralized registry (http://www.embraceregistry.net) that collects together around 1000 services developed by the consortium partners. This article presents the current status of the collection and its associated recommendations and standards definitions. PMID:20462862

  4. 75 FR 14436 - Ameren Corporation, Illinois Power Company, Central Illinois Light Company, Central Illinois...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Ameren Corporation, Illinois Power Company, Central Illinois Light Company, Central Illinois Public Service Company, Ameren Energy Resources Company, LLC, AmerenEnergy Resources Generating Company; Notice of Filing...

  5. Coordinated In-Service Activities for Health Occupations Teachers in Central Pennsylvania. Final Report. Vocational-Technical Education Research Report. Health Occupations, Monograph Number 8. Volume 16, Number 2 (Departmental Classification Number).

    ERIC Educational Resources Information Center

    Hole, F. Marvin; Byrd-Bredbenner, Debra Carol

    Three workshops were held in 1977 in central Pennsylvania to provide a coordinated effort to improve and expand the knowledge of health occupations teachers on the secondary and postsecondary levels. Each workshop provided five days of concentrated learning activities in one of the following areas: methods of instruction for health occupations…

  6. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  7. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  8. Reference Services.

    ERIC Educational Resources Information Center

    Bunge, Charles A.

    1999-01-01

    Discusses library reference services. Topics include the historical development of reference services; instruction in library use, particularly in college and university libraries; guidance; information and referral services and how they differ from traditional question-answering service; and future concerns, including user fees and the planning…

  9. H.R.3593 — 112th Congress (2011-2012) To designate the facility of the United States Postal Service located at 787 State Route 17M in Monroe, New York, as the "National Clandestine Service of the Central Intelligence Agency NCS Officer...

    THOMAS, 112th Congress

    Rep. Hayworth, Nan A. S. [R-NY-19

    2011-12-07

    08/29/2012 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions)

  10. The Emotional Component of Service-Learning

    ERIC Educational Resources Information Center

    Carson, Russell L.; Domangue, Elizabeth A.

    2013-01-01

    The interest in and acceptance of service-learning has insufficiently addressed the inextricable emotional linkage to all of its functions. Utilizing Coles' (1993) conceptualization of the intricate role of emotion in service-learning, this study explored how and why emotion and feeling are central to college students' service-learning…

  11. Service Learning in the Rural Community College.

    ERIC Educational Resources Information Center

    Holton, Nicholas

    Service learning is a pedagogical model that connects community service experiences with academic course learning. Large urban centers are often the leaders in developing service learning programs, due to the central locations of both institutions of higher education and community needs. This paper argues that rural areas have the same problems…

  12. Collection development at the NOAA Central Library

    NASA Technical Reports Server (NTRS)

    Quillen, Steve R.

    1994-01-01

    The National Oceanic and Atmospheric Administration (NOAA) Central Library collection, approximately one million volumes, incorporates the holdings of its predecessor agencies. Within the library, the collections are filed separately, based on their source and/or classification schemes. The NOAA Central Library provides a variety of services to users, ranging from quick reference and interlibrary loan to in-depth research and online data bases.

  13. Trusted Translation Services

    NASA Astrophysics Data System (ADS)

    Atif, Yacine; Serhani, Mohamed Adel; Campbell, Piers; Mathew, Sujith Samuel

    Administering multilingual Web sites and applications reliably, involves interconnected and multipart tasks, where trust in the involved parties and content translation sources is paramount. Published Web sites may reflect content from databases, content management systems and other repositories to manage related Web content. But a Web site mirrored wholly or selectively onto a target language version requires streamlined trusted processes. Traditionally, files are translated and transferred via FTP, e-mail, or other communication means. Similarly, translation instructions are communicated between involved parties through verbal instruction, e-mail, and instruction files lead to a variety of inconsistencies and lack of trust in the translation process. This paper proposes a Web service approach to streamline the translation processes and an integration of trust properties in the proposed translation Web services. Web Services have been instrumental in handling problems inherent to systems integration, allowing web-based systems to converse and communicate data automatically. The OASIS Translation Web Services Technical Committee has released a standard way for Web Services to serve the translation and localization business. This article proposes a framework to centralize translation services at a reputable source providing a workflow and a mechanism to quantify service trust. An implementation of the framework is also described in the context of a localization case study.

  14. Prise en charge d'une menace d'accouchement prématuré sur béance cervico-utérine au moyen d'un pessaire-cerclage obstétrical

    PubMed Central

    Nohuz, Erdogan; Albaut, Maël; Brunel, Angélique; Champel, Nadine; Pellizzaro, Julie; Gallot, Denis; Lemery, Didier; Vendittelli, Françoise

    2015-01-01

    Nous rapportons le recours efficace à un pessaire dans la prise en charge d'une menace d'accouchement prématuré. Une patiente de 28 ans, G2P1, ayant présenté une fausse-couche tardive à 20 semaines d'aménorrhée (SA) un an auparavant, bénéficiait d'un cerclage cervical à 15 SA. L’échographie endovaginale réalisée à 24 SA (sensation de pesanteur pelvienne) révélait un funnelling majeur et une longueur cervicale à 7 mm. Un pessaire obstétrical permettait la poursuite de la grossesse jusqu'au terme de 36 SA. Ce dispositif semble intéressant chez des patientes présentant une béance cervico-isthmique et chez qui un cerclage cervical s'est révélé inefficace. PMID:26161207

  15. Orthopedic services

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007455.htm Orthopedic services To use the sharing features on this page, please enable JavaScript. Orthopedics, or orthopedic services, is the medical specialty that involves the treatment ...

  16. Centralized industrial waste pretreatment

    SciTech Connect

    Palmer, L.H.; Cunningham, D.P.

    1991-11-01

    Four years ago, the Sanitary District of Washington County, Maryland asked the Economic Development Commission and the elected officials what if' the district researched the potential for a centralized industrial waste treatment facility for the county. The reason: about a dozen privately and publicly owned industrial parks cover almost 809 ha (2,000 ac) of Washington County. Most of them opened during the 1980s and all of them are within minutes of two superhighways. The county, which has 120,000 residents, is also home to 20 trucking companies and the main lines of CSX, Conrail, and Norfolk Southern, the largest railroads east of the Mississippi River. The county is home to Mack Trucks Engine and Transmissions facility, Rohr Industries (formally Fairchild Industries), Citicorp Credit Services, Rust-Oleum, Certain-teed PVC products, and many more. Because the county has a strong economic base, reasonable property taxes, and an exceptionally clean environment, the idea for an industrial pretreatment facility was met with enthusiasm from both parties and, therefore, the idea became a concept for planning in winter 1987-88. Plans for serving targeted industries and for isolating and controlling individual wastes discharges are discussed.

  17. Aspects cliniques des cancers bronchopulmonaires primitifs au service d'oncologie du CHUA-HUJRA Antananarivo

    PubMed Central

    Refeno, Valéry; Hasiniatsy, Nomeharisoa Rodrigue Emile; Andrianandrasana, Ny Ony Tiana Florence; Ramahandrisoa, Andriatsihoarana Voahary Nasandratriniavo; Rakotonarivo, Jean Marc; Maevazaka, Joée Larissa; Rakotovao, Hanitrala Jean Louis; Rafaramino, Florine

    2015-01-01

    Le retard de diagnostic des cancers broncho-pulmonaires est l'une des sources du retard de leur prise en charge dans les pays en développement. A notre connaissance, l'aspect clinique des cancers broncho-pulmonaires au Centre Hospitalier Universitaire d'Antananarivo-Hôpital Universitaire Joseph Ravoahangy Andrianavalona (CHUA-HUJRA) n'a jamais été étudié. L'objectif était de décrire les aspects cliniques des cancers broncho-pulmonaires primitifs dans le plus grand centre de cancérologie de Madagascar. C'est une étude rétrospective et descriptive des patients atteints de cancers broncho-pulmonaires primitifs vus au service d'oncologie du CHUA-HUJRA du 1er janvier 2008 au 31 décembre 2013. Nous avons recensé 101 patients (80 hommes et 21 femmes). Les circonstances de découverte sont principalement la toux chronique (n = 29), la dyspnée (n = 16) et l'association d'une hémoptysie à la toux chronique (n = 12). Soixante et onze patients avaient un index de performans status ≥ à 2 au moment du diagnostic. On a retrouvé des bacilles de Koch actives dans le crachat de deux patients. Le délai moyen entre l'apparition des premiers signes et la première consultation était de 11 mois. Le délai moyen entre la première consultation et le diagnostic anatomopathologique était de 3 mois. Le cancer broncho-pulmonaire peut avoir des manifestations cliniques non spécifiques parfois trompeuses qui peuvent retarder leur prise en charge. De ce fait, il doit être recherché devant tout signe respiratoire persistant. Par ailleurs, le délai de prise en charge pré-hospitalière et hospitalière de ces cancers doit être amélioré. PMID:26958134

  18. Central sleep apnea

    MedlinePlus

    ... pressure (CPAP) , bilevel positive airway pressure (BiPAP) or adaptive servo-ventilation (ASV). Some types of central sleep ... et al. The treatment of central sleep apnea syndromes in adults: practice parameters with an evidence-based ...

  19. Central venous catheters - ports

    MedlinePlus

    Central venous catheter - subcutaneous; Port-a-Cath; InfusaPort; PasPort; Subclavian port; Medi - port; Central venous line - port ... catheter is attached to a device called a port that will be under your skin. The port ...

  20. Central Neuropathic Pain Syndromes.

    PubMed

    Watson, James C; Sandroni, Paola

    2016-03-01

    Chronic pain is common in patients with neurologic complications of a central nervous system insult such as stroke. The pain is most commonly musculoskeletal or related to obligatory overuse of neurologically unaffected limbs. However, neuropathic pain can result directly from the central nervous system injury. Impaired sensory discrimination can make it challenging to differentiate central neuropathic pain from other pain types or spasticity. Central neuropathic pain may also begin months to years after the injury, further obscuring recognition of its association with a past neurologic injury. This review focuses on unique clinical features that help distinguish central neuropathic pain. The most common clinical central pain syndromes-central poststroke pain, multiple sclerosis-related pain, and spinal cord injury-related pain-are reviewed in detail. Recent progress in understanding of the pathogenesis of central neuropathic pain is reviewed, and pharmacological, surgical, and neuromodulatory treatments of this notoriously difficult to treat pain syndrome are discussed. PMID:26944242

  1. Survey: National Environmental Satellite Service

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The national Environmental Satellite Service (NESS) receives data at periodic intervals from satellites of the Synchronous Meteorological Satellite/Geostationary Operational Environmental Satellite series and from the Improved TIROS (Television Infrared Observational Satellite) Operational Satellite. Within the conterminous United States, direct readout and processed products are distributed to users over facsimile networks from a central processing and data distribution facility. In addition, the NESS Satellite Field Stations analyze, interpret, and distribute processed geostationary satellite products to regional weather service activities.

  2. Central Police Dispatch: An Exemplary Project.

    ERIC Educational Resources Information Center

    McDonnell, John J.

    The document presents a description of the Central Police Dispatch (PCD) system of Muskegon County, Michigan. The CPD, a civilian-staffed organization, is concerned with the regionalization of police services and improved police communications. The development of the CPD is traced from the Muskegon Interlocal Public Agency (1969-72) to the present…

  3. Fishing for Novel Approaches to Ecosystem Service Forecasts

    EPA Science Inventory

    The ecosystem service concept provides a powerful framework for conserving species and the environments they depend upon. Describing current distributions of ecosystem services and forecasting their future distributions have therefore become central objectives in many conservati...

  4. [Local, central and regional functions. Obsolete concepts?].

    PubMed

    Stene-Larsen, G; Bjørnstad, E; Bergesen, O; Nordhaug, B; Abildgaard, U

    1990-11-30

    As a consequence of the regionalization of the health services in Norway hospitals were given either local, central or regional responsibility. This system was intended to improve the availability of expertise and costly equipment, and at the same time reduce the growth of expenditures on health care. In the last few years, however, many of the smaller hospitals have improved their technical and medical skills to such an extent that this classification system has become less meaningful. Aker hospital in Oslo carries out local, central and regional functions. In a prospective study at this hospital we found that 88% of 980 consecutive medical admissions could be classified as local hospital admissions. Only 5% of the patients needed service at the central level, and 5% at the regional level. In our opinion it would suffice to have two types of hospital ("treatment levels"), standard hospitals and referral hospitals. PMID:2274952

  5. 76 FR 10563 - Nominations for the Western and Central Pacific Fisheries Commission Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-25

    ... Pacific Fisheries Commission Advisory Committee AGENCY: National Marine Fisheries Service (NMFS), National... under the Western and Central Pacific Fisheries Convention Implementation Act (Act). The advisory... Central Pacific Fisheries Convention (Convention), will be given the opportunity to provide input to...

  6. 78 FR 1837 - Nominations for the Western and Central Pacific Fisheries Commission Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-09

    ... Pacific Fisheries Commission Advisory Committee AGENCY: National Marine Fisheries Service (NMFS), National... under the Western and Central Pacific Fisheries Convention Implementation Act (Act). The advisory... Central Pacific Fisheries Convention (Convention), will be given the opportunity to provide input to...

  7. 24 CFR 578.53 - Supportive services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... transportation costs and a cell phone to be used by the individual performing the outreach. (ii) Component...) Developing, securing, and coordinating services; (iii) Using the centralized or coordinated assessment...

  8. 24 CFR 578.53 - Supportive services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... transportation costs and a cell phone to be used by the individual performing the outreach. (ii) Component...) Developing, securing, and coordinating services; (iii) Using the centralized or coordinated assessment...

  9. Service-Learning: Motivations for K-12 Teachers

    ERIC Educational Resources Information Center

    Krebs, Marjori M.

    2006-01-01

    The purpose of this dissertation is to describe the essence of the service-learning experience for K-12 teachers in central and northwest Ohio, specifically exploring teacher motivations for initiating service-learning in the classroom. Service-learning is defined as an educational methodology that incorporates student preparation, service to the…

  10. Planning National Radiotherapy Services

    PubMed Central

    Rosenblatt, Eduardo

    2014-01-01

    Countries, states, and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centers are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries, the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment. This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centers, equipment, staff, education programs, quality assurance, and sustainability aspects. Realistic budgetary and cost considerations must also be part of the project proposal or business plan. PMID:25505730

  11. Prising open the 'black box': An epistemological critique of discursive constructions of scaling up the provision of mental health care in Africa.

    PubMed

    Cooper, Sara

    2015-09-01

    Global mental health research is increasingly highlighting the high levels of untreated mental illness in Africa and calling for the scaling-up of services in order to redress this situation. A particular model of care is being strongly advocated for such scale-up, and a recent explosion of research is providing guidelines for its implementation. This article seeks to open up the 'black box' of international research on scaling up the provision of mental health care in Africa, unearthing the hidden assumptions and power dynamics underpinning the knowledge produced. It insists that gaining a better understanding of care provision demands that we not only fill the gaps in knowledge but also problematize the assumptions upon which existing knowledge is based. This article demonstrates how two interrelated paradigms are strongly mediating research in this area - those of 'scientific evidence' and 'human rights'. Drawing on recent research within the sociology of scientific knowledge, and strands of postcolonial thought, it demonstrates how these paradigms are both underpinned by several contentious epistemological assumptions, assumptions which are deeply inserted within the epistemological order of Western modernity. The main argument is that through their shared ideological undertones of 'objectivity', 'universalism' and 'rationalism', these paradigms are potentially marginalizing other possibly important ways of thinking about care in Africa, ways which might not originate from modernist forms of consciousness. This article makes a plea for a more inclusive and plural archive of knowledge on scaling up mental health care in Africa, one which is more hospitable to diverse epistemological politics and moral landscapes. PMID:25406137

  12. Web Service

    MedlinePlus

    ... www.nlm.nih.gov/medlineplus/webservices.html MedlinePlus Web Service To use the sharing features on this ... please enable JavaScript. MedlinePlus offers a search-based Web service that provides access to MedlinePlus health topic ...

  13. Cleaning Services.

    ERIC Educational Resources Information Center

    Sharpton, James L.

    This curriculum guide provides cleaning services instructional materials for a ninth- and tenth-grade Coordinated Vocational Education and Training: Home and Community Services program. It includes 2 sections and 11 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities,…

  14. Information Service.

    ERIC Educational Resources Information Center

    Scofield, James

    Newspaper librarians discussed the public use of their newspapers' libraries. Policies run the gamut from well-staffed public information services, within or outside the newspaper library, to no service at all to those outside the staff of the paper. Problems of dealing with tax and law enforcement agencies were covered, as well as cooperative…

  15. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  16. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  17. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  18. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  19. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  20. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  1. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  2. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  3. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  4. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  5. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 9 2013-01-01 2013-01-01 false Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  6. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  7. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  8. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 9 2012-01-01 2012-01-01 false Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  9. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 true Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  10. Central line complications

    PubMed Central

    Kornbau, Craig; Lee, Kathryn C; Hughes, Gwendolyn D; Firstenberg, Michael S

    2015-01-01

    Central venous access is a common procedure performed in many clinical settings for a variety of indications. Central lines are not without risk, and there are a multitude of complications that are associated with their placement. Complications can present in an immediate or delayed fashion and vary based on type of central venous access. Significant morbidity and mortality can result from complications related to central venous access. These complications can cause a significant healthcare burden in cost, hospital days, and patient quality of life. Advances in imaging, access technique, and medical devices have reduced and altered the types of complications encountered in clinical practice; but most complications still center around vascular injury, infection, and misplacement. Recognition and management of central line complications is important when caring for patients with vascular access, but prevention is the ultimate goal. This article discusses common and rare complications associated with central venous access, as well as techniques to recognize, manage, and prevent complications. PMID:26557487

  11. Oncoplastic central quadrantectomies

    PubMed Central

    Pasta, Vittorio; D’Orazi, Valerio; Merola, Raffaele; Frusone, Federico; Amabile, Maria Ida; Buè, Rosanna; Monti, Marco

    2016-01-01

    Tumors localized in the central quadrant (centrally located breast tumors) have always represented a challenge for the surgeon because of the critical aesthetical matters related to the nipple-areola complex (NAC). Many years of experience with breast cancer patients treated by using various oncoplastic techniques, has allowed us to develop the modified hemibatwing for the treatment of central breast tumors, where the NAC is involved. Modified hemibatwing—along with the removal of the NAC—is a useful oncoplastic technique and it represents an ideal option for the treatment of central tumors because it assures oncological safety, a reduced surgical timetable and greater aesthetical results. PMID:27563564

  12. Les facteurs prédictifs de malignité dans la prise en charge des tumeurs parotidiennes: à propos de 76 cas

    PubMed Central

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    La pathologie tumorale de la glande parotide est complexe et pose un problème diagnostique et thérapeutique. Une bonne analyse des facteurs prédictifs de malignité de ces tumeurs parotidiennes semble actuellement nécessaire en vue d'une meilleure planification thérapeutique. Le but de ce travail est d’étudier les facteurs prédictifs de malignité dans les tumeurs parotidiennes à travers une étude rétrospective sur 76 cas de tumeurs de la parotide traités au service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale de l'hôpital militaire Avicenne de Marrakech entre janvier 2000 et décembre 2012. Il s'agit de 40 femmes et 36 hommes. L’âge moyen était de 44 ans pour les tumeurs bénignes alors qu'il était de 50 ans pour les tumeurs malignes. Le délai moyen de consultation était de 24 mois pour les tumeurs bénignes et de 16 mois pour les tumeurs malignes. La tuméfaction de la région parotidienne a été un signe révélateur constant chez tous les malades. La malignité est évoquée cliniquement devant la douleur, la paralysie faciale, la fixité par rapport au plan superficiel ou profond et la présence d'adénopathie. L'IRM constitue désormais l'examen de choix dans l'exploration des masses tumorales parotidiennes avec une bonne valeur diagnostique de malignité ou de bénignité. La cytoponction à l'aiguille fine n'a pas de valeur que si elle est positive. La parotidectomie exploratrice avec examen anatomopathologique extemporané demeure la clé du diagnostic positif. Les tumeurs parotidiennes bénignes représentent l'entité la plus fréquente (80%) et l'adénome pléomorphe demeure le type histologique prédominant (61%). Quant aux tumeurs malignes, elles sont plutôt rares, dominées essentiellement par les carcinomes muco épidermoides (6,5%). Le traitement chirurgical est l'option de choix souvent associée à un curage ganglionnaire et une radiothérapie pour les tumeurs malignes. La paralysie faciale est la complication

  13. AAS Career Services

    NASA Astrophysics Data System (ADS)

    Marvel, Kevin B.

    2012-08-01

    The American Astronomical Society provides substantial programs in the area of Career Services.Motivated by the Society's mission to enhance and share humanity's understanding of the Universe, the AAS provides a central resource for advertising positions, interviewing opportunities at its annual winter meeting and information, workshops and networks to enable astronomers to find employment.The programs of the Society in this area are overseen by an active committee on employment and the AAS Council itself.Additional resources that help characterize the field, its growth and facts about employment such as salaries and type of jobs available are regularly summarized and reported on by the American Institute of Physics.

  14. Improving Circulation Services through Staff Involvement

    ERIC Educational Resources Information Center

    Kisby, Cynthia M.; Kilman, Marcus D.

    2007-01-01

    The Circulation Services Department at the University of Central Florida Libraries reports on leadership and training initiatives that resulted in a number of service-enhancing projects implemented by a highly motivated and involved staff. Key elements in reinvigorating the department included a change in leadership philosophy, increased…

  15. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  16. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  17. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  18. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  19. Developing Multiprofessional Teamwork for Integrated Children's Services

    ERIC Educational Resources Information Center

    Anning, Angela; Cottrell, David; Frost, Nick; Green, Josephine; Robinson, Mark

    2006-01-01

    Multiprofessional practice in the delivery of services is a central government imperative in the UK and other countries. This book offers a practical resource to professionals charged with conceptualising, planning, implementing and evaluating multiprofessional practice in children's services. Discussion of dilemmas facing multiprofessional teams…

  20. Vocational Rehabilitation Services for Handicapped Individuals.

    ERIC Educational Resources Information Center

    Goodwill Industries of North Central Pennsylvania, Inc., DuBois.

    The manual describes the vocational rehabilitation program and services for handicapped individuals that are provided by Goodwill Industries of North Central Pennsylvania, Inc., which services an eight-county outreach area. An introductory section provides general background information regarding program objectives, philosophy, and organizational…

  1. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  2. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Deadline for Central Office action. 23.35 Section 23.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Grants to Off-Reservation Indian Organizations for Title II Indian Child and Family Service Programs §...

  3. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Deadline for Central Office action. 23.35 Section 23.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Grants to Off-Reservation Indian Organizations for Title II Indian Child and Family Service Programs §...

  4. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Deadline for Central Office action. 23.35 Section 23.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Grants to Off-Reservation Indian Organizations for Title II Indian Child and Family Service Programs §...

  5. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Deadline for Central Office action. 23.35 Section 23.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Grants to Off-Reservation Indian Organizations for Title II Indian Child and Family Service Programs §...

  6. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Deadline for Central Office action. 23.35 Section 23.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Grants to Off-Reservation Indian Organizations for Title II Indian Child and Family Service Programs §...

  7. Toward Understanding Non-Centralized Technology Support in Higher Education

    ERIC Educational Resources Information Center

    Jackson, Robert Jonathan

    2009-01-01

    The focus of this research is an examination of service quality provided by non-centralized technology personnel, Local Technical Support Providers (LSPs), at a southern research university. The SERVQUAL instrument was selected to measure service quality of LSPs within the Academic Affairs Division. The rationale for selecting and testing SERVQUAL…

  8. Central pontine myelinolysis

    MedlinePlus

    ... from one nerve to another. The most common cause of central pontine myelinolysis is a quick change in the body's sodium ... The nerve damage caused by central pontine myelinolysis is usually ... The disorder can cause serious long-term (chronic) disability.

  9. Central diffraction at ALICE

    NASA Astrophysics Data System (ADS)

    Lämsä, J. W.; Orava, R.

    2011-02-01

    The ALICE experiment is shown to be well suited for studies of exclusive final states from central diffractive reactions. The gluon-rich environment of the central system allows detailed QCD studies and searches for exotic meson states, such as glueballs, hybrids and new charmonium-like states. It would also provide a good testing ground for detailed studies of heavy quarkonia. Due to its central barrel performance, ALICE can accurately measure the low-mass central systems with good purity. The efficiency of the Forward Multiplicity Detector (FMD) and the Forward Shower Counter (FSC) system for detecting rapidity gaps is shown to be adequate for the proposed studies. With this detector arrangement, valuable new data can be obtained by tagging central diffractive processes.

  10. Community Resources Guide for Central Florida = Una Guia de Recursos en la Comunidad de Florida Central.

    ERIC Educational Resources Information Center

    Medina, Linda, Comp.

    Designed to orient Hispanic refugees to the services that are available in Central Florida, this bilingual guide consists of a section of general information on living and working in the United States and a section devoted to various public and private agencies. Provided first are addresses and phone numbers of various government agencies:…

  11. Profil épidémiologique et prise en charge des exacerbations d'asthme chez l'enfant à l'hôpital d'enfants de Rabat au Maroc

    PubMed Central

    Boubkraoui, Mohamed El Mahdi; Benbrahim, Fadoua; Assermouh, Abdellah; El Hafidi, Naima; Benchekroun, Soumia; Mahraoui, Chafiq

    2015-01-01

    Introduction L'exacerbation d'asthme est un phénomène paroxystique qui peut mettre en jeu le pronostic vital. Le but de l’étude est d’évaluer le profil épidémiologique et les modalités de prise en charge de l'exacerbation d'asthme chez les enfants âgés de 2 à 15 ans dans l'unité de pneumoallergologie pédiatrique de l'hôpital d'enfants de Rabat au Maroc. Méthodes Il s'agit d'une étude rétrospective qui a concerné 1461 enfants hospitalisés pour exacerbation d'asthme modérée à sévère durant une période d'un an allant de décembre 2011 à novembre 2012, les exacerbations légères étant traitées en ambulatoire. Résultats Les hospitalisations pour exacerbation d'asthme chez les enfants ont représenté 34% de l'ensemble des hospitalisations avec trois pics en mai, septembre et décembre. L’âge moyen de survenue était de 3 ans et demi avec une prédominance masculine nette. L'exacerbation d'asthme était inaugurale dans 22% des cas. Les infections respiratoires virales dominaient les facteurs déclenchants des exacerbations d'asthme. Le séjour hospitalier était en moyenne de 3 jours. Un transfert en réanimation a été nécessaire dans 2% des cas. L’évolution sous traitement a toujours été favorable et la mortalité a été nulle. Conclusion La prévalence des hospitalisations pour exacerbation d'asthme suit un profil saisonnier lié aux effets environnementaux. La plupart de ces hospitalisations pourraient cependant être évitées grâce à un meilleur contrôle de l'asthme et à l'amélioration de l’éducation thérapeutique de l'enfant asthmatique et de son entourage. PMID:26090031

  12. Central nervous system

    MedlinePlus

    The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main "processing center" for your entire nervous system. They control all the workings of your body.

  13. Central ballast tanker design

    SciTech Connect

    1997-01-01

    The purpose of this paper is to present the CENTRAL BALLAST TANKER Design. This design is intended to reduce the volume of oil spilled from tankers by giving the crew a tanker properly designed and equipped to allow large quantities of oil from ruptured tank(s) to flow safely to a fully-inerted central ballast tank. In addition to reducing the volume of oil spilled, the design also addresses many of the shortcomings of the DOUBLE HULL DESIGN which are increasingly becoming a concern. The following is a brief review of the development of the CENTRAL BALLAST TANKER. The simple operational features, stability, low cost and ease of maintenance of the single hull tanker were important and can be retained with the CENTRAL BALLAST DESIGN.

  14. Central line infections - hospitals

    MedlinePlus

    ... risk is higher if you: Are in the intensive care unit (ICU) Have a weakened immune system or serious ... unless you have washed your hands. Tell your nurse if your central line: Gets dirty Is coming ...

  15. Diabetes insipidus - central

    MedlinePlus

    ... insipidus is caused by a genetic problem. Symptoms Symptoms of central diabetes insipidus include: Increased urine production Excessive thirst Confusion and changes in alertness due to dehydration and higher than normal sodium level in the ...

  16. Higgs central exclusive production

    NASA Astrophysics Data System (ADS)

    Cudell, J. R.; Dechambre, A.; Hernández, O. F.

    2012-01-01

    Using the CHIDe model, we tune the calculation of central exclusive Higgs production to the recent CDF central exclusive dijet data, and predict the cross section for the exclusive production of Higgs boson at the LHC. In this model, due to different choices of the scale in the Sudakov form factor for dijet and Higgs production, it is always below 1 fb, and below 0.3 fb after experimental cuts.

  17. Central centrifugal cicatricial alopecia

    PubMed Central

    Blattner, Collin; Polley, Dennis C.; Ferritto, Frank; Elston, Dirk M.

    2013-01-01

    Central centrifugal cicatricial alopecia is a common cause of progressive permanent apical alopecia. This unique form of alopecia includes entities previously know as “hot comb alopecia,” “follicular degeneration syndrome,” “pseudopelade” in African Americans and “central elliptical pseudopelade” in Caucasians. The etiology appears to be multifactorial and the condition occurs in all races. PMID:23440368

  18. Balanced Centrality of Networks.

    PubMed

    Debono, Mark; Lauri, Josef; Sciriha, Irene

    2014-01-01

    There is an age-old question in all branches of network analysis. What makes an actor in a network important, courted, or sought? Both Crossley and Bonacich contend that rather than its intrinsic wealth or value, an actor's status lies in the structures of its interactions with other actors. Since pairwise relation data in a network can be stored in a two-dimensional array or matrix, graph theory and linear algebra lend themselves as great tools to gauge the centrality (interpreted as importance, power, or popularity, depending on the purpose of the network) of each actor. We express known and new centralities in terms of only two matrices associated with the network. We show that derivations of these expressions can be handled exclusively through the main eigenvectors (not orthogonal to the all-one vector) associated with the adjacency matrix. We also propose a centrality vector (SWIPD) which is a linear combination of the square, walk, power, and degree centrality vectors with weightings of the various centralities depending on the purpose of the network. By comparing actors' scores for various weightings, a clear understanding of which actors are most central is obtained. Moreover, for threshold networks, the (SWIPD) measure turns out to be independent of the weightings. PMID:27437494

  19. Balanced Centrality of Networks

    PubMed Central

    Sciriha, Irene

    2014-01-01

    There is an age-old question in all branches of network analysis. What makes an actor in a network important, courted, or sought? Both Crossley and Bonacich contend that rather than its intrinsic wealth or value, an actor's status lies in the structures of its interactions with other actors. Since pairwise relation data in a network can be stored in a two-dimensional array or matrix, graph theory and linear algebra lend themselves as great tools to gauge the centrality (interpreted as importance, power, or popularity, depending on the purpose of the network) of each actor. We express known and new centralities in terms of only two matrices associated with the network. We show that derivations of these expressions can be handled exclusively through the main eigenvectors (not orthogonal to the all-one vector) associated with the adjacency matrix. We also propose a centrality vector (SWIPD) which is a linear combination of the square, walk, power, and degree centrality vectors with weightings of the various centralities depending on the purpose of the network. By comparing actors' scores for various weightings, a clear understanding of which actors are most central is obtained. Moreover, for threshold networks, the (SWIPD) measure turns out to be independent of the weightings.

  20. Testing Services

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Trace Laboratories is an independent testing laboratory specializing in testing printed circuit boards, automotive products and military hardware. Technical information from NASA Tech Briefs and two subsequent JPL Technical Support packages have assisted Trace in testing surface insulation resistance on printed circuit board materials. Testing time was reduced and customer service was improved because of Jet Propulsion Laboratory technical support packages.

  1. Refrigeration Servicing.

    ERIC Educational Resources Information Center

    Hamilton, Donald L.; And Others

    This self-study course is designed to familiarize Marine enlisted personnel with the services required to be performed on refrigeration equipment. The course contains four study units. Each study unit begins with a general objective, which is a statement of what the student should learn from the unit. The study units are divided into numbered work…

  2. Food Service.

    ERIC Educational Resources Information Center

    Furneisen, Barbara K.

    Written to teach deaf students skills in food services, this guide and the two related documents (see note) present practical skills needed to work in a school dining room setting serving approximately two hundred students and faculty. Eleven units are included, with each unit containing from three to eleven lessons. Each lesson includes an…

  3. Conservation Planning for Ecosystem Services

    PubMed Central

    Chan, Kai M. A; Shaw, M. Rebecca; Cameron, David R; Underwood, Emma C; Daily, Gretchen C

    2006-01-01

    Despite increasing attention to the human dimension of conservation projects, a rigorous, systematic methodology for planning for ecosystem services has not been developed. This is in part because flows of ecosystem services remain poorly characterized at local-to-regional scales, and their protection has not generally been made a priority. We used a spatially explicit conservation planning framework to explore the trade-offs and opportunities for aligning conservation goals for biodiversity with six ecosystem services (carbon storage, flood control, forage production, outdoor recreation, crop pollination, and water provision) in the Central Coast ecoregion of California, United States. We found weak positive and some weak negative associations between the priority areas for biodiversity conservation and the flows of the six ecosystem services across the ecoregion. Excluding the two agriculture-focused services—crop pollination and forage production—eliminates all negative correlations. We compared the degree to which four contrasting conservation network designs protect biodiversity and the flow of the six services. We found that biodiversity conservation protects substantial collateral flows of services. Targeting ecosystem services directly can meet the multiple ecosystem services and biodiversity goals more efficiently but cannot substitute for targeted biodiversity protection (biodiversity losses of 44% relative to targeting biodiversity alone). Strategically targeting only biodiversity plus the four positively associated services offers much promise (relative biodiversity losses of 7%). Here we present an initial analytical framework for integrating biodiversity and ecosystem services in conservation planning and illustrate its application. We found that although there are important potential trade-offs between conservation for biodiversity and for ecosystem services, a systematic planning framework offers scope for identifying valuable synergies. PMID

  4. 40 CFR 3.20 - How will EPA provide notice of changes to the Central Data Exchange?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... section, whenever EPA plans to change Central Data Exchange hardware or software in ways that would affect... the equipment, software, or services needed to transmit electronic documents to the Central...

  5. 78 FR 34428 - Missouri Central Railroad Company-Abandonment Exemption-in Cass, Henry, Johnson, and Pettis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ..., Johnson, and Pettis Counties, MO; Central Midland Railway Company--Discontinuance of Service Exemption--in Cass, Henry, Johnson, and Pettis Counties, MO Missouri Central Railroad Company (MCRR) and...

  6. 75 FR 75681 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System Drugs... and circulation) of the central nervous system. The BBB is an area consisting of specialized...

  7. Graduate Student Services: A Study of the Delivery of Services at the Location Where Students Matriculate

    ERIC Educational Resources Information Center

    Burlison, John G.

    2010-01-01

    This dissertation investigates and explores the best method for the delivery of graduate student services. Essentially, there are two methods for delivery of these services. They can be delivered by virtue of centralization or decentralization. Decentralized delivery, for the purpose of this dissertation is the delivery of graduate student…

  8. College Makes New Connections with Service-Learning Program

    ERIC Educational Resources Information Center

    Ashburn, Elyse

    2009-01-01

    The service learning movement has gained new energy with the election of President Obama, who has made increasing service a central plank of his higher-education agenda. But across the board, colleges and universities struggle with service learning's twin goals of providing meaningful help to the community and academic rigor to students. The…

  9. Service Provision to Students: Where the Gown Best Fits

    ERIC Educational Resources Information Center

    Schulz, Lucy; Szekeres, Judy

    2008-01-01

    One of the challenges facing those responsible for service provision in universities is ensuring that service is provided at the right point in the organisation. Service delivery points can exist at the school/department level, faculty/division level or central unit/university wide level. This does not always follow organisational logic, common…

  10. Geospatial Services in Special Libraries: A Needs Assessment Perspective

    ERIC Educational Resources Information Center

    Barnes, Ilana

    2013-01-01

    Once limited to geographers and mapmakers, Geographic Information Systems (GIS) has taken a growing central role in information management and visualization. Geospatial services run a gamut of different products and services from Google maps to ArcGIS servers to Mobile development. Geospatial services are not new. Libraries have been writing about…

  11. CENTRAL PLATEAU REMEDIATION

    SciTech Connect

    ROMINE, L.D.

    2006-02-01

    A systematic approach to closure planning is being implemented at the Hanford Site's Central Plateau to help achieve the goal of closure by the year 2035. The overall objective of Central Plateau remediation is to protect human health and the environment from the significant quantity of contaminated material that resulted from decades of plutonium production in support of the nation's defense. This goal will be achieved either by removing contaminants or placing the residual contaminated materials in a secure configuration that minimizes further migration to the groundwater and reduces the potential for inadvertent intrusion into contaminated sites. The approach to Central Plateau cleanup used three key concepts--closure zones, closure elements, and closure process steps--to create an organized picture of actions required to complete remediation. These actions were merged with logic ties, constraints, and required resources to produce an integrated time-phased schedule and cost profile for Central Plateau closure. Programmatic risks associated with implementation of Central Plateau closure were identified and analyzed. Actions to mitigate the most significant risks are underway while high priority remediation projects continue to make progress.

  12. EVALUATION OF SERVICE ACTIVITIES UNDERTAKEN BY THE EDUCATIONAL SERVICE CENTER FOR THE PERIOD SEPTEMBER 1, 1966 TO JULY 1, 1967.

    ERIC Educational Resources Information Center

    HOMAN, LARRY E.; KELLY, PATRICK J.

    THE EDUCATIONAL SERVICE CENTER (ESC) SUPPLIES VARIOUS SERVICES TO 28 SCHOOL DISTRICTS IN CENTRAL, WESTERN, AND NORTHERN NEW MEXICO. STATISTICAL INFORMATION IS PRESENTED CONCERNING THE VARIETY AND DISTRIBUTION OF THESE SERVICES (CURRICULUM DEVELOPMENT, PSYCHOLOGICAL TESTING AND GUIDANCE, ADULT EDUCATION AND COMMUNITY DEVELOPMENT, SCHOOL EVALUATION…

  13. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... centralized administrative offset (TOP), Internal Revenue Service offset administered through TOP and Treasury... exclusion criteria, may be excluded from TOP or Cross-Servicing. (b) A 60 day due process notice will be sent to borrowers subject to TOP or Cross-Servicing. The borrower will be given 60 days to resolve...

  14. Hale Central Peak

    NASA Technical Reports Server (NTRS)

    2004-01-01

    19 September 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows some of the mountains that make up the central peak region of Hale Crater, located near 35.8oS, 36.5oW. Dark, smooth-surfaced sand dunes are seen to be climbing up the mountainous slopes. The central peak of a crater consists of rock brought up during the impact from below the crater floor. This autumn image is illuminated from the upper left and covers an area approximately 3 km (1.9 mi) across.

  15. Prise en charge hospitalière de la malnutrition aigue sévère chez l'enfant avec des préparations locales alternatives aux F-75 et F-100: résultats et défis

    PubMed Central

    Nguefack, Félicitée; Adjahoung, Chritoph Akazong; Keugoung, Basile; Kamgaing, Nelly; Dongmo, Roger

    2015-01-01

    Introduction La mise en œuvre des directives de l'OMS permettrait de réduire significativement la mortalité hospitalière due à la malnutrition sévère. Cependant, elle n'est pas effective et la pénurie en aliments thérapeutiques est l'une des principales causes. L’étude décrit notre expérience sur la prise en charge hospitalière de la malnutrition aigue sévère avec des laits alternatifs aux F75 et F100 composés localement. Méthodes Il s'agissait d'un essai clinique non randomisé. La prise en charge des patients utilisait les laits composés localement et une évaluation quotidienne du gain pondéral était faite. Résultats L’étude a porté sur 41 sujets âgés de 6 à 59 mois. Au total, 73,2% avaient le kwashiorkor-marasmique, 17,0% le kwashiorkor, 9,8% le marasme et 41,5% étaient infectés par le VIH. Nous avons noté une prise progressive du poids d'environ 10 g/kg/jour vers le 7ème jour et de 15 à 20 g/kg/jour en fin d'hospitalisation. Le taux de mortalité était de 21,9% soit une réduction de 8,4% des chiffres antérieurs. Conclusion Malgré les obstacles financiers liés au coût des ingrédients, les préparations lactées alternatives aux standards F75 et F100, sont adaptables dans notre contexte. En l'absence des formules standards de l'OMS et lorsque la référence vers une structure qui en disposent n'est pas possible, les préparations locales permettraient de réhabiliter efficacement les patients. D'autres recherches pointues permettraient de tirer les ingrédients uniquement de notre environnement. Elles contribueraient ainsi à minimiser les couts des préparations et de favoriser la pérennisation des laits thérapeutiques locaux. PMID:26587175

  16. What We Can Learn from Service Design in Order to Design Services

    NASA Astrophysics Data System (ADS)

    Giusti, Leonardo; Zancanaro, Massimo

    Service Design emerged as distinct discipline in the late '80s to specifically address the peculiar challenges of a post-industrial society in moving toward a more pervasive offer of services with respect to products. The central tenet of this discipline is that services are radically different from products and a different mindset is necessary for designing them. Its aim was to develop theoretical basis as well as practical methods to design the intermix of processes, artifacts exchanges and user experience which are going on in delivering services. We believe that several of the concepts investigated in the past 20 years of research in Service Design might be fruitfully applied to design the user experience with Service-Oriented Applications for Future Internet. In this paper, we briefly introduce Service Design and we link the key concepts to the challenges posed by Service-Oriented Computing. We will then exemplify some concepts within a simple scenario.

  17. Central Administration. Interim Report.

    ERIC Educational Resources Information Center

    Duke Univ., Durham, NC.

    Because the configuration of the central administration of Duke University has recently been modified, this report was prepared: (1) to describe the changes and rearrangements thus far introduced; (2) to propose desirable clarifications not yet provided; (3) to recommend certain additional changes where these may already appear to be needed; and…

  18. Centralizers of spin subalgebras

    NASA Astrophysics Data System (ADS)

    Arizmendi, Gerardo; Herrera, Rafael

    2015-11-01

    We determine the centralizers of certain isomorphic copies of spin subalgebras spin(r) in so(dr m), where dr is the dimension of a real irreducible representation of Clr0, the even Clifford algebra determined by the positive definite inner product on Rr, where r, m ∈ N.

  19. Central Exclusive Dijet Production

    SciTech Connect

    Dechambre, A.; Cudell, J. R.; Ivanov, I. P.; Hernandez, O.

    2008-08-29

    The ingredients of central exclusive production cross section include large perturbative corrections and soft quantities that must be parametrized and fitted to data. In this talk, we summarize the results of a study of the uncertainties coming from these ingredients, in the case of exclusive dijet production.

  20. CENTRALIZATION OF CAMPUS CONTROLS.

    ERIC Educational Resources Information Center

    1967

    A COLLEGE CAMPUS HAVING A LARGE NUMBER OF SEPARATE BUILDINGS WITH ONE BASIC HEATING AND COOLING SYSTEM IS AN IDEAL SITUATION FOR REALIZING GREAT BENEFITS FROM CENTRALIZED BUILDING CONTROL SYSTEMS. TYPICAL REQUIREMENTS AND ADVANTAGES OF SUCH SYSTEMS ARE DISCUSSED BRIEFLY AND DESCRIPTIONS OF THE SYSTEM AT FOUR MAJOR UNIVERSITIES ARE GIVEN. THIS…

  1. [Central manifestations of dystrophinopathies].

    PubMed

    Cuisset, J-M; Rivier, F

    2015-12-01

    The dystrophin gene involved in Duchenne and Becker muscular dystrophy is expressed in three main tissues resulting in clinical manifestations: skeletal muscle, heart and central nervous system. The 6 different existing dystrophins in the brain may play a role in the maturation and plasticity of neuronal synapses in particular by their functions in clustering and stabilization of different receptors at the post synaptic membrane. The possibility of an intellectual deficiency in Duchenne muscular dystrophy is known from the original description by Duchenne himself. Current data are in line with a constant cognitive impairment with a Gaussian curve shifted intellectual quotient (IQ) at -1 standard deviation from the standard population with an average IQ around 80. Clinical manifestations suggestive of a central nervous system involvement can affect all dystrophinopathies, including isolated central presentations without myopathic sign. The phenotypic spectrum appears broader and more subtle than non specific intellectual deficiency. The isolated or shared involvement of specific cognitive functions is possible (memory functions, executive functions, attention) with or without intellectual deficiency. Autism spectrum disorders are also among the encountered events. In clinical practice, it seems worth to ask for a measurement of serum creatine kinase (CK) in these different situations, keeping in mind that pure forms of central dystrophinopathies with a normal CK level have been recently reported. PMID:26773588

  2. Retiring the central executive.

    PubMed

    Logie, Robert H

    2016-10-01

    Reasoning, problem solving, comprehension, learning and retrieval, inhibition, switching, updating, or multitasking are often referred to as higher cognition, thought to require control processes or the use of a central executive. However, the concept of an executive controller begs the question of what is controlling the controller and so on, leading to an infinite hierarchy of executives or "homunculi". In what is now a QJEP citation classic, Baddeley [Baddeley, A. D. (1996). Exploring the central executive. Quarterly Journal of Experimental Psychology, 49A, 5-28] referred to the concept of a central executive in cognition as a "conceptual ragbag" that acted as a placeholder umbrella term for aspects of cognition that are complex, were poorly understood at the time, and most likely involve several different cognitive functions working in concert. He suggested that with systematic empirical research, advances in understanding might progress sufficiently to allow the executive concept to be "sacked". This article offers an overview of the 1996 article and of some subsequent systematic research and argues that after two decades of research, there is sufficient advance in understanding to suggest that executive control might arise from the interaction among multiple different functions in cognition that use different, but overlapping, brain networks. The article concludes that the central executive concept might now be offered a dignified retirement. PMID:26821744

  3. Central pontine myelinolysis

    PubMed Central

    Ibrahim, N. B. N.

    1981-01-01

    This appears to be the first report of a case of central pontine myelinolysis associated with chronic alcoholism and liver cirrhosis in the United Kingdom. The pathological features and theories of aetiology are briefly discussed. ImagesFig. 1 PMID:7329883

  4. Channeling the Central Dogma.

    PubMed

    Calabrese, Ronald L

    2014-05-21

    How do neurons and networks achieve their characteristic electrical activity, regulate this activity homeostatically, and yet show population variability in expression? In this issue of Neuron, O'Leary et al. (2014) address some of these thorny questions in this theoretical analysis that starts with the Central Dogma. PMID:24853932

  5. Central Dogma Goes Digital.

    PubMed

    Lin, Yihan; Elowitz, Michael B

    2016-03-17

    In this issue of Molecular Cell, Tay and colleagues (Albayrak et al., 2016) describe a new technique to digitally quantify the numbers of protein and mRNA in the same mammalian cell, providing a new way to look at the central dogma of molecular biology. PMID:26990983

  6. Multicultural Central Asia.

    ERIC Educational Resources Information Center

    Boyle, Eric D.

    This article addresses the multicultural aspect of Central Asia in response to the discussion on diversity in U.S. classrooms. Many areas of the world are more diverse than the U.S., and these areas experience successes and failures with many of the same issues the U.S. is currently struggling with. Comparing the U.S. diversity debate with similar…

  7. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

    PubMed Central

    2014-01-01

    Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion

  8. PhEDEx Data Service

    NASA Astrophysics Data System (ADS)

    Egeland, Ricky; Wildish, Tony; Huang, Chih-Hao

    2010-04-01

    The PhEDEx Data Service provides access to information from the central PhEDEx database, as well as certificate-authenticated managerial operations such as requesting the transfer or deletion of data. The Data Service is integrated with the "SiteDB" service for fine-grained access control, providing a safe and secure environment for operations. A plug-in architecture allows server-side modules to be developed rapidly and easily by anyone familiar with the schema, and can automatically return the data in a variety of formats for use by different client technologies. Using HTTP access via the Data Service instead of direct database connections makes it possible to build monitoring web-pages with complex drill-down operations, suitable for debugging or presentation from many aspects. This will form the basis of the new PhEDEx website in the near future, as well as providing access to PhEDEx information and certificate-authenticated services for other CMS dataflow and workflow management tools such as CRAB, WMCore, DBS and the dashboard. A PhEDEx command-line client tool provides one-stop access to all the functions of the PhEDEx Data Service interactively, for use in simple scripts that do not access the service directly. The client tool provides certificate-authenticated access to managerial functions, so all the functions of the PhEDEx Data Service are available to it. The tool can be expanded by plug-ins which can combine or extend the client-side manipulation of data from the Data Service, providing a powerful environment for manipulating data within PhEDEx.

  9. Centralized vs. Distributed PACS for Intensive Care Units

    NASA Astrophysics Data System (ADS)

    Cho, Paul S.; Huang, H. K.; Tillisch, Jan

    1989-05-01

    One clinical environment which can immediately benefit from the implementation of a radiologic PACS is the intensive care unit (ICU). Our previous study has demonstrated the feasibility and timeliness of routine image transmission to an ICU. In anticipation of future expansion of this service, we have investigated two different models for a hospital-wide ICU PACS. These models included a centralized and a distributed processing PACS configuration. Their comparison indicated that although the distributed model offers some major advantages over the centralized model, the latter may hold a rightful place in the inter-departmental service, especially if the cost issue is a critical factor.

  10. Full Service

    NASA Technical Reports Server (NTRS)

    Morring, Frank, Jr.

    2004-01-01

    NASA is moving ahead with the sole-source procurement of a Canadian robot to service the Hubble Space Telescope, gaining confidence the International Space Station (ISS) technology can perform all of the tasks shuttle-launched astronauts were scheduled to do before the Columbia accident changed everything. The U.S. agency is negotiating with MD Robotics, a MacDonald Dettwiler unit located in Brampton, Ontario, for a version of the Special Purpose Dexterous Manipulator (SPDM) the company developed for the ISS. The SPDM would be the business end of a throwaway module designed to replace batteries and gyroscopes, pull old instruments and install new ones before plunging to a targeted reentry over the Pacific.

  11. [CENTRAL ANTICHOLINERGIC... SYNDROME?].

    PubMed

    Danilov, M S; Lebedinskii, K M

    2015-01-01

    While reading special literature in diferent languages the authors noted surprising fact: the term and concept of "central anticholinergic syndrome" is well-known as common anaesthesia complication in German (abbr: ZAS) and partially Spanish sources, but in Russian, English or French literature is used only in toxicological context. Describing etiology, pathogenesis, symptoms, diagnosis and treatment of the complication manifesting with comatose, agitated or shivering forms, the authors analyzing the reasons for such a noticeably diferent approaches to the situation reaching 10% of all the general anaesthesia cases. Probably, ZAS isn't nosologically clearly defined syndrome, but just adverse appearance of one of the fundamental general anaesthesia mechanisms? Anyway, the problem of central cholinergic activity suppression, excessive by its amplitude and/or duration, exists all over the world. German concept of ZAS allows the anaesthesiologist to resolve it on pathogenically generalized basis, while in other professional communities various symptomatic approaches seem to be more common. PMID:27025142

  12. Central Sleep Apnea

    PubMed Central

    Eckert, Danny J.; Jordan, Amy S.; Merchia, Pankaj; Malhotra, Atul

    2008-01-01

    Central sleep apnea (CSA) is characterized by a lack of drive to breathe during sleep, resulting in repetitive periods of insufficient ventilation and compromised gas exchange. These nighttime breathing disturbances can lead to important comorbidity and increased risk of adverse cardiovascular outcomes. There are several manifestations of CSA, including high altitude-induced periodic breathing, idiopathic CSA, narcotic-induced central apnea, obesity hypoventilation syndrome, and Cheyne-Stokes breathing. While unstable ventilatory control during sleep is the hallmark of CSA, the pathophysiology and the prevalence of the various forms of CSA vary greatly. This brief review summarizes the underlying physiology and modulating components influencing ventilatory control in CSA, describes the etiology of each of the various forms of CSA, and examines the key factors that may exacerbate apnea severity. The clinical implications of improved CSA pathophysiology knowledge and the potential for novel therapeutic treatment approaches are also discussed. PMID:17296668

  13. Central Mechanisms of Itch.

    PubMed

    Carstens, Earl; Akiyama, Tasuku

    2016-01-01

    This chapter summarizes recent findings regarding the central transmission of acute and chronic itch. Itch is transduced by cutaneous pruriceptors that transmit signals to neurons in the superficial spinal cord. Spinal itch-signaling circuits utilize several neuropeptides whose receptors represent novel targets to block itch transmission. Itch is relieved by scratching, which activates spinal interneurons to inhibit itch-transmitting neurons. Spinal itch transmission is also thought to be modulated by descending pathways. Itch is transmitted rostrally via ascending pathways to activate a variety of brain regions involved in sensory discrimination of affective and motor responses to itch. The pathophysiological mechanisms of chronic itch are poorly understood but likely involve sensitization of itch-signaling pathways and/or dysfunction of itch-inhibitory circuits. Improved understanding of central itch mechanisms has identified a number of novel targets for the development of antipruritic treatment strategies. PMID:27578065

  14. FNAL central email systems

    SciTech Connect

    Schmidt, Jack; Lilianstrom, Al; Pasetes, Ray; Hill, Kevin; /Fermilab

    2004-10-01

    The FNAL Email System is the primary point of entry for email destined for an employee or user at Fermilab. This centrally supported system is designed for reliability and availability. It uses multiple layers of protection to help ensure that: (1) SPAM messages are tagged properly; (2) All mail is inspected for viruses; and (3) Valid mail gets delivered. This system employs numerous redundant subsystems to accomplish these tasks.

  15. Central sleep apnoea.

    PubMed

    Chowdhuri, Susmita; Badr, M Safwan

    2010-02-01

    Central sleep apnoea (CSA) is characterized by the cessation of breathing during sleep due to absent ventilatory drive and may be associated with symptoms of insomnia, excessive daytime sleepiness or frequent arousals. Central apnoeas occur through two pathophysiologic patterns, either post- hyperventilation or post-hypoventilation. The prevalence of CSA is dependent on the population being studied, the predominant risk factors being elderly age group and co-morbid conditions.Data regarding the racial distribution of this disorder are very limited. CSA may be a clinical marker of underlying medical disorders, including cardiac or neurological disease, with resultant significant morbidity and mortality. Given that the underlying pathogenesis remains poorly understood, therapeutic options are currently limited to empiric treatment with PAP devices and rudimentary attempts at pharmacologic therapy with respiratory stimulant drugs and/or oxygen/carbon dioxide gas supplementation as well as treating the underlying cause. The long-term impact of CSA on health and mortality needs further clarification. Future research should be aimed at elucidating the physiologic determinants and consequences of central breathing instability in populations of different age groups, gender and racial descent, as a prerequisite to the development of novel therapeutic interventions in the different populations. PMID:20308740

  16. Centralization vs. decentralization in medical school libraries.

    PubMed

    Crawford, H

    1966-07-01

    Does the medical school library in the United States operate more commonly under the university library or the medical school administration? University-connected medical school libraries were asked to indicate (a) the source of their budgets, whether from the central library or the medical school, and (b) the responsibility for their acquisitions and cataloging. Returns received from sixtyeight of the seventy eligible institutions showed decentralization to be much the most common: 71 percent of the libraries are funded by their medical schools; 79 percent are responsible for their own acquisitions and processing. The factor most often associated with centralization of both budget and operation is public ownership. Decentralization is associated with service to one or two rather than three or more professional schools. Location of the medical school in a different city from the university is highly favorable to autonomy. Other factors associated with these trends are discussed. PMID:5945568

  17. Central portion of north side (front), showing central entry stair ...

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

    Central portion of north side (front), showing central entry stair and "Puller Hall" sign - U.S. Naval Base, Pearl Harbor, Enlisted Men's Barracks & Mess Hall, Marine Barracks, Neville Way, Pearl City, Honolulu County, HI

  18. Design of a photovoltaic central power station

    SciTech Connect

    Not Available

    1984-02-01

    Photovoltaic central power station designs have been developed for both high-efficiency flat-panel arrays and two-axis tracking concentrator arrays. Both designs are based on a site adjacent to the Saguaro Power Station of Arizona Public Service. The plants are 100 MW each, made of 5 MW subfields. The site specific designs allow detailed cost estimate for site preparation, installation, and engineering. These designs are summarized and cost estimates analyzed. Provided also are recommendations for future work to reduce system cost for each plant design.

  19. Centrally managed name resolution schemes for EPICS

    SciTech Connect

    Jun, D.; Bryan, D.; Watson, W.

    1997-12-01

    The Experimental Physics and Industrial Control System (EPICS) uses a broadcast method to locate resources and controls distributed across control servers. There are many advantages offered by using a centrally managed name resolution method, in which resources are located using a repository. The suitability of DCE Directory Service as a name resolution method is explored, and results from a study involving DCE are discussed. An alternative nameserver method developed and in use at the Thomas Jefferson national Accelerator Facility (Jefferson Lab) is described and results of integrating this new method with existing EPICS utilities presented. The various methods discussed in the paper are compared.

  20. Research and Development Project Behavior Management Services Northwest Alberta. Final Report.

    ERIC Educational Resources Information Center

    Dennis, S.; Stierhoff, K. A.

    The study examines the status of behavioral management services for disabled persons in Alberta, Canada, and offers recommendations regarding alternative service delivery models for the Northwest Region of Alberta. Existing systems are addressed in terms of centralized service models, outreach service models, and combined residential and outreach…

  1. Peripherally inserted central catheter - insertion

    MedlinePlus

    ... central catheters and nontunneled central venous catheters. In: Mauro MA, Murphy KPJ, Thomson KR, et al., eds. ... Procedures . 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:chap 4. Mansour JC, Neiderhuber JE. Establishing and ...

  2. Central hypothyroidism in children.

    PubMed

    García, Marta; Fernández, Ana; Moreno, José C

    2014-01-01

    Central congenital hypothyroidism (CCH) is an underdiagnosed disorder poorly described in childhood and adolescence. Congenital defects in thyroid-stimulating hormone (TSH) synthesis, secretion or bioactivity may lead to a state of 'regulatory' hypothyroidism expressed through aberrantly low or normal TSH levels and low thyroxine (T4), a hormonal pattern undetectable by TSH-based neonatal screening programs for congenital hypothyroidism (CH) implemented in most countries worldwide. CCH is more prevalent than previously thought, reaching 1 in 16,000 neonates in countries consistently identifying CCH through T4-based CH screening strategies. Neonatal detection and early treatment of CCH would prevent the risk of developing mental retardation secondary to late diagnosis of infantile hypothyroidism. CCH is frequently associated with other pituitary defects causing life-threatening situations (like e.g. adrenocorticotropic hormone deficiency) which could benefit from the early detection of CCH, avoiding considerable morbidity and mortality. CCH is not easy to identify clinically, and therefore few children are investigated for the disorder. The current knowledge on the genetic bases of CCH is also scarce. At the hypothalamic level no gene defects causing CCH have yet been identified in humans, but pituitary (thyrotrope)-selective genes encoding the TSH-releasing hormone (TRH) receptor (TRHR), the TSH β-subunit (TSHB) and, recently, the immunoglobulin superfamily factor 1 (IGSF1) are genes involved in isolated central hypothyroidism. Moreover, central hypothyroidism is a complex condition where many regulatory signals are implicated and converge to finely modulate the activity of the hypothalamic-pituitary-thyroid axis. This review focuses on novel pathogenic mechanisms and their implications to understand human CCH and improve the identification and the therapeutic handling of this elusive disease in the pediatric age. PMID:25231446

  3. Central American resource studies

    SciTech Connect

    Van Eeckhout, E.; Laughlin, A.W.

    1989-01-01

    Los Alamos National Laboratory has been working with five Central American countries to assist in the development of their energy and mineral resources. Since 1985, mineral resources in Costa Rica, peat resources in Costa Rica and Panama, geothermal energy resources in Honduras and Guatemala, and geothermal field development in El Salvador and Costa Rica have been topics of study. This paper presents an overview of this work -- within these proceedings are papers that deal with specific aspects of each topic, and these will be duly noted. 15 refs., 4 figs.

  4. Floods in Central China

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This pair of true- and false-color images from the Moderate resolution Imaging Spectroradiometer (MODIS) shows flooding in central China on July 4, 2002. In the false-color image vegetation appears orange and water appears dark blue to black. Because of the cloud cover and the fact that some of the water is filled with sediment, the false-color image provides a clearer picture of where rivers have exceeded their banks and lakes have risen. The river in this image is the Yangtze River, and the large lake is the Poyang Hu. Credits: Jacques Descloitres, MODIS Land Rapid Response Team, NASA/GSFC

  5. Flooding in Central Siberia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A mixture of snowmelt and ice jams in late May and June of this year caused the Taz River (left) and the Yenisey River (right) in central Siberia to overflow their banks. The flooding can be seen in this image taken on June 11, 2002, by the MODIS (Moderate Resolution Imaging Spectroradiometer) instrument aboard the Terra satellite. Normally, the rivers would resemble thin black lines in MODIS imagery. In the false-color images sage green and rusty orange is land, and water is black. Clouds are white and pink. Credit: Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC

  6. Central American electrical interconnection

    SciTech Connect

    Not Available

    1988-12-01

    A technical cooperation grant of $2.25 million, designed to strengthen the capacity of Central American countries to operate their regional interconnected electrical system, was announced by the Inter-American Development Bank (IDB). The grant, extended from the banks Fund for Special Operations, will help improve the capacity of the regions electric power companies to achieve economical, safe operation of the interconnected electric power systems. The funds will also be used to finance regional studies of the accords, procedures, regulations, and supervisory mechanisms for the system, as well as program development and data bases.

  7. Central ignition scenarios for TFTR

    SciTech Connect

    Zweben, S.J.; Redi, M.H.; Bateman, G.

    1986-03-01

    The possibility of obtaining ignition in TFTR by means of very centrally peaked density profiles is examined. It is shown that local central alpha heating can be made to exceed local central energy losses (''central ignition'') under global conditions for which Q greater than or equal to 1. Time dependent 1-D transport simulations show that the normal global ignition requirements are substantially relaxed for plasmas with peaked density profiles. 18 refs., 18 figs.

  8. NASA Shared Services Center breaks ground

    NASA Technical Reports Server (NTRS)

    2006-01-01

    NASA officials and elected leaders were on hand for the groundbreaking ceremony of the NASA Shared Services Center Feb. 24, 2006, on the grounds of Stennis Space Center. The NSSC provides agency centralized administrative processing, human resources, procurement and financial services. From left, Louisiana Economic Development Secretary Mike Olivier, Stennis Space Center Director Rick Gilbrech, Computer Sciences Corp. President Michael Laphen, NASA Deputy Administrator Shana Dale, Rep. Gene Taylor, Sen. Trent Lott, Mississippi Gov. Haley Barbour, NASA Administrator Mike Griffin and Shared Services Center Executive Director Arbuthnot use golden shovels to break ground at the site.

  9. The Agua Salud Project, Central Panama

    NASA Astrophysics Data System (ADS)

    Stallard, R. F.; Elsenbeer, H.; Ogden, F. L.; Hall, J. S.

    2007-12-01

    The Agua Salud Project utilizes the Panama Canal's central role in world commerce to focus global attention on the ecosystem services provided by tropical forests. It will be the largest field experiment of its kind in the tropics aimed at quantifying the environmental services (water, carbon, and biodiversity) provided by tropical forests. The Agua Salud Watershed is our principal field site. This watershed and the headwaters of several adjacent rivers include both protected mature forests and a wide variety of land uses that are typical of rural Panama. Experiments at the scale of entire catchments will permit complete water and carbon inventories and exchanges for different landscape uses. The following questions will be addressed: (1) How do landscape treatments and management approaches affect ecosystem services such as carbon storage, water quality and quantity, dry- season water supply, and biodiversity? (2) Can management techniques be designed to optimize forest production along with ecosystem services during reforestation? (3) Do different tree planting treatments and landscape management approaches influence groundwater storage, which is thought to be critical to maintaining dry-season flow, thus insuring the full operation of the Canal during periods of reduced rainfall and severe climatic events such as El Niño. In addition we anticipate expanding this project to address biodiversity, social, and economic values of these forests.

  10. Leveraging Resources to Create Comprehensive Access Services

    ERIC Educational Resources Information Center

    Boisvert, Pamela K.

    2007-01-01

    The Colleges of Worcester Consortium has created a broad array of statewide, higher education access services over several decades by leveraging federal, state, local, and foundation resources. The consortium comprises thirteen diverse colleges and universities in central Massachusetts and is a nonprofit regional association of these institutions:…

  11. Full Service Document Delivery: Our Likely Future.

    ERIC Educational Resources Information Center

    Saldinger, Jeffrey

    1984-01-01

    Focuses on five issues of central concern to full-service document suppliers (provide on-demand delivery of any material, without limitations of subject, document type, or publication date) and their clients: end user access, ownership versus access, cooperation of all document suppliers, technology, and speed of access. (EJS)

  12. Diabetes and Adult Day Health Services

    ERIC Educational Resources Information Center

    Dabelko, Holly I.; DeCoster, Vaughn A.

    2007-01-01

    The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…

  13. Service vs. Revenue: Conflict or Convergence?

    ERIC Educational Resources Information Center

    DeBard, Robert; Overland, Wanda I.

    2003-01-01

    Discusses how administrators at Bowling Green State University, Ohio, worked to reconcile politics, economics, and today's consumer-oriented students as it renovated the student union, suggesting that a central issue for those responsible for determining services to be provided by student centers is what can best be outsourced and what can be kept…

  14. The New Academic Library and Student Services

    ERIC Educational Resources Information Center

    Morris, Jim

    2007-01-01

    The academic library in the 21st Century must find innovative ways to remain central to the mission of the institution that it represents, and the people that it serves. Some of those ways involve what traditionally has been the province of student services. After hours events with music and art, poetry slams, and electronic gaming are a few of…

  15. INTERIOR VIEW, NORTHWEST ATTIC CHAMBER FROM THE CENTRAL PASSAGE. (NOTE ...

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

    INTERIOR VIEW, NORTHWEST ATTIC CHAMBER FROM THE CENTRAL PASSAGE. (NOTE THE LEFT JAMB OF THE ARCHITRVE MOLDING AROUND THE DOOR. ALL OF THE SERVICE SPACES THROUGHOUT THE WOODLANDS INCLUDED THIS DEGREE OF REFINEMENT - The Woodlands, 4000 Woodlands Avenue, Philadelphia, Philadelphia County, PA

  16. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  17. Measuring Customer Satisfaction. A Central Texas JTPA Study.

    ERIC Educational Resources Information Center

    Angel, P. Linda

    A study was conducted to determine the baseline by which to measure expected improvements in customer satisfaction for Central Texas Job Training Partnership (JTPA) programs. The survey was designed to facilitate assessment of the current level of customer satisfaction with service delivery and influences on customer satisfaction. Data were…

  18. CENTRAL FOOD STORE FACILITIES FOR COLLEGES AND UNIVERSITIES.

    ERIC Educational Resources Information Center

    BLOOMFIELD, BYRON C.

    INSPECTION OF A NUMBER OF INSTALLATIONS WAS ORIENTED TOWARD ARCHITECTURAL AND PLANNING QUESTIONS INVOLVING ECONOMICS AND SERVICES OF CENTRAL FOOD STORE FACILITIES. COMMENCING WITH THE PURCHASING PHILOSOPHY WHICH OVERVIEWS THE ORGANIZATION OF FOODS PURCHASING, SELECTION OF PERSONNEL, SPECIFICATIONS FOR PURCHASING, TECHNIQUES FOR PURCHASING, AND…

  19. 4. VIEW LOOKING WEST DOWN CENTRAL AVENUE AT THE INTERSECTION ...

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

    4. VIEW LOOKING WEST DOWN CENTRAL AVENUE AT THE INTERSECTION WITH SEVENTH STREET. THE PLANT HAS MOST OF THE AMENITIES OF A SMALL TOWN - WATER SUPPLY, WASTE WATER TREATMENT, POLICE FORCE, FIRE DEPARTMENT, FOOD SERVICES, HOSPITAL, COMMUNICATIONS NETWORK, STEAM GENERATION, VEHICLE MAINTENANCE, TRANSPORTATION, AND A GOVERNMENT. - Rocky Flats Plant, Bounded by Indiana Street & Routes 93, 128 & 72, Golden, Jefferson County, CO

  20. Executive Roundtables, 1981: A Report on Central Virginia at Work.

    ERIC Educational Resources Information Center

    Central Virginia Community Coll., Lynchburg.

    In fall 1981, the Central Virginia Community College (CVCC) Board organized five executive roundtable discussions in which representatives of local business and industry, government and social services, and the minority community met with college representatives to evaluate the responsiveness of CVCC to local needs and to assess areas in which the…

  1. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  2. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  3. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  4. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  5. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  6. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  7. A computerized aircraft battery servicing facility

    NASA Technical Reports Server (NTRS)

    Glover, Richard D.

    1992-01-01

    The latest upgrade to the Aerospace Energy Systems Laboratory (AESL) is described. The AESL is a distributed digital system consisting of a central system and battery servicing stations connected by a high-speed serial data bus. The entire system is located in two adjoining rooms; the bus length is approximately 100 ft. Each battery station contains a digital processor, data acquisition, floppy diskette data storage, and operator interfaces. The operator initiates a servicing task and thereafter the battery station monitors the progress of the task and terminates it at the appropriate time. The central system provides data archives, manages the data bus, and provides a timeshare interface for multiple users. The system also hosts software production tools for the battery stations and the central system.

  8. Social determinants of workers' health in Central America.

    PubMed

    Aragón, Aurora; Partanen, Timo; Felknor, Sarah; Corriols, Marianela

    2011-01-01

    This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region. PMID:21905391

  9. P2P Approach for Web Services Publishing and Discovery

    NASA Astrophysics Data System (ADS)

    Islam, Mohmammad Towhidul; Akon, Mursalin; Shen, Xuemin (Sherman)

    Web service is an emerging paradigm for distributing business applications from different platforms to a wide variety of clients. The critical factor in seamlessly accessing web services is to discover the appropriate service and the related service providers. Unfortunately, current web service technologies use centralized directory to keep the service index, which is not scalable and at the same time vulnerable to single point of failure. Peer to peer system is a popular decentralized architecture which can be used for key look up service with scalability and self organization. Thus there is an opportunity to intersect the P2P framework with web services to provide the scalable solution. In this chapter, we discuss the key methods to deploy web services using the peer-to-peer technology.

  10. 75 FR 9576 - Civil Nuclear Policy Mission to Central and Eastern Europe

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-03

    ....S. companies from across the civil nuclear supply chain, including engineering services; fuel... International Trade Administration Civil Nuclear Policy Mission to Central and Eastern Europe AGENCY... States Department of Commerce, International Trade Administration is organizing a Civil Nuclear...

  11. Central pit craters on Ganymede

    NASA Astrophysics Data System (ADS)

    Alzate, Nathalia; Barlow, Nadine G.

    2011-02-01

    Central pit craters are common on Mars, Ganymede and Callisto, and thus are generally believed to require target volatiles in their formation. The purpose of this study is to identify the environmental conditions under which central pit craters form on Ganymede. We have conducted a study of 471 central pit craters with diameters between 5 and 150 km on Ganymede and compared the results to 1604 central pit craters on Mars (diameter range 5-160 km). Both floor and summit pits occur on Mars whereas floor pits dominate on Ganymede. Central peak craters are found in similar locations and diameter ranges as central pit craters on Mars and overlap in location and at diameters <60 km on Ganymede. Central pit craters show no regional variations on either Ganymede or Mars and are not concentrated on specific geologic units. Central pit craters show a range of preservation states, indicating that conditions favoring central pit formation have existed since crater-retaining surfaces have existed on Ganymede and Mars. Central pit craters on Ganymede are generally about three times larger than those on Mars, probably due to gravity scaling although target characteristics and resolution also may play a role. Central pits tend to be larger relative to their parent crater on Ganymede than on Mars, probably because of Ganymede's purer ice crust. A transition to different characteristics occurs in Ganymede's icy crust at depths of 4-7 km based on the larger pit-to-crater-diameter relationship for craters in the 70-130-km-diameter range and lack of central peaks in craters larger than 60-km-diameter. We use our results to constrain the proposed formation models for central pits on these two bodies. Our results are most consistent with the melt-drainage model for central pit formation.

  12. Future Flight Central

    NASA Technical Reports Server (NTRS)

    1999-01-01

    NASA 'Future Flight Central,' the world's first full-scale virtual airport control tower, opened December 13, 1999 at NASA Ames Research Center, Moffett Field, California. Constructed at a cost of $10 million, the two story facility was jointly funded by NASA and the Federal Aviation Administration (FAA). The facility is designed to test ways to solve potential air and ground traffic problems at commercial airports under realistic airport conditions and configurations. The facility provides an opportunity for airlines and airports to mitigate passenger delays by fine tuning airport hub operations, gate management, ramp movement procedures, and various other airport improvements. Twelve rear projection screens provide a seamless 360 degree high- resolution view of the airport or other screens being depicted. The imaging system, powered by supercomputers, provides a realistic view of weather conditions, enviromental and seasonal effects and the movement of up to 200 active aircraft and ground vehicles.

  13. Brucellosis in Central America.

    PubMed

    Moreno, Edgardo

    2002-12-20

    Brucellosis is a disease of domestic animals and humans in Central America (CA). Bovine and swine brucellosis caused by Brucella abortus and Brucella suis, respectively, have been identified in all CA countries, while ovine and caprine brucellosis caused by Brucella melitensis has been detected in Guatemala. The prevalence of bovine brucellosis is estimated between 4 and 8%, with higher prevalence in dairy herds, with losses calculated at 25 million US dollars per year. National Control Programs based in calf vaccination and removal of the reactors have had little impact in the control of brucellosis in CA. In a region where experimentation with new vaccines is not affordable, unrestricted adult vaccination by the conjunctival route with S19 is recommended. This strategy is expected to reduce the prevalence and density of the bacteria to numbers where "clean" vaccination would be possible. Thereafter, serological identification and elimination of the reactors could be initiated under more favorable conditions of herd infection. PMID:12414131

  14. Flooding in Central China

    NASA Technical Reports Server (NTRS)

    2002-01-01

    During the summer of 2002, frequent, heavy rains gave rise to floods and landslides throughout China that have killed over 1,000 people and affected millions. This false-color image of the western Yangtze River and Dongting Lake in central China was acquired on August 21, 2002, by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra spacecraft. (right) The latest flooding crisis in China centers on Dingtong Lake in the center of the image. Heavy rains have caused it to swell over its banks and swamp lakefront towns in the province of Hunan. As of August 23, 2002, more than 250,000 people have been evacuated, and over one million people have been brought in to fortify the dikes around the lake. Normally the lake would appear much smaller and more defined in the MODIS image. Credit: Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC.

  15. Central solar energy receiver

    DOEpatents

    Drost, M. Kevin

    1983-01-01

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  16. Thermal Performance Data Services (TPDS)

    NASA Technical Reports Server (NTRS)

    French, Richard T.; Wright, Michael J.

    2013-01-01

    Initiated as a NASA Engineering and Safety Center (NESC) assessment in 2009, the Thermal Performance Database (TPDB) was a response to the need for a centralized thermal performance data archive. The assessment was renamed Thermal Performance Data Services (TPDS) in 2012; the undertaking has had two fronts of activity: the development of a repository software application and the collection of historical thermal performance data sets from dispersed sources within the thermal performance community. This assessment has delivered a foundational tool on which additional features should be built to increase efficiency, expand the protection of critical Agency investments, and provide new discipline-advancing work opportunities. This report contains the information from the assessment.

  17. Central America's shrinking forests.

    PubMed

    1992-01-01

    This news brief reports that 66% of deforestation in Central America has happened in the past 40 years, based on World Conservation Union (WCU) data. Deforestation is expected to continue. The population of Central America and Mexico grew by 28% between 1977 and 1987. Growth is decreasing but remains high at 2.5% in all countries of the region except Panama. 29 million was the regional population in 1990; the projection is for 63 million by 2025. Population is migrating to urban centers. Forests declined by 13% and croplands increased from 4% to 13% of total land area and pasture land from 2% to 37%. There was an increase in unproductive land from 145 to 24%, i.e., 50% of El Salvador's land had soil degradation as does 30% of Guatemala's. In addition to deforestation and soil degradation, there has been soil erosion leading to sedimentation buildup near dam sites and in rivers, which diminishes hydroelectric power capability. Silting also affects groundwater resources, which impact on a safe drinking water supply. Population growth results in increased demand for fuelwood, urban land, and agricultural land. New techniques practiced widely are needed in order to meet the region's needs or demands. Slowing population growth buys time for adjusting to the necessary changes needed for sustaining the region's population. WCU urges conservation organizations to raise awareness about the role population plays in environmental degradation, and to support efforts to reduce birth rates. Women's status needs to be improved through income-generating projects, for instance, and cooperation is needed between conservation groups and organizations involved with improving maternal and child health. PMID:12285833

  18. Jobs with Service Programs: Home Services

    ERIC Educational Resources Information Center

    Kahl, Anne

    1976-01-01

    A review of the kinds of jobs available in services developed to help the homebound elderly: Home health care, homemaker-home health aide, chore service, home repair and maintenance, home-delivered meals, telephone reassurance, and friendly visiting. (JT)

  19. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  20. Managing Copyright Clearance Services in Higher Education Libraries.

    ERIC Educational Resources Information Center

    Gadd, Elizabeth

    2001-01-01

    Investigated centralized copyright clearance services in higher education institutions based on the findings of a questionnaire survey and five case study interviews in United Kingdom libraries. Examines reasons why services were established, how they were funded and staffed, their overall remit, problems, and good practice guidelines. (Author/LRW)

  1. Leadership for Service-Learning: The National Leadership Conference.

    ERIC Educational Resources Information Center

    Kielsmeier, James C.

    The central theme of the 10-day National Leadership Conference (NLC), sponsored by the American Youth Foundation at Camp Miniwanca (Michigan), is to train high school students in leadership for service; its goal is to sharpen service-learning leadership skills of young people and teachers and to encourage their application to transform and serve…

  2. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  3. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  4. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  5. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  6. 18 CFR 367.25 - Determination of service cost.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Determination of service cost. 367.25 Section 367.25 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT...

  7. 18 CFR 367.25 - Determination of service cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Determination of service cost. 367.25 Section 367.25 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT...

  8. 18 CFR 367.25 - Determination of service cost.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Determination of service cost. 367.25 Section 367.25 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT...

  9. 18 CFR 367.25 - Determination of service cost.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Determination of service cost. 367.25 Section 367.25 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT...

  10. 18 CFR 367.25 - Determination of service cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Determination of service cost. 367.25 Section 367.25 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT...

  11. The Progression of Early Intervention Disability Services in Ireland

    ERIC Educational Resources Information Center

    Carroll, Clare; Murphy, Geraldine; Sixsmith, Jane

    2013-01-01

    The Republic of Ireland is an island situated in north-west Europe inhabited by 4.6 million people, with 2.8% between 0 and 4 years of age with a disability (Central Statistics Office, 2012). The Irish Government funds the Irish health services, which, in turn, directly and indirectly funds disability services. Education and Disability legislation…

  12. Advancing the Women's Agenda within Bureaucracies: Services for Rape Victims.

    ERIC Educational Resources Information Center

    Boles, Janet K.

    Those studying the distribution of urban services have generally concluded that services are distributed according to bureaucratic decision rules based on professional and bureaucratic norms such as need, efficiency, economy, equity, and convenience. Interest groups and elected officials may play a central role in effecting changes in bureaucratic…

  13. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 9 2013-01-01 2013-01-01 false Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  14. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 9 2012-01-01 2012-01-01 false Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  15. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  16. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  17. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 true Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  18. 78 FR 11733 - Georgia Southwestern Railroad, Inc.-Discontinuance of Service Exemption-in Chattahoochee, Marion...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... Surface Transportation Board Georgia Southwestern Railroad, Inc.--Discontinuance of Service Exemption--in Chattahoochee, Marion, and Schley Counties, GA.; Central of Georgia Railroad Company--Discontinuance of Service Exemption--in Chattahoochee, Marion, and Schley Counties, GA Central of Georgia Railroad Company (CGA)...

  19. Encouraging Community Service through Service Learning.

    ERIC Educational Resources Information Center

    McCarthy, Anne M.; Tucker, Mary L.

    2002-01-01

    Using a modified Solomon four-group design, 437 business students were divided into 6 treatment and 2 control groups. Treatments included service-learning lectures, service-learning projects, or lecture and project with and/or without pre and posttests. Hierarchical regression analyses indicated service learning treatments significantly affected…

  20. Cable Television Service; Cable Television Relay Service.

    ERIC Educational Resources Information Center

    Federal Register, 1972

    1972-01-01

    The rules and regulations of the Federal Communications Commission (FCC) concerning cable television service and cable relay service are presented along with the comments of the National Cable Television Association, the National Association of Broadcasters, the Association of Maximum Service Telecasters, and a major group of program suppliers.…

  1. Designing Quality Service: The Service Excellence Model.

    ERIC Educational Resources Information Center

    Ellicott, Michael A.; Conard, Rodney J.

    1997-01-01

    Recent experiences of manufacturing and commercial service industries provide insights to college facilities managers for combining downsizing with quality improvement. The Service Excellence Model emphasizes creation of shared responsibility, focus on core service processes, empowerment of cross-functional process-improvement teams, performance…

  2. Le domaine des co-infections et des maladies concomitantes du Réseau canadien pour les essais VIH des IRSC : lignes directrices canadiennes pour la prise en charge et le traitement de la co-infection par le VIH et l’hépatite C chez les adultes

    PubMed Central

    Hull, Mark; Giguère, Pierre; Klein, Marina; Shafran, Stephen; Tseng, Alice; Côté, Pierre; Poliquin, Marc; Cooper, Curtis

    2014-01-01

    HISTORIQUE : De 20 % à 30 % des Canadiens qui vivent avec le VIH sont co-infectés par le virus de l’hépatite C (VHC), lequel est responsable d’une morbidité et d’une mortalité importantes. La prise en charge du VIH et du VHC est plus complexe en raison de l’évolution accélérée de la maladie hépatique, du choix et des critères d’initiation de la thérapie antirétrovirale et du traitement anti-VHC, de la prise en charge de la santé mentale et des toxicomanies, des obstacles socioéconomiques et des interactions entre les nouvelles thérapies antivirales à action directe du VHC et les antirétroviraux OBJECTIF : Élaborer des normes nationales de prise en charge des adultes co-infectés par le VHC et le VIH dans le contexte canadien. MÉTHODOLOGIE : Le Réseau canadien pour les essais VIH des Instituts de recherche en santé du Canada a réuni un groupe d’experts possédant des compétences cliniques en co-infection par le VIH et le VHC pour réviser les publications à jour ainsi que les lignes directrices et les protocoles en place. Après une vaste sollicitation afin d’obtenir des points de vue, le groupe de travail a approuvé des recommandations consensuelles, qu’il a caractérisées au moyen d’une échelle de qualité des preuves fondée sur la classe (bienfaits par rapport aux préjudices) et sur la catégorie (degré de certitude). RÉSULTATS : Toutes les personnes co-infectées par le VIH et le VHC devraient subir une évaluation en vue de recevoir un traitement du VHC. Les personnes qui ne sont pas en mesure d’entreprendre un traitement du VHC devraient être soignées pour le VIH afin de ralentir l’évolution de la maladie hépatique. La norme de traitement du VHC de génotype 1 est un régime comprenant de l’interféron pégylé et de la ribavirine dosée en fonction du poids, associés à un inhibiteur de la protéase du VHC. Pour les génotypes 2 ou 3, une bithérapie classique est recommandée pendant 24 semaines s

  3. The International Doris Service (IDS)

    NASA Astrophysics Data System (ADS)

    Tavernier, G.; Feissel-Vernier, M.; Lemoine, F.; Noll, C.; Ries, J.; Soudarin, L.; Willis, P.

    The DORIS system was developed for precise orbit determination and precise positioning on Earth. In continuation of the DORIS Pilot Experiment initiated in 1999, the International DORIS Service (IDS) officially started on July 1, 2003 as an IAG Service after the decision of the IAG Executive Committee at the IUGG General Assembly in Sapporo. Following this decision, the IERS Directing board accepted the DORIS Service as a new IERS external service. Six satellites fitted out with DORIS receivers are currently flying, permanently observed by 56 well distributed stations. Among them, three satellites equipped with new DORIS receivers (Jason-1, ENVISAT and SPOT5) have been successfully launched between Dec. 2001 and May 2002. All of them host a navigation function, called DIODE. Two new stations have been added to the permanent network in 2003: Crozet (French Southern Indian Ocean territories) and Jiufeng (China). In response to proposals submitted by candidate host agencies in the frame of IDS, the following stations were installed: Wettzell (Germany), Gavdos (radar altimeter calibration site in Crete), Lambert and Sorsdal (Glacier movement monitoring in Antarctica) in Winter 2001/2002, 2002/2003 and 2003/2004. The 2003 and early 2004 highlights include the renovation of a number of stations, reorganization of the Data Centers, and new developments in the coordination of analyses. While the Analysis Centers continue their support to IERS, the Analysis Coordinator and the Central Bureau are jointly developing comparison and combination activities that eventually aim at benefiting to the IERS Combination Pilot Project.

  4. Prevention of unsafe abortion in countries of Central Eastern Europe and Central Asia.

    PubMed

    Hodorogea, Stelian; Comendant, Rodica

    2010-07-01

    Despite permissive laws and a well-developed network of facilities, the incidence of unsafe abortion and the resulting maternal mortality is unacceptably high in Central and Eastern Europe and Central Asia, with one-quarter of all maternal deaths reported to occur as a consequence of abortion. Among the reasons that oblige women to submit themselves to risky procedures are new legislative barriers to accessing pregnancy termination, the unequal distribution of abortion services and healthcare providers, the increased costs of abortion services or unofficial payments, coupled with an increase in the number of impoverished and disadvantaged individuals. The quality of abortion services remains very poor. Safe abortion techniques, including manual vacuum aspiration under local anesthesia and medical abortion, are slowly being implemented. Less safe methods such as dilatation and curettage and general anesthesia are widely used. Unsafe techniques are also practiced extensively in the case of second trimester abortions. Many women from these regions of the world still rely on and accept abortion as a means of fertility control. Although abortions have fallen significantly in Eastern Europe over the last decade, both in absolute numbers and as rates, this region continues to have the highest abortion rates in the world. Concerted efforts by governments, professional associations, and international donors are needed to reduce the consequences of unsafe abortion. PMID:20471645

  5. Evaluation of Service Activities Undertaken by the Educational Service Center for the Period July 1, 1967 to December, 1968.

    ERIC Educational Resources Information Center

    Legant, Jean

    According to this 1967-68 evaluation report, the Educational Service Center (ESC)--funded under Title III of the Elementary and Secondary Education Act--provided on-demand services to 29 northern, central, and western New Mexico school districts. In the document, 9 tables show the distribution and variety of ESC assistance in the areas of…

  6. Marketing Youth Services.

    ERIC Educational Resources Information Center

    Dimick, Barbara

    1995-01-01

    Marketing techniques in youth services are useful for designing programs, collections, and services and for determining customer needs. The marketing mix--product, place, price, and practice--provides a framework for service analysis. (AEF)

  7. Theme: Service Learning.

    ERIC Educational Resources Information Center

    Agricultural Education Magazine, 2001

    2001-01-01

    Twelve theme articles discuss service learning and reflection in agricultural education, student perspective on service learning, Future Farmers of America, character education, intergenerational projects, agricultural communications, and service learning as advocacy. (SK)

  8. 76 FR 4393 - Discover Financial Services Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... Discover Financial Services Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION... Financial Services negotiated service agreement to the market dominant product list. This notice addresses... 3020, et seq., to add a Discover Financial Services (DFS) negotiated service agreement to the...

  9. An Empirically Developed Model for Evaluating the Central Office Operations of a School System.

    ERIC Educational Resources Information Center

    Carriker, Don

    This model provides a structure for uniformly evaluating all operations of a school central office, where the assumption that those offices exist to provide services is tenable. The model provides a means for assessing the importance as well as the efficiency with which the tasks of central office operations are carried out. Formative data is…

  10. 78 FR 63481 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  11. 77 FR 20037 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  12. 78 FR 20328 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  13. 75 FR 36428 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  14. 75 FR 12768 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  15. 76 FR 3912 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  16. 75 FR 17417 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  17. 78 FR 63478 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  18. 41 CFR 101-5.105 - Operation of the centralized facility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Operation of the centralized facility. 101-5.105 Section 101-5.105 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES...

  19. 38 CFR 14.502 - Requests for legal opinions from Central Office.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... opinions from Central Office. 14.502 Section 14.502 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS § 14.502 Requests for legal opinions from Central Office. Requests for formal legal advice, including interpretation of law...

  20. 38 CFR 14.502 - Requests for legal opinions from Central Office.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... opinions from Central Office. 14.502 Section 14.502 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS § 14.502 Requests for legal opinions from Central Office. Requests for formal legal advice, including interpretation of law...

  1. 38 CFR 14.502 - Requests for legal opinions from Central Office.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... opinions from Central Office. 14.502 Section 14.502 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS § 14.502 Requests for legal opinions from Central Office. Requests for formal legal advice, including interpretation of law...

  2. 38 CFR 14.502 - Requests for legal opinions from Central Office.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... opinions from Central Office. 14.502 Section 14.502 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS § 14.502 Requests for legal opinions from Central Office. Requests for formal legal advice, including interpretation of law...

  3. 75 FR 16175 - Notice of Inventory Completion: Museum of Cultural and Natural History, Central Michigan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... National Park Service Notice of Inventory Completion: Museum of Cultural and Natural History, Central... possession of the Museum of Cultural and Natural History, Central Michigan University, Mt. Pleasant, MI. The... notice. A detailed assessment of the human remains was made by the Museum of Cultural and Natural...

  4. 7 CFR 319.56-25 - Papayas from Central America and Brazil.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Papayas from Central America and Brazil. 319.56-25 Section 319.56-25 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOREIGN QUARANTINE NOTICES Fruits and Vegetables § 319.56-25 Papayas from Central America...

  5. Cancer Genetics Services Directory

    MedlinePlus

    ... Overview–for health professionals Research NCI Cancer Genetics Services Directory This directory lists professionals who provide services related to cancer genetics (cancer risk assessment, genetic ...

  6. Central Nervous System Lipoproteins

    PubMed Central

    Mahley, Robert W.

    2016-01-01

    ApoE on high-density lipoproteins is primarily responsible for lipid transport and cholesterol homeostasis in the central nervous system (CNS). Normally produced mostly by astrocytes, apoE is also produced under neuropathologic conditions by neurons. ApoE on high-density lipoproteins is critical in redistributing cholesterol and phospholipids for membrane repair and remodeling. The 3 main structural isoforms differ in their effectiveness. Unlike apoE2 and apoE3, apoE4 has markedly altered CNS metabolism, is associated with Alzheimer disease and other neurodegenerative disorders, and is expressed at lower levels in brain and cerebrospinal fluid. ApoE4-expressing cultured astrocytes and neurons have reduced cholesterol and phospholipid secretion, decreased lipid-binding capacity, and increased intracellular degradation. Two structural features are responsible for apoE4 dysfunction: domain interaction, in which arginine-61 interacts ionically with glutamic acid-255, and a less stable conformation than apoE3 and apoE2. Blocking domain interaction by gene targeting (replacing arginine-61 with threonine) or by small-molecule structure correctors increases CNS apoE4 levels and lipid-binding capacity and decreases intracellular degradation. Small molecules (drugs) that disrupt domain interaction, so-called structure correctors, could prevent the apoE4-associated neuropathology by blocking the formation of neurotoxic fragments. Understanding how to modulate CNS cholesterol transport and metabolism is providing important insights into CNS health and disease. PMID:27174096

  7. Central Disorders of Hypersomnolence

    PubMed Central

    Khan, Zeeshan

    2015-01-01

    The central disorders of hypersomnolence are characterized by severe daytime sleepiness, which is present despite normal quality and timing of nocturnal sleep. Recent reclassification distinguishes three main subtypes: narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia (IH), which are the focus of this review. Narcolepsy type 1 results from loss of hypothalamic hypocretin neurons, while the pathophysiology underlying narcolepsy type 2 and IH remains to be fully elucidated. Treatment of all three disorders focuses on the management of sleepiness, with additional treatment of cataplexy in those patients with narcolepsy type 1. Sleepiness can be treated with modafinil/armodafinil or sympathomimetic CNS stimulants, which have been shown to be beneficial in randomized controlled trials of narcolepsy and, quite recently, IH. In those patients with narcolepsy type 1, sodium oxybate is effective for the treatment of both sleepiness and cataplexy. Despite these treatments, there remains a subset of hypersomnolent patients with persistent sleepiness, in whom alternate therapies are needed. Emerging treatments for sleepiness include histamine H3 antagonists (eg, pitolisant) and possibly negative allosteric modulators of the gamma-aminobutyric acid-A receptor (eg, clarithromycin and flumazenil). PMID:26149554

  8. Central odontogenic fibroma

    PubMed Central

    Venugopal, Sanjay; Radhakrishna, Satish; Raj, Akshatha; Sawhney, Anshul

    2014-01-01

    Central odontogenic fibroma (COF), which has been categorized under the subheading of odontogenic tumors of ectomesenchyme, is such an uncommon neoplasm that much of its nature is left uncharted. COF is a rare tumor that accounts for 0.1% of all odontogenic tumors. Clinically, the lesion grows slowly and leads to cortical expansion. Radiologically, the lesion may be unilocular or multilocular. In some cases, it may be associated with root resorption or displacement. Histopathologically, the lesion is characterized by mature collagen fibers and numerous fibroblasts. A case of COF of the mandible in a male patient aged 49 years is described in this report. The patient showed no symptoms, no history of swelling discomfort or pain, and was unaware of the presence of the lesion. Orthopantomogram (OPG) showed generalized bone loss along with a unilocular radiolucent area, with a clear sclerotic lining and angular bone loss. Surgical enucleation of the lesion along with placement of osseo-graft, which is a bioresorbable demineralized bone matrix (DMBM), and platelet-rich fibrin was carried out in the defect site. Following surgery, patient was recalled for revaluation of the lesion; the surgical site showed good healing and an increase in bone height was seen. PMID:24872637

  9. [Central auditory prosthesis].

    PubMed

    Lenarz, T; Lim, H; Joseph, G; Reuter, G; Lenarz, M

    2009-06-01

    Deaf patients with severe sensory hearing loss can benefit from a cochlear implant (CI), which stimulates the auditory nerve fibers. However, patients who do not have an intact auditory nerve cannot benefit from a CI. The majority of these patients are neurofibromatosis type 2 (NF2) patients who developed neural deafness due to growth or surgical removal of a bilateral acoustic neuroma. The only current solution is the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus in the brainstem. Although the ABI provides improvement in environmental awareness and lip-reading capabilities, only a few NF2 patients have achieved some limited open set speech perception. In the search for alternative procedures our research group in collaboration with Cochlear Ltd. (Australia) developed a human prototype auditory midbrain implant (AMI), which is designed to electrically stimulate the inferior colliculus (IC). The IC has the potential as a new target for an auditory prosthesis as it provides access to neural projections necessary for speech perception as well as a systematic map of spectral information. In this paper the present status of research and development in the field of central auditory prostheses is presented with respect to technology, surgical technique and hearing results as well as the background concepts of ABI and AMI. PMID:19517084

  10. [MANAGEMENT OF CENTRAL HYPERSOMNIAS].

    PubMed

    Dauvilliers, Yves; Lopez, Régis

    2016-06-01

    Central hypersomnias include narcolepsy type 1, type 2 and idiopathic hypersomnia with daytime sleepiness excessive in the foreground of the clinical symptoms. Despite major advances in our understanding of the mechanisms of the narcolepsy type 1 with a low level of hypocretin-1 in cerebrospinal fluid, its current management is only symptomatic. The current management is also only symptomatic for type 2 narcolepsy and idiopathic hypersomnia with an unknown pathophysiology. Treatment options may vary from a single drug targeting several symptoms or several drugs treating a specific symptom. The treatment of daytime sleepiness is based on modafinil in first intention. Other psychostimulants such as methylphenidate, pitolisant and exceptionally dextro-amfetamine may be considered. In narcolepsy type 1, antidepressants such as inhibitors of the reuptake of serotonin and noradrenaline will be considered to improve cataplexy. Sodium oxybate is an effective treatment on sleepiness, cataplexy and bad night sleep in narcolepsy. The management for other symptoms or comorbidities should be considered it necessary such as hallucinations, sleep paralysis, the disturbed nighttime sleep, unpleasant dreams, parasomnias, depressive symptoms, overweight/obesity, cardiovascular disease and obstructive sleep apnea syndrome. Important therapeutic perspectives are to be expected concerning new psychostimulant and anticataplectiques, but mainly on immune-based therapies administered as early as possible after disease onset and on hypocretin replacement therapy for patients with severe symptoms. PMID:27538329

  11. Central pontine myelinolysis.

    PubMed

    Kiley, M A; King, M; Burns, R J

    1999-03-01

    Central pontine myelinolysis (CPM) was initially associated with alcoholism. Subsequently other factors, including rapid reversal of hyponatraemia and extreme serum hypoosmolality associated with severe burns, have been identified as other important factors in its pathogenesis. Extra-pontine lesions have also been described. CPM may be found at autopsy, either having been overlooked during life or as an incidental finding. Its precise incidence is not known but the ability to diagnose it during life has been helped by modern neuroimaging, particularly magnetic resonance imaging (MRI) of the brain stem. In the past the prognosis for CPM was thought to be invariably fatal. It is clear now that with the greater general awareness of the disorder and the ability to diagnose it during life that some degree of recovery is possible. However, the number who do recover and the degree of recovery is not known. We report a 40-year-old man who developed CPM presenting with quadriparesis and inability to speak and swallow. There were risk factors for CPM and the diagnosis was confirmed by MRI scanning. He made a complete recovery although he remains ataxic. We are reporting this case as we believe it is important to make clinicians aware of the potential for recovery of CPM. While no specific treatment has been shown to influence the degree and rate of recovery of the demyelination, the fact that the quadriplegia and bulbar paralysis can recover fully is of considerable importance. In particular, it means that when the diagnosis is made, complete and vigorous nursing and medical care is warranted. PMID:18639140

  12. Central and southern Africa

    SciTech Connect

    McGrew, H.J.

    1981-10-01

    Exploration in central and southern Africa continued to expand during 1980. The greatest concentration of activity was in Nigeria. However, there was considerable increase in the level of exploratory work in Cameroon and Congo. Significant new finds have been made in Ivory Coast. Geological and geophysical activity was carried out in 18 of the countries, with those in the western part having the largest share. Seismic work involved 225 party months of operation. Most of this time was spent on land, but marine operations accounted for 73,389 km of new control. Gravity and magnetic data were recorded during the marine surveys, and several large aeromagnetic projects were undertaken to obtain a total of 164,498 line km of data. Exploratory and development drilling accounted for a total of 304 wells and 2,605,044 ft (794,212 m) of hole. The 92 exploratory wells that were drilled resulted in 47 oil and gas discoveries. In development drilling 89% of the 212 wells were successful. At the end of the year, 27 exploratory wells were underway, and 34 development wells were being drilled for a total of 61. Oil production from the countries that this review covers was 918,747,009 bbl in 1980, a drop of about 9% from the previous year. Countries showing a decline in production were Nigeria, Gabon, Cabinda, and Zaire. Increases were recorded in Cameroon, Congo, and Ghana. A new country was added to the list of producers when production from the Belier field in Ivory Coast came on stream. 33 figures, 15 tables.

  13. 78 FR 18335 - Central Arizona Project-Rate Order No. WAPA-158

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ...This action is to extend the rate setting formula for the Central Arizona Project, reflected in Transmission Service Rate Schedules CAP-FT2, CAP-NFT2, and CAP-NITS2, from January 1, 2013, through December 31, 2015. These Transmission Service Rate Schedules contain formula rates recalculated from annual updated financial and load...

  14. Central American Grandparents Raising Grandchildren

    ERIC Educational Resources Information Center

    Fuller-Thomson, Esme; Minkler, Meredith

    2007-01-01

    This study documents the prevalence and profile of Central American grandparents raising grandchildren in the United States of America. Using nationally representative data from the Census 2000 Supplementary Survey, Central American grandparent caregivers are compared with their noncare-giving peers. Results indicate that nationally an estimated…

  15. Estimating Health Services Requirements

    NASA Technical Reports Server (NTRS)

    Alexander, H. M.

    1985-01-01

    In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.

  16. Evaluating Internet Information Services.

    ERIC Educational Resources Information Center

    1996

    The following four papers focus on the topic of evaluating Internet information services: "Some Evaluation Criteria To Assess Internet Information Services" (Carmel Galvin); "The Teacher Librarian's Role as Evaluator of Internet Information Services" (Pru Mitchell); "How Students Evaluate Internet Information Services" (Ross Todd); and "Internet…

  17. Service Opportunities for Youths.

    ERIC Educational Resources Information Center

    Heffernan, David; Tarlov, Suzanne

    The emerging youth service movement has reinforced and built on the foundation of service in traditional organizations and focuses on tapping youth talent and energy. Youth service is a concept that has roots in pre-20th century American society. Service programs today increasingly include training, education, prevention, and employment…

  18. Library Reference Service.

    ERIC Educational Resources Information Center

    Schippleck, Suzanne

    The Inglewood, California, public library provides a manual on reference service. The theory, purpose, and objectives of reference are noted, and goals and activities are described in terms of budget, personnel, resources, and services. A chapter on organization covers service structure, information services, relationships with other library…

  19. Service Without Guns

    ERIC Educational Resources Information Center

    Eberly, Donald J.; Gal, Reuven

    2006-01-01

    "Service Without Guns"--by Donald J. Eberly and Reuven Gal with a guest chapter by Michael Sherraden--notes the many similarities between military service and civilian National Youth Service (NYS) and concludes that NYS can and should become as large and influential in the 21st Century as military service was in the 20th. The book examines the…

  20. Implementing Service Learning.

    ERIC Educational Resources Information Center

    Degelman, Charles, Ed.

    1999-01-01

    This theme issue of "Service-Learning Network" explores some challenges and rewards of integrating service learning into school and community culture. The lead article, "Integrating Community Service Learning with School Culture" (Sheldon Berman), surveys the integration of community service learning in the culture of school reform. "Program…

  1. Reference Service Policy Statement.

    ERIC Educational Resources Information Center

    Young, William F.

    This reference service policy manual provides general guidelines to encourage reference service of the highest possible quality and to insure uniform practice. The policy refers only to reference service in the University Libraries and is intended for use in conjunction with other policies and procedures issued by the Reference Services Division.…

  2. SHARING EDUCATIONAL SERVICES.

    ERIC Educational Resources Information Center

    Catskill Area Project in Small School Design, Oneonta, NY.

    SHARED SERVICES, A COOPERATIVE SCHOOL RESOURCE PROGRAM, IS DEFINED IN DETAIL. INCLUDED IS A DISCUSSION OF THEIR NEED, ADVANTAGES, GROWTH, DESIGN, AND OPERATION. SPECIFIC PROCEDURES FOR OBTAINING STATE AID IN SHARED SERVICES, EFFECTS OF SHARED SERVICES ON THE SCHOOL, AND HINTS CONCERNING SHARED SERVICES ARE DESCRIBED. CHARACTERISTICS OF THE SMALL…

  3. Central control of body temperature

    PubMed Central

    Morrison, Shaun F.

    2016-01-01

    Central neural circuits orchestrate the behavioral and autonomic repertoire that maintains body temperature during environmental temperature challenges and alters body temperature during the inflammatory response and behavioral states and in response to declining energy homeostasis. This review summarizes the central nervous system circuit mechanisms controlling the principal thermoeffectors for body temperature regulation: cutaneous vasoconstriction regulating heat loss and shivering and brown adipose tissue for thermogenesis. The activation of these thermoeffectors is regulated by parallel but distinct efferent pathways within the central nervous system that share a common peripheral thermal sensory input. The model for the neural circuit mechanism underlying central thermoregulatory control provides a useful platform for further understanding of the functional organization of central thermoregulation, for elucidating the hypothalamic circuitry and neurotransmitters involved in body temperature regulation, and for the discovery of novel therapeutic approaches to modulating body temperature and energy homeostasis. PMID:27239289

  4. Controlling centrality in complex networks

    PubMed Central

    Nicosia, V.; Criado, R.; Romance, M.; Russo, G.; Latora, V.

    2012-01-01

    Spectral centrality measures allow to identify influential individuals in social groups, to rank Web pages by popularity, and even to determine the impact of scientific researches. The centrality score of a node within a network crucially depends on the entire pattern of connections, so that the usual approach is to compute node centralities once the network structure is assigned. We face here with the inverse problem, that is, we study how to modify the centrality scores of the nodes by acting on the structure of a given network. We show that there exist particular subsets of nodes, called controlling sets, which can assign any prescribed set of centrality values to all the nodes of a graph, by cooperatively tuning the weights of their out-going links. We found that many large networks from the real world have surprisingly small controlling sets, containing even less than 5 – 10% of the nodes. PMID:22355732

  5. Central control of body temperature.

    PubMed

    Morrison, Shaun F

    2016-01-01

    Central neural circuits orchestrate the behavioral and autonomic repertoire that maintains body temperature during environmental temperature challenges and alters body temperature during the inflammatory response and behavioral states and in response to declining energy homeostasis. This review summarizes the central nervous system circuit mechanisms controlling the principal thermoeffectors for body temperature regulation: cutaneous vasoconstriction regulating heat loss and shivering and brown adipose tissue for thermogenesis. The activation of these thermoeffectors is regulated by parallel but distinct efferent pathways within the central nervous system that share a common peripheral thermal sensory input. The model for the neural circuit mechanism underlying central thermoregulatory control provides a useful platform for further understanding of the functional organization of central thermoregulation, for elucidating the hypothalamic circuitry and neurotransmitters involved in body temperature regulation, and for the discovery of novel therapeutic approaches to modulating body temperature and energy homeostasis. PMID:27239289

  6. North Central Thailand

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This radar image shows the dramatic landscape in the Phang Hoei Range of north central Thailand, about 40 kilometers (25 miles) northeast of the city of Lom Sak. The plateau, shown in green to the left of center, is the area of Phu Kradung National Park. This plateau is a remnant of a once larger plateau, another portion of which is seen along the right side of the image. The plateaus have been dissected by water erosion over thousands of years. Forest areas appear green on the image; agricultural areas and settlements appear as red and blue. North is toward the lower right. The area shown is 38 by 50 kilometers (24 by 31 miles) and is centered at 16.96 degrees north latitude, 101.67 degrees east longitude. Colors are assigned to different radar frequencies and polarizations as follows: red is L-band horizontally transmitted and horizontally received; green is L-band horizontally transmitted and vertically received; blue is C-band horizontally transmitted and vertically received. The image was acquired by the Spaceborne Imaging Radar-C/X-band Synthetic Aperture (SIR-C/X-SAR) imaging radar on October 3, 1994, when it flew aboard the space shuttle Endeavour. SIR-C/X-SAR is a joint mission of the U.S./German and Italian space agencies.

    Spaceborne Imaging Radar-C and X-Band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by

  7. MyOcean Central Information System - Achievements and Perspectives

    NASA Astrophysics Data System (ADS)

    de Dianous, Rémi; Jolibois, Tony; Besnard, Sophie

    2015-04-01

    MyOcean (http://www.myocean.eu) is providing a pre-operational service, for forecasts, analysis and expertise on ocean currents, temperature, salinity, sea level, primary ecosystems and ice coverage. Since 2009, three successive projects (MyOcean-I, MyOcean-II and MyOcean-Follow-on) have been designed to prepare and to lead the demonstration phases of the future Copernicus Marine Environment Monitoring Service. The main goal of these projects was to build a system of systems offering the users a unique access point to European oceanographic data. Reaching this goal at European level with 59 partners from 28 different countries was a real challenge: initially, each local system had its own human processes and methodology, its own interfaces for production and dissemination. At the end of MyOcean Follow-on, any user can connect to one web portal, browse an interactive catalogue of products and services, use one login to access all data disseminated through harmonized interfaces in a common format and contact a unique centralized service desk. In this organization the central information system plays a key role. The production of observation and forecasting data is done by 48 Production Units (PU). Product download and visualisation are hosted by 26 Dissemination Units (DU). All these products and associated services are gathered in a single system hiding the intricate distributed organization of PUs and DUs. This central system will be presented in detail, including notably the technical choices in architecture and technologies which have been made and why, and the lessons learned during these years of real life of the system, taking into account internal and external feedbacks. Then, perspectives will be presented to sketch the future of such system in the next Marine Copernicus Service which is meant to be fully operational from 2015 onwards.

  8. OCULUS Sea Track Fusion Service

    NASA Astrophysics Data System (ADS)

    Panagiotou, Stylianos C.; Rizogiannis, Constantinos; Katsoulis, Stavros; Lampropoulos, Vassilis; Kanellopoulos, Sotirios; Thomopoulos, Stelios C. A.

    2015-06-01

    Oculus Sea is a complete solution regarding maritime surveillance and communications at Local as well as Central Command and Control level. It includes a robust and independent track fusion service whose main functions include: 1) Interaction with the User to suggest the fusion of two or more tracks, confirm Track ID and Vessel Metadata creation for the fused track, and suggest de-association of two tracks 2) Fusion of same vessel tracks arriving simultaneously from multiple radar sensors featuring track Association, track Fusion of associated tracks to produce a more accurate track, and Multiple tracking filters and fusion algorithms 3) Unique Track ID Generator for each fused track 4) Track Dissemination Service. Oculus Sea Track Fusion Service adopts a system architecture where each sensor is associated with a Kalman estimator/tracker that obtains an estimate of the state vector and its respective error covariance matrix. Finally, at the fusion center, association and track state estimation fusion are carried out. The expected benefits of this system include multi-sensor information fusion, enhanced spatial resolution, and improved target detection.

  9. Eye casualty services in London

    PubMed Central

    Smith, H B; Daniel, C S; Verma, S

    2013-01-01

    The combined pressures of the European Working Time Directive, 4 h waiting time target, and growing rates of unplanned hospital attendances have forced a major consolidation of eye casualty departments across the country, with the remaining units seeing a rapid increase in demand. We examine the effect of these changes on the provision of emergency eye care in Central London, and see what wider lessons can be learned. We surveyed the managers responsible for each of London's 8 out-of-hours eye casualty services, analysed data on attendance numbers, and conducted detailed interviews with lead clinicians. At London's two largest units, Moorfields Eye Hospital and the Western Eye Hospital, annual attendance numbers have been rising at 7.9% per year (to 76 034 patients in 2010/11) and 9.6% per year (to 31 128 patients in 2010/11), respectively. Using Moorfields as a case study, we discuss methods to increase capacity and efficiency in response to this demand, and also examine some of the unintended consequences of service consolidation including patients travelling long distances to geographically inappropriate units, and confusion over responsibility for out-of-hours inpatient cover. We describe a novel ‘referral pathway' developed to minimise unnecessary travelling and delay for patients, and propose a forum for the strategic planning of London's eye casualty services in the future. PMID:23370420

  10. Focus on: Deaconess Hospital Biomedical Services Department.

    PubMed

    Pastorello, R A

    1986-01-01

    This paper describes the Biomedical Services Department of Deaconess Hospital, which is centrally located in Oklahoma City, OK. The hospital provides family-centered general and acute care with practically all medical specialties represented. The Department consists of one department supervisor, one technician, and one part-time shared-service secretary. The Department is responsible for the repair, safety testing, and calibration of over 600 instruments, and serves an important role in the selection and support of patient care equipment. Training of users is another major role for this department. PMID:10279020

  11. Prognosis of Central-Eastern Mediterranean waterspouts

    NASA Astrophysics Data System (ADS)

    Keul, Alexander G.; Sioutas, Michalis V.; Szilagyi, Wade

    The North American waterspout forecasting methodology by Szilagyi is applied on a sample of 110 waterspout events for the years 2002-2006 over the Central-Eastern Mediterranean (the Adriatic, Ionian and Aegean Sea). First, the geographical distribution and frequency of the phenomena are shown. Four synoptic types of waterspout-prone circulation patterns are considered. For the Adriatic cases, five thermodynamic indices (KI, TT, SWEAT, CAPE, BRN) are used as possible predictors. The testing of the Szilagyi Waterspout Nomogram and Index (SWI), developed for the Great Lakes region, was favorable for the Mediterranean case data, validating its use as a prognostic tool. Results were presented and discussed at the 4th European Conference on Severe Storms ECSS at Trieste. Meteorologists should standardize and evaluate waterspout prognostic tools and implement a visual interface to improve the service for relevant user groups.

  12. Central Dynamics of Globular Clusters

    NASA Astrophysics Data System (ADS)

    Noyola, Eva; Baumgardt, H.

    2007-12-01

    Globular clusters have historically been classified into two groups due to their dynamical state. They are considered to be either pre-core-collapse or post-core-collapse systems. Clusters are considered as post-core-collapse when they show concentrated surface brightness profiles, with a steep central cusp; while pre-core collapse clusters are less concentrated and have flat central cores. Recent observational results show that some clusters have central surface brightness profiles with intermediate central slopes, showing shallow cusps. These observations could be explained by the presence of a single or a binary intermediate mass black hole in the center of the clusters. In this work, we create realistic synthetic images from the output of N-body models. The images attempt to mock the resolution and point spread function of the high resolution cameras on board the Hubble Space Telescope. The models are created with and without central black holes, where the no black hole models are allowed to reach core-collapse. We measure surface brightness profiles both from integrated light and from star counts. From the profiles, we obtain parameters such as central surface brightness slope, core radius, and half light radius. We also test how well a King model describes each profile. We find that the black hole models produce shallow cusps if the black hole is larger than a certain mass; while models without central black holes produce more concentrated profiles. This approach, allows to make a thorough comparison between observations and models.

  13. Re-centralized central chiller plant serves hospital

    SciTech Connect

    Seckman, T.C.

    1997-05-01

    Baptist Hospital in Nashville, Tenn., is a 759-bed complex consisting of 13 buildings. Space cooling for nine of these is provided by seven electric hermetic centrifugal chillers. Located in three buildings--Central, Kidd, and Emergency (ER), which houses the newest chiller plant--these machines have a combined chilled water generation capacity of 5,800 tons. The five oldest units use CFC-11. HCFC-123 is the refrigerant used in the ER machines. In 1995, a new phase of chiller operation was initiated when the three plants were tied together to create a re-centralized central chilled water plant. This was done when the 1,300-ton chiller was added to the ER plant. The ER plant will ultimately replace the two older plants. Linking the three together was done to provide greater reliability and operating flexibility during the years that the ER plant is incrementally enlarged and the older Central and Kidd chillers are selectively retired.

  14. Geospatial database for regional environmental assessment of central Colorado.

    USGS Publications Warehouse

    Church, Stanley E.; San Juan, Carma A.; Fey, David L.; Schmidt, Travis S.; Klein, Terry L.; DeWitt, Ed H.; Wanty, Richard B.; Verplanck, Philip L.; Mitchell, Katharine A.; Adams, Monique G.; Choate, LaDonna M.; Todorov, Todor I.; Rockwell, Barnaby W.; McEachron, Luke; Anthony, Michael W.

    2012-01-01

    In conjunction with the future planning needs of the U.S. Department of Agriculture, Forest Service, the U.S. Geological Survey conducted a detailed environmental assessment of the effects of historical mining on Forest Service lands in central Colorado. Stream sediment, macroinvertebrate, and various filtered and unfiltered water quality samples were collected during low-flow over a four-year period from 2004–2007. This report summarizes the sampling strategy, data collection, and analyses performed on these samples. The data are presented in Geographic Information System, Microsoft Excel, and comma-delimited formats. Reports on data interpretation are being prepared separately.

  15. 18 CFR 367.24 - Construction and service contracts for other companies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... organization and equipment. (4) The support services performed by the service company in connection with the... COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT TO THE PROVISIONS OF THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005,...

  16. Pathways into and through Mental Health Services for Children and Adolescents.

    ERIC Educational Resources Information Center

    Farmer, Elizabeth M. Z.; Burns, Barbara J.; Phillips, Susan D.; Angold, Adrian; Costello, E. Jane

    2003-01-01

    Examined points of entry into mental health service system for children and adolescents and patterns of movement through five service sectors (specialty mental health services, education, general medicine, juvenile justice, child welfare). Education sector plays central role as point of entry. Interagency collaboration among education, specialty…

  17. The Four Furies: Primary Tensions between Service-Learners and Host Agencies

    ERIC Educational Resources Information Center

    Mills, Steven D.

    2012-01-01

    This paper explores four potent tensions between service-learning students and their community agency hosts. These tensions result from naturally opposing perspectives and are reflected in the service-learning literature focused on criticism and complaint. Given the centrality of the alliance between service-learners and their community host…

  18. Theory and Practical Application of Information Research Services at Lakeland Community College.

    ERIC Educational Resources Information Center

    Valvoda, Mary Alice

    The focus of this report is an in-depth analysis of the Research Services Office (RSO) at Lakeland Community College, including specialized information services and procedures of the RSO. Research services at Lakeland include but are not limited to: (1) acquisition, centralization, and coordination of internal reports; (2) collection of…

  19. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Naturalization Service Systems-limited access. 16.99 Section 16.99 Judicial Administration DEPARTMENT OF JUSTICE... Naturalization Service Alien File (A-File) and Central Index System (CIS), JUSTICE/INS-001A. (2) The Immigration and Naturalization Service Index System, JUSTICE/INS-001 which consists of the following...

  20. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Naturalization Service Systems-limited access. 16.99 Section 16.99 Judicial Administration DEPARTMENT OF JUSTICE... Naturalization Service Alien File (A-File) and Central Index System (CIS), JUSTICE/INS-001A. (2) The Immigration and Naturalization Service Index System, JUSTICE/INS-001 which consists of the following...

  1. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Naturalization Service Systems-limited access. 16.99 Section 16.99 Judicial Administration DEPARTMENT OF JUSTICE... Naturalization Service Alien File (A-File) and Central Index System (CIS), JUSTICE/INS-001A. (2) The Immigration and Naturalization Service Index System, JUSTICE/INS-001 which consists of the following...

  2. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Naturalization Service Systems-limited access. 16.99 Section 16.99 Judicial Administration DEPARTMENT OF JUSTICE... Naturalization Service Alien File (A-File) and Central Index System (CIS), JUSTICE/INS-001A. (2) The Immigration and Naturalization Service Index System, JUSTICE/INS-001 which consists of the following...

  3. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Naturalization Service Systems-limited access. 16.99 Section 16.99 Judicial Administration DEPARTMENT OF JUSTICE... Naturalization Service Alien File (A-File) and Central Index System (CIS), JUSTICE/INS-001A. (2) The Immigration and Naturalization Service Index System, JUSTICE/INS-001 which consists of the following...

  4. "Unruly Pupils" in Pre-Service English Language Teachers' Teaching Practicum Experiences

    ERIC Educational Resources Information Center

    Gao, Xuesong; Benson, Phil

    2012-01-01

    The teaching practicum is a pivotal event for pre-service teachers to experience the transition from being students to being teachers. This paper examines the emergence of "unruly pupils" as a central concern for pre-service English language teachers in their teaching practicum. The inquiry relates the pre-service teachers' perceived challenge of…

  5. Reciprocal Exchange: Understanding the Community Partner Perspective in Higher Education Service-Learning

    ERIC Educational Resources Information Center

    Petri, Alexis Nicolle

    2012-01-01

    This study investigates service-learning from the community partners' perspective, especially in terms of reciprocity. As a central construct in the theory of service-learning, reciprocity for community partners is virtually unknown. Little scholarship exists that explains or explores the benefits and opportunity costs of service-learning.…

  6. Realizing Shared Services--A Punctuated Process Analysis of a Public IT Department

    ERIC Educational Resources Information Center

    Olsen, Timothy John

    2012-01-01

    IT services are increasingly being offered via a shared service model. This model promises the benefits of centralization and consolidation, as well as an increased customer satisfaction. Adopting shared services is not easy as it necessitates a major organizational change, with few documented exemplars to guide managers. This research explores a…

  7. Centralized digital control of accelerators

    SciTech Connect

    Melen, R.E.

    1983-09-01

    In contrasting the title of this paper with a second paper to be presented at this conference entitled Distributed Digital Control of Accelerators, a potential reader might be led to believe that this paper will focus on systems whose computing intelligence is centered in one or more computers in a centralized location. Instead, this paper will describe the architectural evolution of SLAC's computer based accelerator control systems with respect to the distribution of their intelligence. However, the use of the word centralized in the title is appropriate because these systems are based on the use of centralized large and computationally powerful processors that are typically supported by networks of smaller distributed processors.

  8. IUE observations of central stars

    NASA Technical Reports Server (NTRS)

    Heap, S. R.

    1983-01-01

    IUE satellite data on sixty galactic planetary nebulae (PN) and three PNs in the Magellanic clouds are examined to establish a mass distribution among the central star types. An evolutionary lineage was determined for the observed central stars, based on UV magnitudes, demonstrating that central stars in optically thin nebulae have a narrow distribution around 0.58 solar mass, whereas stars in optically thick nebulae exhibited the highest masses of the sample, implying that highest mass stars in PN are the most difficult to detect. No definitive correlation was found between the mass of an object and its spectral type.

  9. A framework for implementing data services in multi-service mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Ali, Mohammed O.; Leung, Victor C. M.; Spolsky, Andrew I.

    1988-01-01

    Mobile satellite systems being planned for introduction in the early 1990s are expected to be invariably of the multi-service type. Mobile Telephone Service (MTS), Mobile Radio Service (MRS), and Mobile Data Service (MDS) are the major classifications used to categorize the many user applications to be supported. The MTS and MRS services encompass circuit-switched voice communication applications, and may be efficiently implemented using a centralized Demand-Assigned Multiple Access (DAMA) scheme. Applications under the MDS category are, on the other hand, message-oriented and expected to vary widely in characteristics; from simplex mode short messaging applications to long duration, full-duplex interactive data communication and large file transfer applications. For some applications under this service category, the conventional circuit-based DAMA scheme may prove highly inefficient due to the long time required to set up and establish communication links relative to the actual message transmission time. It is proposed that by defining a set of basic bearer services to be supported in MDS and optimizing their transmission and access schemes independent of the MTS and MRS services, the MDS applications can be more efficiently integrated into the multi-service design of mobile satellite systems.

  10. Central sensitization as a component of post-deployment syndrome

    PubMed Central

    Lewis, Jeffrey D.; Wassermann, Eric M.; Chao, Wendy; Ramage, Amy E.; Robin, Donald A.; Clauw, Daniel J.

    2016-01-01

    Many service members and veterans report chronic unexplained symptoms such as pain, fatigue and memory complaints, which have most recently been characterized as post-deployment syndrome (PDS). Chronic widespread pain is a component of this syndrome, producing significant disability and considerable health care costs. The similarity between the nature of these complaints and other medically unexplained illnesses such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome suggest that they may share a common mechanism. Here, we provide support for PDS as a consequence of pain and sensory amplification secondary to neuroplastic changes within the central nervous system, a phenomenon often termed central sensitization. We also discuss how factors such as stress and genetics may promote chronic widespread pain in veterans and service members who develop PDS. PMID:23232159

  11. Mental health services in the Solomon Islands.

    PubMed

    Orotaloa, Paul; Blignault, Ilse

    2012-06-01

    The Solomon Islands comprise an archipelago of nearly 1,000 islands and coral atolls and have an estimated population of 549,574 people. Formal mental health services date back to 1950 when an asylum was established. Since then the process of mental health service development has been largely one of incremental change, with a major boost to community services in the last two decades. During the 1990s a mental health outpatient clinic was established in Honiara, together with attempts to recruit nursing staff as psychiatric coordinators in the provinces. In 1996, the Ministry commenced sending registered nurses for psychiatric training in Papua New Guinea. By 2010, there were 13 psychiatric nurses and one psychiatrist, with a second psychiatrist in training. A National Mental Health Policy was drafted in 2009 but is yet to be endorsed by Cabinet. A significant portion of the population still turns to traditional healers or church leaders for purposes of healing, seeking help from Western medicine only after all other alternatives in the community have been exhausted. There is still a long way to go before mental health services are available, affordable and accessible to the whole population, including people living in geographically remote areas. Realization of this vision requires increased resourcing for mental health services; improved communication and collaboration between the centrally-based, national mental health services and the provincial health services; and closer, ongoing relationships between all stakeholders and partners, both locally and internationally. PMID:26767360

  12. Elimination of Rhodnius prolixus in Central America

    PubMed Central

    2012-01-01

    Rhodnius prolixus is one of the main vectors of Trypanosoma cruzi, causative agent of Chagas disease. In Central America, it was first discovered in 1915 in El Salvador, from where it spread northwest to Guatemala and Mexico, and southeast to Nicaragua and Costa Rica, arriving also in Honduras in the late 1950s. Indoor residual spraying (IRS) by the antimalaria services of Costa Rica prevented its spread southwards, and similar IRS programmes appear to have eliminated it from El Salvador by the late 1970s. In 1997, by resolution of the Ministers of Health of the seven Central American countries, a multinational initiative against Chagas disease (IPCA) was launched with one of the specific objectives being the elimination of R. prolixus from the region. As a result, more and more infested areas were encountered, and progressively sprayed using an IRS strategy already deployed against Triatoma infestans in the southern cone countries of South America. In 2008, Guatemala became the first of these countries to be formally certified as free of Chagas disease transmission due to R. prolixus. The other infested countries have since been similarly certified, and none of these has reported the presence of R. prolixus since June 2010. Further surveillance is required, but current evidence suggests that R. prolixus may now been eliminated from throughout the mesoamerican region, with a corresponding decline in the incidence of T. cruzi infections. PMID:22357219

  13. The CMS central hadron calorimeter

    SciTech Connect

    Freeman, J.

    1998-11-01

    The CMS central hadron calorimeter is a brass absorber/scintillator sampling structure. We describe details of the mechanical and optical structure. We also discuss calibration techniques, and finally the anticipated construction schedule. {copyright} {ital 1998 American Institute of Physics.}

  14. Percutaneously inserted central catheter - infants

    MedlinePlus

    PICC - infants; PQC - infants; Pic line - infants; Per-Q cath - infants ... A percutaneously inserted central catheter (PICC) is a long, very thin, soft plastic tube that is put into a small blood vessel. This article addresses PICCs in ...

  15. Central-Office Real Estate.

    ERIC Educational Resources Information Center

    Pardini, Priscilla

    2003-01-01

    Describes how to upgrade a school district's central-office facilities without incurring taxpayer enmity. Includes case studies from Harford County, Maryland; Orange and Broward Counties, Florida; South Milwaukee, Wisconsin; Mt. Baker, Washington; Chicago, Illinois; and Rochester, New Hampshire. (PKP)

  16. Central Fan Integrated Ventilation Systems

    SciTech Connect

    2009-05-12

    This information sheet describes one example of a ventilation system design, a central fan integrated supply (CFIS) system, a mechanical ventilation and pollutant source control to ensure that there is reasonable indoor air quality inside the house.

  17. Central Newspaper to Observe Centennial.

    ERIC Educational Resources Information Center

    Melingagio, John

    1986-01-01

    Reports on the efforts of a school newspaper staff to prove that the newspaper at Omaha Central High School is 100 years old and discusses the students' opinions of the paper throughout its history. (DF)

  18. Rehabilitation innovations in Central America.

    PubMed

    Couch, R H

    1993-01-01

    In an extensive qualitative research project sponsored by the Partners of the Americas (32 professional and lay people from Panama, Costa Rica, Nicaragua, Honduras, El Salvador, Guatemala, Belize, the United States and the Dominican Republic) employment opportunities were examined for disabled youth in Central America. Despite economic and attitudinal barriers field researchers found innovations in financing, special education and rehabilitation programming, job development and job placement alternatives for those who live with disability in Central America. PMID:8486439

  19. CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

    SciTech Connect

    BERGMAN, T. B.; STEFANSKI, L. D.; SEELEY, P. N.; ZINSLI, L. C.; CUSACK, L. J.

    2012-09-19

    THE CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY WAS CONDUCTED TO DEVELOP AN OPTIMAL SEQUENCE OF REMEDIATION ACTIVITIES IMPLEMENTING THE CERCLA DECISION ON THE CENTRAL PLATEAU. THE STUDY DEFINES A SEQUENCE OF ACTIVITIES THAT RESULT IN AN EFFECTIVE USE OF RESOURCES FROM A STRATEGIC PERSPECTIVE WHEN CONSIDERING EQUIPMENT PROCUREMENT AND STAGING, WORKFORCE MOBILIZATION/DEMOBILIZATION, WORKFORCE LEVELING, WORKFORCE SKILL-MIX, AND OTHER REMEDIATION/DISPOSITION PROJECT EXECUTION PARAMETERS.

  20. Centralization or decentralization of technology information: future cooperation or competition

    SciTech Connect

    Rivera, E.

    1982-01-01

    Although advocates of decentralization cite the values of individual privacy, human dimensions, and potential for creativity and innovation, the advent of microcomputer technology during the past five years brought the first real reversal of the trend toward centralization. Both systems have their economic, social, and technical consequences. Centralization, for example, has the advantages of scale economy, coordination, and the control of lower-level activities to meet higher-level goals. At issue are the problems of sharing and data distribution. A hybridism of systems will take place in the next five years along with a conversion to smaller, more-flexible and personal systems as microprocessors come down in price. Application will determine the extent of centralization for each system. The shift will affect education, international forums, the type of work conducted in the service sector, and life styles, and will introduce legal, political, and organizational problems. 7 references. (DCK)

  1. Introduction to the LaRC central scientific computing complex

    NASA Technical Reports Server (NTRS)

    Shoosmith, John N.

    1993-01-01

    The computers and associated equipment that make up the Central Scientific Computing Complex of the Langley Research Center are briefly described. The electronic networks that provide access to the various components of the complex and a number of areas that can be used by Langley and contractors staff for special applications (scientific visualization, image processing, software engineering, and grid generation) are also described. Flight simulation facilities that use the central computers are described. Management of the complex, procedures for its use, and available services and resources are discussed. This document is intended for new users of the complex, for current users who wish to keep appraised of changes, and for visitors who need to understand the role of central scientific computers at Langley.

  2. Feature centrality: naming versus imagining.

    PubMed

    Sloman, S A; Ahn, W K

    1999-05-01

    Being white is central to whether we call an animal a "polar bear," but it is fairly peripheral to our concept of what a polar bear is. We propose that a feature is central to category naming in proportion to the feature's category validity--the probability of the feature, given the category. In contrast, a feature is conceptually central in a representation of the object to the extent that the feature is depended on by other features. Further, we propose that naming and conceptual centrality are more likely to disagree for features that hold at more specific levels (such as is white, which holds only for the specific category of polar bear) than for features that hold at intermediate levels of abstraction (such as has claws, which holds for all bears). In support of these hypotheses, we report evidence that increasing the abstractness of category features has a greater effect on judgments of conceptual centrality than on judgments of name centrality and that other category features depend more on intermediate-level category features than on specific ones. PMID:10355241

  3. Attribute centrality and imaginative thought.

    PubMed

    Ward, T B; Dodds, R A; Saunders, K N; Sifonis, C M

    2000-12-01

    Participants' representations of the concept human were examined to differentiate three types of associations between concepts and their component attributes: the capacity of concepts to cue attributes (attribute accessibility), the capacity of attributes to cue concepts (instance accessibility), and the extent to which attributes are thought of as central to concepts (attribute centrality). The findings provide information about the concept human itself and, more generally, about the functionally distinct roles those different attribute-concept associations play in guiding imaginative thought. College students listed attributes that differentiate humans from other animals, rated the centrality of those attributes, and listed animals that possess those attributes. Other students drew and described extraterrestrials that possessed some of the attributes that were found to vary across those listing and rating tasks. Rated centrality was the most important determinant of an attribute's impact on imaginative generation. When the imagined extraterrestrials were supposed to possess attributes that had been rated as central to humans (intelligence, emotional complexity, or opposable thumbs), participants projected more aspects of human form onto them than when the creatures were supposed to possess less central attributes or when attributes were unspecified. PMID:11219966

  4. Invoices for Online Services.

    ERIC Educational Resources Information Center

    Forrest, Vicki

    1988-01-01

    Review of current billing practices for online services in Great Britain discusses determinants of successful numeric data display; invoice structure; display format; invoice content; display characteristics; and invoice regularity. Sample invoices from several services are included. (three references) (MES)

  5. The Customer Service Experience.

    ERIC Educational Resources Information Center

    Bell, Chip R.

    2001-01-01

    Discusses ways to embed customer service learning and customer loyalty including making customers think, examining every aspect of customers' service encounters with staff, providing follow-up, making learning fun, and involving customers in your business. (JOW)

  6. Cancer Genetics Services Directory

    MedlinePlus

    ... Prevention Overview–for health professionals Research NCI Cancer Genetics Services Directory This directory lists professionals who provide services related to cancer genetics (cancer risk assessment, genetic counseling, genetic susceptibility testing, ...

  7. Home Care Services

    MedlinePlus

    ... are chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with bathing, ... insurance will help cover the cost of certain home care services.

  8. Emergency Medical Services

    MedlinePlus

    ... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

  9. Heart and vascular services

    MedlinePlus

    ... gov/ency/article/007459.htm Heart and vascular services To use the sharing features on this page, ... blood vessels (arteries and veins). Heart and vascular services refers to the branch of medicine that focuses ...

  10. Emergency Medical Services

    MedlinePlus

    ... and need help right away, you should use emergency medical services. These services use specially trained people ... facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  11. Communications and media services

    NASA Technical Reports Server (NTRS)

    Mcculla, James W.; Kukowski, James F.

    1990-01-01

    NASA's internal and external communication methods are reviewed. NASA information services for the media, for the public, and for employees are discussed. Consideration is given to electron information distribution, the NASA TV-audio system, the NASA broadcast news service, astronaut appearances, technology and information exhibits, speaker services, and NASA news reports for internal communications. Also, the NASA worldwide electronic mail network is described and trends for future NASA communications and media services are outlined.

  12. Holding Services to Account

    ERIC Educational Resources Information Center

    Clegg, J.

    2008-01-01

    Background: Recently, the frequency of audit inspections of health services for people with intellectual disability (ID) in the UK has increased, from occasional inquiries to a systematic audit of all services. From 2008, a process of continuous audit "surveillance" of specialist health services is to be introduced. Similar regimes of inspection…

  13. Audiology Services Manual.

    ERIC Educational Resources Information Center

    Gallaudet Coll., Washington, DC. Pre-College Programs.

    The manual describes audiology services offered at the Model Secondary School for the Deaf (MSSD). Components are listed for diagnostic services, instructional services, program development, training, and publications. Testing and reporting procedures for MSSD students are outlined. Testing includes pure-tone air conduction testing, tympanometry,…

  14. Secondary Services in Physics.

    ERIC Educational Resources Information Center

    Cooper, Marianne; Terry, Edward

    The basic characteristics of sixty-nine secondary services in physics were analyzed in terms of sponsorship and distribution by: (1) country of origin, (2) language, (3) age, (4) frequency of publication, (5) subject and geographical coverage and (6) size. The eight major services, in terms of size, are identified. The use of the services by the…

  15. Talking about Customer Service.

    ERIC Educational Resources Information Center

    Talley, Mary; Axelroth, Joan

    2001-01-01

    Discusses customer service in information centers and how to define it. Topics include the effects of competition, that give customers more choices; defining customers, and defining services; communications; physical environment; change, in customers and in technology; measuring customer service; and evaluating policies and procedures. (LRW)

  16. Partnerships for Service Learning.

    ERIC Educational Resources Information Center

    Jacoby, Barbara

    1999-01-01

    Defines service learning. Examines the nature of partnerships for service learning, profiles successful institutional partnerships, and provides guidance in establishing successful partnerships in a wide range of institutions. Profiles several service-learning programs, including programs at University of Utah, Chandler-Gilbert Community College,…

  17. Computers and Reference Service.

    ERIC Educational Resources Information Center

    Purcell, Royal

    1989-01-01

    Discusses the current status and potential for automated library reference services in the areas of community information systems, online catalogs, remote online reference services, and telephone reference services. Several models of the reference procedure which might be used in developing expert systems are examined. (19 references) (CLB)

  18. Learning through Community Service.

    ERIC Educational Resources Information Center

    Powell, Gwynn M.

    2001-01-01

    In implementing community service programs, camps need to develop safe, specific projects. Key planning points for service projects are presented. Risk management considerations specific to community service projects include developing guidelines for camper interaction with the public; discussing first-aid and emergency precautions, including…

  19. Linking Service Learning & Standards.

    ERIC Educational Resources Information Center

    Degelman, Charles, Ed.

    2000-01-01

    This theme issue explores the connection between service learning and standards-based education. In the lead article, "Service Learning and Standards: Are They Compatible?" (Brian Loney), an educator applies his extensive experience with Active Citizenship Today, a successful social studies service-learning program, to a representative set of…

  20. Simple Lookup Service

    Energy Science and Technology Software Center (ESTSC)

    2013-05-01

    Simple Lookup Service (sLS) is a REST/JSON based lookup service that allows users to publish information in the form of key-value pairs and search for the published information. The lookup service supports both pull and push model. This software can be used to create a distributed architecture/cloud.

  1. Leadership in Children's Services

    ERIC Educational Resources Information Center

    Booker, Roger

    2012-01-01

    This paper examines the different contexts for leadership in children's services with a particular focus on integrated working. It reviews contemporary theories that appear to offer relevant frameworks for thinking about children's service leadership. It is argued that children's services require leadership at all levels to enable a dynamic,…

  2. Outreach Library Services.

    ERIC Educational Resources Information Center

    The Bookmark, 1985

    1985-01-01

    Focusing on the theme, Outreach Library Services, the articles in this publication provide a panoramic view of outreach services in eight of the public library systems in New York State. The compilation also contains four papers on special topics. Articles included are: (1) "Not So Trivial: In Pursuit of Outreach Services" (Joan F. Cooke, Finger…

  3. Full-Service Schools.

    ERIC Educational Resources Information Center

    McChesney, Jim

    1996-01-01

    This research summary reviews six publications that explore the need for integrated school-based community services and describe ways in which challenges can be overcome to create effective full-time schools. The publications include the following: (1) "Full-Service Schools: A Revolution in Health and Social Services for Children, Youth, and…

  4. 1. GENERAL VIEW OF THE SOUTHBOUND SERVICE STATION AND SERVICE ...

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

    1. GENERAL VIEW OF THE SOUTHBOUND SERVICE STATION AND SERVICE ISLAND. - Merritt Parkway, Greenwich (Southbound) Service Station, Abutting North side of Merritt Parkway, Greenwich, Fairfield County, CT

  5. Defining a service tech

    SciTech Connect

    Keeler, J.A.

    1996-01-01

    The job title for a service technician in the fuel oil industry is discussed. A service technician in any of the many diversified service fields, has three basic task to perform: The service technician is a professional, a consultant, and a logical thinking individual who appears to be the Einstein of service knowledge in the eyes of the customer; the technician must be able to take the necessary action to complete the call and to make the system operable as well as start, check and tune the system; and the technician must complete the paperwork. The rule is that all paperwork must be completed before leaving the job site.

  6. CopperCore Service Integration

    ERIC Educational Resources Information Center

    Vogten, Hubert; Martens, Harrie; Nadolski, Rob; Tattersall, Colin; van Rosmalen, Peter; Koper, Rob

    2007-01-01

    In an e-learning environment there is a need to integrate various e-learning services like assessment services, collaboration services, learning design services and communication services. In this article we present the design and implementation of a generic integrative service framework, called CopperCore Service Integration (CCSI). We will…

  7. Coverage centralities for temporal networks*

    NASA Astrophysics Data System (ADS)

    Takaguchi, Taro; Yano, Yosuke; Yoshida, Yuichi

    2016-02-01

    Structure of real networked systems, such as social relationship, can be modeled as temporal networks in which each edge appears only at the prescribed time. Understanding the structure of temporal networks requires quantifying the importance of a temporal vertex, which is a pair of vertex index and time. In this paper, we define two centrality measures of a temporal vertex based on the fastest temporal paths which use the temporal vertex. The definition is free from parameters and robust against the change in time scale on which we focus. In addition, we can efficiently compute these centrality values for all temporal vertices. Using the two centrality measures, we reveal that distributions of these centrality values of real-world temporal networks are heterogeneous. For various datasets, we also demonstrate that a majority of the highly central temporal vertices are located within a narrow time window around a particular time. In other words, there is a bottleneck time at which most information sent in the temporal network passes through a small number of temporal vertices, which suggests an important role of these temporal vertices in spreading phenomena. Contribution to the Topical Issue "Temporal Network Theory and Applications", edited by Petter Holme.Supplementary material in the form of one pdf file available from the Journal web page at http://dx.doi.org/10.1140/epjb/e2016-60498-7

  8. Network centrality of metro systems.

    PubMed

    Derrible, Sybil

    2012-01-01

    Whilst being hailed as the remedy to the world's ills, cities will need to adapt in the 21(st) century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the evolution of centrality with network size and examine several individual systems in more detail. Betweenness was notably found to consistently become more evenly distributed with size (i.e. no "winner takes all") unlike other complex network properties. Two distinct regimes were also observed that are representative of their structure. Moreover, the share of betweenness was found to decrease in a power law with size (with exponent 1 for the average node), but the share of most central nodes decreases much slower than least central nodes (0.87 vs. 2.48). Finally the betweenness of individual stations in several systems were examined, which can be useful to locate stations where passengers can be redistributed to relieve pressure from overcrowded stations. Overall, this study offers significant insights that can help planners in their task to design the systems of tomorrow, and similar undertakings can easily be imagined to other urban infrastructure systems (e.g., electricity grid, water/wastewater system, etc.) to develop more sustainable cities. PMID:22792373

  9. Unifying access to services: ESO's user portal

    NASA Astrophysics Data System (ADS)

    Chavan, A. M.; Tacconi-Garman, L. E.; Peron, M.; Sogni, F.; Canavan, T.; Nass, P.

    2006-06-01

    The European Southern Observatory (ESO) is in the process of creating a central access point for all services offered to its user community via the Web. That gateway, called the User Portal, will provide registered users with a personalized set of service access points, the actual set depending on each user's privileges. Correspondence between users and ESO will take place by way of "profiles", that is, contact information. Each user may have several active profiles, so that an investigator may choose, for instance, whether their data should be delivered to their own address or to a collaborator. To application developers, the portal will offer authentication and authorization services, either via database queries or an LDAP server. The User Portal is being developed as a Web application using Java-based technology, including servlets and JSPs.

  10. Spatial services grid

    NASA Astrophysics Data System (ADS)

    Cao, Jian; Li, Qi; Cheng, Jicheng

    2005-10-01

    This paper discusses the concept, key technologies and main application of Spatial Services Grid. The technologies of Grid computing and Webservice is playing a revolutionary role in studying the spatial information services. The concept of the SSG (Spatial Services Grid) is put forward based on the SIG (Spatial Information Grid) and OGSA (open grid service architecture). Firstly, the grid computing is reviewed and the key technologies of SIG and their main applications are reviewed. Secondly, the grid computing and three kinds of SIG (in broad sense)--SDG (spatial data grid), SIG (spatial information grid) and SSG (spatial services grid) and their relationships are proposed. Thirdly, the key technologies of the SSG (spatial services grid) is put forward. Finally, three representative applications of SSG (spatial services grid) are discussed. The first application is urban location based services gird, which is a typical spatial services grid and can be constructed on OGSA (Open Grid Services Architecture) and digital city platform. The second application is region sustainable development grid which is the key to the urban development. The third application is Region disaster and emergency management services grid.

  11. Coproduction of healthcare service

    PubMed Central

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-01-01

    Efforts to ensure effective participation of patients in healthcare are called by many names—patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always ‘coproduced’. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. PMID:26376674

  12. Coproduction of healthcare service.

    PubMed

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. PMID:26376674

  13. Site authorization service (SAZ)

    SciTech Connect

    Dane Skow; Igor Mandrichenko; Vijay Sehkri

    2003-10-01

    In this paper the authors present a methodology to provide an additional level of centralized control for the grid resources. This centralized control is applied to site-wide distribution of various grids and thus provides an upper hand in the maintenance.

  14. Upper Mantle Discontinuities Underneath Central and Southern Mexico

    NASA Astrophysics Data System (ADS)

    Perez-Campos, X.; Clayton, R. W.

    2011-12-01

    Central and southern Mexico are affected by the subduction of Cocos plate beneath North American plate. The MesoAmerican Subduction Experiment (MASE) and the Veracruz-Oaxaca (VEOX) project have mapped the geometry of the Cocos slab. It is characterized in central Mexico by a shallow horizontal geometry up to ~300 km from the trench, then it dives steeply (70°) into the mantle, to its apparent end at 500 km depth. In contrast, some 400 km to the south, the slab subducts smoothly, with a dip angle of ~26° to a depth of 150 km. We use receiver functions from teleseismic events, recorded at stations from MASE, VEOX, and the Servicio Sismológico Nacional (SSN, Mexican National Seismological Service) to map the upper mantle discontinuities and properties of the transition zone in central and southern Mexico. We also use data from the Mapping the Rivera Subduction Zone (MARS) Experiment to get a complete picture of the subduction regime in central Mexico and compare the mantle transition zone in a slab tear regime. The 410 discontinuity shows significant variation in topography in central Mexico, particularly where the slab is expected to reach such depth. The 660 discontinuity shows a smoother topography, indicating that the slab does not penetrate this far down. The results will be compared with a ridge regime in the Gulf of California.

  15. Apport de l’écho-doppler artériel des membres inférieurs dans la prise en charge du pied diabétique à l'hôpital Saint-Jean de Dieu de Thiès (Sénégal)

    PubMed Central

    Dia, Aliou Amadou; Affangla, Désiré Alain; Dione, Jean-Michel; Akpo, Géraud; Mbengue, Marie; Ka, Mamadou Mourtalla; Diop, Bernard Marcel

    2015-01-01

    Introduction Le pied diabétique se définit comme l'ensemble des manifestations trophiques du pied survenant chez le diabétique par atteinte nerveuse, artérielle et ou infectieuse. Le pied diabétique est un problème majeur de santé publique à l’échelle mondiale avec un taux d'amputation de membres inférieurs très élevé. L’écho-doppler artériel des membres inférieurs est de nos jours incontournable dans la prise en charge du pied diabétique. Le but de cette étude est de montrer la place prépondérante qu'occupe l’écho-doppler artériel dans le bilan lésionnel du pied diabétique. Méthodes Nous avons mené une étude rétrospective monocentrique incluant 46 patients sur une période de 24 mois, de mars 2012 à mars 2014 à l'hôpital Saint-Jean de Dieu, un des deux hôpitaux de référence de la région de Thiès, doté depuis juillet 2011 d'un centre moderne de traitement du diabète et des maladies cardio-métaboliques (Diabcarmet). Dans les critères d'inclusion, nous avons sélectionné tous les patients diabétiques adressés pour un écho-doppler artériel des membres inférieurs dans le cadre d'une prise en charge du pied diabétique. Etaient exclus de l’étude, les patients artéritiques non-diabétiques et les patients diabétiques asymptomatiques référés pour un bilan écho-doppler de routine. Résultats Le sex-ratio était de 1.42 (27 hommes pour 19 femmes). L’âge moyen des patients était de 62,86 ans avec des extrêmes de 23 et 88 ans. 60% des patients (n=28) étaient âgés entre 50 et 70 ans. Le diabète de type 2 était retrouvé chez 95% des patients (n=44) alors que le diabète de type 1 représentait 5% (n=2). La moyenne d’évolution du diabète était estimée à 8 ans, avec des extrêmes de 2 et 20 ans. On notait une atteinte du pied droit chez 24 patients, une atteinte du pied gauche chez 18 patients et une atteinte bilatérale chez 4 patients. La plupart du temps, les lésions du pied diabétique survenaient

  16. Stratégie de prise en charge de l'hypertension artérielle en hémodialyse chronique: un modèle appliqué d’éducation thérapeutique des patients (ETP)

    PubMed Central

    El Harraqui, Ryme; Naima, Abda; Yassamine, Bentata; Haddiya, Intissar

    2014-01-01

    Même après l'entrée en dialyse, la prévalence de l'hypertension artérielle (HTA) reste élevée. Elle est souvent greffée d'une forte morbi-mortalité, et altère la qualité de vie des patients hémodialysés chroniques. La « méthode du poids sec (PS) », établie par Scribner, présente un intérêt indéniable dans la gestion de l'HTA chez le patient hémodialysé. Le but de notre travail était de déterminer la prévalence et les facteurs de risque (FDR) de l'HTA chez nos hémodialysés chroniques et d'en tenter une réduction en nous basant sur une stratégie d’éducation thérapeutique basée sur les recommandations de Scribner. Nous avons mené une étude prospective interventionnelle en trois mois et en trois phases, auprès des 93 hémodialysés chroniques de l'Hôpital Al Farabi d'Oujda. En phase 1, nous avons déterminé la prévalence de l'HTA par la surveillance horaire de la tension artérielle (TA) durant la séance de dialyse pendant deux semaines, soit sur un total de 442 séances. Les patients ont également mesuré leur pression artérielle (PA) hors-centre de façon biquotidienne les jours de non-dialyse, soit un total de 1720 mesures hors-centre. L'HTA a été définie par une Pression Artérielle Systolique (PAS) supérieure ou égale à 140mmHg et/ou une Pression Artérielle Diastolique (PAD) supérieure ou égale à 90mmHg sur au moins 2 mesures. En phase 2, les patients hypertendus ont bénéficié d'une prise en charge basée sur les recommandations de Scribner et une éducation thérapeutique (ETP). En phase 3, nous évalué les retombées de notre prise en charge. Une HTA a été notée sur 231 séances chez 57 patients, soit une prévalence de 61,3%. La PAS moyenne était de 172,75±17,69 (145-220) mmHg. Les FDR retenus sont: l’âge, la PPID importante, le non respect des règles hygiéno-diététiques (RHD) et le rythme de 2 séances de dialyse/semaine. Au départ, 13 patients (22,8%) étaient dialysés trois fois par

  17. Pathophysiology of central sleep apneas.

    PubMed

    Hernandez, Adam B; Patil, Susheel P

    2016-05-01

    The transition from wake to sleep is accompanied by a host of physiologic changes, which result in major alterations in respiratory control and may result in sleep-related breathing disorders. The central sleep apneas are a group of sleep-related breathing disorders that are characterized by recurrent episodes of airflow reduction or cessation due to a temporary reduction or absence of central respiratory drive. The fundamental hallmark of central sleep apnea (CSA) disorders is the presence of ventilatory control instability; however, additional mechanisms play a role in one or more specific manifestations of CSA. CSA may manifest during conditions of eucapnia/hypocapnia or chronic hypercapnia, which is a useful clinical classification that lends understanding to the underlying pathophysiology and potential therapies. In this review, an overview of normal breathing physiology is provided, followed by a discussion of pathophysiologic mechanisms that promote CSA and the mechanisms that are specific to different manifestations of CSA. PMID:26782104

  18. Satellite Services Workshop, Volume 1

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Key issues associated with the orbital servicing of satellites are examined including servicing spacecraft and equipment, servicing operations, economics, satellite design, docking and berthing, and fluid management.

  19. Service providers' views of community participation at six Australian primary healthcare services: scope for empowerment and challenges to implementation.

    PubMed

    Freeman, Toby; Baum, Frances E; Jolley, Gwyneth M; Lawless, Angela; Edwards, Tahnia; Javanparast, Sara; Ziersch, Anna

    2016-01-01

    Community participation is a key principle of comprehensive primary health care (PHC). There is little literature on how community participation is implemented at Australian PHC services. As part of a wider study conducted in partnership with five South Australian PHC services, and one Aboriginal community controlled health service in the Northern Territory, 68 staff, manager, regional health executives, and departmental funders were interviewed about community participation, perceived benefits, and factors that influenced implementation. Additional data were collected through analysis of policy documents, service reports on activity, and a web-based survey completed by 130 staff. A variety of community participation strategies was reported, ranging from consultation and participation as a means to improve service quality and acceptability, to substantive and structural participation strategies with an emphasis on empowerment. The Aboriginal community controlled health service in our study reported the most comprehensive community participation. Respondents from all services were positive about the benefits of participation but reported that efforts to involve service users had to compete with a centrally directed model of care emphasising individual treatment services, particularly at state-managed services. More empowering substantive and structural participation strategies were less common than consultation or participation used to achieve prescribed goals. The most commonly reported barriers to community participation were budget and lack of flexibility in service delivery. The current central control of the state-managed services needs to be replaced with more local management decision making if empowering community participation is to be strengthened and embedded more effectively in the culture of services. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24789355

  20. Geothermal activities in Central America

    SciTech Connect

    Whetten, J.T.; Hanold, R.J.

    1985-09-11

    The Agency for International Development is funding a new program in energy and minerals for Central America. Geothermal energy is an important component. A country-wide geothermal assessment has started in Honduras, and other assessment activities are in progress or planned for Costa Rica, El Salvador, Guatemala, and Panama. Instrumentation for well logging has been provided to Costa Rica, and a self-contained logging truck will be made available for use throughout Central America. An important objective of this program is to involve the private sector in resource development. 4 refs., 3 figs.

  1. MRDIS Standalone Central Alarm Station

    SciTech Connect

    2012-09-12

    The MRDIS Standalone Central Alarm Station(MRDIS-CAS} is a software system for receiving, storing, and reviewing radiation data collected by the Mobile Radiation Detection and Identification System (MRDIS}, a mobile radiation scanning system developed for use in foreign ports for the DOE Megaports Initiative. It is designed to run on one of the on board computers in the MRDIS cab. It will collect, store, and display data from the MRDIS without the need for wireless communications or centralized server technology. It is intended to be a lightweight replacement for a distributed Megaports communication system in ports where the necessary communications infrastructure does not exist for a full Megaports communications system.

  2. Focusing on customer service.

    PubMed

    1996-01-01

    This booklet is devoted to a consideration of how good customer service in family planning programs can generate demand for products and services, bring customers back, and reduce costs. Customer service is defined as increasing client satisfaction through continuous concern for client preferences, staff accountability to clients, and respect for the rights of clients. Issues discussed include the introduction of a customer service approach and gaining staff commitment. The experience of PROSALUD in Bolivia in recruiting appropriate staff, supervising staff, soliciting client feedback, and marketing services is offered as an example of a successful customer service approach. The key customer service functions are described as 1) establishing a welcoming atmosphere, 2) streamlining client flow, 3) personalizing client services, and 4) organizing and providing clear information to clients. The role of the manager in developing procedures is explored, and the COPE (Client-Oriented Provider-Efficient) process is presented as a good way to begin to make improvements. Techniques in staff training in customer service include brainstorming, role playing, using case studies (examples of which are provided), and engaging in practice sessions. Training also leads to the development of effective customer service attitudes, and the differences between these and organizational/staff-focused attitudes are illustrated in a chart. The use of communication skills (asking open-ended questions, helping clients express their concerns, engaging in active listening, and handling difficult situations) is considered. Good recovery skills are important when things go wrong. Gathering and using client feedback is the next topic considered. This involves identifying, recording, and discussing customer service issues as well as taking action on these issues and evaluating the results. The booklet ends by providing a sample of customer service indicators, considering the maintenance of a

  3. The prisoner as patient - a health services satisfaction survey

    PubMed Central

    Bjørngaard, Johan Håkon; Rustad, Åse-Bente; Kjelsberg, Ellen

    2009-01-01

    Background There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. Methods The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity in Norway. A total of 1,150 prison inmates with prison health services experiences completed a satisfaction questionnaire (90% response rate). The patients' satisfaction was measured on a 12-item index. Multilevel analyses were used to analyze both patient and service characteristics as predictors of satisfaction. Results The study revealed high levels of dissatisfaction with prison health services. There were substantial differences between services, with between-service-variance accounting for 9% of the total variance. Satisfaction was significantly associated with a senior staff member's evaluation of the health services possessing adequate resources and the quality of drug abuse treatment. At the patient level, satisfaction was significantly associated with older age, frequent consultations and better self-perceived health. Conclusion Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement. PMID:19785736

  4. Memory Management of Multimedia Services in Smart Homes

    NASA Astrophysics Data System (ADS)

    Kamel, Ibrahim; Muhaureq, Sanaa A.

    Nowadays there is a wide spectrum of applications that run in smart home environments. Consequently, home gateway, which is a central component in the smart home, must manage many applications despite limited memory resources. OSGi is a middleware standard for home gateways. OSGi models services as dependent components. Moreover, these applications might differ in their importance. Services collaborate and complement each other to achieve the required results. This paper addresses the following problem: given a home gateway that hosts several applications with different priorities and arbitrary dependencies among them. When the gateway runs out of memory, which application or service will be stopped or kicked out of memory to start a new service. Note that stopping a given service means that all the services that depend on it will be stopped too. Because of the service dependencies, traditional memory management techniques, in the operating system literatures might not be efficient. Our goal is to stop the least important and the least number of services. The paper presents a novel algorithm for home gateway memory management. The proposed algorithm takes into consideration the priority of the application and dependencies between different services, in addition to the amount of memory occupied by each service. We implement the proposed algorithm and performed many experiments to evaluate its performance and execution time. The proposed algorithm is implemented as a part of the OSGi framework (Open Service Gateway initiative). We used best fit and worst fit as yardstick to show the effectiveness of the proposed algorithm.

  5. Database Access Integration Services (DAIS)

    SciTech Connect

    Mitchell, P. . Sensor and System Development Center); Nordell, D. )

    1992-12-01

    The Database Access Integration Services (DAIS) is a collection of services that facilitate access to data among diverse data systems in an electric utility communications network. DAIS provides access to data in distributed, heterogeneous data systems that include relational database management systems, other database management systems, control systems, file systems, and application systems. It also provides a common method for describing data, common data access operations and essential support services including a data dictionary, a data directory and distributed data access management capabilities. The DAIS project has developed specifications intended for vendor and third-party implementation. The software developed is only to implement a data access integration demonstration. These specifications can serve as a basis for influencing industry standards development. One important consequence of this strategy is that most actual software development will be performed by vendors, not utilities. DAIS is a tool to support data access. It is policy neutral regarding issues such as local or central administration of data or standardization of information model contents (e.g., EPRI Plant Information Network). As a tool, it can be used to help realize such policies. The DAIS does not provide data storage facilities, schema integration, distributed query processing, distributed applications or cooperative processing. Rather, DAIS is complementary to these functions and can be used with other software that does provide these functions. This project documented the requirements for the DAIS. These requirements are the basis for design of the DAIS specifications. The key requirements for a DAIS are: Uniform access to heterogeneous utility data systems, remote update; coexistence with local data systems; local autonomy ; Security and access restriction enforcement; OSI compatibility; open architecture and extensibility; and operating platform independence.

  6. Ecosystem biogeochemical function and services in an urbanizing desert region

    NASA Astrophysics Data System (ADS)

    Grimm, N. B.; Cook, E. M.; Earl, S.; Hale, R. L.; Hall, S. J.; Hartnett, H. E.; Iwaniec, D.; Larson, E. K.; McHale, M.; Sponseller, R. A.

    2009-12-01

    Ecosystem services derive from underlying ecosystem processes but are distinguished by their benefits to society. Among ecosystem services, those associated with biogeochemical cycling and regulation of water, air, and soil quality are relatively unrecognized by the public, although concentrations of some materials are regulated by local, state and national laws. The disconnection between their importance and the degree to which these services are acknowledged means that biogeochemical ecosystem services have seldom been considered in urban planning and design. Drawing from research at multiple scales in the central Arizona region that includes over twenty cities and towns comprising metropolitan Phoenix, we illustrate the relationships between ecosystem functions and services in three areas. First, at household to whole-city scales, we show that the overriding influence of water and material inputs mediated by humans is changing biogeochemical patterns in soil and vegetation. Second, we show how human modification of aquatic ecosystems for water delivery, stormwater management, and wastewater removal give rise to important trade-offs among these services. And finally, we illustrate the limited capacity of surrounding unproductive desert ecosystems to assimilate the air pollutants generated by this region of >4 million inhabitants. We argue that urban planning and design that take into account the ecosystem functions underlying biogeochemical ecosystem services will be most effective in management of potential pollution problems associated with all of these cases. This paper thus highlights biogeochemical research conducted at the central Arizona-Phoenix LTER within a framework of ecosystem services.

  7. 7 CFR 800.76 - Prohibited services; restricted services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Prohibited services; restricted services. 800.76..., PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Kinds of Official Services § 800.76 Prohibited services; restricted services. (a)...

  8. 22 CFR 22.4 - Requests for services, Foreign Service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Requests for services, Foreign Service. 22.4 Section 22.4 Foreign Relations DEPARTMENT OF STATE FEES AND FUNDS SCHEDULE OF FEES FOR CONSULAR SERVICES-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.4 Requests for services, Foreign Service. Officers of...

  9. 22 CFR 22.4 - Requests for services, Foreign Service.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Requests for services, Foreign Service. 22.4 Section 22.4 Foreign Relations DEPARTMENT OF STATE FEES AND FUNDS SCHEDULE OF FEES FOR CONSULAR SERVICES-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.4 Requests for services, Foreign Service. Officers of...

  10. 22 CFR 22.4 - Requests for services, Foreign Service.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Requests for services, Foreign Service. 22.4 Section 22.4 Foreign Relations DEPARTMENT OF STATE FEES AND FUNDS SCHEDULE OF FEES FOR CONSULAR SERVICES-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.4 Requests for services, Foreign Service. Officers of...

  11. 22 CFR 22.4 - Requests for services, Foreign Service.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Requests for services, Foreign Service. 22.4 Section 22.4 Foreign Relations DEPARTMENT OF STATE FEES AND FUNDS SCHEDULE OF FEES FOR CONSULAR SERVICES-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.4 Requests for services, Foreign Service. Officers of...

  12. 22 CFR 22.4 - Requests for services, Foreign Service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Requests for services, Foreign Service. 22.4 Section 22.4 Foreign Relations DEPARTMENT OF STATE FEES AND FUNDS SCHEDULE OF FEES FOR CONSULAR SERVICES-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.4 Requests for services, Foreign Service. Officers of...

  13. 7 CFR 800.76 - Prohibited services; restricted services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Prohibited services; restricted services. 800.76..., PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Kinds of Official Services § 800.76 Prohibited services; restricted services. (a)...

  14. 7 CFR 800.76 - Prohibited services; restricted services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Prohibited services; restricted services. 800.76..., PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Kinds of Official Services § 800.76 Prohibited services; restricted services. (a)...

  15. 7 CFR 800.76 - Prohibited services; restricted services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Prohibited services; restricted services. 800.76..., PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Kinds of Official Services § 800.76 Prohibited services; restricted services. (a)...

  16. 7 CFR 800.76 - Prohibited services; restricted services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 7 2013-01-01 2013-01-01 false Prohibited services; restricted services. 800.76..., PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Kinds of Official Services § 800.76 Prohibited services; restricted services. (a)...

  17. 39 CFR 3001.75 - Service by the Postal Service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Service by the Postal Service. 3001.75 Section 3001.75 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules Applicable to Requests for Changes in the Nature of Postal Services § 3001.75 Service by the Postal...

  18. 39 CFR 3001.75 - Service by the Postal Service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Service by the Postal Service. 3001.75 Section 3001.75 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules Applicable to Requests for Changes in the Nature of Postal Services § 3001.75 Service by the Postal...

  19. 39 CFR 3001.75 - Service by the Postal Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Service by the Postal Service. 3001.75 Section 3001.75 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES OF PRACTICE AND PROCEDURE Rules Applicable to Requests for Changes in the Nature of Postal Services § 3001.75 Service by the Postal...

  20. Illustrating the Central Limit Theorem

    ERIC Educational Resources Information Center

    Corcoran, Mimi

    2016-01-01

    Statistics is enjoying some well-deserved limelight across mathematics curricula of late. Some statistical concepts, however, are not especially intuitive, and students struggle to comprehend and apply them. As an AP Statistics teacher, the author appreciates the central limit theorem as a foundational concept that plays a crucial role in…