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1

Guam Medical Plans Do Not Ensure Active Duty Family Members Will Have Adequate Access to Dental Care.  

National Technical Information Service (NTIS)

The Inspector General, Department of Defense (IG/DoD) evaluated DoD's plans for providing dental care to active duty family members (ADFMs) in Guam in view of the anticipated growth in population resulting from the planned base closure in Okinawa and subs...

A. F. Carey

2011-01-01

2

How much care for older people will be needed? What can policies do to avoid or reduce dependency and to ensure that adequate care  

Microsoft Academic Search

The number of older people is rising in all European countries. Because older people (people aged 65 years and above) consume more health care than the rest of the population, this poses challenges for budget management and for the overall sustainability of health and long-term care expenditures. Longevity has risen everywhere, in particular in the EU15 and further increases in

Cristina Masseria; Elias Mossialos

3

Ensuring adequate supply of molten metal to castings  

Microsoft Academic Search

Adequate supply of molten metal to castings must be ensured to prevent the appearance of shrinkage defects (blisters and developed porosity), which result from the formation of enclosed regions where the alloy solidifies with an inadequate supply. Cast alloys are characterized by different propensi? ties for the formation of shrinkage blisters and shrink? age porosity. The balance of these two

E. B. Ten; A. S. Drokin; D. A. Anosov

2010-01-01

4

ENSURING ADEQUATE SAFETY WHEN USING HYDROGEN AS A FUEL  

SciTech Connect

Demonstration projects using hydrogen as a fuel are becoming very common. Often these projects rely on project-specific risk evaluations to support project safety decisions. This is necessary because regulations, codes, and standards (hereafter referred to as standards) are just being developed. This paper will review some of the approaches being used in these evolving standards, and techniques which demonstration projects can implement to bridge the gap between current requirements and stakeholder desires. Many of the evolving standards for hydrogen-fuel use performance-based language, which establishes minimum performance and safety objectives, as compared with prescriptive-based language that prescribes specific design solutions. This is being done for several reasons including: (1) concern that establishing specific design solutions too early will stifle invention, (2) sparse performance data necessary to support selection of design approaches, and (3) a risk-adverse public which is unwilling to accept losses that were incurred in developing previous prescriptive design standards. The evolving standards often contain words such as: ''The manufacturer shall implement the measures and provide the information necessary to minimize the risk of endangering a person's safety or health''. This typically implies that the manufacturer or project manager must produce and document an acceptable level of risk. If accomplished using comprehensive and systematic process the demonstration project risk assessment can ease the transition to widespread commercialization. An approach to adequately evaluate and document the safety risk will be presented.

Coutts, D

2007-01-22

5

33 CFR 155.4050 - Ensuring that the salvors and marine firefighters are adequate.  

Code of Federal Regulations, 2010 CFR

... Ensuring that the salvors and marine firefighters are adequate. ...HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS Salvage and Marine Firefighting § 155.4050...

2009-07-01

6

33 CFR 155.4050 - Ensuring that the salvors and marine firefighters are adequate.  

Code of Federal Regulations, 2010 CFR

... Ensuring that the salvors and marine firefighters are adequate. ...HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS Salvage and Marine Firefighting § 155.4050...

2010-07-01

7

33 CFR 155.4050 - Ensuring that the salvors and marine firefighters are adequate.  

Code of Federal Regulations, 2013 CFR

... Ensuring that the salvors and marine firefighters are adequate. ...HOMELAND SECURITY (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS Salvage and Marine Firefighting § 155.4050...

2013-07-01

8

Role of primary health care in ensuring access to medicines.  

PubMed

To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization. PMID:20564760

Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

2010-06-01

9

Role of Primary Health Care in Ensuring Access to Medicines  

PubMed Central

To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization.

Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

2010-01-01

10

Ensuring an Adequate Education: Opportunity to Learn, Law, and Social Science  

Microsoft Academic Search

The Massachusetts Education Reform Act of 1993 and the decisions of the States highest court interpreting the state constitutions education clause are benchmarks in efforts at law-based education reform. This article discusses the implications of legislative and judicial mandates concerning the provision of education and the extent to which these mandates fail to ensure a fair and meaningful opportunity to

Diana Pullin

2007-01-01

11

The role of Taiwan's National Health Insurance program in influencing adequate prenatal care.  

PubMed

This paper reviews achievements in the utilization of prenatal care by pregnant women in Taiwan by analysing the 1989 and 1996 National Maternal and Infant Health Survey data. More precisely, it identifies and examines the programmatic and non-programmatic factors that influence prenatal care utilization, thus determining the areas that require further attention from the programe. Logistic regression results show that the adequacy of prenatal care use was significantly associated with the implementation of the National Health Insurance (NHI). A higher likelihood of adequate care utilization was found among women who were married or employed, had a higher level of education, had more experience with regard to pregnancy and were at higher risk in terms of obstetrics. The effect of facility choice showed variations after the implementation of the NHI programme. Prior to NHI, no differences were noted between the use of clinics and hospitals. After the implementation of NHI, on the other hand, women who received most of their care from clinics had a higher likelihood of receiving more adequate prenatal care than those who received care from hospitals. Regional differences in seeking adequate prenatal care were also evident. Mothers who were living in southern areas were less likely to receive adequate prenatal care despite the implementation of NHI. The Bureau of NHI, therefore, still needs to work on mechanisms to ensure that more attention is given to the distribution of its medical resources and that additional health care accessibility is provided to pregnant women in these areas. PMID:15239208

Liu, Tsai-Ching; Chen, Chin-Shyan

12

[The global and national context regarding the challenges involved in ensuring adequate access to water for human consumption].  

PubMed

The scope of this article is to analyze the challenges involved in ensuring access to water for human consumption taking the international and national context into consideration. Based on the UN declaration that access to safe and clean drinking water is a fundamental human right, vulnerabilities are identified that can consist in restrictions to access to adequate supplies. The distribution of water and the population across the planet, pollution, inadequate policies and management lead to environmental injustice. The iniquity of access to water constitutes the contemporary water crisis. From the 1980s onwards, the transnational water market emerged for private control that occurs at three main levels: surface and underground water sources; bottled water; and public water supply services. The conflicts of the multiple uses of water resources, the market and environmental problems have contributed to rendering the health of the population and ecosystems vulnerable. Adequate public policies are essential to ensure the basic human right to access to safe and clean drinking water. PMID:22699642

Augusto, Lia Giraldo da Silva; Gurgel, Id Gomes Dantas; Cmara Neto, Henrique Fernandes; de Melo, Carlos Henrique; Costa, Andr Monteiro

2012-06-01

13

Factors Affecting Adequate Prenatal Care and the Prenatal Care Visits of Immigrant Women to Taiwan.  

PubMed

This paper investigates prenatal care utilization, identifies factors affecting the adequacy of prenatal care, and explores the effect of adequate initial timing of prenatal care on total prenatal care visits among Taiwan new immigrant females. Data was obtained from the 2008 Prenatal Care Utilization among Taiwan New Immigrant Females Survey on women who either had at least one preschool-aged child or had delivered their infants but were still hospitalized (N=476). The Adequacy of Prenatal Care Utilization Index was applied to rate the prenatal care adequacy. The logistic regression model was used to investigate factors associated with the adequacy of prenatal care utilization, and the linear regression model was estimated to identify the impact of influential factors on the prenatal care usage. Females' nationality, employment, and transportation convenience increased the likelihood of receiving adequate prenatal care. Having adequate initial timing of prenatal care was found to be positively related to the frequency of prenatal care visits. Prenatal care utilization can be affected by factors within the health care system and by characteristics of the population; therefore, a measure of prenatal care utilization cannot distinguish these factors but reflects the result of all of them in varying combinations. PMID:23065308

Liang, Yia-Wun; Chang, Hua-Pin; Lin, Yu-Hsiu; Lin, Long-Yau; Chen, Wen-Yi

2012-10-12

14

Systems and processes that ensure high quality care.  

PubMed

This is the second in a series of articles examining the components of good corporate governance. It considers how the structures and processes for quality governance can affect an organisation's ability to be assured about the quality of care. Complex information systems and procedures can lead to poor quality care, but sound structures and processes alone are insufficient to ensure good governance, and behavioural factors play a significant part in making sure that staff are enabled to provide good quality care. The next article in this series looks at how the information reporting of an organisation can affect its governance. PMID:23252087

Bassett, Sally; Westmore, Kathryn

2012-10-01

15

Caring for an Ageing Population: Are Physiotherapy Graduates Adequately Prepared?  

ERIC Educational Resources Information Center

|In view of South African policy developments related to the care of older persons, it was necessary to examine the nature of the geriatrics content within physiotherapy curricula. A survey was conducted amongst final-year student physiotherapists at South African universities, together with content analysis of physiotherapy curricula. Very little

Ramklass, Serela S.; Butau, Anne; Ntinga, Nomusa; Cele, Nozipho

2010-01-01

16

Caring for an Ageing Population: Are Physiotherapy Graduates Adequately Prepared?  

ERIC Educational Resources Information Center

In view of South African policy developments related to the care of older persons, it was necessary to examine the nature of the geriatrics content within physiotherapy curricula. A survey was conducted amongst final-year student physiotherapists at South African universities, together with content analysis of physiotherapy curricula. Very little

Ramklass, Serela S.; Butau, Anne; Ntinga, Nomusa; Cele, Nozipho

2010-01-01

17

A commentary on "Securing Access to Health Care." Ethics Commission access report urges adequate care for all.  

PubMed

Society has a moral obligation to provide adequate access to health care for all, concludes the President's Commission for te Study of Ethical Problems in Medicine and Biomedical and Behavorial Research in its report Securing Access to Health Care. Though the federal government's involvement is not necessary if private forces are able to achieve equity in health care delivery, the government bears the ultimate responsibility for ensuring that society fulfills its obligations. Meeting these objectives will require changes in the country's political and economic systems, which traditionally have not emphasized subordinating the individual good to the common good. The needs of the poor must take priority even at risk of burdening the advantaged. The commission recognizes that it is irresponsible to advocate equity without acknowledging the need to control costs. Greater equity can be attained only if changes in health care management practices are adopted and if decisions regarding resource use are based on social goals. Thus placing the needs of the poor first may mean a commitment to use less high-cost treatment. The report presents an opportunity to promote a more just health care policy. Catholic health care facilities, for example, can be made models of institutions that have met the needs of the poor, and they can become social justice advocates for government policies that benefit the poor and the disadvantaged. PMID:10267321

Weber, L J

18

9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).  

Code of Federal Regulations, 2013 CFR

...involved in the care and use of animals regarding handling, immobilization, anesthesia, analgesia, tranquilization, and euthanasia; and (5) Adequate pre-procedural and post-procedural care in accordance with established veterinary medical and...

2013-01-01

19

Ensuring competency in end-of-life care: controlling symptoms  

PubMed Central

Background Palliative medicine is assuming an increasingly important role in patient care. The Education for Physicians in End-of-life Care (EPEC) Project is an ambitious program to increase core palliative care skills for all physicians. It is not intended to transmit specialty level competencies in palliative care. Method The EPEC Curriculum was developed to be a comprehensive syllabus including trainer notes, multiple approaches to teaching the material, slides, and videos of clinical encounters to trigger discussion are provided. The content was developed through a combination of expert opinion, participant feedback and selected literature review. Content development was guided by the goal of teaching core competencies not included in the training of generalist and non-palliative medicine specialist physicians. Results Whole patient assessment forms the basis for good symptom control. Approaches to the medical management of pain, depression, anxiety, breathlessness (dyspnea), nausea/vomiting, constipation, fatigue/weakness and the symptoms common during the last hours of life are described. Conclusion While some physicians will have specialist palliative care services upon which to call, most in the world will need to provide the initial approaches to symptom control at the end-of-life.

Ferris, Frank D; von Gunten, Charles F; Emanuel, Linda L

2002-01-01

20

The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems  

PubMed Central

Objectives: As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods: Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe) health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results: Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion: The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine surveillance and medical intelligence as the backbone of the health sector is necessary, besides adequate management couple with strong leadership principles.

Osain, Menizibeya Welcome

2011-01-01

21

Ensuring quality care: what do you get for your money?  

PubMed

In the rush to produce balanced scorecards and outcomes measures, managed care organizations must recognize the need to better assess the clinical competencies of their contracted skilled nursing facilities. Health plan quality management staffs, although composed of gifted professionals, generally do not have sufficient skilled nursing facility (SNF)-related experience or knowledge to support evaluation and qualification of these providers. The successfully implemented Altman-Conrad (A-C) SNF quality management process objectively measures and monitors managed care contracted services provided by SNFs. The A-C process requires a health plan's quality management/utilization management staff to engage in a team-based educational endeavor. This effort is designed to generate measurable outcomes specific to the health plan's needs. The proven benefits of the process include improved member services, greater member satisfaction, more productive days for SNFs, more effective discharges, and the generation of a win-win relationship between the health plan and its contract providers. PMID:10185717

Altman, S; Conrad, S

22

Unbearable Pain: India's Obligation to Ensure Palliative Care  

NSDL National Science Digital Library

The Human Rights Watch organization has written this report, which talks about the difficulties faced by patients in major cancer hospitals across India. Released in October 2009, this 102-page report takes an investigative look into the pain treatment situation in these hospitals. The report identifies three key obstacles to improving the availability of pain treatment and palliative care, including restrictive drug regulations and the failure to train doctors about pain treatment methods. Visitors will find that the report is divided into several major sections including "Palliative Care and Pain Treatment in India" and "The Plight of Patients". Additionally, interested parties can also view the appendices attached to the report. An online slide show and a video feature round out the site.

23

Orphan Care in Botswana's Working Households: Growing Responsibilities in the Absence of Adequate Support  

PubMed Central

Objectives. Botswana has one of the worlds highest HIV-prevalence rates and the worlds highest percentages of orphaned children among its population. We assessed the ability of income-earning households in Botswana to adequately care for orphans. Methods. We used data from the Botswana Family Health Needs Study (2002), a sample of 1033 working adults with caregiving responsibilities who used public services, to assess whether households with orphan-care responsibilities encountered financial and other difficulties. Thirty-seven percent of respondents provided orphan care, usually to extended family members. We applied logistic regression models to determine the factors associated with experiencing problems related to orphan caregiving. Results. Nearly half of working households with orphan-care responsibilities reported experiencing financial and other difficulties because of orphan care. Issues of concern included caring for multiple orphans, caring for sick adults and orphans simultaneously, receiving no assistance, and low income. Conclusions. The orphan crisis is impoverishing even working households, where caregivers lack sufficient resources to provide basic needs. Neither the public sector nor communities provide adequate safety nets. International assistance is critical to build capacity within the social welfare infrastructure and to fund community-level activities that support households. Lessons from Botswanas orphan crisis can provide valuable insights to policymakers throughout sub-Saharan Africa.

Miller, Candace M.; Gruskin, Sofia; Subramanian, S.V.; Rajaraman, Divya; Heymann, S. Jody

2006-01-01

24

Informal Care Can Be Better Than Adequate: Development and Evaluation of the Exemplary Care Scale  

Microsoft Academic Search

Purpose: To evaluate a new measure assessing excellent, or exemplary, informal carean aspect of caregiving that has received little attention. The Exemplary Care Scale (ECS) was developed on the basis of insights from previous research with items generated by the authors in consultation with a multidisciplinary research team. Design: 310 informal caregivers and 283 of their elderly care recipients completed

W. Keith Dooley; David R. Shaffer; Charles E. Lance; Gail M. Williamson

2007-01-01

25

Childhood loss of parent, lack of adequate parental care and adult depression: a replication.  

PubMed

A study of women living in Islington has confirmed earlier findings that the loss of a mother before the age of 17 (by death or separation) is associated with an increase in clinical depression in adulthood. Lack of adequate parental care following the loss accounted for the increase in disorder and there was some evidence that it acted as a 'vulnerability factor' increasing risk of onset of depression during a 1-year follow-up period, in the presence of a severe life event or major difficulty. Premarital pregnancy, marital separation/divorce and negative evaluation of self were identified as factors intervening between childhood lack of care and adult depression. PMID:2955002

Bifulco, A T; Brown, G W; Harris, T O

26

What is adequate health care and how can quality of care be improved?  

Microsoft Academic Search

Attempts to improve patient care, its increasing cost and the aggressive malpractice environment have highlighted the need for standards of professional accountability. However, current measures of quality of care have mostly been met with skepticism by the medical community. These measures have been criticized for their uncertain validity and for focussing on secondary aspects of service that measure what is

Jochanan Benbassat; Mark Taragin

1998-01-01

27

Ensuring Quality Cancer Care: Symposium. Abstract, Executive Summary and Final Report of Symposiu.  

National Technical Information Service (NTIS)

In 1999 report, Ensuring Quality Cancer Care, the Institute of Medicine concluded that, 'for many Americans with cancer there is a wide gulf between what could be construed as the ideal and the reality of their experience with cancer care.' In order to fu...

C. L. Bennett

2001-01-01

28

Calculated and experimental substantiation of operating conditions under which adequate erosion resistance of valves used in power units at nuclear power stations is ensured  

NASA Astrophysics Data System (ADS)

A procedure for revealing factors causing damage to metal and the dominating mechanism through which this damage occurs that was developed earlier is applied for substantiating the operating conditions of valves with D nom = 800 mm installed in the multiple forced circulation loop of power units at nuclear power stations equipped with RBMK-1000 reactors under which their resistance to erosion is ensured. Operating conditions under which cavitation erosion may occur are established, and practical proposals on how to prevent damage to the metal of a throttle-control valves body are presented.

Tomarov, G. V.; Shipkov, A. A.; Koreshkova, N. S.

2010-05-01

29

Phenytoin loading doses in adult critical care patients: does current practice achieve adequate drug levels?  

PubMed

Phenytoin is regularly employed in the critically ill for prophylaxis against or treatment of seizure disorders. No prior studies have examined current dosing practices in an Australasian intensive care unit (ICU) setting. The aims of this study were to: a) describe the adequacy of contemporary dosing in respect to free and total serum phenytoin concentrations; b) identify factors associated with therapeutic drug concentrations; and c) examine the accuracy of predictive equations that estimate free concentrations in this setting. All patients receiving a loading dose of phenytoin in a tertiary-level ICU were eligible for enrolment; 53 patients were enrolled in the study. Serum samples to determine free and total phenytoin concentrations (measured by high performance liquid chromatography) were then drawn prior to the following dose. Free concentrations below the recommended target (<1 mg/l) were considered as suboptimal. The most common indication for phenytoin loading was traumatic brain injury (49%) and the mean administered dose was 14.5 (3.66) mg/kg. Twenty-six patients (49%) had suboptimal trough free concentrations, although this subgroup was significantly heavier and therefore received a lower per kilogram dose (12.8 [3.1] vs 16.3 [3.4] mg/kg, P=0.001). In multivariate analysis, larger weight adjusted doses (P=0.018), higher albumin concentration (P=0.034) and receiving phenytoin for an indication other than seizure (P=0.035), were associated with a greater likelihood of adequate concentrations. In conclusion, phenytoin dosing remains complex in critically ill patients, although lower per kilogram loading doses are strongly associated with free concentrations below the desired target. PMID:23977911

Putt, M T; Udy, A A; Jarrett, P; Martin, J; Hennig, S; Salmon, N; Lipman, J; Roberts, J A

2013-09-01

30

Hepatitis and the Need for Adequate Standards in Federally Supported Day Care.  

ERIC Educational Resources Information Center

|This article examines findings in three epidemiological studies of day care centers and concludes that higher standards of care can reduce the incidence of hepatitis among parents and staff. (Author/DB)|

Silva, Richard J.

1980-01-01

31

The cost-effectiveness of voluntary intrapartum rapid human immunodeficiency virus testing for women without adequate prenatal care  

Microsoft Academic Search

Objectives: We sought to determine the health and economic consequences of voluntary rapid human immunodeficiency testing during labor for women who have not received adequate prenatal care. Study Design: A decision-tree model was used to assess the number of pediatric human immunodeficiency virus cases that would be averted if women who were unable to determine their human immunodeficiency virus serostatus

William A. Grobman; Patricia M. Garcia

1999-01-01

32

Assuring Adequate Health Insurance: Results of the National Survey of Children With Special Health Care Needs  

Microsoft Academic Search

Objective. The purpose of this article is to report the findings of the 2001 National Survey of Children With Special Health Care Needs regarding the extent to which children with special health care needs (CSHCN) have access to public or private health insur- ance that meets their needs. Methodology. As part of its effort to develop systems of care for

Lynda Honberg; Merle McPherson; Bonnie Strickland; Julia C. Gage; Paul W. Newacheck

2010-01-01

33

9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).  

Code of Federal Regulations, 2010 CFR

... That daily observation of animals may be accomplished by someone...accurate information on problems of animal health, behavior, and well-being is conveyed...involved in the care and use of animals regarding handling,...

2010-01-01

34

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2010 CFR

... That daily observation of animals may be accomplished by someone...accurate information on problems of animal health, behavior, and well-being is conveyed...involved in the care and use of animals regarding handling,...

2009-01-01

35

Canada's Compassionate Care Benefit: Is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?  

Microsoft Academic Search

BackgroundAn increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision\\u000a of adequate palliative\\/end-of-life (P\\/EOL) care. Informal caregivers who take on the responsibility of providing P\\/EOL care\\u000a often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically\\u000a examine how Canada's Compassionate Care Benefit (CCB) - a contributory benefits

Allison M Williams; Jeanette A Eby; Valorie A Crooks; Kelli Stajduhar; Melissa Giesbrecht; Mirjana Vuksan; S Robin Cohen; Kevin Brazil; Diane Allan

2011-01-01

36

Cardiac disease and heart failure in cancer patients: is our training adequate to provide optimal care?  

PubMed

The care of patients with cancer who have cardiac disease is dispersed both sequentially and concurrently across multiple providers, and an important goal of education is communication among the providers regarding change of therapy, toxicity of therapy, and symptom assessments. Changes must be made to improve the delivery of cardiac care in patients with cancer and cancer survivors. Therefore, the authors propose a multilevel approach that includes short, targeted curriculum for housestaff training programs in internal medicine, family medicine, pediatrics, cardiology and oncology; increasing presence at national meetings of internists, oncologists and cardiologists; and an Internet-based repository of core information. PMID:21749887

Chen, Carol L; Steingart, Richard

2011-05-20

37

Adequate health literacy is associated with higher heart failure knowledge and self care confidence in hospitalized patients  

PubMed Central

Heart failure (HF) patients with inadequate health literacy are at increased risk for poor self care and negative health outcomes such as hospital readmission. The purpose of this study was to examine prevalence of inadequate health literacy; reliability of the Dutch HF Knowledge Scale (DHFKS) and Self Care of Heart Failure Index (SCHFI); and differences in HF knowledge, HF self care, and 30-day readmission rate by health literacy level among patients hospitalized with HF. The convenience sample included adults (N=95) admitted to a large urban teaching hospital with primary diagnosis of HF. Measures included the Short Test of Functional Health Literacy in Adults, DHFKS, SCHFI, and readmission at 30 days post-discharge. The sample was 59 14 years in age, 51% male, 67% African American; 35% had less than high school education, 35% were employed, 73% lived with someone who helps with their HF care, and 16% were readmitted within 30 days of index admission. Health literacy was inadequate for 42%, marginal for 19%, and adequate for 39%. Reliability of the DHFKS and SCHFI scales was comparable to prior reports. Mean knowledge score was 11.43 2.26, SCHFI subscale scores were 56.82 17.12 for maintenance, 63.64 18.29 for management, and 65.02 16.34 for confidence. Those with adequate health literacy were younger and had higher education level, HF knowledge scores, and HF self care confidence compared to those with marginal or inadequate health literacy. Self care maintenance and management scores and 30-day readmission rate did not differ by health literacy level. These findings demonstrate the high prevalence of inadequate and marginal health literacy and that health literacy is an important consideration in promoting HF knowledge and confidence in self care behaviors, particularly among older adults and those with less than high school education.

Dennison, Cheryl R.; McEntee, Mindy L.; Samuel, Laura; Johnson, Brandon J.; Rotman, Stacey; Kielty, Alexandra; Russell, Stuart D.

2010-01-01

38

Public health implications for adequate transitional care for HIV-infected prisoners: five essential components.  

PubMed

In the United States, 10 million inmates are released every year, and human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) prevalence is several-fold greater in criminal justice populations than in the community. Few effective linkage-to-the-community programs are currently available for prisoners infected with HIV. As a result, combination antiretroviral therapy (cART) is seldom continued after release, and virological and immunological outcomes worsen. Poor HIV treatment outcomes result from a myriad of obstacles that released prisoners face upon reentering the community, including homelessness, lack of medical insurance, relapse to drug and alcohol use, and mental illness. This article will focus on 5 distinct factors that contribute significantly to treatment outcomes for released prisoners infected with HIV and have profound individual and public health implications: (1) adaptation of case management services to facilitate linkage to care; (2) continuity of cART; (3) treatment of substance use disorders; (4) continuity of mental illness treatment; and (5) reducing HIV-associated risk-taking behaviors as part of secondary prevention. PMID:21844030

Springer, Sandra A; Spaulding, Anne C; Meyer, Jaimie P; Altice, Frederick L

2011-09-01

39

Vigorous cleaning and adequate ventilation are necessary to control an outbreak in a neonatal intensive care unit.  

PubMed

An outbreak of Bacillus cereus (B. cereus) bacteremia occurred in our neonatal intensive care unit (NICU) in July 2005. Many strains of B. cereus were cultured from patient specimens, as well as from environmental samples such as the surfaces of instruments and air in the NICU. Some of these strains were analyzed by pulsed field gel electrophoresis, and several were confirmed to be identical. We speculated that the bacterial load in the environment had initially increased and then possibly spread throughout the NICU facility via the airflow of the ventilation system. For this reason, besides maintaining standard precautions, we performed a vigorous clean of the NICU, and covered the vents to prevent dust falling from them. These protective measures ended the outbreak. In the hospital environment, adequate ventilation is important, especially in single-occupancy isolation rooms and operating theaters. However, the criteria for the adequate ventilation of multioccupancy rooms for acute care environments such as the NICU have not yet been defined. We need to pay more attention to these environmental factors in order to avoid cross contamination and infectious outbreaks. PMID:22038125

Shimono, Nobuyuki; Hayashi, Jun; Matsumoto, Hiroko; Miyake, Noriko; Uchida, Yujiro; Shimoda, Shinji; Furusyo, Norihiro; Akashi, Koichi

2011-10-26

40

Ensuring quality cancer care: a follow-up review of the Institute of Medicine's 10 recommendations for improving the quality of cancer care in America.  

PubMed

Responding to growing concerns regarding the safety, quality, and efficacy of cancer care in the United States, the Institute of Medicine (IOM) of the National Academy of Sciences commissioned a comprehensive review of cancer care delivery in the US health care system in the late 1990s. The National Cancer Policy Board (NCPB), a 20-member board with broad representation, performed this review. In its review, the NCPB focused on the state of cancer care delivery at that time, its shortcomings, and ways to measure and improve the quality of cancer care. The NCPB described an ideal cancer care system in which patients would have equitable access to coordinated, guideline-based care and novel therapies throughout the course of their disease. In 1999, the IOM published the results of this review in its influential report, Ensuring Quality Cancer Care. The report outlined 10 recommendations, which, when implemented, would: 1) improve the quality of cancer care, 2) increase the current understanding of quality cancer care, and 3) reduce or eliminate access barriers to quality cancer care. Despite the fervor generated by this report, there are lingering doubts regarding the safety and quality of cancer care in the United States today. Increased awareness of medical errors and barriers to quality care, coupled with escalating health care costs, has prompted national efforts to reform the health care system. These efforts by health care providers and policymakers should bridge the gap between the ideal state described in Ensuring Quality Cancer Care and the current state of cancer care in the United States. PMID:22045610

Spinks, Tracy; Albright, Heidi W; Feeley, Thomas W; Walters, Ron; Burke, Thomas W; Aloia, Thomas; Bruera, Eduardo; Buzdar, Aman; Foxhall, Lewis; Hui, David; Summers, Barbara; Rodriguez, Alma; Dubois, Raymond; Shine, Kenneth I

2011-11-01

41

Reduced brain corticotropin-releasing factor receptor activation is required for adequate maternal care and maternal aggression in lactating rats.  

PubMed

The brain corticotropin-releasing factor (CRF) system triggers a variety of neuroendocrine and behavioural responses to stress. Whether maternal behaviour and emotionality in lactation are modulated by CRF has rarely been investigated. In the present study, we measured CRF mRNA expression within the parvocellular part of the paraventricular nucleus in virgin and lactating Wistar rats bred for high (HAB) and low (LAB) anxiety-related behaviour or non-selected for anxiety (NAB). Further, we intracerebroventricularly infused synthetic CRF or the CRF receptor (CRF-R) antagonist D-Phe to manipulate CRF-R1/2 non-specifically in lactating HAB, LAB, and NAB dams, and monitored maternal care, maternal motivation, maternal aggression, and anxiety. The CRF mRNA expression in the parvocellular part of the paraventricular nucleus was higher in HAB vs. LAB rats independent of reproductive status. The lactation-specific decrease of CRF mRNA was confirmed in LAB and NAB dams but was absent in HAB dams. Intracerebroventricular CRF decreased maternal care under basal conditions in the home cage in all breeding lines and reduced attack behaviour in HAB and LAB dams during maternal defence. In contrast, D-Phe rescued maternal care after exposure to maternal defence in the home cage without influencing maternal aggression. Furthermore, D-Phe decreased and CRF tended to increase anxiety in HAB/NAB and LAB dams, respectively, suggesting an anxiogenic effect of CRF in lactating females. In conclusion, low CRF-R activation during lactation is an essential prerequisite for the adequate occurrence of maternal behaviour. PMID:23742269

Klampfl, Stefanie M; Neumann, Inga D; Bosch, Oliver J

2013-06-07

42

The pregnant trauma patient in the intensive care unit: collaborative care to ensure safety and prevent injury.  

PubMed

The pregnant woman who has experienced trauma will need to be transferred to an appropriate setting once she is stabilized. Nursing has evolved into many specialty areas with specific sets of skills developed to care for women in these areas. The trauma team and the intensive care unit team will most likely be uncomfortable with the pregnant woman. The perinatal team may be uncomfortable with the injuries or illness that brought the woman to the trauma unit. Together the combined knowledge of all teams can provide for safe care of the woman and fetus and prevent injury occurring to them. Collaborative care is part of the overall plan of care, which follows a formal plan already established by the leadership teams of the 2 units. The purpose of this article is to review collaborative care in the intensive care unit and to provide an overview of the nursing skill sets necessary to care for the pregnant trauma woman. PMID:18287900

Sosa, Mary Ellen Burke

43

Ensuring cultural sensitivity for Muslim patients in the Australian ICU: Considerations for care.  

PubMed

Australia is a diverse and multicultural nation, made up of a population with a predominant Christian faith. Islam, the second largest religion in the world, has demonstrated significant growth in Australia in the last decade. Coming from various countries of origin and cultural backgrounds, Muslim beliefs can range from what is considered 'traditional' to very 'liberal'. It is neither possible nor practical for every intensive care clinician to have an intimate understanding of Islam and Muslim practices, and cultural variations amongst Muslims will mean that not all beliefs/practices will be applicable to all Muslims. However, being open and flexible in the way that care is provided and respectful of the needs of Muslim patients and their families is essential to providing culturally sensitive care. This discussion paper aims to describe the Islamic faith in terms of Islamic teachings, beliefs and common practices, considering how this impacts upon the perception of illness, the family unit and how it functions, decision-making and care preferences, particularly at the end of life in the intensive care unit. PMID:23693083

Bloomer, Melissa J; Al-Mutair, Abbas

2013-05-18

44

Adequate formalization  

Microsoft Academic Search

This article identifies problems with regard to providing criteria that regulate the matching of logical formulae and natural\\u000a language. We then take on to solve these problems by defining a necessary and sufficient criterion of adequate formalization.\\u000a On the basis of this criterion we argue that logic should not be seen as an ars iudicandi capable of evaluating the validity

Michael Baumgartner; Timm Lampert

2008-01-01

45

Mentoring and social skills training: ensuring better outcomes for youth in foster care.  

PubMed

Youth in foster care face significant life challenges that make it more likely that they will face negative outcomes (i.e., school failure, homelessness, and incarceration). While the reason(s) for out-of-home placement (i.e., family violence, abuse, neglect and/or abandonment) provide some context for negative outcomes, such negative outcomes need not be a foregone conclusion. In fact, interventions created to serve at-risk youth could ostensibly address the needs of youth in foster care as well, given that they often face similar social, emotional, and other challenges. Specifically, the author posits that supporting foster care youth through the use ofmentoring and social skills training could reduce the negative outcomes far too common for many of these youth. PMID:21950175

Williams, Charles A

2011-01-01

46

Mentoring and Social Skills Training: Ensuring Better Outcomes for Youth in Foster Care  

ERIC Educational Resources Information Center

Youth in foster care face significant life challenges that make it more likely that they will face negative outcomes (i.e., school failure, homelessness, and incarceration). While the reason(s) for out-of-home placement (i.e., family violence, abuse, neglect and/or abandonment) provide some context for negative outcomes, such negative outcomes

Williams, Charles A.

2011-01-01

47

Ensuring Safe Medication Administration to Children in New Jersey's Child Care Programs. ACNJ Special Report  

ERIC Educational Resources Information Center

Modern medications allow children with a variety of acute and chronic health conditions to participate in daily activities. However, parents and child care providers may not realize that there are different dosage strengths available on the market. The parent or staff may not fully understand the dosage or a miscommunication may occur. These

Burdette, Dianne S.; Coogan, Mary E.; Giosa, Ritamarie; Lucarelli, Patti; Pavignano, Debra

2006-01-01

48

Vasopressin in vasodilatory shock: ensure organ blood flow, but take care of the heart!  

PubMed Central

Supplementary arginine vasopressin infusion in advanced vasodilatory shock may be accompanied by a decrease in cardiac index and systemic oxygen transport capacity in approximately 40% of patients. While a reduction of cardiac output most frequently occurs in patients with hyperdynamic circulation, it is less often observed in patients with low cardiac index. Infusion of inotropes, such as dobutamine, may be an effective strategy to restore systemic blood flow. However, when administering inotropic drugs, systemic blood flow should be increased to adequately meet systemic demands (assessed by central or mixed venous oxygen saturation) without putting an excessive beta-adrenergic stress on the heart. Overcorrection of cardiac index to hyperdynamic values with inotropes places myocardial oxygen supply at significant risk.

Dunser, Martin W; Hasibeder, Walter R

2006-01-01

49

Remote home health care technologies: how to ensure privacy? Build it in: Privacy by Design  

Microsoft Academic Search

Current advances in connectivity, sensor technology, computing power and the development of complex algorithms for processing\\u000a health-related data are paving the way for the delivery of innovative long-term health care services in the future. Such technological\\u000a developments will, in particular, assist the elderly and infirm to live independently, at home, for much longer periods. The\\u000a home is, in fact, becoming

Ann Cavoukian; Angus Fisher; Scott Killen; David A. Hoffman

2010-01-01

50

How home care is essential to ensuring successful orthodontic treatment outcomes.  

PubMed

Patients can significantly affect the outcome of their orthodontic treatment. A practice committed to developing the right systems, scripts, and educational materials will experience a more satisfied patient, increased efficiencies, and higher profits. Educating and motivating patients to maintain their oral health and providing recommendations or dispensing of home care tools such as a power toothbrush increases patient compliance, positively impacts treatment outcomes, enhances customer service, and generates a new revenue stream for the practice. In a tight economy and a highly competitive orthodontic market, a power toothbrush can positively impact your marketing and case close rate. Treatment and fees being relatively equal, patients will tend to accept treatment from a practice that can demonstrate concern for the patients' overall oral health and greater value-added components to the orthodontic case. Power toothbrushes as part of a comprehensive orthodontic treatment provide a great differentiating marketing strategy. PMID:15495447

Levin, Roger

2004-09-01

51

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study  

PubMed Central

Background Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. Methods Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. Results Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. Conclusion General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

Whitford, David L; Hickey, Anne; Horgan, Frances; O'Sullivan, Bernadette; McGee, Hannah; O'Neill, Desmond

2009-01-01

52

Opioid-Induced Sedation in the Postanesthesia Care Unit Does Not Insure Adequate Pain Relief: A Case-Control Study  

Microsoft Academic Search

BACKGROUND: Sedation can occur during intravenous titration of morphine for acute pain control in the postanesthesia care unit (PACU). We designed this case-control study to evaluate the relationship between opioid-induced sedation in the PACU and adequacy of early postoperative analgesia. METHODS: Intravenous morphine was titrated in 2 mg (body weight 60 kg) or 3 mg (body weight 60 kg) boluses

Claude Lentschener; Patrice Tostivint; Marc E. Gentili; Yves Ozier

2007-01-01

53

H. R. 4604: a bill to promote competition in the natural gas market, to ensure open access to transportation service, to encourage production of natural gas, to provide natural gas consumers with adequate supplies at reasonable prices, to eliminate demand restraints, and for other purposes. Introduced in the House of Representatives, Ninety-Ninth Congress, Second Session, April 16, 1986  

SciTech Connect

The Natural Gas Policy Act Amendments of 1986 promotes competition in the natural gas market. Title I ensures open access to transportation service by requiring that interstate pipelines not discriminate in providing transportation services. Title II encourages production of natural gas by removing wellhead price controls and repealing jurisdiction over first sales. Title III provides natural gas consumers with adequate supplies at reasonable prices and eliminates demand restraints. The bill was referred to the House Committee on Energy and Commerce.

Not Available

1986-01-01

54

Are process indicators adequate to assess essential obstetric care at district level?--a case study from Rufiji district, Tanzania.  

PubMed

To assess coverage and quality of essential obstetric care (EOC) and the appropriateness of using processindicators, a 3-month follow-up study was done in Rufiji district, Tanzania, involving 2 hospitals, 4 health centres, 10 large dispensaries and 10 randomly selected small dispensaries. Data collection was done on process indicators as suggested by UNICEF/WHO/UNFPA (UN) and 'unmet obstetric need (UON) for major obstetric intervention (MOI)'. With standard values in (brackets), the district had two comprehensive EOC facilities, births in EOC amounted to 62% (15%), met need for EOC was 76% (100%), caesarean section (C/S) rate 4.1% (> 5%), hospital case fatality rate (CFR) 1.0% (< 1%) and successful obstetric referrals 46% (100%). MOI for absolute maternal indication in the district was 2.6% (1-2%). All four maternal deaths occurred due to transport failures. The process indicators gave contradictory impressions on the coverage and quality of care and failed to link to the outcome of delivery complications in the study. PMID:16623194

Urassa, David P; Carlstedt, Anders; Nystrm, Lennarth; Massawe, Siriel N; Lindmark, Gunilla

2005-12-01

55

Adequate Wound Care and Use of Bed Nets as Protective Factors against Buruli Ulcer: Results from a Case Control Study in Cameroon  

PubMed Central

Background Buruli ulcer is an infectious disease involving the skin, caused by Mycobacterium ulcerans. Its exact transmission mechanism remains unknown. Several arguments indicate a possible role for insects in its transmission. A previous case-control study in the Nyong valley region in central Cameroon showed an unexpected association between bed net use and protection against Buruli ulcer. We investigated whether this association persisted in a newly discovered endemic Buruli ulcer focus in Bankim, northwestern Cameroon. Methodology/Principal Findings We conducted a case-control study on 77 Buruli ulcer cases and 153 age-, gender- and village-matched controls. Participants were interviewed about their activities and habits. Multivariate conditional logistic regression analysis identified systematic use of a bed net (Odds-Ratio (OR)?=?0.4, 95% Confidence Interval [95%CI]?=?[0.20.9], p-value (p)?=?0.04), cleansing wounds with soap (OR [95%CI]?=?0.1 [0.030.3], p<0.0001) and growing cassava (OR [95%CI]?=?0.3 [0.20.7], p?=?0.005) as independent protective factors. Independent risk factors were bathing in the Mbam River (OR [95%CI]?=?6.9 [1.435], p?=?0.02) and reporting scratch lesions after insect bites (OR [95%CI]?=?2.7 [1.45.4], p?=?0.004). The proportion of cases that could be prevented by systematic bed net use was 32%, and by adequate wound care was 34%. Conclusions/Significance Our study confirms that two previously identified factors, adequate wound care and bed net use, significantly decreased the risk of Buruli ulcer. These associations withstand generalization to different geographic, climatic and epidemiologic settings. Involvement of insects in the household environment, and the relationship between wound hygiene and M. ulcerans infection should now be investigated.

Landier, Jordi; Boisier, Pascal; Fotso Piam, Felix; Noumen-Djeunga, Blanbin; Sime, Joseph; Wantong, Fidele Gaetan; Marsollier, Laurent; Fontanet, Arnaud; Eyangoh, Sara

2011-01-01

56

Considering Accreditation in Gerontology: The Importance of Interprofessional Collaborative Competencies to Ensure Quality Health Care for Older Adults  

Microsoft Academic Search

The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their coursework. This article details the core interprofessional collaborative competencies that need to be an

Lynette R. Goldberg; Jennifer Scott Koontz; Nicole Rogers; Jean Brickell

2012-01-01

57

Action on AMD. Optimising patient management: act now to ensure current and continual delivery of best possible patient care  

PubMed Central

In recent years, there have been significant advances in the clinical management of patients with wet age-related macular degeneration (wet AMD)a rapidly progressing and potentially blinding degenerative eye disease. Wet AMD is responsible for more than half of registered severe sight impairment (blindness) in the United Kingdom, and patients who are being treated for wet AMD require frequent and long-term follow-up for treatment to be most effective. The clinical workload associated with the frequent follow-up required is substantial. Furthermore, as more new patients are diagnosed and the population continues to age, the patient population will continue to increase. It is thus vital that clinical services continue to adapt so that they can provide a fast and efficient service for patients with wet AMD. This Action on AMDdocument has been developed by eye health-care professionals and patient representatives, the Action on AMDgroup. It is intended to highlight the urgent and continuing need for change within wet AMD services. This document also serves as a guide for eye health-care professionals, NHS commissioners, and providers to present possible solutions for improving NHS retinal and macular services. Examples of good practice and service development are considered and can be drawn upon to help services meet the recommended quality of care and achieve best possible outcomes.

Amoaku, W; Blakeney, S; Freeman, M; Gale, R; Johnston, R; Kelly, S P; McLaughlan, B; Sahu, D; Varma, D

2012-01-01

58

Enteral feeding for high-risk neonates: a digest for nurses into putative risk and benefits to ensure safe and comfortable care.  

PubMed

Enteral feeding is considered a relatively safe method of providing nutritional support to high-risk neonates. Nonetheless, there are associated risks, which can be classified as follows: factors to consider before initiating enteral feeding; feeding tube placement; delivery of milk feedings; and gastrointestinal, environmental, and technical factors. For each classification, this article highlights adverse consequences and synthesizes the literature for evidence-based nursing practice recommendations, which are summarized in the "Conclusion" section. Many gaps are identified in the research literature, and directions for future research are described to ensure safe and comfortable care for high-risk neonates receiving enteral feedings. PMID:15796426

Premji, Shahirose S

59

Delay in the provision of adequate care to women who died from abortion-related complications in the principal maternity hospital of Gabon  

Microsoft Academic Search

Deaths resulting from unsafe induced abortions represent a major component of maternal mortality in countries with restrictive abortion laws. Delays in obtaining care for maternal complications constitute a known determinant of a womans risk of death. However, data on the role of delays in providing care at health care facilities are sparse. The association between the cause of maternal death

Sosthene Mayi-Tsonga; Litochenko Oksana; Isabelle Ndombi; Thierno Diallo; Maria Helena de Sousa; Anbal Fandes

2009-01-01

60

Behaviourally Adequate Software Testing  

Microsoft Academic Search

Identifying a finite test set that adequately captures the essential behaviour of a program such that all faults are identified is a well-established problem. Traditional adequacy metrics can be impractical, and may be misleading even if they are satisfied. One intuitive notion of adequacy, which has been discussed in theoretical terms over the past three decades, is the idea of

Gordon Fraser; Neil Walkinshaw

2012-01-01

61

Defibrillation: ensuring its success.  

PubMed

In this issue, we evaluate two alternatives to the gelled paddles traditionally used in defibrillation: disposable defibrillator pads and disposable defibrillator electrodes. These devices offer certain advantages over gel and are designed primarily to ensure adequate electrical contact for successful defibrillation. We evaluated three disposable defibrillator pads from three manufacturers and two disposable defibrillator electrodes from two manufacturers and rated them according to their suitability for three applications: general hospital use, cardiac catheterization and electrophysiology laboratory use, and prehospital use. We rated the AMI, ConMed, and 3M pads Acceptable for all three applications. Because electrodes offer advantages as well as present problems when used for different applications, we rated them accordingly. The Darox and Physio-Control electrodes are rated Conditionally Acceptable-Not Recommended, Acceptable, and Conditionally Acceptable for the three applications, respectively. Purchasing decisions should be based on a thorough understanding of the issues behind our conclusions, which can be gained only by reading this evaluation in its entirety. PMID:2372318

1990-02-01

62

Adequate and Sufficient FE for Young People.  

ERIC Educational Resources Information Center

|This document is designed for further education (FE) colleges and individuals responsible for regional FE planning in the United Kingdom. Based on several case studies and the views of selected stakeholders in FE, it presents a framework for ensuring adequate and sufficient FE for young people. Discussed in the document's four sections are the

Further Education Development Agency, London (England).

63

Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care? Practice resources appear to be a determining factor in whether or not physicians treating predominantly minority patients deliver care of adequate quality  

Microsoft Academic Search

Racial and ethnic disparities in primary health care likely reflect the aggregate socioeconomic composition of a physician's patient panels as well as differences in individ- ual patients' characteristics. National physician survey data indicate that physicians in high-minority practices depend more on low-paying Medicaid, receive lower private insur- ance reimbursements, and have lower incomes. These constrained resources help explain the greater

James D. Reschovsky; Ann S. O'Malley

64

Ensuring specialty nurse competence to care for older adults: reflections on a decade of collaboration between specialty nursing associations and the hartford institute for geriatric nursing.  

PubMed

Geriatric preparation of specialty nurses is critical because their direct care and administrative responsibilities profoundly impact the care of countless older patients in all settings. For a decade, the Hartford Institute for Geriatric Nursing, NYU College of Nursing, has worked with 54 national specialty nursing associations, and intensely with 14, to develop strategies for new standards for quality care for older patients. A successful blueprint for specialty associations to sustain and enhance these outcomes will be presented. PMID:24061584

Esterson, Jessica; Bazile, Yamilee; Mezey, Mathy; Cortes, Tara A; Huba, George J

2013-10-01

65

Ensuring pain relief for children at the end of life  

PubMed Central

Pain management in the context of pediatric palliative care can be challenging. The present article reviews, through a case-based presentation, the nonpharmacological and pharmacological methods used to ensure adequate pain control in children facing end of life. Details on the impressive range of opioid dosages required and routes of administration are highlighted from published literature and clinical experience. Where available, evidence-based recommendations are provided. Potential side effects of pain medication and barriers to good pain control are discussed. Novel analgesics and innovative delivery methods are presented as future tools enhancing pain relief at the end of life. Some challenges to ethically grounded research in this important context of care are reviewed.

Gregoire, Marie-Claude; Frager, Gerri

2006-01-01

66

Is health insurance enough? A usual source of care may be more important to ensure a child receives preventive health counseling.  

PubMed

Despite the promise of expanded health insurance coverage for children in the United States, a usual source of care (USC) may have a bigger impact on a child's receipt of preventive health counseling. We examined the effects of insurance versus USC on receipt of education and counseling regarding prevention of childhood injuries and disease. We conducted secondary analyses of 2002-2006 data from a nationally-representative sample of child participants (?17 years) in the Medical Expenditure Panel Survey (n = 49,947). Children with both insurance and a USC had the lowest rates of missed counseling, and children with neither one had the highest rates. Children with only insurance were more likely than those with only a USC to have never received preventive health counseling from a health care provider regarding healthy eating (aRR 1.21, 95% CI 1.12-1.31); regular exercise (aRR 1.06, 95% CI 1.01-1.12), use of car safety devices (aRR 1.10, 95% CI 1.03-1.17), use of bicycle helmets (aRR 1.11, 95% CI 1.05-1.18), and risks of second hand smoke exposure (aRR 1.12, 95% CI 1.04-1.20). A USC may play an equally or more important role than insurance in improving access to health education and counseling for children. To better meet preventive counseling needs of children, a robust primary care workforce and improved delivery of care in medical homes must accompany expansions in insurance coverage. PMID:21373938

DeVoe, Jennifer E; Tillotson, Carrie J; Wallace, Lorraine S; Lesko, Sarah E; Pandhi, Nancy

2012-02-01

67

Is Health Insurance Enough? A Usual Source of Care may be More Important to Ensure a Child Receives Preventive Health Counseling  

Microsoft Academic Search

Despite the promise of expanded health insurance coverage for children in the United States, a usual source of care (USC)\\u000a may have a bigger impact on a childs receipt of preventive health counseling. We examined the effects of insurance versus\\u000a USC on receipt of education and counseling regarding prevention of childhood injuries and disease. We conducted secondary\\u000a analyses of 20022006

Jennifer E. DeVoeCarrie; Carrie J. Tillotson; Lorraine S. WallaceSarah; Sarah E. Lesko; Nancy Pandhi

68

Ensuring Students' Success  

ERIC Educational Resources Information Center

|James L. Oblinger, Chancellor of North Carolina State University, argues that higher education must continually evolve new methods of teaching and learning to support students' lifelong skills and impending careers. Part of ensuring students' success lies in finding alternative learning models, such as the Student-Centered Activities for Large

Oblinger, James L.

2006-01-01

69

Ensuring safer drinking water  

Microsoft Academic Search

Today's regulatory environment has led to the proliferation of voluntary consensus standards and certification programs that are important to ensuring safety and health in a number of areas. One such area -- the treatment and delivery of potable water -- is addressed by the Drinking Water Additives Program.'' At the request of the Environmental Protection Agency (EPA), this program was

J. Christensen; P. Higgins

1994-01-01

70

Ensuring Streams Flow  

Microsoft Academic Search

. It is our aim to develop an elementary strong functional programming(ESFP) system. To be useful, ESFP should include structuressuch as streams which can be computationally unwound infinitely often.We describe a syntactic analysis to ensure that infinitely proceedingstructures, which we shall term codata, are productive. This analysis is anextension of the check for guardedness that has been used with definitionsover

Alastair Telford; David Turner

1997-01-01

71

ACSB: What is adequate performance?  

Microsoft Academic Search

Amplitude companded sideband (ACSB) is a new modulation technique that uses a much smaller channel width than does conventional frequency modulation (FM). Among the requirements of a land mobile Communications system is adequate speech intelligibility. This paper explores this aspect of \\

L. T. Jones; W. A. Kissick

1987-01-01

72

Preventing Absenteeism and Promoting Resilience Among Health Care Workers in Biological Emergencies.  

National Technical Information Service (NTIS)

The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, health care absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic, such...

A. M. Lesperance J. S. Miller

2009-01-01

73

Can Managed Care And Competition Control Medicare Costs? It will take more than managed care and competitive options to ensure that Medicare can meets its obligations in the future  

Microsoft Academic Search

Medicare+Choice (M+C) was conceived to bring managed care and competi- tive forces to bear on Medicare. Ultimately, M+C could not thrive under the conditions of the marketplace and the Balanced Budget Act of 1997. Here I review what went wrong and the lessons from the experience, concluding that M+C is a tool, not a strategy. While managed care in a

Marsha Gold

2003-01-01

74

Ensuring Atomicity of Multilevel Transactions  

Microsoft Academic Search

Ensuring atomicity is a major outstanding problem with present methods of handling multilevel transactions. The chief difficulty is that a high section of a transaction may be unable to complete due to violations of the integrity con- straints, and a rollback of sections can be exploited to im- plement a covert channel. We define a notion of semantic atomicity which

Paul Ammann; Sushil Jajodia; Indrakshi Ray

1996-01-01

75

Crossing Community Sectors: Challenges Faced by Families of Children With Special Health Care Needs  

Microsoft Academic Search

This article identifies unmet needs and challenges of 37 families caring for children with special health care needs (CSHCN). Data were collected in focus groups. Data saturation occurred in the third group. Another group was conducted to ensure adequate inclusion of rural participants. Mean age of participants was 36 years. Most participants were women (92%), Caucasian (65%), high school graduates

Melanie Lutenbacher; Sharon Karp; Gladys Ajero; Dara Howe; Mamie Williams

2005-01-01

76

Guidance for Industry: Adequate and Appropriate Donor ...  

Center for Biologics Evaluation and Research (CBER)

... for Industry: Adequate and Appropriate Donor Screening Tests for Hepatitis B; Hepatitis B Surface Antigen (HBsAg) Assays Used to Test Donors of ... More results from www.fda.gov/biologicsbloodvaccines/guidancecomplianceregulatoryinformation/guidances

77

Improved multiplicity-edited ADEQUATE experiments  

NASA Astrophysics Data System (ADS)

A very simple strategy is proposed to extract carbon multiplicity information along with the classic knowledge of carbon-carbon connectivities in ADEQUATE experiments without affecting the sensitivity ratios of the original pulse schemes. These new multiplicity-edited ADEQUATE experiments prove to be highly helpful for complete 1H and 13C resonance assignment and also for automated and easy spin system characterization of samples at natural abundance, using a single NMR experiment.

Parella, Teodor; Snchez-Ferrando, Francesc

2004-01-01

78

Nutrition in the curriculum for health-care professionals  

Microsoft Academic Search

Argues that a substantial amount of nutrition should be included in the curriculum for all health-care professionals, including nurses, osteopaths, physiotherapists, podiatrists and retail pharmacists. The Department of Health has set up a Nutrition Task Force, charged with ensuring nutrition education of consumers, food manufacturers and retailers, and also adequate nutrition training in the curriculum for health professionals. The Task

David A. Bender

1995-01-01

79

Ensuring Quality Care: The Challenges of Measuring Performance and Consumer Satisfaction. Workshop for Senior State and Local Health Officials. Held in Vail, Colorado on May 18-20, 1998.  

National Technical Information Service (NTIS)

This workshop was presented by AHCPR's User Liaison Program and held in Vail, Colorado, on May 18-20 1998. Its purposes were to explain the shift of much of the U.S. population into managed care and the resulting need for better ways to measure the qualit...

1999-01-01

80

Asbestos/NESHAP adequately wet guidance  

SciTech Connect

The Asbestos NESHAP requires facility owners and/or operators involved in demolition and renovation activities to control emissions of particulate asbestos to the outside air because no safe concentration of airborne asbestos has ever been established. The primary method used to control asbestos emissions is to adequately wet the Asbestos Containing Material (ACM) with a wetting agent prior to, during and after demolition/renovation activities. The purpose of the document is to provide guidance to asbestos inspectors and the regulated community on how to determine if friable ACM is adequately wet as required by the Asbestos NESHAP.

Shafer, R.; Throwe, S.; Salgado, O.; Garlow, C.; Hoerath, E.

1990-12-01

81

HACCP approach to ensure the safety and quality of food packaging  

Microsoft Academic Search

EC Directive 93\\/43\\/EEC of 14 June 1993 on the hygiene of foodstuffs has been implemented in the Netherlands through the Food and Commodity Act (Warenwet) of 14 December 1995. This Directive requires food companies to identify steps in their activities that are critical to ensuring food safety, and to ensure that adequate safety procedures are identified, implemented, maintained and reviewed

E. H. G. Bovee; N. de Kruijf; J. Jetten; A. W. Barendsz

1997-01-01

82

29 CFR 505.5 - Adequate assurances.  

Code of Federal Regulations, 2013 CFR

...PRODUCTIONS ASSISTED BY GRANTS FROM THE NATIONAL ENDOWMENTS FOR THE ARTS AND HUMANITIES § 505.5 Adequate assurances. (a) Initial...filing with the Chairperson of the National Endowment for the Arts or the Chairperson of the National Endowment for the...

2013-07-01

83

Health Care Planning and Quality Care.  

National Technical Information Service (NTIS)

Basic ingredients in health care planning and quality care are addressed. Proper planning can assure that adequate manpower facilities are available to insure proper patient care. Thus, one of the most basic ingredients in quality health care is continual...

M. K. Duval

1972-01-01

84

ENSURING THE PRIVACY OF PROTECTED HEALTH INFORMATION IN RESEARCH  

Microsoft Academic Search

An issue of mounting importance for health-care providers and researchers in the United States is that of ensuring the privacy of health information of patients involved in research. Laws and statutes dealing with this issue may be germane in other countries. What do authors and research centers need to know about privacy? How can readers be assured that private information

Bart N. Green

85

[Abdominal cure procedures. Adequate use of Nobecutan Spray].  

PubMed

Open abdominal wounds, complicated by infection and/or risk of eventration tend to become chronic and usually require frequent prolonged cure. Habitual changing of bandages develop into one of the clearest risk factors leading to the deterioration of perilesional cutaneous integrity. This brings with it new complications which draw out the evolution of the process, provoking an important deterioration in quality of life for the person who suffers this and a considerable increase in health costs. What is needed is a product and a procedure which control the risk of irritation, which protect the skin, which favor a patient's comfort and which shorten treatment requirements while lowering health care expenses. This report invites medical personnel to think seriously about the scientific rationale, and treatment practice, as to why and how to apply Nobecutan adequately, this reports concludes stating the benefits in the adequate use of this product. The objective of this report is to guarantee the adequate use of this product in treatment of complicated abdominal wounds. This product responds to the needs which are present in these clinical cases favoring skin care apt isolation and protection, while at the same time, facilitating the placement and stability of dressings and bandages used to cure wounds. In order for this to happen, the correct use of this product is essential; medical personnel must pay attention to precautions and recommendations for proper application. The author's experiences in habitual handling of this product during various years, included in the procedures for standardized cures for these wounds, corroborates its usefulness; the author considers use of this product to be highly effective while being simple to apply; furthermore, one succeeds in providing quality care and optimizes resources employed. PMID:20143738

Lpez Soto, Rosa Mara

2009-12-01

86

A cautionary tale: the dysfunction of American health care  

Microsoft Academic Search

Attempts to reform the US health care system in the 1980s and 1990s were inspired by the systems inability to adequately provide access, ensure quality, and restrain costs. In the era of managed care, after the Clinton administrations failed legislative effort at reform, access, quality, and costs are still problems, and medical professionals are increasingly dissatisfied. To aid understanding of

Roy M. Poses

2003-01-01

87

Ensuring the Safety of Your Endoscopic Procedure  

MedlinePLUS

... Preparation of an Endoscope for Each Procedure Ensures Patient Safety In all areas of medicine and surgery, complex ... continually improving the design of endoscopes to ensure patient safety. Quality Assurance and Training Any facility in which ...

88

A community-based programme to provide prompt and adequate treatment of presumptive malaria in children  

Microsoft Academic Search

A community-based programme to ensure prompt and adequate treatment of presumptive episodes of clinical malaria in children has been established in a rural province of Burkina Faso. The implementation strategy was based on training a core group of mothers in every village and supplying community health workers with essential antimalarial drugs specially packed in age-specific bags containing a full course

Franco Pagnoni; Nathalie Convelbo; Justin Tiendrebeogo; Simon Cousens; Fulvio Esposito

1997-01-01

89

Ensuring the Power of Caring for One Child  

ERIC Educational Resources Information Center

|Schools must be places where powerful adults step into children's lives. Adolescence is the most difficult time in the course of building an individual's identity and sense of worth. In this article, the author emphasizes that all students should walk paths that enable them to make essential connections with the adults in their lives, and that it

Silva, Peggy

2006-01-01

90

Nutritional status of older people in long term care settings: current status and future directions  

Microsoft Academic Search

Despite being preventable and treatable, in the 21st Century, malnutrition remains a problem in the developed world and the nutritional needs of many older people in long-term care settings are not met. The UK government has pledged to provide high-quality care for this sector of the population, including minimum standards to ensure adequate nutrition. However, research is still needed into

David T. Cowan; Julia D. Roberts; Joanne M. Fitzpatrick; Alison E. While; Julie Baldwin

2004-01-01

91

Food safety of allergic patients in hospitals: implementation of a quality strategy to ensure correct management.  

PubMed

Food allergy could affect up to 8% of children. Four cases of food anaphylaxis in hospitalized children are reported, pointing to the need of food allergenic safety procedures in hospital settings. The implementation of the operating procedure in hospital food production units (HFPU) of Nancy University Hospital is described. The dietetics Department developed on hypoallergenic diet and specific avoidance diets. Dieticians within HFPU managed the choice of starting materials, the circuit organization in order to avoid any risk of contamination during preparation and cooking of food, product traceability, and trained the staff of HFPU. Within the care units physicians, dieticians, nurses, hospital workers are involved in meal management. A diet monitoring sheet is integrated into the patient's nursing file and enables the dietician to validate the diet in the computer, the nurses to display the patient's diet on the schedule on the wall in their office. The hospital workers finally use a tray form indicating the patient's identity, his/her diet and the menu of the day. Such a procedure absolutely secures the whole circuit and specifies the responsibilities of each person, whilst ensuring effective cooperation between all partners. Since 1999, the implementation of this multi-step strategy has prevented from any further reaction in a department specialized for food allergies in children and in adults. As setting up food allergenic safety in hospitals in not addressed adequately in the European directives, it's judicious to draw attention of hospital catering managers and hospital canteen staff to this necessity. PMID:12793114

Sergeant, P; Kanny, G; Morisset, M; Waguet, J C; Bastien, C; Moneret-Vautrin, D A

2003-04-01

92

40 CFR 716.25 - Adequate file search.  

Code of Federal Regulations, 2013 CFR

... 2013-07-01 false Adequate file search. 716.25 Section 716.25 Protection...General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in...

2013-07-01

93

Safety and excellence--is regulation ensuring their achievement  

SciTech Connect

Canada has a large, vigorous nuclear industry staffed by competent people, and a vigourous, independent regulatory agency similarly staffed. Nevertheless, there have been many signs over the last few years that the level of operating and engineering excellence needed to ensure a high level of safety was not being achieved in some key sections of the industry. Years of successful, accident-free operation - a hallmark of Canadian nuclear generating stations - are not by themselves a proof of adequate safety. Signs that the level of excellence is not being met in the nuclear reactor business have been seen, for example, in reviews of significant events, in the standard of generating documentation, and in the time taken to implement necessary design modifications. In the radioisotope business, the number of violations of licence conditions has been growing steadily, and there are an unacceptable number of workers exceeding regulatory dose limits. While many of these violations are minor in themselves, their prevalence suggests a degree of complacency has been developing which will be an enemy of excellence. Equally, the level of review, assessment, inspection and confirmatory research carried out in the past by the Atomic Energy Control Board (AECB) has been clearly inadequate. The paper discusses these and other examples of a lack of excellence, particularly in organization and management within its licensees and its effect on safety,. and identifies some of the performance indicators used. The paper also identifies some of the actions that are being taken by the AECB and the licensees to ensure an adequate level of safety is being maintained. The AECB is increasing, for example, its frequency of inspections in several industrial sectors and increasing its depth of safety review of nuclear generating stations.

Levesque, R.J.A. (Atomic Energy Control Board, Ottawa, Ontario (Canada))

1992-01-01

94

DATABASE MANAGEMENT TECHNIQUES TO ENSURE PROJECT INTEGRITY  

EPA Science Inventory

The Drinking Water Research Division of the Risk Reduction Engineering Laboratory in Cincinnati, Ohio is responsible for conducting field scale research projects on the cost and performance of drinking water treatment technology in support of the Safe Drinking Water Act. o ensure...

95

Ensuring Subjects' Understanding of Informed Consent.  

ERIC Educational Resources Information Center

A discussion of informed consent by human subjects in experimentation presents background on the consent issue, including federal requirements; lists factors that may affect a subject's ability to understand the consent document; and offers suggestions for preparing consent forms to ensure the subject's better comprehension. (Author/MSE)

Smith, Deborah L.; And Others

1995-01-01

96

Ensuring equine biosecurity at London 2012.  

PubMed

The London 2012 Olympic and Paralympic Equestrian Games were the highest profile event in the 2012 equestrian calendar and were the culmination of four years of detailed and meticulous biosecurity planning to ensure that all horses arrived, competed and returned home safely and in good health. Josh Slater, Anthony Greenleaves and Andy Paterson describe how this was achieved. PMID:23378308

Slater, Josh

2013-02-01

97

Ensuring Academic Literacy for ELL Students  

ERIC Educational Resources Information Center

|Ensuring that English language learning (ELL) students have equal access to content-area curriculum continues to be a challenge for many secondary educators. Although efforts to develop students' English skills are well intentioned, they frequently fall short of addressing each of the four interrelated dimensions of the culturally and

Perez, Della; Holmes, Melissa

2010-01-01

98

Ensuring Opioid Availability: Methods and Resources  

Microsoft Academic Search

The pain and palliative care fields are encouraged to learn about government drug control policy and to engage with their governments to examine these policies and their implementation in order to address impediments to patient access to pain management. Although pain management is a necessary part of palliative care, it is often impossible because strict national and state regulations block

David E. Joranson; Karen M. Ryan

2007-01-01

99

International data transfers between the United States and the European Union: are the procedural provisions of the Safe Harbor solution adequate?  

Microsoft Academic Search

Data transfers out of the European Union are only admissible if the third country ensures an adequate level of protection. With regard to the United States, organizations may adhere to so-called Safe Harbor principles whereby an adequate level of protection is admitted. This article reviews the relevant procedural provisions on granting the Safe Harbor status. It concludes that the current

Alexander Zinser

2004-01-01

100

Gender perspectives and quality of care: Towards appropriate and adequate health care for women  

Microsoft Academic Search

Gender inequalities in health are a consequence of the basic inequality between men and women in many societies. Despite the importance of socio-economic factors, women's health is also greatly affected by the extent and quality of health services available to them. Both non-governmental women's organizations and feminist health researchers have in recent years identified major gender inequalities in access to

Cecile M. T. Gijsbers van Wijk; Katja P. van Vliet; Annemarie M. Kolk

1996-01-01

101

Risk-analysis procedures ensure system safety  

Microsoft Academic Search

Conducting risk analysis and safety- engineering studies before construction of a sour-gas pipeline system will build redundancies into the system and ensure safe operation and maintenance. A recent analysis of a sour-gas pipeline built in Texas provides an example of procedures for safety engineering and risk assessment. This first of two articles presents the risk-analysis methodology and minimum safety systems

M. Mannan; D. B. Pfenning; C. D. Zinn

1991-01-01

102

Pulmonary rehabilitation and self-care after ambulatory surgery.  

PubMed

Over 30 million Americans are living with chronic lung disease in the United States. The long-term ongoing care required by these individuals is a major contributor to American health care costs. Clinicians caring for persons with chronic respiratory disease are faced with minimal time in which to prepare patients for adequate self-care abilities. Often times, the clinician may assume that all of the "bases have been covered." In reality, it is because this assumption is made that persons with chronic respiratory disease are often not receiving the full breadth of information that they need to increase their self-care abilities and optimize their quality of life. This article prepares the perianesthesia clinician to ensure that the important tenets of self-care information are addressed for the person with overt and/or underlying chronic respiratory disease. PMID:9934079

Geiger-Bronsky, M

1998-12-01

103

Self-reported segregation experience throughout the life course and its association with adequate health literacy  

PubMed Central

Residential segregation has been shown to be associated with health outcomes and health care utilization. We examined the association between racial composition of five physical environments throughout the life course and adequate health literacy among 836 community health center patients in Suffolk County, NY. Respondents who attended a mostly White junior high school or currently lived in a mostly White neighborhood were more likely to have adequate health literacy compared to those educated or living in predominantly minority or diverse environments. This association was independent of the respondents race, ethnicity, age, education, and country of birth.

Gaskin, Darrell J.; Si, Xuemei; Stafford, Jewel D.; Lachance, Christina; Kaphingst, Kimberly A.

2012-01-01

104

Tidal volumes which are perceived to be adequate for resuscitation  

Microsoft Academic Search

Observers trained in basic life support assessed chest rise in 34 patients who were anaesthetised and paralysed and whose lungs were being mechanically ventilated prior to routine surgery. Making 67 independent assessments, the observers indicated the tidal volume that they considered produced adequate chest rise for resuscitation. The mean tidal volume perceived to be adequate was 384 ml with 95%

Peter Baskett; Jerry Nolan; Michael Parr

1996-01-01

105

Towards more adequate colour histograms for in-body images  

Microsoft Academic Search

Although there is a growing number of scientific papers describing classification of in-body images, most of it is based on traditional colour histograms. In this paper we explain why these might not be the most adequate visual features for in-body image classification. Based on a colour dynamic range maximization criterion, we propose a methodology for creating more adequate colour histograms,

A. Sousa; M. Dinis-Ribeiro; M. Areia; M. Correia; M. Coimbra

2008-01-01

106

Measuring corporate culture to ensure mission fulfillment.  

PubMed

Ancilla Systems, Inc., Elk Grove Village, Il, developed a mission-based performance evaluation program to provide tangible evidence of mission fulfillment and ensure the provision of high-quality healthcare. the program--Characteristics of Service--translates the language of healthcare action and evaluates corporate culture to ensure that it fulfills the expectations of its sponsor. The nine Characteristics of Service are: Respect for the dignity of all persons. Orientation toward the family unit. Quality and personalized services. Local health systems with a spectrum of services responsive to the unique needs of the community. Formal and informal partnerships with physicians. Active participation and collaboration with related community service agencies and other healthcare providers. Faithfulness to Catholic identity through close relationships with Church and religious institute resources. Effective political advocacy through education. Research and development of innovative approaches to healthcare. In establishing the behavior standards that would exemplify the characteristics, program developers used terms that correspond to specific, observable, measurable performance. All healthcare facilities are evaluated on how well they meet the behavior standards. The evaluation process includes data collection, analysis, and a final report. Data collection begins with a review of regular hospital-conducted surveys, which provide quantifiable information to measure performance against key expected behaviors. Additional data are derived from medical staff development plans and the monthly quality assurance audit. On-site surveys fill information gaps that remain after all written reports are collected. PMID:10290848

Hulsebus-Fong, C

1988-11-01

107

Communication skills to ensure patient satisfaction.  

PubMed

Every pediatrician would want to satisfy their patients and their parents to sustain good practice, earn name and fame and simultaneously to avoid litigation in this era of consumer protection act. This can be achieved only by use of good communication skills. Today the patients demand time, information and want their questions to be answered. They expect politeness, empathy and human touch from doctors. Time constraints, arrogance, telephone calls, language barriers and cultural insensitivity are the important barriers to good communication. Research has shown that doctor, who undergoes training to acquire good communication skills, can better satisfy his patients. Good communication skill is an art which can be acquired or improved by putting conscious efforts in day to day practice. Such skills should also be incorporated as part of medical teaching curriculum. Asking open ended questions, effective listening, appropriate praise, providing enough information as part of advice and finally checking their understanding, are the key areas of communication during medical interview. During this process pediatrician should ensure to address the parental concerns, should empathize with parents and involve parents in decision making. This will not only ensure satisfaction of parents but also their adherence to the therapy and to the pediatrician. PMID:23378053

Shendurnikar, Niranjan; Thakkar, Pareshkumar A

2013-02-03

108

Legislation allows Black Lung benefits to be awarded without adequate evidence of disability  

SciTech Connect

Social Security Administration approval of black lung claims is based on provisions of law which GAO believes do not adequately ensure that benefits are provided only to those entitled to them. Under the 1977 amendments to the Federal Coal Mine Health and Safety Act such claims were based on affidavits from spouses and other dependent persons, inconclusive medical evidence, and presumptions based on years of coal mine employment. GAO believes that medical evidence should be the basis for determining disability and death from black lung.

Not Available

1980-07-28

109

4 CFR 200.14 - Responsibility for maintaining adequate safeguards.  

Code of Federal Regulations, 2012 CFR

...conditions are adequate to prevent unauthorized access to such systems in any form. (2) Access to and use of identifiable personal data...those persons whose duties require such access. Proper control of personal data in any form...

2012-01-01

110

4 CFR 200.14 - Responsibility for maintaining adequate safeguards.  

Code of Federal Regulations, 2011 CFR

...conditions are adequate to prevent unauthorized access to such systems in any form. (2) Access to and use of identifiable personal data...those persons whose duties require such access. Proper control of personal data in any form...

2011-01-01

111

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2013 CFR

...of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly...

2013-07-01

112

Energy Regulation: Hydropower Impacts on Fish Should be Adequately Considered.  

National Technical Information Service (NTIS)

The report discusses the Federal Energy Regulatory Commission's (Commission's) handling of fish and wildlife concerns in licensing and monitoring the operations of hydroelectric projects. Recommendations made by GAO are that the Commission Chairman ensure...

1986-01-01

113

The Financial Fair Play Regulations of UEFA: An Adequate Concept to Ensure the Long-Term Viability and Sustainability of European Club Football?  

Microsoft Academic Search

In response to the severe financial plight of many clubs that regularly take part in European competitions, UEFA developed the concept of Financial Fair Play as an extension of its licensing regulations. The aim of the concept is to curtail financial foul play in European football (nonpayment of liabilities owing to rival clubs or employees) and financial doping (excessive funding

J. Christian Mller; Joachim Lammert; Gregor Hovemann

2012-01-01

114

Actions Needed to Ensure Scientific and Technical Information is Adequately Reviewed at Goddard Space Flight Center, Johnson Space Center, Langley Research Center, and Marshall Space Flight Center.  

National Technical Information Service (NTIS)

This audit was initiated in response to a hotline complaint regarding the review, approval, and release of scientific and technical information (STI) at Johnson Space Center. The complainant alleged that Johnson personnel conducting export control reviews...

2008-01-01

115

Calculated and experimental substantiation of operating conditions under which adequate erosion resistance of valves used in power units at nuclear power stations is ensured  

Microsoft Academic Search

A procedure for revealing factors causing damage to metal and the dominating mechanism through which this damage occurs that\\u000a was developed earlier is applied for substantiating the operating conditions of valves with D\\u000a nom = 800 mm installed in the multiple forced circulation loop of power units at nuclear power stations equipped with RBMK-1000\\u000a reactors under which their resistance to

G. V. Tomarov; A. A. Shipkov; N. S. Koreshkova

2010-01-01

116

Universal Health Insurance in India: Ensuring Equity, Efficiency, and Quality  

PubMed Central

Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP) health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI). Large proportion of informal sector labor in India's workforce prevents major upscaling of social health insurance (SHI). Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS), with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete.

Prinja, Shankar; Kaur, Manmeet; Kumar, Rajesh

2012-01-01

117

Acoustical and noise redesign considerations when trying to increase patient privacy while ensuring comfort  

Microsoft Academic Search

An internal assessment was undertaken to understand the flow of patients to ensure comfort and privacy during their health care experience at Mayo Clinic. A number of different prototypes, work flows, and methodologies were utilized and assessed to determine the ``best experience for our patients.'' A number of prototypes ranging from self-check in to personal pagers were assessed along with

Eric Klavetter

2005-01-01

118

Challenges and solutions ensuring EUVL photomask integrity  

NASA Astrophysics Data System (ADS)

Industry roadmaps indicate that the introduction of Extreme Ultraviolet Lithography (EUVL) is on track for high volume manufacturing. Although, there has been significant progress in each of the individual subsets of the EUVL infrastructure, the absolute management of the process outside of the scanner and up to the point-of-exposure has been highlighted as critical requirement for the adoption of EUVL. Significant changes in the EUV system environment and mask architecture are driving a zero process tolerance level. Any unforeseen contamination introduced to the scanner environment from the EUV mask could cause considerable downtime and yield loss. Absolute mask integrity at the point-of-exposure must be guaranteed. EUV mask cleaning processes-of-record have been developed and introduced to the industry [1]. The issue is not longer "how to clean the mask" but, "how to keep it clean". With the introduction of EUVL, mask cleanliness extends out beyond the traditional mask cleaning tool. Complete control of contamination and/or particles during transportation, handling and storage will require a holistic approach to mask management. A new environment specifically for EUV mask integrity must be developed and fully tested for the sub 16nm half-pitch node introduction. The SUSS MaskTrack Pro (MTP) InSync was introduced as the solution for EUV mask integrity. SUSS demonstrated the fully automated handling of EUV masks into and out of a Dual Pod System [2]. Intrinsic cleanliness of each individual handling and storage step of the inner pod (EIP) and EUV mask inside the MTP InSync Tool was investigated and reported. A target specification of a PRP <= 0.08 as criterion for the cross contamination between EIP and the EUV reticle during handling within MTP InSync has been achieved and therefore proofing the applicability for the Dual Pod automation. Moreover an appropriate automated handling, other aspects like backside particle contamination and EIP cleanliness plays a significant role to ensure EUV mask integrity. With this concept in mind a system for particle detection has been integrated into MTP InSync. This allows verifying the POR performance for backside cleaning by measuring particles down to 150nm size. A dynamic capture rate of larger 97% at 200nm particle size based on PSLs was achieved; for EIP cleaning, a dry-cleaning technology is under investigation. During feasibility studies high particle removal efficiency (PRE) results larger 99% has been achieved for particles down to 100nm. In this paper, the full scope and roadmap of the MTP InSync will be discussed. Preliminary results of backside particle detection and challenges on EUV Inner Pod (EIP) cleaning will be presented.

Brux, O.; Dre, P.; Schmalfu, H.; Jonckheere, R.; Koolen-Hermkens, W.

2012-06-01

119

Long-term care coverage: the need is now.  

PubMed

As the world population steadily ages, the future of America's long-term healthcare system is facing a major crisis. By the year 2050, approximately 22 percent of the United States population is expected to be over the age of 65 and more than 19 million Americans will require long-term care. Long-term care financing will be increasingly important, since nursing home care can lead to financial catastrophe. The key to preventing this catastrophe for the elderly is appropriate third-party coverage. Although more insurance companies are offering long-term care policies today, three major obstacles to the success of such insurance remain: lack of knowledge about the extent of public funding for long-term care, denial of the need for such insurance, and lack of public awareness of potential liabilities inherent in financing long-term care. Congress is supporting the development of long-term care insurance, and states are placing long-term care legislation at the top of their agendas. Tax incentives have been proposed in the form of tax-free individual retirement accounts to finance long-term care, individual medical accounts, tax credits for policyholders, and favorable tax treatment for employers who offer long-term care benefits. But only coordination of public and private financiers will ensure adequate protection for all consumers of long-term care services. PMID:10312281

Constable, J F; Wong, S A

1987-11-01

120

The argument for integrating vector control with multiple drug administration campaigns to ensure elimination of lymphatic filariasis  

Microsoft Academic Search

BACKGROUND: There is a danger that mass drug administration campaigns may fail to maintain adequate treatment coverage to achieve lymphatic filariasis elimination. Hence, additional measures to suppress transmission might be needed to ensure the success of the Global Program for the Elimination of Lymphatic Filariasis. DISCUSSION: Vector control successfully eliminated lymphatic filariasis when implemented alone or with mass drug administration.

TR Burkot; DN Durrheim; WD Melrose; R Speare; K Ichimori

2006-01-01

121

Ensuring That Cosmetics Used in the United States Are Safe  

MedlinePLUS

... Basics Webinar Series Children FDA Basics Metrics - FDA Basics Video: Ensuring That Cosmetics Used in the United States ... safety? How FDA Evaluates Regulated Products: Cosmetics FDA Basics Video: Ensuring That Cosmetics Used in the United States ...

122

CAN EXPERIMENTAL MEMORY RESEARCH ADEQUATELY EXPLAIN MEMORY FOR TRAUMA?  

Microsoft Academic Search

In the debate on memories of traumatic events (especially childhood abuse), traumatic memories and dissociative amnesia are central topics. These phenomena are frequently described as dissociative memory problems. The aim of the present article is to assess to what extent memory mechanisms as identified in experimental research (such as encoding, storage, and retrieval factors) are adequate in explaining memories of

Philip Spinhoven; Ellert R. S. Nijenhuis; Richard Van Dyck

1999-01-01

123

Do Beginning Teachers Receive Adequate Support from Their Headteachers?  

ERIC Educational Resources Information Center

The article examines the problems faced by beginning teachers in Cyprus and the extent to which headteachers are considered to provide adequate guidance and support to them. Data were collected through interviews with 25 school teachers in Cyprus, who had recently entered teaching (within 1-5 years) in public primary schools. According to the

Menon, Maria Eliophotou

2012-01-01

124

Humanitarian and civic assistance health care training and cultural awareness promoting health care pluralism.  

PubMed

Integration between traditional and contemporary health care in a host nation can be beneficial to nation- and capacity-building and, subsequently, to the overall health of the society. "Traditional" health care in this sense refers to the indigenous health care system in the host nation, which includes characteristic religious or cultural practices, whereas "contemporary" health care is also known as "conventional" or "Westernized"; integration is a synchronization of these two health care forms. However, the choice of integration depends on the political and cultural situation of the nation in which the Department of Defense health care personnel are intervening. Thus, cultural awareness training is essential to ensure the success of missions related to global health and in promoting a health care system that is most beneficial to the society. The present study attempts to show the benefits of both cultural training and health care integration, and how adequately evaluating their efficacy has been problematic. The author proposes that determinants of this efficacy are better documentation collection, extensive predeployment cultural awareness and sensitivity training, and extensive after-action reports for future development. PMID:23756013

Facchini, Rose E

2013-05-01

125

Developing an adequate "pneumatraumatology": understanding the spiritual impacts of traumatic injury.  

PubMed

Psychosocial interventions and systematic theology are primary resources for chaplains and congregational pastors who care for victims of physical trauma. Yet these resources may not be adequate to address the spiritual impacts of trauma. This article proposes a preliminary "pneumatraumatology," drawing on early Christian asceticism and Buddhist mysticism to describe one way of understanding the spiritual impacts of traumatic injury. It also suggests possible responses to these impacts informed by narrative/constructionist perspectives and Breggemann's understanding of the dimensions of spiritual transformation in the Hebrew Bible. PMID:12090222

Bidwell, Duane R

2002-01-01

126

Using Agents and Simulation to Develop Adequate Thinking Styles  

Microsoft Academic Search

Reinforcement learning theory encourages the use of agents for stimulating and assisting learners in their efforts to develop thinking styles. In this study the authors looked at a similar scenario of human-environmental interaction using Internet-mediated simulations as learning environments. One hundred and forty-nine vocational high schools students participated in this study to see if they can develop adequate thinking style

Dai-yi Wang; Zong-han Wu; Chuen-tsai Sun; Sunny S. J. Lin

2005-01-01

127

Ensuring on-time quality data management deliverables from global clinical data management teams.  

PubMed

The growing emphasis on off-site and off-shore clinical data management activities mandates a paramount need for adequate solutions geared toward on-time, quality deliverables. The author has been leading large teams that have been involved in successful global clinical data management endeavors. While each study scenario is unique and has to be approached as such, there are several elements in defining strategy and team structure in global clinical data management that can be applied universally. In this article, key roles, practices, and high-level procedures are laid out as a road map to ensure success with the model. PMID:21350730

Haque, Zia

2010-10-01

128

Adequation of mini satellites to oceanic altimetry missions  

NASA Astrophysics Data System (ADS)

Association of the mini satellite concept and oceanic altimetry missions is discussed. Mission definition and most constraining requirements (mesoscale for example) demonstrate mini satellites to be quite adequate for such missions. Progress in altimeter characteristics, orbit determination, and position reporting allow consideration of oceanic altimetry missions using low Earth orbit satellites. Satellite constellation, trace keeping and orbital period, and required payload characteristics are exposed. The mission requirements covering Sun synchronous orbit, service area, ground system, and launcher characteristics as well as constellation maintenance strategy are specified. Two options for the satellite, orbital mechanics, propulsion, onboard power and stabilizing subsystems, onboard management, satellite ground linkings, mechanical and thermal subsystems, budgets, and planning are discussed.

Bellaieche, G.; Aguttes, J. P.

1993-01-01

129

EL CUIDADO DE S DE LA EMBARAZADA DIABTICA COMO UNA VIA PARA ASEGURAR UN HIJO SANO SELF-CARE OF DIABETIC PREGNANT WOMEN, A WAY OF ENSURING A HEALTHY BABY O CUIDADO DE SI DE GESTANTES DIABTICAS COMO UM CAMINHO PARA ASSEGURAR UM FILHO SAUDVEL  

Microsoft Academic Search

This focused ethnography explored the beliefs, values, habits and behavioral patterns of diabetic pregnant women who were treated in Hospital Doutor Enrique Tejera, residents of three poor, urban communities in the city of Valencia, Venezuela. The purpose of this study was to find the meaning of self-care for these pregnant women. The Health Analysis, the Theory of Diversity, and the

Carmen Amarilis; Guerra de Castillo; Marta Luca Vsquez

2006-01-01

130

Adequate drainage system design for heap leaching structures.  

PubMed

The paper describes an optimum design of a drainage system for a heap leaching structure which has positive impacts on both mine environment and mine economics. In order to properly design a drainage system the causes of an increase in the acid level of the heap which in turn produces severe problems in the hydrometallurgy processes must be evaluated. One of the most significant negative impacts induced by an increase in the acid level within a heap structure is the increase of pore acid pressure which in turn increases the potential of a heap-slide that may endanger the mine environment. In this paper, initially the thickness of gravelly drainage layer is determined via existing empirical equations. Then by assuming that the calculated thickness is constant throughout the heap structure, an approach has been proposed to calculate the required internal diameter of the slotted polyethylene pipes which are used for auxiliary drainage purposes. In order to adequately design this diameter, the pipe's cross-sectional deformation due to stepped heap structure overburden pressure is taken into account. Finally, a design of an adequate drainage system for the heap structure 2 at Sarcheshmeh copper mine is presented and the results are compared with those calculated by exiting equations. PMID:17321044

Majdi, Abbas; Amini, Mehdi; Nasab, Saeed Karimi

2007-01-14

131

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2013 CFR

... Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL...a research facility with more than one Doctor of Veterinary Medicine (DVM) may appoint to the IACUC another DVM with...

2013-01-01

132

Ensuring required reliability for nuclear reactor protection systems  

Microsoft Academic Search

One of the fundamental questions arising in nuclear plant design is ensuring safe operation in various operating regimes. Safe reactor operation is achieved not only by ensuring high values for the equipment reliability indicators during normal operation, but also by the correct actions of plant staff and of the safety systems. Since the failure of various types of equipment can

A. I. Pereguda; A. A. Petrenko

1989-01-01

133

Nursing Staff in Hospitals and Nursing Homes: Is It Adequate.  

National Technical Information Service (NTIS)

The purpose of this study is to determine whether and to what extent there is need for an increase in the number of nurses in hospitals and nursing homes in order to promote the quality of patient care and reduce the incidence among nurses of work-related...

C. K. Davis F. A. Sloan G. S. Wunderlich

1996-01-01

134

Phase-adequate engagement at the post-school transition.  

PubMed

The transition from general education (e.g., high school) to vocational and tertiary education (e.g., college, vocational school) or to the labor market presents a number of developmental challenges. These challenges include making career choices and, more broadly, managing the transition. Coping with these challenges depends on the individual, their social network, and wider societal, cultural, and institutional conditions. This article discusses the informative value of developmental regulation, career development, and identity theories, for conceptualizing phase-adequate engagement at the post-school transition. Although previous psychological research has focused on individuals' career and transition-related engagement and its outcomes, we suggest this picture is limited because little is known about how young people's engagement is complemented and affected by the behavior of significant others and shaped by structural constraints and opportunities. Implications for future developmental research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved). PMID:23127301

Dietrich, Julia; Parker, Philip; Salmela-Aro, Katariina

2012-11-01

135

World oil supply adequate for 93's healthy demand  

SciTech Connect

This paper reports that world oil supply and demand fundamentals have changed little in the past year, bringing some stability to the market. That could change in 1993 as demand resumes a more healthy growth rate, and production declines continue in the U.S. and the C.I.S. Though there's little chance average prices will increase significantly, crude markets could be more volatile this year. Offsetting upward pressures on oil prices resulting from accelerated demand are plans by Persian Gulf producers to expand productive capacity, the possibility that Iraq will reenter the international oil market, and continued economic decline in eastern Europe and the former republics of the Soviet Union. When it's all added up, world oil supply looks more than adequate for 1993. If events occur in a particular combination, prices could weaken.

Beck, R.J.

1993-01-25

136

The Last Word: Magnetic Storm-Still an Adequate Name?  

NASA Astrophysics Data System (ADS)

The magnetic storm is the principal and most complex collective phenomenon in geospace. It involves the magnetic fields of the Sun and the Earth, as well as plasma originating in the solar and terrestrial atmosphere. Magnetic storms involve more than just the geomagnetic field, as the original perception suggests. They involve a variety of dynamic processes among which charged particle acceleration and electric current intensification are the most important. Is the name still adequate, or should we switch to something more general and wide-ranging, such as ``space storms,'' or ``geospace storms''? The oldest printed record of ``magnetic storms'' that I was able to find appears in a letter published in Annalen der Physik written by the famous explorer Alexander von Humboldt to Paul Erman. I located this paper in the amazingly rich library of the Air Force Research Laboratory at Hanscom Air Force Base in Massachusetts with the kind help of Mike Heinemann.

Daglis, Ioannis A.

137

Does nasoenteral feeding afford adequate gastroduodenal stress prophylaxis?  

PubMed

Serial pH measurements were performed on 366 gastric aspirates from 20 critically ill patients receiving nasoenteral feeding with Osmolite or Isocal HCN, with no other means of gastric acid buffering. Ten patients (group A) received continuous intraduodenal feeding, and ten patients (group B) received continuous intragastric feeding. Gastric pH was at least 5.0 in 33 (23%) aspirates from group A, compared to 120 (54%) from group B (p less than .001). Only two (20%) group A patients had gastric pH values of 5.0 or greater for at least half of the measurements, compared to six (60%) group B patients. These data indicate that continuous intragastric feeding with Osmolite or Isocal HCN controlled gastric pH better than did intraduodenal feeding. However, neither technique adequately neutralized gastric acidity in these critically ill patients. PMID:3087699

Valentine, R J; Turner, W W; Borman, K R; Weigelt, J A

1986-07-01

138

Dairy products: how they fit in nutritionally adequate diets.  

PubMed

Individual diet modeling with linear programming recently provided evidence that plant-based products, fish, and fresh dairy products consumption should be increased in the French population to reach nutrient-based recommendations. The aim of our study was to estimate the number of portions of the different milk-based food categories fitting into nutritionally adequate diets. Starting from the diet observed for each adult in the 1999 French Enqute Individuelle et Nationale sur les Consommations Alimentaires survey (n=1,171), an isocaloric nutritionally adequate diet was modeled that simultaneously met a whole set of nutrient constraints (based on nutrient recommendations) while deviating the least from the observed diet food content. Variations in weight, energy, and nutrients between observed and modeled diets were calculated for each food group (n=7), with a focus on milk-based products (n=4 categories). The diet optimization process increased the weights of three food groups: fruit and vegetables (+62%), starchy foods (+37%), and dairy products (+19%). Across milk-based food categories, the optimization increased yogurts (+60%) and milk (+17%) and decreased cheeses (-48%) without change to milk desserts. Cheeses represented one out of two consumed portions of milk-based products in observed diets, whereas in modeled diets cheeses, milk, and yogurts each represented about one portion per day. Milk desserts were similar before and after optimization, at approximately one portion per week. These results confirm that a large increase in intake of plant-based products is needed. They show that rebalancing the intake of milk-based products in favor of the least energy-dense ones (ie, yogurts and milk) will help individuals in this population reach nutritional adequacy. PMID:23790410

Clerfeuille, Edouard; Maillot, Matthieu; Verger, Eric O; Lluch, Anne; Darmon, Nicole; Rolf-Pedersen, Nathalie

2013-07-01

139

Better care and better teaching. New model of postpartum care for early discharge programs.  

PubMed Central

PROBLEM BEING ADDRESSED: Rapid postpartum discharge has reduced opportunities to detect early newborn or parenting problems and to teach neonatal assessment and maternal postpartum care to medical trainees. OBJECTIVE OF PROGRAM: Development of a program to not only ensure adequate care of mothers and newborns after early hospital discharge, but also to teach outpatient assessment skills to family medicine residents. MAIN COMPONENTS OF PROGRAM: In an urban, secondary care, university-affiliated teaching hospital predominantly training family medicine residents, an interdisciplinary committee created and supervised a neonatal and maternal postpartum assessment program. Newborn infants and their mothers are seen by a family physician, a family medicine resident, and a nurse within 48 hours of discharge, after which care is assumed in the community by the child's primary care physician. An assessment protocol developed by the interdisciplinary group promotes standardized mother and child care and a structured learning experience for trainees. CONCLUSION: Rapid follow up of early discharged infants and their mothers can be facilitated by a program of standardized assessment by a roster of pooled, interacting family physicians and nurses. When this assessment occurs in a teaching milieu, a comprehensive learning experience can be combined with defined objectives that emphasize and encourage newborn and maternal assessment for ambulatory patients.

Yaffe, M. J.; Russillo, B.; Hyland, C.; Kovacs, L.; McAlister, E.

2001-01-01

140

Do British travel agents provide adequate health advice for travellers?  

PubMed Central

Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised.

Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

2000-01-01

141

Engineered Surety Using the Risk Equation (EnSURE)  

SciTech Connect

Engineered Surety Using the Risk Equation (EnSURE) is a new approach being developed by Sandia National Laboratories for determining and mitigating risk. The EnSURE approach is based on the risk equation, which can be defined by the following equation: R = (Pa)(1-Pe)(C). Where R is risk, Pa is the likelihood of attack, Pe is the system effectiveness and C is the consequence. EnSURE considers each of the components of risk to help in assessing surety (e.g. security, safety, environmental) and providing for the most cost-effective ways to reduce risk. EnSURE is intended to help in evaluating and reducing the risk from either man-caused or natural events. It will help the decision-makers identify possible targets, evaluate the consequences of an event, assess the risk based on the threat and the existing conditions and then help in the application of mitigating measures. EnSURE is in the development stages. It builds on existing and ongoing development activities at Sandia, as well as the considerable work done in the fields of consequence analysis, risk analysis and intelligence. The components of EnSURE include consequences, constraints, threat, target/goal identification, facility/process characterization, evaluation and analysis, system improvement, and decision making. This paper provides a brief description of EnSURE.

Jaeger, C.D.; Paulus, W.K.; Duggan, R.A.; Miyoshi, D.S.

1998-07-16

142

45 CFR 1182.15 - Institute responsibility for maintaining adequate technical, physical, and security safeguards to...  

Code of Federal Regulations, 2012 CFR

...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility of maintaining adequate technical, physical, and security safeguards...

2012-10-01

143

45 CFR 1182.15 - Institute responsibility for maintaining adequate technical, physical, and security safeguards to...  

Code of Federal Regulations, 2011 CFR

...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility of maintaining adequate technical, physical, and security safeguards...

2011-10-01

144

Infectious disease in pediatric out-of-home child care.  

PubMed

Provision of some form of child care outside of the home is certainly not a new phenomenon. In the past, most out-of-home care was provided by a relative, a friend, or someone who had a specific relationship with the family of the child. The frequency of utilization of child care centers for out-of-home care and the different formats of out-of-home care services has increased within recent decades and will vary by geographic location. Also, there is an increased utilization of temporary child care such as "mother's day out" or baby-sitting services provided at churches, grocery stores, and other places. Child care centers represent special risks for transmission of infectious agents because young children exhibit high susceptibility to many community-acquired viruses and bacteria; they lack developmental understanding required for good hygiene; and they frequently receive antibiotics (appropriately and inappropriately). Infections acquired in child care centers can significantly impact the health of the children who acquire the infection and also result in significant economic impacts on the child's family, particularly if 1 or more of the parents has to lose time from work. In the United States, it is estimated that families who have children in child care lose 13 days of work per year for all types of infections. Interventions that have proven valuable for reducing infections within child care centers include the following: (1) formal written policies for infection control within the child care center, (2) formal education of child care center staff concerning infection control practices (needs to be repeated; preferably on a recurring basis), (3) good hand hygiene by both staff and children, (4) appropriate cleaning of contaminated surfaces, (5) separation of food preparation and diaper changing, (6) exclusion of certain ill children, (7) cohorting ill children when exclusion is not possible, (8) ensuring adequate age-appropriate immunization of child care attendees and staff, and (9) optimal ratios of children to staff. PMID:15947744

Brady, Michael T

2005-06-01

145

Dose Limits for Man do not Adequately Protect the Ecosystem  

SciTech Connect

It has been known for quite some time that different organisms display differing degrees of sensitivity to the effects of ionizing radiations. Some microorganisms such as the bacterium Micrococcus radiodurans, along with many species of invertebrates, are extremely radio-resistant. Humans might be categorized as being relatively sensitive to radiation, and are a bit more resistant than some pine trees. Therefore, it could be argued that maintaining the dose limits necessary to protect humans will also result in the protection of most other species of flora and fauna. This concept is usually referred to as the anthropocentric approach. In other words, if man is protected then the environment is also adequately protected. The ecocentric approach might be stated as; the health of humans is effectively protected only when the environment is not unduly exposed to radiation. The ICRP is working on new recommendations dealing with the protection of the environment, and this debate should help to highlight a number of relevant issues concerning that topic.

Higley, Kathryn A.; Alexakhin, Rudolf M.; McDonald, Joseph C.

2004-08-01

146

34 CFR 300.154 - Methods of ensuring services.  

Code of Federal Regulations, 2013 CFR

...responsible for developing the child's IEP). (2) The...5 relating to assistive technology devices, § 300.6 relating to assistive technology services, § 300.34 relating...necessary for ensuring FAPE to children with disabilities...

2013-07-01

147

Regulatory Considerations to Ensure Clean and Safe Drinking Water  

EPA Science Inventory

Federal drinking water regulations are based on risk assessment of human health effects and research conducted on source water, treatment technologies, residuals, and distribution systems. The book chapter summarizes the role that EPA research plays in ensuring pure drinking wat...

148

FDA to Convene Public Hearing on Ensuring the Safety of ...  

Center for Food Safety and Applied Nutrition (CFSAN)

... FDA to Convene Public Hearing on Ensuring the Safety of Imported Foods and Animal Feed: Comparability of Food Safety Systems and Import ... More results from www.fda.gov/food/newsevents/constituentupdates

149

Is knowledge of leprosy adequate among teachers? A comparative study.  

PubMed

A cross-sectional comparative study on the levels of knowledge and attitude on leprosy among teachers and students was carried out in a rural area of Vellore district in Tamil Nadu, India. A total of 30 teachers and 120 students participated in the study. It was found that knowledge about leprosy among teachers was inadequate. Only 23.4% of teachers stated that germs caused leprosy, while 23.4% mentioned immoral conduct, 20.0% marrying a leprosy patient, 6.6% insects and 26.6% did not know the causes of leprosy. While 80.0% of teachers knew that anaesthetic hypopigmented patches were a sign of leprosy, enlarged painful nerves were not mentioned by a single teacher, although this sign was identified by 17.5% of students. Teachers had a more positive attitude towards leprosy than students and this was statistically significant (p < 0.001). This paper discusses the need for continuous education, especially for teachers and through them the students, using different media so as to ensure sustained knowledge for behavioural change in the community. PMID:10405541

Rajaratnam, J; Abel, R; Arumai, M

1999-03-01

150

Human subject protection in India - is it adequate?  

PubMed

India's experience in clinical trials is shorter in time than that of the developed countries but as in everything else in the current globalizing environment, business compulsions characterized by compressed timelines are strong persuaders to catch up. Most global pharmaceutical and biotechnology organizations include India in their strategic plans, Immediate implementation of aspects that attract benefit are an urgent necessity. Technical and ethical issues that remain unresolved constrain India from reaching its deserved potential. To take fullest advantage of the current inflow of clinical trials, India must adopt, without delay, an all-inclusive approach and invest in a widespread and comprehensive GCP-compliance programme taking into account India-related cultural and socioeconomic issues. The initiative should not be allowed to flag. Government, the pharmaceutical and biotechnological research industries, the medical and pharmacy profession including relevant training institutes, the media and the public have a stake in such investment. The programme should involve assessing gaps in current clinical trial compliance measures and possible solutions, set the field for rectification and ensure implementation through mandate and penalty as feasible. PMID:21829776

Mahaluxmivala, Narges

2010-01-01

151

Monitoring the eye lens: which dose quantity is adequate?  

NASA Astrophysics Data System (ADS)

Recent epidemiological studies suggest a rather low dose threshold (below 0.5 Gy) for the induction of a cataract of the eye lens. Some other studies even assume that there is no threshold at all. Therefore, protection measures have to be optimized and current dose limits for the eye lens may be reduced in the future. The question of which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens arises from this situation. While in many countries dosemeters calibrated in terms of the dose equivalent quantity Hp(0.07) have been seen as being adequate for monitoring the dose to the eye lens, this might be questionable in the case of reduced dose limits and, thus, it may become necessary to use the dose equivalent quantity Hp(3) for this purpose. To discuss this question, the dose conversion coefficients for the equivalent dose of the eye lens (in the following eye lens dose) were determined for realistic photon and beta radiation fields and compared with the values of the corresponding conversion coefficients for the different operational quantities. The values obtained lead to the following conclusions: in radiation fields where most of the dose comes from photons, especially x-rays, it is appropriate to use dosemeters calibrated in terms of Hp(0.07) on a slab phantom, while in other radiation fields (dominated by beta radiation or unknown contributions of photon and beta radiation) dosemeters calibrated in terms of Hp(3) on a slab phantom should be used. As an alternative, dosemeters calibrated in terms of Hp(0.07) on a slab phantom could also be used; however, in radiation fields containing beta radiation with the end point energy near 1 MeV, an overestimation of the eye lens dose by up to a factor of 550 is possible.

Behrens, R.; Dietze, G.

2010-07-01

152

Nonshivering thermogenesis and its adequate measurement in metabolic studies.  

PubMed

Alterations in nonshivering thermogenesis are presently discussed as being both potentially causative of and able to counteract obesity. However, the necessity for mammals to defend their body temperature means that the ambient temperature profoundly affects the outcome and interpretation of metabolic experiments. An adequate understanding and assessment of nonshivering thermogenesis is therefore paramount for metabolic studies. Classical nonshivering thermogenesis is facultative, i.e. it is only activated when an animal acutely requires extra heat (switched on in minutes), and adaptive, i.e. it takes weeks for an increase in capacity to develop. Nonshivering thermogenesis is fully due to brown adipose tissue activity; adaptation corresponds to the recruitment of this tissue. Diet-induced thermogenesis is probably also facultative and adaptive and due to brown adipose tissue activity. Although all mammals respond to injected/infused norepinephrine (noradrenaline) with an increase in metabolism, in non-adapted mammals this increase mainly represents the response of organs not involved in nonshivering thermogenesis; only the increase after adaptation represents nonshivering thermogenesis. Thermogenesis (metabolism) should be expressed per animal, and not per body mass [not even to any power (0.75 or 0.66)]. A 'cold tolerance test' does not examine nonshivering thermogenesis capacity; rather it tests shivering capacity and endurance. For mice, normal animal house temperatures are markedly below thermoneutrality, and the mice therefore have a metabolic rate and food consumption about 1.5 times higher than their intrinsic requirements. Housing and examining mice at normal house temperatures carries a high risk of identifying false positives for intrinsic metabolic changes; in particular, mutations/treatments that affect the animal's insulation (fur, skin) may lead to such problems. Correspondingly, true alterations in intrinsic metabolic rate remain undetected when metabolism is examined at temperatures below thermoneutrality. Thus, experiments with animals kept and examined at thermoneutrality are likely to yield an improved possibility of identifying agents and genes important for human energy balance. PMID:21177944

Cannon, Barbara; Nedergaard, Jan

2011-01-15

153

The antenatal care debate.  

PubMed

The antenatal care debate has focused on the frequency of antenatal care, its content, continuity, quality, organization, effectiveness and impact on morbidity and mortality. Established antenatal care schedules have been called into question. Randomized controlled trials comparing reduced schedules with routine antenatal care have shown similar or better outcomes for the reduced protocols. Furthermore, midwives, with or without physicians, can provide continuous maternity care comparable to obstetrician-led care. Some women disliked the new protocol, but a reduced protocol of high quality provided by competent midwives is cost-effective, spares scarce physicians and ensures women's satisfaction. It is recommended globally. PMID:15332747

Baldo, M H

2001-11-01

154

Ethnic-specific predictors of prenatal care utilisation in Hawaii.  

PubMed

The state of Hawaii has had near-universal health insurance coverage for the last 20 years. Its highly diverse population offers the opportunity for a unique, natural experiment in the United States on the examination of social differences in health care utilisation when financial barriers are removed. Therefore, the objective of this study is to examine predictors of prenatal care utilisation patterns in the four major ethnic groups in Hawaii. The data used in this study are the 1979-92 Hawaii livebirth vital record files. A total of 165,301 singleton livebirths to Hawaii-resident mothers of Caucasian, native Hawaiian, Japanese or Filipino ancestry were selected. Despite near-universal health care coverage in Hawaii, a surprising number of women did not adequately utilise prenatal care, with large differences between groups. Multivariate analyses indicated that similar maternal socio-demographic factors were associated with prenatal care use in each ethnic group. Social variation continues to exist among all ethnic groups even in the presence of universal access to care. These data emphasise the need to address the distinct cultural needs of populations for providing health services, and further challenge the assumption that removal of financial barriers will ensure a high level of prenatal care use. PMID:9620565

Kogan, M D; Alexander, G R; Mor, J M; Kieffer, E C

1998-04-01

155

Perceptions about prenatal care: views of urban vulnerable groups  

PubMed Central

Background In the United States, infant mortality rates remain more than twice as high for African Americans as compared to other racial groups. Lack of adherence to prenatal care schedules in vulnerable, hard to reach, urban, poor women is associated with high infant mortality, particularly for women who abuse substances, are homeless, or live in communities having high poverty and high infant mortality. This issue is of concern to the women, their partners, and members of their communities. Because they are not part of the system, these womens' views are often not included in other studies. Methods This qualitative study used focus groups with four distinct categories of people, to collect observations about prenatal care from various perspectives. The 169 subjects included homeless women; women with current or history of substance abuse; significant others of homeless women; and residents of a community with high infant mortality and poverty indices, and low incidence of adequate prenatal care. A process of coding and recoding using Ethnograph and counting ensured reliability and validity of the process of theme identification. Results Barriers and motivators to prenatal care were identified in focus groups. Pervasive issues identified were drug lifestyle, negative attitudes of health care providers and staff, and non-inclusion of male partners in the prenatal experience. Conclusions Designing prenatal care relevant to vulnerable women in urban communities takes creativity, thoughtfulness, and sensitivity. System changes recommended include increased attention to substance abuse treatment/prenatal care interaction, focus on provider/staff attitudes, and commitment to inclusion of male partners.

Milligan, Renee; Wingrove, Barbara K; Richards, Leslie; Rodan, Margaret; Monroe-Lord, Lillie; Jackson, Velishie; Hatcher, Barbara; Harris, Cynthia; Henderson, Cassandra; Johnson, Allan A

2002-01-01

156

Practice development in aged care nursing of older people: the perspective of ageing and spiritual care.  

PubMed

This third paper on older people nursing and spirituality moves beyond the literature reviewed in the two previous papers, exploring directions for the practice and continuing research in this field. Issues of chronic illness challenge nurses working with older people to focus on continuing health promotion and opportunities for spiritual promotion of resilience and transcendence. The changes from monocultural to multicultural societies challenge nurses to know how to provide culturally and faith appropriate care. The extension of palliative care to the needs of those growing older and dying is noted as an important area for developing spiritual care. It is asserted that spiritual assessment forms a basis for the provision of spiritual care for all of these themes. Ethical perspectives of older people nursing must be carefully addressed as frail and vulnerable older people struggle with issues of compromised autonomy. Further research should focus on spirituality as seen through the eyes of older people and examine the interface between nurses and patients, where the relationship becomes the guiding basis for practice. Education in nursing courses and through continuing programmes of education is needed to ensure adequate understanding of spirituality in the nursing role. PMID:20925906

Mackinlay, Elizabeth

2008-06-01

157

Screening for Cushing's syndrome: new immunoassays require adequate normative data.  

PubMed

Cushing's syndrome results from chronic inappropriate exposure to excessive glucocorticoid concentrations. Low-dose dexamethasone suppression, late-night salivary cortisol, and 24-h urinary free cortisol are regarded as screening tests of first choice. Consequently, measurement of circulating cortisol (e. g., in serum, saliva, and urine) is mandatory in the diagnostic workup of suspected patients. The particular analytical procedure needs to be chosen carefully. Antibody-based immunoassays offer several potential advantages: they require small volumes and are widely available, relatively cheap, and easy to handle. Modern (ideally automated) systems also have a rapid turnaround time on a large number of samples and demonstrate high analytical accuracy. However, there are some important pitfalls. Inadequate standardization and poor interlaboratory performance remain problematic and precise reference ranges are lacking for some of the newer assays. Immunoassays are also susceptible to error due to cross-reactivity with cortisol metabolites or exogenous glucocorticoids. In contrast, steroid analysis by modern chromatographic and mass spectrometric techniques is largely independent from such interference and is therefore regarded as diagnostic gold standard. To date, however, these procedures are costly, time-consuming, and at least at present restricted to a limited number of specialized centers. This review puts special emphasis on the potential advantages of salivary cortisol analysis by immunoassays. It has been shown in numerous studies that such an approach allows excellent identification of hypercortisolemic states. In this context, use of automated systems may allow for broader use of this diagnostic tool. PMID:23417245

Deutschbein, T; Petersenn, S

2013-02-15

158

The DEA's Balancing Act to Ensure Public Health and Safety.  

PubMed

In their article in this issue, Reidenberg and Willis assert that there are multiple barriers to the adequate treatment of pain and that one of these barriers is fear of government action against a physician who prescribes opioids for patients in pain.(1) At the same time, the authors state that the risk of a physician's being punished by either a state medical board or the Drug Enforcement Administration (DEA) for a patient in pain with adequate medical record documentation is very small. PMID:17505495

Rannazzisi, J T

2007-06-01

159

Strategies for ensuring quality data from Indian investigational sites  

PubMed Central

The topic of ensuring quality and compliance is and must be a top priority in the conduct of clinical trials, as warranted by regulatory guidelines as well as the inherent responsibility of the professionals conducting such research. Fast-growing emerging clinical geographies such as India demand special attention due to rapid growth and associated factors that may put study quality at risk. In this paper, we used the basic principle of PDCA (Plan, Do, Check, and Adjust) to structure the processes of a clinical trial from protocol to final analysis in order to highlight the interactive nature of involved people and processes required to ensure quality of data and site functioning.

Hajos, Antal K.; Kamble, Sujal K.

2011-01-01

160

Carrier screening in preconception consultation in primary care.  

PubMed

Discussing carrier screening during preconception consultation in primary care has a number of advantages in terms of promoting autonomy and enabling the greatest range of reproductive choices. For those with a family history of an inherited condition, this ought to be a routine discussion; however, this can be expanded to include the wider population, especially for those conditions for which carrier frequencies are considered relatively common. There is published literature from around the world regarding experiences with carrier screening in primary care for cystic fibrosis, haemoglobinopathies, fragile X syndrome, Tay-Sachs disease and spinal muscular atrophy, although many of these have tended to focus on consultations during rather than before pregnancy. Overall, these studies reveal that population carrier screening is well received by the participants with apparent minimal psychosocial harms; however, challenges exist in terms of approaches to ensure couples receive adequate information to make personally relevant decisions and for ongoing health professional engagement. PMID:22183783

Metcalfe, Sylvia A

2011-12-20

161

PERFORMANCE-BASED MEASUREMENT SYSTEMS - ENSURING DATA DEFENSIBILITY  

EPA Science Inventory

The use of established methods for the analysis of environmental samples procedures has been one factor that courts have used to determine if the science use in the analysis is adequate for the purposes intended. This established "comfort-zone" may be shaken by efforts to appro...

162

Managing care in Medicaid managed care.  

PubMed

This commentary discusses the journey of SoonerCare, Oklahoma's Medicaid program, and its experience going from a statewide fee-for-service system to a partially capitated, commercial managed care system to a statewide medical home program. It describes in detail the current program and how the Oklahoma Health Care Authority, the state's Medicaid agency, addresses utilization control through various patient interventions. While the system and many of its interventions are young, the Oklahoma Health Care Authority continues to look forward in how to build upon and improve its system to ensure quality, appropriate, and efficient service delivery. PMID:23748263

Fogarty, Mike; Splinter, Garth L; Kimble, L Carter

163

An Approach for Ensuring Robust Safeguard against Location Privacy Violation  

Microsoft Academic Search

The challenge of preserving user's location privacy is more important now than ever before with the proliferation of handheld devices and the pervasive use of location based services. To protect location privacy, we must ensure k-anonymity so that the user remains indistinguishable among k-1 other users. There is no better way but to use a location anonymizer (LA) to achieve

Chowdhury Sharif Hasan; Sheikh Iqbal Ahamed

2010-01-01

164

Good Work Ensures Employment Success. Myths and Realities No. 2.  

ERIC Educational Resources Information Center

|It is a myth that skills alone ensure employment. Other keys to workplace success include continuous learning, emotional intelligence, networking, flexibility, and commitment to business objectives. Although academic degrees, skill certifications, and other documentation of accomplishments provide access to employment, they are significant only

Brown, Bettina Lankard

165

A Method To Ensure Heterogeneous Mixing of Grade 9 Classes.  

ERIC Educational Resources Information Center

This paper presents outcomes of a practicum that was designed to address a need that was created when the Ministry of Education in Ontario, Canada, mandated that all grade 9 classes be "destreamed." A review of educational literature found no methods for ensuring that classes are truly heterogeneously mixed. The practicum was designed to gather

Brydges, Bruce

166

Working together to ensure safety at hydro projects  

Microsoft Academic Search

Providing for public safety around a hydroelectric facility can be critically important to the welfare of a hydro-power producer. With this in mind, Wisconsin Electric Power Company and Wisconsin Public Service Corporation have worked together to develop consistent safety signage and several for their hydro projects. Although the two utilities sometimes compete for electric customers, they cooperate to ensure the

Bartel

1993-01-01

167

Water quality--how to ensure a pure supply.  

PubMed

Mark Bosley, systems specialist at designer, developer and manufacturer of water purification systems for the healthcare and research sectors Purite, examines the growing regulatory framework governing the purity and quality of water supplied to decontamination centres, and discusses some of the latest technologies used to ensure the required standards are met. PMID:19711671

Bosley, Mark

2009-08-01

168

Ensuring Student Success through Collaboration. Bulletin No. 94076.  

ERIC Educational Resources Information Center

|Wisconsin designed a proposal to the Council of Chief State School Officers (CCSSO) for funding through a grant program: "Ensuring Student Success Through Collaboration." With the financial support made available by CCSSO through this grant program, a statewide meeting on May 26, 1993, was held to explore school/community collaboration to address

Wisconsin State Dept. of Public Instruction, Madison.

169

Dealing with Diversity. Ensuring Success for Every Student.  

ERIC Educational Resources Information Center

|Four essays consider aspects of ensuring that every child can succeed in school. The first, "Appearing Acts: Creating Readers in a High School English Class" (Joan Kernan Cone), explores the self-perceptions of students and uses them to inspire their enthusiasm for reading. The cultural sensitivity of the teacher is instrumental in making

Cone, Joan Kernan; And Others

170

Continuously ensuring quality through software product certification: A case study  

Microsoft Academic Search

This paper focuses on the measures we take at software certification approach to continually ensure quality as we use and operate software in certain environment. Previous study has showed that certification of software products is feasible and demonstrate the practicality of the implementation in real situation. In 2007, SCM-prod model has been developed based on end product quality approach of

Jamaiah Yahaya; Aziz Deraman; Abdul Razak Hamdan

2010-01-01

171

INTERIOR VIEW WITH ANNEALING OVEN AND OPERATOR ENSURING THAT ALL ...  

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

INTERIOR VIEW WITH ANNEALING OVEN AND OPERATOR ENSURING THAT ALL ENTERING PIPE IS STRAIGHT AND THAT THE CORE HAS BEEN REMOVED FROM THE BELL END OF EACH PIPE - McWane Cast Iron Pipe Company, Pipe Casting Area, 1201 Vanderbilt Road, Birmingham, Jefferson County, AL

172

ENSURING THE PRIVACY AND CONFIDENTIALITY OF ELECTRONIC HEALTH RECORDS  

Microsoft Academic Search

In 2004, President Bush announced his plan to ensure that most Americans would have electronic health records within ten years. Al- though substantial progress has been made toward achieving that goal, this progress has primarily reflected institutional interests and priorities by focusing on system architecture and technical standards. This article argues that in order for a nationwide transition to elec-

Nicolas P. Terry; Leslie P. Francis

173

Making the Grade: How Boards Can Ensure Academic Quality  

ERIC Educational Resources Information Center

"Making the Grade: How Boards Can Ensure Academic Quality" fills a significant void in today's boardroom discussions with its clear, realistic advice and its "perfect pitch" balancing act with respect to board involvement with the heart of the academic enterprise: teaching and learning. NCHEMS vice president Peter Ewell clarifies the grey areas of

Ewell, Peter

2006-01-01

174

Ensuring Equal Access to High-Quality Education. Revised  

ERIC Educational Resources Information Center

|The Office for Civil Rights (OCR) in the U.S. Department of Education (Department) is a law enforcement agency charged with enforcing federal civil rights laws to ensure that educational institutions receiving federal financial assistance do not engage in discriminatory conduct. OCR enforces the federal civil rights laws that prohibit

Office for Civil Rights, US Department of Education, 2011

2011-01-01

175

Safety and excellence--is regulation ensuring their achievement  

Microsoft Academic Search

Canada has a large, vigorous nuclear industry staffed by competent people, and a vigourous, independent regulatory agency similarly staffed. Nevertheless, there have been many signs over the last few years that the level of operating and engineering excellence needed to ensure a high level of safety was not being achieved in some key sections of the industry. Years of successful,

R. J. A

1992-01-01

176

ENSURING ENVIRONMENTALLY SUSTAINABLE PRODUCTION OF DEDICATED BIOMASS FEEDSTOCKS  

Microsoft Academic Search

Ensuring acceptance of dedicated biomass feedstocks by landowners, agricultural communities, environmental and public interest groups, requires that the environmental benefits, concerns, and risks associated with their production be quantified. Establishment and management measures to benefit soil and water quality are being identified by ongoing research. Field studies are showing that nutrients are retained within the rooting zone of dedicated feedstocks,

V. R. Tolbert; D. A. Mays; A. Houston; D. D. Tyle; C. H. Perry; K. E. Brooks; B. R. Bock; J. D. Joslin; C. C. Trettin; J. Isebrands

177

Competing demands in psychosocial care  

Microsoft Academic Search

A considerable body of knowledge now exists in the area of depressive disorders in primary care. Primary care clinicians appear to identify less than half of patients with major depressive disorder and adequately treat only a portion of those they identify. However, recent research suggests that identification and treatment of depressive disorders in primary care is a far more complex

Michael S. Klinkman

1997-01-01

178

Ensuring safe water in post-chemical, biological, radiological and nuclear emergencies.  

PubMed

Disaster scenarios are dismal and often result in mass displacement and migration of people. In eventuality of emergency situations, people need to be rehabilitated and provided with an adequate supply of drinking water, the most essential natural resource needed for survival, which is often not easily available even during non-disaster periods. In the aftermath of a natural or human-made disaster affecting mankind and livestock, the prime aim is to ensure supply of safe water to reduce the occurrence and spread of water borne disease due to interrupted, poor and polluted water supply. Chemical, biological, radiological and nuclear (CBRN) emergencies augment the dilemma as an additional risk of "contamination" is added. The associated risks posed to health and life should be reduced to as low as reasonably achievable. Maintaining a high level of preparedness is the crux of quick relief and efficient response to ensure continuous supply of safe water, enabling survival and sustenance. The underlying objective would be to educate and train the persons concerned to lay down the procedures for the detection, cleaning, and treatment, purification including desalination, disinfection, and decontamination of water. The basic information to influence the organization of preparedness and execution of relief measures at all levels while maintaining minimum standards in water management at the place of disaster, are discussed in this article. PMID:21829321

Amar, Praveen Kumar

2010-07-01

179

Acoustical and noise redesign considerations when trying to increase patient privacy while ensuring comfort  

NASA Astrophysics Data System (ADS)

An internal assessment was undertaken to understand the flow of patients to ensure comfort and privacy during their health care experience at Mayo Clinic. A number of different prototypes, work flows, and methodologies were utilized and assessed to determine the ``best experience for our patients.'' A number of prototypes ranging from self-check in to personal pagers were assessed along with creating environments that introduced ``passive distractions'' for acoustical and noise management, which can range from fireplaces, to coffee shops to playgrounds to ``tech corridors.'' While a number of these designs are currently being piloted, the over-reaching goal is to make the patient experience ``like no other'' when receiving their care at Mayo Clinic.

Klavetter, Eric

2005-09-01

180

Ensuring Accurate Knowledge of Prematurity Outcomes for Prenatal Counseling  

Microsoft Academic Search

ABSTRACT. Objectives. To determine the accuracy of knowledge of different health care providers regarding survival and long-term morbidity rates for very prema- ture infants and to examine whether a focused educa- tional intervention improves the accuracy of this knowl- edge and influences health care decisions. Methods. Using hypothetical case scenarios with in- fants at <28 weeks of gestation, we surveyed

Fermin Blanco; Gautham Suresh; Diantha Howard; Roger F. Soll

2010-01-01

181

75 FR 69648 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers  

Federal Register 2010, 2011, 2012, 2013

...Requirements for Defining Adequate Protection...AGENCY: Defense Nuclear Facilities Safety...Secretary of Energy requesting an...SECRETARY OF ENERGY Safety Analysis Requirements for Defining Adequate Protection...5) Atomic Energy Act of 1954...Energy's (DOE) nuclear safety...

2010-11-15

182

75 FR 74022 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers  

Federal Register 2010, 2011, 2012, 2013

...Requirements for Defining Adequate Protection...AGENCY: Defense Nuclear Facilities Safety...Secretary of Energy requesting an...Secretary of Energy Safety Analysis Requirements for Defining Adequate Protection...5), Atomic Energy Act of 1954...Energy's (DOE) nuclear safety...

2010-11-30

183

42 CFR 435.919 - Timely and adequate notice concerning adverse actions.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Timely and adequate notice concerning adverse actions. 435.919 Section 435.919 Public Health...Eligibility § 435.919 Timely and adequate notice concerning adverse actions. (a) The agency must give beneficiaries...

2012-10-01

184

Costs and How to Pay (Long-Term Care)  

MedlinePLUS

... Expand Long-term Care Insurance Costs Expand Using Life Insurance to Pay for Long-term Care Expand Paying ... long-term care insurance , personal income and savings, life insurance, annuities and reverse mortgages to ensure they can ...

185

Drinking Water in Schools and Child Care Facilities  

MedlinePLUS

... Schools & Child Care Facilities Drinking Water in Schools & Child Care Facilities This one-stop EPA site provides information about drinking water quality in schools and child care facilities. Ensuring drinking water quality at these facilities ...

186

Ensuring the Survival of the ClinicianScientist  

Microsoft Academic Search

Multiple forces threaten the survival of the physicianscientist as an academic species. Among these forces are: (1) the changing health environment; (2) greater complexity and rapid advances in biomedical science which demand total 'retooling' of the MDPhD graduate of medical science training programs after completion of their clinical training; (3) longer and more rigorous research training required to adequately train

Robert W. Schrier

1998-01-01

187

SIR technology helps ensure safe landings for NASA  

NASA Astrophysics Data System (ADS)

The use of a subsurface interface radar (SIR) system to ensure that lake-bed runways are free of unseen fissures and voids is described. SIR systems nonintrusively detect anomalies underground or embedded in concrete and other man-made materials. The effectiveness of an SIR system is influenced by the type of soil, with best results obtained for dry, sandy soil. Results of the application of SIR technology to Edwards AFB runways are summarized.

Kratochvil, Gary; Fenner, Thomas; Benson, Richard

1992-12-01

188

Problems and conception of ensuring radiation safety during Mars missions  

NASA Astrophysics Data System (ADS)

The Mars mission differs from near-Earth manned space flights by radiation environment and duration. The importance of effective using the weight of the spacecraft increases greatly because all the necessary things for the mission must be included in its starting weight. For this reason the development of optimal systems of radiation safety ensuring (RSES) acquires especial importance. It is the result of sharp change of radiation environment in the interplanetary space as compared to the one in the near-Earth orbits and significant increase of the interplanetary flight duration. The demand of a harder limitation of unfavorable factors effects should lead to radiation safety (RS) standards hardening. The main principles of ensuring the RS of the Mars mission (optimizing, radiation risk, ALARA) and the conception of RSES, developed on the basis of the described approach and the experience obtained during orbital flights are presented in the report. The problems that can impede the ensuring of the crew members' RS are also given here.

Petrov, V. M.

2004-01-01

189

3 CFR - Ensuring Responsible Spending of Recovery Act Funds  

Code of Federal Regulations, 2010 CFR

...preserve and improve access to affordable health care, provide middle-class tax...technological advances in science and health to increase economic efficiency...technological advances in science and health to increase economic...

2010-01-01

190

Role of the Food Safety Modernization Act in Ensuring the ...  

Center for Food Safety and Applied Nutrition (CFSAN)

... in the US Public Health Service, a veterinarian, and has a Masters of Public Health degree. ... So she knows the issues that your industry cares about. ... More results from www.fda.gov/food/guidanceregulation/fsma

191

Ensuring prehospital care in thermal injuries: experience from an explosion in a textile factory.  

PubMed

The objective of this work was to inform about the performance of the rescue service, in collaboration with other members of an integrated rescue system, in responding to an event in which several subjects suffered burn injuries. Proper organization of the work by a doctor of the rescue group at the site of the explosion, the work of the rescue service dispatchers, and the coordination of the activities of the different rescue teams are the prerequisite for the successful avoidance of the sequelae of mass disasters. PMID:12053434

Hadac, V

2002-01-01

192

Defense Health Care: Additional Efforts Needed to Ensure Compliance with Personality Disorder Separation Requirements.  

National Technical Information Service (NTIS)

At DOD, a personality disorder can render a servicemember unsuitable for service. GAO was required to report on personality disorder separations and examined (1) the extent that selected military installations complied with DOD's separation requirements a...

2008-01-01

193

42 CFR 440.185 - Respiratory care for ventilator-dependent individuals.  

Code of Federal Regulations, 2012 CFR

...for the availability of respiratory care services, would require respiratory care as an inpatient in a hospital...to have payment made for inpatient care under the State plan; (4) Has adequate social support services to be cared...

2012-10-01

194

42 CFR 418.112 - Condition of participation: Hospices that provide hospice care to residents of a SNF/NF or ICF/MR.  

Code of Federal Regulations, 2010 CFR

...MR representatives and other health care providers participating in the provision of care for the terminal illness and related conditions and other conditions to ensure quality of care for the patient and family. (2) Ensure that...

2010-10-01

195

42 CFR 418.112 - Condition of participation: Hospices that provide hospice care to residents of a SNF/NF or ICF/MR.  

Code of Federal Regulations, 2010 CFR

...MR representatives and other health care providers participating in the provision of care for the terminal illness and related conditions and other conditions to ensure quality of care for the patient and family. (2) Ensure that...

2009-10-01

196

Perceived Access to General Medical and Psychiatric Care Among Veterans With Bipolar Disorder  

PubMed Central

Objectives. We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services. Methods. Patients were recruited from the Continuous Improvement for Veterans in CareMood Disorders study. We used multivariable logistic regression analyses to assess whether predisposing (demographic characteristics), enabling (e.g., homelessness), or need (bipolar symptoms, substance abuse) factors were associated with difficulties in obtaining care, difficulties in locating specialty providers, and forgoing care because of cost. Results. Patients reported greater difficulty in accessing general medical services than in accessing psychiatric care. Individuals experiencing bipolar symptoms more frequently avoided psychiatric care because of cost (odds ratio [OR] = 2.43) and perceived greater difficulties in accessing medical specialists (OR = 2.06). Homeless individuals were more likely to report hospitalization barriers, whereas older and minority patients generally encountered fewer problems accessing treatment. Conclusions. Need and enabling factors were most influential in predicting self-reported difficulties in accessing care, subsequently interfering with treatment dynamics and jeopardizing clinical outcomes. Efforts in the Department of Veterans Affairs to expand mental health care access should be coupled with efforts to ensure adequate access to general medical services among patients with chronic mental illnesses.

Copeland, Laurel A.; McCarthy, John F.; Bauer, Mark S.; Kilbourne, Amy M.

2009-01-01

197

Literacy in the World of the Aged Care Worker.  

ERIC Educational Resources Information Center

Australia's Aged Care Act of 1997 mandates a number of key reforms aimed at ensuring consistency in the quality of care and well-being for all residents of aged care facilities. The law required residential aged care facilities to provide high-quality care within a framework of continuous improvement which requires aged care workers to perform the

Wyse, Linda; Casarotto, Nadia

198

Role of the law in ensuring work related road safety.  

PubMed

Some 150 deaths and serious injuries are caused each week by people who were driving in the course of their work. The police, health and safety executive and government are seeking to improve this startling statistic by ensuring that organizations, including NHS Trusts, comply with health and safety law and fulfil their duty to carry out an assessment of risks associated with work related driving and implement a policy to minimize those risks. Failing to comply could result in prosecution by the police and health and safety executive. PMID:18361177

Griffith, Richard; Tengnah, Cassam

2007-12-01

199

[The "Bolsa Famlia" family grant scheme: the interface between professional practice and the human right to adequate food and nutrition].  

PubMed

The Human Right to Adequate Nutrition must be ensured through the public policies included in SAN, namely the Food and Nutritional Security campaign. Besides the income transfer geared to ensuring access to basic social rights, the "Bolsa Famlia" Program (PBF) is included in this context. This study seeks to analyze the operational aspects of the PBF and also ascertain whether or not the health professionals see the program as a core element of the SAN public policy. With this in mind, semi-structured interviews were conducted with primary healthcare workers involved directly both with the PBF and with the families who receive this benefit. By the end of the study, it was possible to perceive the importance of training health professionals who work in this area, because when one dissociates the social reality in which the beneficiaries live from the program objectives, this can lead to the simple mechanization of these practices. In this respect, it should be stressed that health professionals need to understand the proposals of the program as political and social strategies which, in addition to providing immediate relief, strive to overcome the problems related to poverty and hunger. PMID:22899156

Ramos, Camila Irigonh; Cuervo, Maria Rita Macedo

2012-08-01

200

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour  

PubMed Central

Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery.

2011-01-01

201

Effects of prophylactic indomethacin in extremely low birth weight infants with and without adequate exposure to antenatal steroids  

PubMed Central

Objective To examine if antenatal steroids modify the immediate and long-term effects of prophylactic indomethacin in extremely low birth weight infants. Design Post-hoc subgroup analysis of data from the Trial of Indomethacin Prophylaxis in Preterms. Setting Thirty-two neonatal intensive care units in Canada, the United States, Australia, New Zealand, and Hong Kong. Participants A total of 1195 infants with birth weights of 500 to 999 g and known exposure to antenatal steroids. We defined as adequate any exposure to antenatal steroids that occurred at least 24 hours before delivery. Intervention Indomethacin or placebo intravenously once daily for the first three days. Outcome Measures Death or survival to 18 months with 1 or more of cerebral palsy, cognitive delay, severe hearing loss, and bilateral blindness; severe peri-and intraventricular hemorrhage; patent ductus arteriosus; and surgical closure of a patent ductus arteriosus. Results Of the 1195 infants in this analysis cohort, 670 had adequate and 525 had inadequate exposure to antenatal steroids. There was little statistical evidence of heterogeneity in the effects of prophylactic indomethacin between the subgroups for any of the outcomes. The adjusted p values for interaction were as low as 0.15 for the end point of death or impairment at 18 months, and as high as 0.80 for the outcome of surgical duct closure. Conclusion There was little evidence that the effects of prophylactic indomethacin vary in extremely low birth weight infants with and without adequate exposure to antenatal steroids.

Schmidt, Barbara; Seshia, Mary; Shankaran, Seetha; Mildenhall, Lindsay; Tyson, Jon; Lui, Kei; Fok, Tai; Roberts, Robin

2012-01-01

202

Palliative Care Consultation Service and Palliative Care Unit: Why Do We Need Both?  

PubMed Central

Background. Palliative care (PC) infrastructure has developed differently around the globe. Whereas some institutions consider the palliative care unit (PCU) a valuable component, others report that the sole provision of a state-of-the art palliative care consultation service (PCCS) suffices to adequately care for the severely ill and dying. Objective. To aid institutional planning, this study aimed at gathering patient data to distinguish assignments of a concomitantly run PCU and PCCS at a large hospital and academic medical center. Methods. Demographics, Eastern Cooperative Oncology Group performance status, symptom/problem burden, discharge modality, and team satisfaction with care for all 601 PCU and 851 PCCS patients treated in 2009 and 2010 were retrospectively analyzed. Results. Patients admitted to the PCU versus those consulted by the PCCS: (a) had a significantly worse performance status (odds ratio [OR], 1.48); (b) were significantly more likely to suffer from severe symptoms and psychosocial problems (OR, 2.05), in particular concerning physical suffering and complexity of care; and (c) were significantly much more likely to die during hospital stay (OR, 11.03). For patients who were dying or in other challenging clinical situations (suffering from various severe symptoms), self-rated team satisfaction was significantly higher for the PCU than the PCCS. Conclusion. This study presents a direct comparison between patients in a PCU and a PCCS. Results strongly support the hypothesis that the coexistence of both institutions in one hospital contributes to the goal of ensuring optimal high-quality PC for patients in complex and challenging clinical situations.

Frechen, Sebastian; Sladek, Markus; Ostgathe, Christoph; Voltz, Raymond

2012-01-01

203

Anxiety in primary care  

Microsoft Academic Search

Anxiety disorders are common within primary care (PC) settings and are associated with patient functional impairment, distress,\\u000a and high utilization of medical care services. Data from PC settings indicate that detection of anxiety disorders is low.\\u000a Furthermore, adequate psychosocial and pharmacologic treatment of anxiety disorders in accordance with empirically validated\\u000a guidelines remains low in PC. When patients do receive treatment

Kristen Hope Demertzis; Michelle G. Craske

2006-01-01

204

Biodiversity ensures plant-pollinator phenological synchrony against climate change.  

PubMed

Climate change has the potential to alter the phenological synchrony between interacting mutualists, such as plants and their pollinators. However, high levels of biodiversity might buffer the negative effects of species-specific phenological shifts and maintain synchrony at the community level, as predicted by the biodiversity insurance hypothesis. Here, we explore how biodiversity might enhance and stabilise phenological synchrony between a valuable crop, apple and its native pollinators. We combine 46years of data on apple flowering phenology with historical records of bee pollinators over the same period. When the key apple pollinators are considered altogether, we found extensive synchrony between bee activity and apple peak bloom due to complementarity among bee species' activity periods, and also a stable trend over time due to differential responses to warming climate among bee species. A simulation model confirms that high biodiversity levels can ensure plant-pollinator phenological synchrony and thus pollination function. PMID:23968538

Bartomeus, Ignasi; Park, Mia G; Gibbs, Jason; Danforth, Bryan N; Lakso, Alan N; Winfree, Rachael

2013-08-22

205

Neuronal Oscillations Enhance Stimulus Discrimination by Ensuring Action Potential Precision  

PubMed Central

Although oscillations in membrane potential are a prominent feature of sensory, motor, and cognitive function, their precise role in signal processing remains elusive. Here we show, using a combination of in vivo, in vitro, and theoretical approaches, that both synaptically and intrinsically generated membrane potential oscillations dramatically improve action potential (AP) precision by removing the membrane potential variance associated with jitter-accumulating trains of APs. This increased AP precision occurred irrespective of cell type andat oscillation frequencies ranging from 3 to 65 Hzpermitted accurate discernment of up to 1,000 different stimuli. At low oscillation frequencies, stimulus discrimination showed a clear phase dependence whereby inputs arriving during the trough and the early rising phase of an oscillation cycle were most robustly discriminated. Thus, by ensuring AP precision, membrane potential oscillations dramatically enhance the discriminatory capabilities of individual neurons and networks of cells and provide one attractive explanation for their abundance in neurophysiological systems.

Schaefer, Andreas T; Angelo, Kamilla; Spors, Hartwig

2006-01-01

206

Ensuring data consistency over CMS distributed computing system  

SciTech Connect

CMS utilizes a distributed infrastructure of computing centers to custodially store data, to provide organized processing resources, and to provide analysis computing resources for users. Integrated over the whole system, even in the first year of data taking, the available disk storage approaches 10 petabytes of space. Maintaining consistency between the data bookkeeping, the data transfer system, and physical storage is an interesting technical and operations challenge. In this paper we will discuss the CMS effort to ensure that data is consistently available at all computing centers. We will discuss the technical tools that monitor the consistency of the catalogs and the physical storage as well as the operations model used to find and solve inconsistencies.

Rossman, Paul; /Fermilab

2009-05-01

207

Transcription Factor Redundancy Ensures Induction of the Antiviral State*  

PubMed Central

The transcriptional response to virus infection is thought to be predominantly induced by interferon (IFN) signaling. Here we demonstrate that, in the absence of IFN signaling, an IFN-like transcriptome is still maintained. This transcriptional activity is mediated from IFN-stimulated response elements (ISREs) that bind to both the IFN-stimulated gene factor 3 (ISGF3) as well as to IFN response factor 7 (IRF7). Through a combination of both in vitro biochemistry and in vivo transcriptional profiling, we have dissected what constitutes IRF-specific, ISGF3-specific, or universal ISREs. Taken together, the data presented here suggest that IRF7 can induce an IFN-like transcriptome in the absence of type-I or -III signaling and therefore provides a level of redundancy to cells to ensure the induction of the antiviral state.

Schmid, Sonja; Mordstein, Markus; Kochs, Georg; Garcia-Sastre, Adolfo; tenOever, Benjamin R.

2010-01-01

208

European legislation impedes critical care research and fails to protect patients' rights  

PubMed Central

The European Clinical Trials Directive requires an informed consent from the patient or a proxy in drug trials. Although informed consent is a valuable tool to protect patients' rights in clinical trials, this requirement largely impedes research in critical care settings, and if pursued in this context, it does not provide the patient with adequate protection. Instead of insisting on informed consent, we suggest that the focus should be shifted towards two other ethically relevant elements in human experimentation: risk assessment and selection of research subjects. When reviewing protocols in which a waiver of consent is deemed necessary, the Ethical Review Board should ensure that non-therapeutic risks are minimal, that the research is specifically designed to benefit critically ill patients, and that it cannot be conducted under circumstances where an informed consent can be obtained. If the European Directive is changed accordingly, this permits clinical trials in critical care settings, while adequate protection from risky non-therapeutic procedures is ensured and exploitation of the patient as an easily accessible research subject is prevented.

2011-01-01

209

Rivaroxaban: Practical Considerations for Ensuring Safety and Efficacy.  

PubMed

Rivaroxaban is the first agent available within a new class of anticoagulants called direct factor Xa inhibitors. Rivaroxaban is approved for use in the United States for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, for the prevention of deep vein thrombosis in patients undergoing total hip replacement and total knee replacement, for the treatment of deep vein thrombosis and pulmonary embolism, and for the reduction in risk of recurrence of deep vein thrombosis and pulmonary embolism (with additional indications under review). Rivaroxaban dose and frequency of administration vary depending on the indication. As of result of predictable pharmacokinetics and pharmacodynamics, a fixed dose of rivaroxaban is administered without routine coagulation testing. Rivaroxaban has a short half-life, undergoes a dual mode of elimination (hepatic and renal), and is a substrate for P-glycoprotein. Rivaroxaban has a lower potential for drug interactions compared with warfarin. Despite the advantages of a once/day fixed-dose oral agent, in many clinical situations limited evidence is available to guide optimal management of rivaroxaban therapy. In this article, we review the available evidence and provide recommendations where possible for such situations including the desire to monitor the anticoagulation intensity, use in special patient populations, managing drug interactions, and transitioning across anticoagulant agents. Potential strategies for reversing rivaroxaban's anticoagulant effect are reviewed. Health systems will need to perform a systematic safety evaluation and ensure that numerous hospital policies related to anticoagulation are updated to include rivaroxaban. A comprehensive approach to education is needed for clinicians, patients, and technical support personnel involved in patient interactions to ensure safe use. PMID:23712587

Smythe, Maureen A; Fanikos, John; Gulseth, Michael P; Wittkowsky, Ann K; Spinler, Sarah A; Dager, William E; Nutescu, Edith A

2013-05-26

210

Adequate use of allele frequencies in Hispanics--a problem elucidated in nephrotic syndrome  

PubMed Central

Previous studies in children with focal segmental glomerulosclerosis (FSGS) and nephrotic syndrome (NS) in the USA have revealed inter-ethnic differences in their clinical presentation and outcome. However, ethnicity was based on self-identification rather than on molecular genetic data. Here, we show that genetic heterogeneity exists in self-identified Hispanic (Spanish-American) patients with steroid-resistant nephrotic syndrome (SRNS), as patients may be either of Caucasian or Mesoamerican (Native-American) genetic background. Twenty-one self-identified Hispanic patients with SRNS from 18 families were initially evaluated for mutations in the NPHS2 and WT1 genes. All patients resided and were cared for in the USA. We performed a total genome search for linkage in all Hispanic patients using 250K single nucleotide polymorphism microarrays, comparing Caucasian with Mesoamerican allele frequencies to determine regions of homozygosity by descent and to establish the correct allele frequency for each family. We found that only ten families (56%) of the 18 self-identified Hispanic families are genetically of Mesoamerican descent, whereas the other eight families (44%) are of Caucasian descent. Due to the small number of families examined, we were unable to draw any conclusion on the prevalence of NPHS2 and WT1 in this ethnic group, but the data do suggest that self-identification of ethnicity in Hispanic-American patients is not an adequate basis for genetic studies, as this cohort may represent not only patients of Mesoamerican origin but also patients of Caucasian origin. Thus, one needs to critically review previous studies of FSGS/SRNS patients that involved Hispanic patients as a group. Future larger studies may employ a total genome search for linkage to test self-identified Hispanic ethnicity for true Mesoamerican versus Caucasian ethnicity in order to generate valid genetic data.

Chernin, Gil; Heeringa, Saskia F.; Vega-Warner, Virginia; Schoeb, Dominik S.; Nurnberg, Peter

2010-01-01

211

Standardized nursing care plans for acute care SCI: improved documentation.  

PubMed

Adequate documentation of spinal cord injury (SCI) nursing care is necessary for evaluation of patient progress and compliance with standards of care. The objective criteria used to evaluate nursing care include the nursing data base, the care plan, and the nurses' notes. The nursing care plan reflects the needs of the SCI client and is the basis from which documentation about these needs arises. Standards for acute care SCI nursing were recently developed for the 10 designated SCI centers in Florida. To improve the documentation of these standards, neuroscience nurses at Shands Hospital developed standardized care plans that can be individualized for each SCI client. The implementation of these care plans improved documentation of the standards for acute care SCI nursing. Additional benefits included an increased awareness of the nursing diagnoses among staff nurses and improved equality of care for the SCI client. PMID:2320992

Guin, P

1990-03-01

212

Productive Ward initiative promotes better communication between mental health teams and ensures timely discharge for patients.  

PubMed

ACCESSIBLE SUMMARY: This paper discusses how an acute inpatient unit has implemented the 'Productive Ward' initiative, and utilized three of the Productive Ward Modules - Ward Round, Admissions and Planned Discharge, and Patient Status At a Glance - to promote better communication and working between inpatient nursing and medical teams, Home Treatment Team and Community Mental Health Team (CMHT), as they endeavour to ensure timely discharge for patients. Using the Patient Status At a Glance board to make information on patient status clear and immediate, nursing staff have begun utilizing the Zoning system for managing and targeting nursing resources - a red, amber and green traffic light system, which identifies and categorizes patient risk on a daily basis. Ward staff have initiated a daily 'Rapid Review' of patients, a tightly focused meeting, involving the ward nursing staff, the Inpatient Medical Team, the Home Treatment Team and the CMHT to discuss allocation of Care Co-ordinators, and to identify accommodation issues and other potential blocks to timely discharge. ABSTRACT: The Productive Ward is an initiative whereby nursing staff are empowered to bring about changes in the workplace to streamline systems and release time to care for patients. It is an evidence-based approach, which brings about improved clinical and safety outcomes. This paper discusses how three of the Productive Ward Modules - Ward Round, Admissions and Planned Discharge, and Patient Status At a Glance - have meshed to promote better communication and working between inpatient nursing and medical teams, Home Treatment Team and Community Mental Health Team, and to endeavour to ensure timely discharge for patients. PMID:23157208

Lennard, C

2012-11-15

213

Surge capacity concepts for health care facilities: the CO-S-TR model for initial incident assessment.  

PubMed

Facility-based health care personnel often lack emergency management training and experience, making it a challenge to efficiently assess evolving incidents and rapidly mobilize appropriate resources. We propose the CO-S-TR model, a simple conceptual tool for hospital incident command personnel to prioritize initial incident actions to adequately address key components of surge capacity. There are 3 major categories in the tool, each with 4 subelements. "CO" stands for command, control, communications, and coordination and ensures that an incident management structure is implemented. "S" considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations. "TR" comprises tracking, triage, treatment, and transportation: basic patient care and patient movement functions. This comprehensive yet simple approach is designed to be implemented in the immediate aftermath of an incident, and complements the incident command system by aiding effective incident assessment and surge capacity responses at the health care facility level. PMID:18769268

Hick, John L; Koenig, Kristi L; Barbisch, Donna; Bey, Tareg A

2008-09-01

214

Care and Consent.  

ERIC Educational Resources Information Center

|Discusses the legal ramifications of informed consent for medical treatment of schoolchildren, including the problems posed by parents unwilling to give adequate medical protection to their children because of religious or other reasons. Covers the types of medical care that minors can receive without parental consent. (WD)|

Gottesman, Roberta

1981-01-01

215

42 CFR 438.207 - Assurances of adequate capacity and services.  

Code of Federal Regulations, 2010 CFR

...207 Assurances of adequate capacity and services. (a) Basic...demonstrates that it has the capacity to serve the expected enrollment...that would affect adequate capacity and services, including...ii) Enrollment of a new population in the MCO, PIHP, or...

2009-10-01

216

42 CFR 438.207 - Assurances of adequate capacity and services.  

Code of Federal Regulations, 2010 CFR

...207 Assurances of adequate capacity and services. (a) Basic...demonstrates that it has the capacity to serve the expected enrollment...that would affect adequate capacity and services, including...ii) Enrollment of a new population in the MCO, PIHP, or...

2010-10-01

217

Intensive care management of community-acquired Klebsiella pneumoniae.  

PubMed

The clinical features of 18 patients with Klebsiella pneumoniae requiring intensive care unit (ICU) management are presented. All patients required ventilatory support; 17 were given constant positive pressure ventilation and 10 required greater than 10 cm positive end expiratory pressure. The clinical picture was characteristic: pre-existing medical disease, clinical features of severe pneumonia and copious purulent bronchial secretions, Gram--ve organisms on Gram's stain and lobar consolidation on the chest radiograph were common. Septicaemic shock, confusion and uncompensated metabolic acidosis were the presenting clinical features predicting a poor outcome. Antimicrobial chemotherapy, that combined an aminoglycoside and a third generation cephalosporin to ensure adequate early antibiotic serum levels, may help to improve the prognosis. PMID:2014354

Hammond, J M; Potgieter, P D; Linton, D M; Forder, A A

1991-01-01

218

Chordee repair utilizing a novel technique ensuring neurovascular bundle preservation.  

PubMed

Penile chordee, with and without hypospadias, is amenable to surgical correction. The Nesbit technique of dorsal plication of the ventral tunica albuginea is effective in correcting most cases of corporal disproportion. A hazard with this approach is the potential inclusion of the dorsal neurovascular bundle, with resultant erectile and sensory dysfunction. We developed a simple technique using the Freer elevator to isolate the neurovascular bundle prior to plication. This ensures that no injury occurs to the neurovascular bundle during plication. Since 1994, 37 boys with chordee have been repaired using this approach. Their ages at the time of operation ranged from 5 months to 28 years (mean 9 months). Following standard degloving of the penis, an incision through Buck's fascia is made lateral and parallel to the neurovascular bundle at the maximum level of the chordee. A similar incision is carried out on the contralateral side. A 4-mm-wide Freer elevator is positioned under Buck's fascia while hugging the tunica albuginea. The Freer elevator slides across the midline to the contralateral side, separating Buck's fascia and underlying layers from the tunica albuginea. Following isolation of the bundle, each corporal body is plicated by creating a longitudinal incision through the tunica albuginea, which then is closed transversely with a 5-0 polydioxanone suture. Buck's fascia subsequently is closed with an absorbable suture following confirmation of chordee correction. No complications have been encountered during a mean follow-up of 21 months (range 5-51 months). No patients have required reoperation for persistent chordee. We developed a technique that elevates the neurovascular bundle prior to plication, thereby ensuring no injury to this structure. We have successfully used this modified Nesbit technique since 1994 and have had no complications. Utilization of the Freer elevator adds an estimated 5 minutes to chordee correction compared to a standard plication lateral to the neurovascular bundles. Although long-term follow-up needs to be performed to confirm any erectile or sensory advantage, this approach should be considered whenever plication is to be performed. PMID:10708139

Dean, G E; Burno, D K; Zaontz, M R

2000-03-01

219

45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...  

Code of Federal Regulations, 2012 CFR

...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility of maintaining adequate technical, physical, and security safeguards...

2012-10-01

220

45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...  

Code of Federal Regulations, 2011 CFR

...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility of maintaining adequate technical, physical, and security safeguards...

2011-10-01

221

45 CFR 2508.10 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...  

Code of Federal Regulations, 2012 CFR

...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility of maintaining adequate technical, physical, and security safeguards to...

2012-10-01

222

45 CFR 2508.10 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...  

Code of Federal Regulations, 2011 CFR

...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility for maintaining adequate technical, physical, and security safeguards to prevent...responsibility of maintaining adequate technical, physical, and security safeguards to...

2011-10-01

223

Equipping the critical care environment.  

PubMed

Equipping the critical care unit is a complex endeavor, and requires careful planning and continuous oversight by a multidisciplinary team. The selection, purchase, placement and installation of many components of the critical care environment must be considered in the earliest stages of the unit design process to ensure successful integration of space allocation, utility support and user interfaces. The hospital's leadership team, bedside clinicians and engineering support must work closely with architects, equipment planners, construction liaisons, interior designers and other experts throughout all phases of the project to ensure the desired outcomes. PMID:21921716

Gambacorta, Cathy; Charrin, Lisa

224

Robust mitotic entry is ensured by a latching switch.  

PubMed

Cell cycle events are driven by Cyclin dependent kinases (CDKs) and by their counter-acting phosphatases. Activation of the Cdk1:Cyclin B complex during mitotic entry is controlled by the Wee1/Myt1 inhibitory kinases and by Cdc25 activatory phosphatase, which are themselves regulated by Cdk1:Cyclin B within two positive circuits. Impairing these two feedbacks with chemical inhibitors induces a transient entry into M phase referred to as mitotic collapse. The pathology of mitotic collapse reveals that the positive circuits play a significant role in maintaining the M phase state. To better understand the function of these feedback loops during G2/M transition, we propose a simple model for mitotic entry in mammalian cells including spatial control over Greatwall kinase phosphorylation. After parameter calibration, the model is able to recapture the complex and non-intuitive molecular dynamics reported by Potapova et al. (Potapova et al., 2011). Moreover, it predicts the temporal patterns of other mitotic regulators which have not yet been experimentally tested and suggests a general design principle of cell cycle control: latching switches buffer the cellular stresses which accompany cell cycle processes to ensure that the transitions are smooth and robust. PMID:24143279

Tuck, Chloe; Zhang, Tongli; Potapova, Tamara; Malumbres, Marcos; Novk, Bla

2013-07-26

225

Robust mitotic entry is ensured by a latching switch  

PubMed Central

Summary Cell cycle events are driven by Cyclin dependent kinases (CDKs) and by their counter-acting phosphatases. Activation of the Cdk1:Cyclin B complex during mitotic entry is controlled by the Wee1/Myt1 inhibitory kinases and by Cdc25 activatory phosphatase, which are themselves regulated by Cdk1:Cyclin B within two positive circuits. Impairing these two feedbacks with chemical inhibitors induces a transient entry into M phase referred to as mitotic collapse. The pathology of mitotic collapse reveals that the positive circuits play a significant role in maintaining the M phase state. To better understand the function of these feedback loops during G2/M transition, we propose a simple model for mitotic entry in mammalian cells including spatial control over Greatwall kinase phosphorylation. After parameter calibration, the model is able to recapture the complex and non-intuitive molecular dynamics reported by Potapova et al. (Potapova et al., 2011). Moreover, it predicts the temporal patterns of other mitotic regulators which have not yet been experimentally tested and suggests a general design principle of cell cycle control: latching switches buffer the cellular stresses which accompany cell cycle processes to ensure that the transitions are smooth and robust.

Tuck, Chloe; Zhang, Tongli; Potapova, Tamara; Malumbres, Marcos; Novak, Bela

2013-01-01

226

Physician payment disclosure under health care reform: will the sun shine?  

PubMed

Pharmaceutical marketing has become a mainstay in U.S. health care delivery and traditionally has been directed toward physicians. In an attempt to address potential undue influence of industry and conflicts of interest that arise, states and the recently upheld health care reform act have passed transparency, or "sunshine," laws requiring disclosure of industry payments to physicians. The Centers for Medicare & Medicaid Services recently announced the final rule for the Sunshine Provisions as part of the reform act. However, the future effectiveness of these provisions are questionable and may be limited given the changing landscape of pharmaceutical marketing away from physician detailing to other forms of promotion. To address this changing paradigm, more proactive policy solutions will be necessary to ensure adequate and ethical regulation of pharmaceutical promotion. PMID:23657702

Mackey, Tim K; Liang, Bryan A

227

Workers' compensation in the United States and the role of the primary care physician.  

PubMed

The workers' compensation system was designed as a no-fault system in the early years of the last century. The system is organized on a state level. There are three differing models in current use: the single public fund, the single private fund, and an open market. States range as well in the amount of choice available to the injured workers in their selection of health care providers. In each state though, the physician plays an integral role in ensuring that the injured worker obtains adequate medical care in a prompt and efficient manner. The physician's function is either as treating physician, or as one who provides an independent medical evaluation for either the employee's lawyer, the employer, the insurer or their counsel or the state. Many obvious improvements in the system have not been made because political agreement on the state level is often lacking. PMID:11072289

Pye, H; Orris, P

2000-12-01

228

Pediatric palliative care and hospice care commitments, guidelines, and recommendations.  

PubMed

Pediatric palliative care and pediatric hospice care (PPC-PHC) are often essential aspects of medical care for patients who have life-threatening conditions or need end-of-life care. PPC-PHC aims to relieve suffering, improve quality of life, facilitate informed decision-making, and assist in care coordination between clinicians and across sites of care. Core commitments of PPC-PHC include being patient centered and family engaged; respecting and partnering with patients and families; pursuing care that is high quality, readily accessible, and equitable; providing care across the age spectrum and life span, integrated into the continuum of care; ensuring that all clinicians can provide basic palliative care and consult PPC-PHC specialists in a timely manner; and improving care through research and quality improvement efforts. PPC-PHC guidelines and recommendations include ensuring that all large health care organizations serving children with life-threatening conditions have dedicated interdisciplinary PPC-PHC teams, which should develop collaborative relationships between hospital- and community-based teams; that PPC-PHC be provided as integrated multimodal care and practiced as a cornerstone of patient safety and quality for patients with life-threatening conditions; that PPC-PHC teams should facilitate clear, compassionate, and forthright discussions about medical issues and the goals of care and support families, siblings, and health care staff; that PPC-PHC be part of all pediatric education and training curricula, be an active area of research and quality improvement, and exemplify the highest ethical standards; and that PPC-PHC services be supported by financial and regulatory arrangements to ensure access to high-quality PPC-PHC by all patients with life-threatening and life-shortening diseases. PMID:24167168

2013-10-28

229

Working together to ensure safety at hydro projects  

SciTech Connect

Providing for public safety around a hydroelectric facility can be critically important to the welfare of a hydro-power producer. With this in mind, Wisconsin Electric Power Company and Wisconsin Public Service Corporation have worked together to develop consistent safety signage and several for their hydro projects. Although the two utilities sometimes compete for electric customers, they cooperate to ensure the safety to those customers. Both WE and WPS took steps in 1986 to make their operations safer through involvement in the Wisconsin/Michigan Hydro User Group. The organization has 25 members-primarily of electric utilities and paper companies-who operate hydro facilities in the two states. The two areas that the HUG studied in public safety were signs and warning systems. HUG established a sign committee to study how to increase safety of people around hydro plants through signs, explained Ted Handrick, hydro plant superintendent at WPS. The committee's recommendations led to development of a statewide uniform sign system adopted by all HUG members. The committee used Wisconsin Department of Natural Resources' guidelines for warning signs and portages in developing the signage standards. HUG members are converting to these new sign standards as they replace old signs and/or install new signs. Notices describing the new signage system have been placed near each hydro plant, at boat landings, and in campgrounds. The signs are mounted well above ground level so they can be seen and easily read by recreationalists. Warning systems, in accordance with HUG warning standards, were installed at WE and WPS hydro facilities. These systems alert nearby recreational users of rapid increases in water flow when generating units are turned on or when spillway gates are opened. Soon after the authors installed equipment to remotely operate its hydro facilities, the utility experienced a dramatic increase increase in intrusion on dams and other structures at the projects.

Bartel, J.W. (Wisconsin Electric Power Co., Milwaukee (United States))

1993-05-01

230

Multiple sensors ensure guide strand selection in human RNAi pathways.  

PubMed

Small RNAs guide RNA-induced silencing complexes (RISCs) to bind to cognate mRNA transcripts and trigger silencing of protein expression during RNA interference (RNAi) in eukaryotes. A fundamental aspect of this process is the asymmetric loading of one strand of a short interfering RNA (siRNA) or microRNA (miRNA) duplex onto RISCs for correct target recognition. Here, we use a reconstituted system to determine the extent to which the core components of the human RNAi machinery contribute to RNA guide strand selection. We show that Argonaute2 (Ago2), the endonuclease that binds directly to siRNAs and miRNAs within RISC, has intrinsic but substrate-dependent RNA strand selection capability. This activity can be enhanced substantially when Ago2 is in complex with the endonuclease Dicer and the double-stranded RNA-binding proteins (dsRBPs)-trans-activation response (TAR) RNA-binding protein (TRBP) or protein activator of PKR (PACT). The extent to which human Dicer/dsRBP complexes contribute to strand selection is dictated by specific duplex parameters such as thermodynamics, 5' nucleotide identity, and structure. Surprisingly, our results also suggest that strand selection for some miRNAs is enhanced by PACT-containing complexes but not by those containing TRBP. Furthermore, overall mRNA targeting by miRNAs is disfavored for complexes containing TRBP but not PACT. These findings demonstrate that multiple proteins collaborate to ensure optimal strand selection in humans and reveal the possibility of delineating RNAi pathways based on the presence of TRBP or PACT. PMID:23531496

Noland, Cameron L; Doudna, Jennifer A

2013-03-26

231

Self-care: a foundational science.  

PubMed

Further development of conceptual elements of the theory of self-care, one of the three constituent theories of Orem's self-care deficit theory of nursing, is reported. Five content areas of a practical science of self-care are identified; one content area, self-care requisites, is refined and developed. The nature of self-care requisites is reformulated; guides and standards for the expression of self-care requisites, examples of expressed self-care requisites, and a self-care practice guide are described. These developments are illustrated using the example of the requisite to maintain an adequate fluid intake. PMID:11873354

Denyes, M J; Orem, D E; Bekel, G; SozWiss

2001-01-01

232

Prenatal Care  

MedlinePLUS

... information as easy to read as possible. Prenatal care fact sheet What is prenatal care? Why do ... More information on prenatal care What is prenatal care? Prenatal care is the health care you get ...

233

A blueprint-based case study analysis of nutrition services provided in a midterm care facility for the elderly.  

PubMed

Ensuring nutritionally adequate food intake in institutions is a complex and important challenge for dietitians. To tackle this problem, we argue that dietitians need to adopt a systematic, integrative, and patient-centered approach to identify and manage more effectively organizational determinants of the quality of food intake under their control. In this study, we introduce such an approach, the blueprint-based case study, that we applied in the context of a midterm care facility for elderly patients. Data gathered through interviews and field observations were used to develop, from the perspective of key patient encounters, detailed representations of the food, nutrition, and nursing activities necessary to ensure adequate food intake. These service "blueprints" were developed to illustrate all activities that might potentially impact on the nutritional, sensory, functional, and social quality of patients' meals. They were also used as roadmaps to develop a case study analysis in which critical areas were identified and opportunities for improvement put forth, while considering services' resources and priorities. By providing a precise, objective, yet comprehensive mapping of the service operations and management, the blueprint-based case study approach represents a valuable tool to determine the optimal allocation of resources to insure nutritionally adequate food intake to patients. PMID:12616261

Paquet, Catherine; St-Arnaud-Mckenzie, Danielle; Ferland, Guylaine; Dub, Laurette

2003-03-01

234

Percentage of Adults with High Blood Pressure Whose Hypertension Is Adequately Controlled  

MedlinePLUS

... Whose Hypertension is Adequately Controlled Last updated 20 Mar 2012 Download these data Explore these data Row ... this age range not included. Last updated 20 Mar 2012 Download these data Explore these data Row ...

235

Does the Medicare PIP-DCG Model Adequately Adjust for Selection Bias.  

National Technical Information Service (NTIS)

Objective to determine whether the principal inpatient diagnostic cost group (PIP-DCG) model adequately adjusts for HMO (health maintenance organization) favorable selection, and if not, to quantify the model's bias in predicting resource use of HMO enrol...

H. Kan

2002-01-01

236

34 CFR 200.21 - Adequate yearly progress of a State.  

Code of Federal Regulations, 2013 CFR

...of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly...

2013-07-01

237

Cultural competence in primary care services  

Microsoft Academic Search

The assessment of cultural competence in providing primary care services for women is addressed. Emphasis is placed on the ways in which cultural competency attainment can ensure the availability of key primary care components to all women, especially those from certain vulnerable populations and those who have specific primary health care needs. A cultural competence continuum is described that will

Jo-Anna L. Rorie; Lisa L. Paine; Mary K. Barger

1996-01-01

238

Perinatal substance abuse and human subjects research: are privacy protections adequate?  

PubMed

Privacy incursions in the clinical care of substance abusing pregnant women have gained lay and professional attention recently as the result of a high-profile Supreme Court finding in Ferguson vs City of Charleston et al. In March, 2001 the Supreme Court determined that nonconsensual drug screening of pregnant women by clinicians in a public hospital violated the women's Fourth Amendment rights to be secure against unreasonable search and seizure. Coercive or punitive policy approaches to perinatal substance abuse are often based on mistaken assumptions about the nature of addiction and the outcomes of punitive interventions. Much attention has been given to efforts to criminalize pregnancy for drug using women, and civil laws are also coming under increasing scrutiny. Although no state has passed a law criminalizing pregnancy and drug use, an estimated 250 women in more than 30 states have been prosecuted around the country on theories of "fetal abuse." A growing number of states (eighteen to date) have amended their civil child welfare laws to address specifically the subject of a woman's drug use during pregnancy. No one has examined how these laws and social policies could affect research that includes pregnant and parenting women; women (and their families) who stand to lose a great deal should their drug use be brought to the attention of child welfare or criminal justice authorities. We examine the adequacy of current protective mechanisms, such as federal certificates of confidentiality, in protecting research subjects (and investigators) who may be subject to punitive civil or criminal sanctions. We determine that current protective mechanisms may be insufficient to protect research subjects and that investigators and IRB members are often ignorant of the risks imposed by punitive policy approaches to perinatal substance abuse or fall prey to the same mistaken assumptions that inform punitive policies. We conclude that investigators and IRB members have a moral responsibility to understand local, state and national policies and laws governing perinatal substance abuse. Investigators and IRB members should balance the harms of punitive interventions against the protections that may, or may not be afforded to prospective research subjects as well as the prospective benefits, individual and social, of the research. In situations where criminal or punitive policies are in effect, investigators and IRB members should consider whether adequate protections can be achieved. In the context of inadequate protections, potential risks to prospective research subjects and their families may outweigh the individual or social benefits that accrue from the research. Clinical researchers are professionally obligated to work toward amending laws and policies that are not in the best interests of prospective research subjects. PMID:12587139

Marshall, Mary Faith; Menikoff, Jerry; Paltrow, Lynn M

2003-01-01

239

Challenges of implementing depression care management in the primary care setting.  

PubMed

Empirical evidence shows that care management is an effective tool for improving depression treatment in primary care patients. However, several conceptual and practical issues have not been sufficiently addressed. This article explores questions concerning the scope of care management services within the chronic illness care model; optimal ways to identify depressed patients in the primary care setting; responsibilities and desirable qualifications of depression care managers; the location and manner in which care managers interact with patients; costs of services provided by care managers; and the level of supervision by mental health specialists that is necessary to ensure quality care. PMID:16215660

Belnap, Bea Herbeck; Kuebler, Julie; Upshur, Carole; Kerber, Kevin; Mockrin, Deborah Ruth; Kilbourne, Amy M; Rollman, Bruce L

2006-01-01

240

Adequate sleep among adolescents is positively associated with health status and health-related behaviors  

Microsoft Academic Search

BACKGROUND: Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 68 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was

Mei-Yen Chen; Edward K Wang; Yi-Jong Jeng

2006-01-01

241

Detection of alloimmunization to ensure safer transfusion practice  

PubMed Central

Background: Serological safety is an integral part of overall safety for blood banks. Emphasis is on the use of routinue Red Blood Cell (RBC) antibody screen test, at set time intervals, to reduce risks related to alloantibodies. Also emphasis is on importance of issuing antigen negative blood to alloantibody positive patients. Effect of using leucodepleted blood on the rate of alloimmunization is highlighted. The concept of provision of phenotypically matched blood is suggested. Materials and Methods: Antibody screen test is important to select appropriate blood for transfusion. Repeat antibody screen testing, except if time interval between the earlier and subsequent transfusion was less than 72 hours, followed by antibody identification, if required, was performed in patients being treated with repeat multiple blood transfusions. Between February 2008 and June 2009, repeat samples of 306 multi-transfused patients were analyzed. Search for irregular antibodies and reading of results was conducted using RBC panels (three-cell panel of Column Agglutination Technology (CAT) and two cell panel of the Solid Phase Red Cell Adherence Technology (SPRCAT). Specificities of antibodies were investigated using appropriate panels, 11 cell panel of CAT and 16 cell panel of SPRCA. These technologies, detecting agglutination in columns and reactions in solid phase, evaluate the attachment of irregular incomplete antibody to antigen in the first phase of immunological reaction more directly and hence improve the reading of agglutination. Three to four log leuco reduced red blood cells were transfused to patients in the study using blood collection bags with integral filters. Results: Alloimmunization rate of 4.24% was detected from 306 multiply transfused patients tested and followed up. The Transfusion therapy may become significantly complicated. Conclusion: Red cell antibody screening and identification and subsequent issue of antigen negative blood have a significant role in improving blood safety. Centers that have incorporated antibody screen test and identification have ensured safe transfusion. Identified patients should be flagged in a database and information shared. Such patients can be given carry-on cards and educated about the names of the identified antibodies. Full red cell phenotyping of individuals, patients and donors, can be feasibility.

Sood, Rashmi; Makroo, R. N.; Riana, Vimarsh; Rosamma, N. L.

2013-01-01

242

The Challenges in Building an Adequate and Comprehensive Fund-Ensuring System for Rural Compulsory Education in China: Empirical Evidence from the Implementation of "Two Exemptions and One Subsidy" (TEOS)  

ERIC Educational Resources Information Center

|Beginning in 2006, the "two exemptions and one subsidy" (TEOS) policy was integrated into the New Mechanism for Assured Funding for Rural Compulsory Education (hereafter the "New Mechanism"). The New Mechanism includes TEOS, raising the standard of public expenditure guarantees for rural compulsory education stage schools, creating a permanent

Yanqing, Ding

2008-01-01

243

38 CFR 17.63 - Approval of community residential care facilities.  

Code of Federal Regulations, 2013 CFR

...community residential care facility; (iv...duty and available to care for the resident and ensure the health and safety of each resident...community residential care provider and staff...the facility. (k) Cost of community...

2013-07-01

244

[Post-gunshot wound lesions of the peripheral nerves which may be prevented with adequate primary surgical wound care].  

PubMed

The retrospective study includes 24 wounded persons with iatrogenic peripheral nerve lesion and 94 wounded whose neural damage occurred due to peripheral nerve engagement in scar tissue after main artery reconstruction, missile bone fracture or after soft tissues defects covering by Tiersch transplants. The authors analyzed frequency and localization of these lesions, intraoperative findings, applied operative procedures and clinical findings during preoperative follow-up. It is recommended to create the new bad for exposed peripheral nerve from adjacent muscles as part of primary surgical wound treatment. This procedure eliminates the risk of subsequent epineural scar formation in all situations that have been described (soft tissue defects, artery reconstruction and bone fracture) and makes the later operations on peripheral nerves unnecessary. PMID:9229929

Roganovi?, Z; Anti?, B; Petkovi?, S; Tadi?, R; Savi?, M

245

English Proficiency and Access to Health Insurance in Hispanics Who Are Elderly: Implications for Adequate Health Care  

ERIC Educational Resources Information Center

|Medicare, as a publicly funded insurance program, has produced significant improvement in the overall health of America's elderly populations. However, health disparities still persist between Hispanic and non-Hispanic White populations in terms of overall access to health services. This study utilized data from the Hispanic Established

Caesar, Lena G.

2006-01-01

246

The challenge of supporting care for dementia in primary care.  

PubMed

Most patients with dementia receive care within primary care systems and have challenging medical and psychiatric issues. Their dementia related symptoms are often not recognized by the primary care system; they suffer from multiple chronic medical conditions; receive numerous psychotropic medications including anticholinergics; and display clinically relevant behavioral and psychological symptoms. Improving the care for such vulnerable patients demands supporting the primary care system with various resources, including dementia care managers, access to and coordination with interdisciplinary dementia specialists, and a feasible dementia screening and diagnosis process. Understanding primary care clinics as a complex adaptive system may enhance our capacity to deliver a flexible supportive process using the above crucial resources to adequately assess and effectively manage patients with dementia. Such a complex adaptive system process would have the best probability of surviving the unknowable future challenges that will face the primary care system. PMID:18225464

Boustani, Malaz; Schubert, Cathy; Sennour, Youcef

2007-01-01

247

Ensuring Credit to Data Creators: A Case Study for Geodesy  

NASA Astrophysics Data System (ADS)

UNAVCO, the NSF and NASA-funded facility that supports and promotes Earth science by advancing high-precision techniques for the measurement of crustal deformation, has operated a Global Navigation Satellite System (GNSS) Data Archive since 1992. For the GNSS domain, the UNAVCO Archive has established best practices for data and metadata preservation, and provides tools for openly tracking data provenance. The GNSS data collection at the UNAVCO Archive represents the efforts of over 400 principal investigators and uncounted years of effort by these individuals and their students in globally distributed field installations, sometimes in situations of significant danger, whether from geologic hazards or political/civil unrest. Our investigators also expend considerable effort in following best practices for data and metadata management. UNAVCO, with the support of its consortium membership, has committed to an open data policy for data in the Archive. Once the data and metadata are archived by UNAVCO, they are distributed by anonymous access to thousands of users who cannot be accurately identified. Consequently, the UNAVCO commitment to open data access was reached with a degree of trepidation on the part of a segment of the principal investigators who contribute their data with no guarantee that their colleagues (or competitors) will follow a code of ethics in their research and publications with respect to the data they have downloaded from the UNAVCO Archive. The UNAVCO community has recognized the need to develop, adopt, and follow a data citation policy among themselves and to advocate for data citation more generally within the science publication arena. The role of the UNAVCO Archive in this process has been to provide data citation guidance and to develop and implement mechanisms to assign digital object identifiers (DOIs) to data sets within the UNAVCO Archive. The UNAVCO community is interested in digital object identifiers primarily as a means to facilitate citation for the purpose of ensuring credit to the data creators. UNAVCO's archiving and metadata management systems are generally well-suited to assigning and maintaining DOIs for two styles of logical collections of data: campaigns, which are spatially and temporally well-defined; and stations, which represent ongoing collection at a single spatial position at the Earth's surface. These two styles form the basis for implementing approximately 3,000 DOIs that can encompass the current holdings in the UNAVCO Archive. In addition, aggregations of DOIs into a superset DOI is advantageous for numerous cases where groupings of stations are naturally used in research studies. There are about 100 such natural collections of stations. However, research using GNSS data can also utilize several hundred or more stations in unique combinations, where tallying the individual DOIs within a reference list is cumbersome. We are grappling with the complexities that inevitably crop up when assigning DOIs, including subsetting, versioning, and aggregating. We also foresee the need for mechanisms for users to go beyond our predefined collections and/or aggregations to define their own ad-hoc collections. Our goal is to create a system for DOI assignment and utilization that succeeds in facilitating data citation within our community of geodesy scientists.

Boler, F. M.; Gorman, A.

2011-12-01

248

21 CFR 212.20 - What activities must I perform to ensure drug quality?  

Code of Federal Regulations, 2013 CFR

...activities must I perform to ensure drug quality? 212.20 Section 212.20 Food...POSITRON EMISSION TOMOGRAPHY DRUGS Quality Assurance § 212.20 What activities must I perform to ensure drug quality? (a) Production...

2013-04-01

249

24 CFR 81.102 - Verification and enforcement to ensure GSE data integrity.  

Code of Federal Regulations, 2010 CFR

... Verification and enforcement to ensure GSE data integrity. 81.102 Section 81... Verification and enforcement to ensure GSE data integrity. (a) Independent verification...information, and reports provided by each GSE, including conducting on-site...

2009-04-01

250

24 CFR 81.102 - Verification and enforcement to ensure GSE data integrity.  

Code of Federal Regulations, 2010 CFR

... Verification and enforcement to ensure GSE data integrity. 81.102 Section 81... Verification and enforcement to ensure GSE data integrity. (a) Independent verification...information, and reports provided by each GSE, including conducting on-site...

2010-04-01

251

28 CFR 97.20 - Standards to ensure the safety of violent prisoners during transport.  

Code of Federal Regulations, 2010 CFR

...are in effect to ensure that female prisoners are separated from male prisoners...are in effect to ensure that female guards are on duty to supervise the transportation of female violent prisoners, where practicable;...

2010-07-01

252

28 CFR 97.20 - Standards to ensure the safety of violent prisoners during transport.  

Code of Federal Regulations, 2010 CFR

...are in effect to ensure that female prisoners are separated from male prisoners...are in effect to ensure that female guards are on duty to supervise the transportation of female violent prisoners, where practicable;...

2009-07-01

253

30 CFR 1227.501 - What are a State's responsibilities to ensure that reporters correct erroneous data?  

Code of Federal Regulations, 2013 CFR

...State's responsibilities to ensure that reporters correct erroneous data? 1227.501...State's responsibilities to ensure that reporters correct erroneous data? To ensure...the Standards ; (b) Ensure that reporters accurately and timely correct all...

2013-07-01

254

75 FR 52916 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...  

Federal Register 2010, 2011, 2012, 2013

...RIN-2060-AQ45 Action To Ensure Authority To Issue Permits Under the Prevention of Significant...rule ``Action to Ensure Authority to Issue Permits under the Prevention of Significant...proposed ``Action to Ensure Authority to Issue Permits under the Prevention of...

2010-08-30

255

[How to ensure that glaucoma is stable? Intraocular pressure].  

PubMed

In patients with open-angle glaucoma, intraocular pressure (IOP) obtained through treatment should guard against the progression of glaucoma damage. This depends on the initial state of intraocular pressure, but also on the stage of glaucoma, how fast the alterations are progressing, the patient's age and life expectancy, as well as the presence of other risk factors. To determine the ideal level of treated IOP, the term "target pressure" is often used. This term is very much open to criticism, however, because it calls on a static figure for what is highly variable biological information belonging to the body's biological rhythms. A large number of formulas are used to calculate this target pressure number, but all of them come up against the disadvantage of not taking into account the variations in IOP during the day/night cycle. Yet it is these very variations that can characterize the severity of the disease in terms of IOP. In a glaucoma patient, the IOP curve plotted over 24 h has higher IOP values during the day than at night, contrary to a healthy subject. Fluctuations of more than 10 mmHg are not rare during the day/night cycle, most often with many peaks, which are deleterious for retinal nerve fibers. These dynamic pressure parameters are essential both in determining the therapeutic strategy and in evaluating the effectiveness of treatment. In practice, with any case of open-angle glaucoma and before any treatment is given, a diurnal curve should be established. Six to eight measurements between 8 AM and 6 or 8 PM should be enough. They should be carefully combined with concomitant measures of systemic blood pressure. Once treatment has started, we suggest that a new diurnal curve be established 1 month and then 4 months after the beginning of treatment. The treatment will be modified if needed, based on IOP criteria established at 1 month, and on IOP, perimetric, and anatomic criteria determined again at 4 months. If the disease continues to worsen despite a satisfactory diurnal IOP, IOP should be measured over 24 h, associated with Holter monitoring, looking for an escape of pressure at night. PMID:17072216

Romanet, J-P; Palombi, K; Nol, C; Chiquet, C; Savy, O; Buguet, A

2006-05-01

256

Nursing Faculty Care Expressions, Patterns, and Practices Related to Teaching Culture Care  

Microsoft Academic Search

Introduction: Teaching culture care in nursing education is critical to ensuring a culturally competent workforce. The purpose of this qualitative study was to discover faculty care that facilitates teaching students to provide culture care.\\u000aResearch questions were:\\u000a1. In what ways do nursing faculty care expressions, patterns, and practices influence teaching culture care?\\u000a2. In what ways do worldview, culture

Sandra J Mixer

2009-01-01

257

Home Care  

MedlinePLUS

Home Care Basic Facts & Information Role of Health Care Professionals in Home Care Your physician is the leader of an interdisciplinary ... travel to see the healthcare team. Is Home Care Right for You? Home care is especially useful ...

258

[World WarII and current care provision : Impact of war-related trauma on present professional care situations.  

PubMed

BACKROUND: This study represents the first empirical research into the impact of war-related trauma on present professional care situations in Germany. METHODS: A total of 105 professional caregivers from North Rhine-Westphalia were questioned in a standardized form about the impact of war-related trauma on the daily work. RESULTS: Of the professional caregivers questioned 82?%reported that they were already caring for a person suffering from post-war trauma and 77?% stated that war-related trauma had an impact on the daily work. Altogether 63?% reported that war-related trauma is highly significant for the daily work. The professional caregivers reported that there was often a lack of knowledge and awareness of the topic among colleagues. CONCLUSIONS: The study showed that there is a need for increasing awareness and providing further staff education and training regarding the treatment of people suffering from (war-related) trauma in order to ensure adequate care for those concerned. PMID:23743885

Wilhelm, I; Zank, S

2013-06-01

259

Importance of adequate exercise in the detection of coronary heart disease by radionuclide ventriculography  

SciTech Connect

Rest and exercise radionuclide ventriculograms were obtained on 77 symptomatic patients without prior documented coronary artery disease (CAD). Coronary artery disease was present by angiograms in 48. Radionuclide ventriculography (RNV) was abnormal in 41 patients (overall sensitivity 85%). In 29 patients with normal coronary arteries, RNV was normal in 24 (specificity 83%). To determine if the exercise level affects sensitivity, the studies were graded for adequacy of exercise. It was considered adequate if patients developed (a) chest pain, or (b) ST segment depression of at least 1 mm, or (c) if they achieved a pressure rate product greater than 250. Among the 48 patients with coronary artery disease, 35 achieved adequate exercise. Thirty-three had an abnormal RNV (sensitivity 94%). In 13 patients who failed to achieve adequate exercise, RNV was abnormal in eight (sensitivity of only 62%). Some patients with coronary artery disease may have a normal ventricular response at inadequate levels of stress.

Brady, T.J.; Thrall, J.H.; Lo, K.; Pitt, B.

1980-12-01

260

Barriers to quality patient care in rural district hospitals.  

PubMed

Currently barriers exist in delivering quality health care. This study aimed to investigate such barriers in the eight rural district hospitals of the West Coast Winelands Region, three type A and five type B hospitals. A quantitative descriptive design was applied which included the total population of nursing staff (n = 340) working at the time of data collection. A self-administered questionnaire was distributed with a response rate of 82%.Reliability of the instrument was verified using the Cronbach alpha coefficient and a pilot study. The validity, specifically construct and content validity, were assured by means of an extensive literature review, pilot study and use of experts. Ethics approval was obtained from the relevant stakeholders.Results showed that 272 participants (97%) disagreed that provision of staff was adequate, with staff above 40 years of age more likely to disagree (p = <0.01). A statistically significant association was shown between availability of doctors and staff not being able to cope with emergencies (p = <0.01). Most participants (n =212; 76%) indicated that they were not receiving continuing education, with the registered nurses more likely to disagree (? test, p = 0.02). Participants in both hospital types A (n = 131; 82%) and B (n = 108; 91%) also disagreed that provision of equipment and consumables was adequate.The research showed that inadequacies relating to human resources, professional development, consumables and equipment influenced the quality of patient care. Urgent attention should be given to the problems identified to ensure quality of patient care in rural hospitals. PMID:23327761

Eygelaar, Johanna E; Stellenberg, Ethelwynn L

2012-05-09

261

Does private insurance adequately protect families of children with mental health disorders?  

PubMed Central

Objective Although private insurance typically covers many health care costs, the challenges faced by families caring for a sick child are substantial. These challenges may be more severe for CSHCN with mental illnesses than for other special needs children. Our objective is to determine whether families of privately insured children needing mental health care face different burdens than other families in caring for their children. Patients and Methods We use the 20052006 National Survey of Children with Special Health Care Needs (NS-CSHCN) to study privately insured children ages 617. We compare CSHCN with mental health care needs (N=4,918) to three groups: children with no SHCN (N=2,346), CSHCN with no mental health care needs (N=16,250), and CSHCN with no mental health care need but a need for other specialty services (N=7,902). The latter group is a subset of CSHCN with no mental health care need. We use weighted logistic regression and study outcomes across four domains: financial burden, health plan experiences, labor market and time effects, and parent experience with services. Results We find that families of children with mental health care needs face significantly greater financial barriers, have more negative health plan experiences, and are more likely to reduce their labor market participation to care for their child than other families. Conclusions Families of privately insured CSHCN needing mental health care face a higher burden than other families in caring for their children. Policies are needed to aid these families in obtaining affordable, high quality care for their children.

Barry, Colleen L.

2009-01-01

262

An analysis of allied health professional training in care homes for older people in Glasgow  

Microsoft Academic Search

The training of care staff in care homes for older people is important to ensure the maintenance of evidence-based and effective care. Moreover, training can assist in changing attitudes and promoting improved quality care for residents.To this end the Allied Health Professional (AHP) Care Homes Training Team provides training to care staff throughout the greater Glasgow area. This study sought

Jeanette Clelland; Danny Scott; Donna McKenzie

2005-01-01

263

Challenges to HIV prevention in psychiatric settings: perceptions of South African mental health care providers.  

PubMed

Mental health services in South Africa increasingly feel the brunt of the AIDS epidemic. Despite the high prevalence of infection in the psychiatric setting, HIV risk reduction interventions targeting South Africans with psychiatric illness remain few and far between. The attitudes of mental health care providers about sexual relations and HIV among people with mental illness continue to influence the extent to which these issues are addressed in care settings. This study examines these attitudes through the use of a semi-structured interview administered to 46 mental health care providers in four provinces of South Africa. I found that personal, contextual and political factors in the clinic and the hospital create barriers to integrating prevention activities. In particular, providers face at least three challenges to intervening in the epidemic among their patients: their own views of psychiatric illness, the transitions occurring in the mental health care system, and shifting social attitudes toward sexuality. Barriers operate at the individual level, the institutional level, and the societal level. At the individual level providers' perceptions of psychiatric symptoms shape their outlook on intervention with psychiatric patients. At the institutional level disruptive transitions in service delivery relegate HIV services to lesser importance. At the societal level, personal beliefs about sexuality and mental illness have remained slow to change despite major political changes. Minimizing barriers to implementing HIV prevention services requires institutional and health care policies that ensure adequate resources for treating people with mental illness and for staff development and support. PMID:16647793

Collins, Pamela Y

2006-05-02

264

Preventive Health Care for the Elderly  

PubMed Central

Demographic, economic and humanitarian considerations dictate that effective preventive health care be provided to the elderly. A disease-specific approach to geriatric preventive health care will not suffice; measures to enhance or maintain physical, mental and social function must also be emphasized. Unfortunately, the effectiveness of many preventive care procedures has not been adequately investigated in the elderly. Research is urgently needed to determine the efficacy of and appropriate target population for various geriatric preventive health care measures.

Stults, Barry M.

1984-01-01

265

[Use of music in palliative care].  

PubMed

Man is mortal, which means that as the earthly body perishes being, final. Disease and death will always be an inevitable and integral part of human experience. The way in which we try to identify and respond to the unique and individual needs of the dying is an indication of our maturity as a society. The number of people requiring palliative care is growing. Palliative care does not intend to either accelerate or postpone death she emphasizes the life and looks at dying as a normal process. It is an active form of care for patients with advanced, progressive illness, with the aim of suppressing pain and other symptoms in addition to providing psychological, social and spiritual support which ensures the best possible quality of life for patients and their families. Therefore requires a coordinated and interdisciplinary contribution team. The variety of professions in a team, and determine the needs of patients should be ready to provide physical, psychological, social and spiritual support using methods that result from an interdisciplinary, collaborative team approach. Development of a holistic approach and awareness in the medical and allied professions has led to a renewal of interest in the inclusion of music and other expressive media in contemporary concepts of palliative care, which are consistent with problem areas, clinical manifestations and the needs of patients. Music offers a direct and uncomplicated medium of intimacy, living in a man who listens to her, has a place where words lose their power. Music is like our existence, constantly polarizing and emotionally stimulating, as it touches the medium of the earliest layers of our becoming. The use of music in palliative care has proved very effective for a variety of effects that music creates in patients. These effects are achieved through the use of various musical techniques, such as musical improvisation, songwriting, receiving creative techniques, guided by imagination and music. These techniques allow the diversity of objectives in treating patients such as reducing anxiety and stress, relaxation, pain control, reducing confusion spiritual, emotional expression, experience, self-awareness, encourage creative expression, causing mood swings - emotional, cognitive and behavioral, inducing the patient's imagination, enabling patient's chronological classification of life experiences, and the elaboration of unresolved pain, sorrow or errors. Adequate selection and use of musical techniques in palliative care in the service of achieving the best possible quality of life for patients at the end of life. PMID:22994012

Skrbina, Dijana; Simunovi?, Dubravka; Santek, Vjerocka; Njegovan-Zvonarevi?, Tatjana

2011-12-01

266

Expanded Medical Home Model Works for Children in Foster Care  

ERIC Educational Resources Information Center

|The Illinois Child Welfare Department implemented a statewide health care system to ensure that children in foster care obtain quality health care by providing each child with a medical home. This study demonstrates that the Medical Home model works for children in foster care providing better health outcomes in higher immunization rates. These

Jaudes, Paula Kienberger; Champagne, Vince; Harden, Allen; Masterson, James; Bilaver, Lucy A.

2012-01-01

267

Auditing urinary catheter care.  

PubMed

Urinary catheters are the main cause of hospital-acquired urinary tract infections among inpatients. Healthcare staff can reduce the risk of patients developing an infection by ensuring they give evidence-based care and by removing the catheter as soon as it is no longer necessary. An audit conducted in a Hampshire hospital demonstrated there was poor documented evidence that best practice was being carried out. Therefore a urinary catheter assessment and monitoring tool was designed to promote best practice and produce clear evidence that care had been provided. PMID:22375340

Dailly, Sue

268

The Unequal Effect of Adequate Yearly Progress: Evidence From School Visits  

Microsoft Academic Search

The authors report insights, based on annual site visits to elementary and middle schools in three states from 2004 to 2006, into the incentive effect of the No Child Left Behind Acts requirement that increasing percentages of students make Adequate Yearly Progress (AYP) in every public school. They develop a framework, drawing on the physics concept of an attractor basin,

Abigail B. Brown; Jack W. Clift

2010-01-01

269

Calculating and Reducing Errors Associated with the Evaluation of Adequate Yearly Progress.  

ERIC Educational Resources Information Center

|In the Spring, 1996, issue of "CRESST Line," E. Baker and R. Linn commented that, in efforts to measure the progress of schools, "the fluctuations due to differences in the students themselves could conceal differences in instructional effects." This is particularly true in the context of the evaluation of adequate yearly progress required by

Hill, Richard

270

Calculating and Reducing Errors Associated with the Evaluation of Adequate Yearly Progress.  

ERIC Educational Resources Information Center

In the Spring, 1996, issue of "CRESST Line," E. Baker and R. Linn commented that, in efforts to measure the progress of schools, "the fluctuations due to differences in the students themselves could conceal differences in instructional effects." This is particularly true in the context of the evaluation of adequate yearly progress required by

Hill, Richard

271

A technique for adequate coverage of the proximal suture line during abdominal aortic aneurysm repair  

Microsoft Academic Search

The proximal suture line is a vulnerable area after abdominal aortic aneurysm repairs. This area has been implicated in various postoperative complications, such as pseudoaneurysm formation, graft-enteric fistula, and suture line disruption. We present a technique that provides safe and adequate coverage of this suture line by using the aneurysm sac. This technique is derived from the z-plasty technique used

Aditya K. Kaza; Jeffrey T. Cope; John A. Kern; David C. Cassada; Stewart M. Long; Steven M. Fiser; Irving L. Kron; Curtis G. Tribble

2001-01-01

272

Conducting Tests of Hypotheses: The Need for an Adequate Sample Size  

ERIC Educational Resources Information Center

|This article addresses the importance of obtaining a sample of an adequate size for the purpose of testing hypotheses. The logic underlying the requirement for a minimum sample size for hypothesis testing is discussed, as well as the criteria for determining it. Implications for researchers working with convenient samples of a fixed size are also

Asraf, Ratnawati Mohd; Brewer, James K.

2004-01-01

273

The Neonatal Bowel Output Study: Indicators of Adequate Breast Milk Intake in Neonates  

Microsoft Academic Search

Purpose: This study describes the bowel habits of neonates who were exclusively breastfed during the first 14 days following birth to determine whether bowel output (frequency and character) could be used as a proxy measure for adequate breast milk intake. Study Design: A prospective, descriptive study was conducted. During the 14-day study period, mothers kept a log of their infants'

Linda C. Shrago; Elizabeth Reifsnider; Kathleen Insel

2006-01-01

274

Middle East (Is the US Policy Adequate Today to Promote Peace in the Middle East).  

National Technical Information Service (NTIS)

The basic question is whether or not the US policy in the Middle East is adequate to promote peace over the next decade. Is modification required or should we devise a new policy based upon the current situation. Data was gathered using literature search,...

E. Hammonds

1972-01-01

275

Defining an adequate dose of acupuncture using a neurophysiological approach a narrative review of the literature  

Microsoft Academic Search

Many different styles of acupuncture practice exist, and lack of agreement on the optimal acupuncture treatment for any particular condition may mean that some patients do not receive the best treatment. This uncertainty also makes the negative results of sham controlled trials difficult to interpret. Unless we can be sure that both adequate acupuncture and an inactive sham were used

Adrian White; Mike Cummings; Panos Barlas; Francesco Cardini; Jacqueline Filshie; Nadine E Foster; Thomas Lundeberg; Elisabet Stener-Victorin; Claudia Witt

2008-01-01

276

Is the college environment adequate for accessing to nutrition education: A study in Taiwan  

Microsoft Academic Search

This study designed by understanding the nutrition knowledge, attitude and nutrition related practices of non-nutrition major college students to know if the current colleges provide adequate environment for learning nutrition. The relationship between nutrition knowledge, attitude and practices were also investigated. A questionnaire which was developed to measure students' nutrition knowledge, attitudes, and practices, was distributed to 2413 non-nutrition major

Yueching Wong; Yi-Chia Huang; Su-Lin Chen; Shigeru Yamamoto

1999-01-01

277

Facilitating Adequate Prioritization of Safety Goals in Distributed Teams at the Norwegian Continental Shelf  

Microsoft Academic Search

Petroleum installation employees have to balance safety goals versus other types of goals as a part of their daily work activities. To reduce the risk for incidents and accidents, it is critical to obtain a better understanding of how to facilitate adequate prioritization of safety goals, i.e., prioritizations in accordance with the standards set by the company in charge. The

A. B. Skjerve; G. Rindahl; H. O. Randem; S. Sarshar

278

Adequate Yearly Progress in Small Rural Schools and Rural Low-Income Schools  

ERIC Educational Resources Information Center

|Adequate yearly progress (AYP) on No Child Left Behind criteria was examined for a randomly selected sample of districts that qualify for the Rural Education Achievement Program (REAP). The sample involved 10% of districts that were eligible for the Small Rural Schools Achievement (SRSA) program and 10% that were eligible for the Rural and

Farmer, Thomas W.; Leung, Man-Chi; Banks, Jonathan; Schaefer, Victoria; Andrews, Bruce; Murray, Robert Allen

2006-01-01

279

Towards Defining Adequate Lithium Trials for Individuals with Mental Retardation and Mental Illness.  

ERIC Educational Resources Information Center

|Use of lithium with mentally retarded individuals with psychiatric conditions and/or behavior disturbances is discussed. The paper describes components of an adequate clinical trial and reviews case studies and double-blind cases. The paper concludes that aggression is the best indicator for lithium use, and reviews treatment parameters and

Pary, Robert J.

1991-01-01

280

Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia1-3  

Microsoft Academic Search

Background:Saltiodizationisthemainstrategyforreducingiodine deficiency disorders worldwide. Characteristics of families not us- ing iodized salt need to be known to expand coverage. Objective:Theobjectivewastodeterminewhetherfamilieswhodo not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using io- dized salt. Design: Use of adequately iodized salt (30 ppm), measured by rapid test kits, was assessed between

Richard D Semba; Saskia de Pee; Sonja Y Hess; Kai Sun; Mayang Sari; Martin W Bloem

281

The Diligent Prosecution Bar to Citizen Suits: The Search for Adequate Representation  

Microsoft Academic Search

To ensure that citizen suits assist but do not replace or overshadow government enforcement actions, all environmental statutes which authorize citizen suits bar such suits in certain circumstances. This short Article examines the relatively narrow but important problems created by one such bar, namely the statutory bar on a citizen suit if the federal or state government is diligently prosecuting

Peter A Appel

2003-01-01

282

21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.  

Code of Federal Regulations, 2011 CFR

21 Food and Drugs 7 2011-04-01...adequate substantiation of safety has not been obtained. 740.10 Section 740.10 Food and Drugs FOOD AND DRUG ADMINISTRATION...adequate substantiation of safety has not been...

2011-04-01

283

36 CFR 1222.22 - What records are required to provide for adequate documentation of agency business?  

Code of Federal Regulations, 2011 CFR

...provide for adequate documentation of agency business? 1222.22 Section 1222.22 ...AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL...provide for adequate documentation of agency business? To meet their obligation for...

2011-07-01

284

21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.  

Code of Federal Regulations, 2010 CFR

... § 740.10 Labeling of cosmetic products for which adequate...Each ingredient used in a cosmetic product and each finished cosmetic product shall be adequately...substantiated for safety prior to marketing. Any such ingredient...

2010-04-01

285

21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.  

Code of Federal Regulations, 2010 CFR

... § 740.10 Labeling of cosmetic products for which adequate...Each ingredient used in a cosmetic product and each finished cosmetic product shall be adequately...substantiated for safety prior to marketing. Any such ingredient...

2009-04-01

286

Oral care.  

PubMed

Adequate dental and oral hygiene may become a challenge for all users and especially for elderly people and young children because of their limited motor skills. The same holds true for patients undergoing/recovering from chemo-/radiotherapy with accompanying sensitive mucosal conditions. Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath (halitosis), fungal infection and gum diseases. The use of a toothbrush is the most important measure for oral hygiene. Toothbrushes with soft bristles operated carefully by hand or via an electric device help to remove plaque and to avoid mucosal trauma. A handlebar with a grip cover can be helpful for manually disabled patients or for those with reduced motor skills. In case of oral hygiene at the bedside or of patients during/after chemo-/radiotherapy a gauze pad can be helpful for gently cleaning the teeth, gums and tongue. The use of fluoride toothpaste is imperative for the daily oral hygiene. Detergents such as sodium lauryl sulphate improve the cleaning action but may also dehydrate and irritate the mucous membrane. The use of products containing detergents and flavouring agents (peppermint, menthol, cinnamon) should therefore be avoided by bedridden patients or those with dry mouth and sensitive mucosa. Aids for suitable interdental cleaning, such as dental floss, interdental brushes or dental sticks, are often complicated to operate. Their correct use should be instructed by healthcare professionals. To support dental care, additional fluoridation with a fluoride gel or rinse can be useful. Products further containing antiseptics such as chlorhexidine or triclosan reduce the quantity of bacteria in the mouth. For patients undergoing or having undergone radio-/chemotherapy, a mouthwash that concomitantly moisturizes the oral mucosa is advisable. PMID:21325845

Hitz Lindenmller, Irne; Lambrecht, J Thomas

2011-02-10

287

The Role of Medicaid in Promoting Access to High-Quality, High-Value Maternity Care  

Microsoft Academic Search

One of the most challenging aspects of health care improvement and reform is ensuring that individuals, particularly those who are vulnerable and low income, have access to care. Just as challenging is the imperative to ensure that the care accessed is of the highest quality possible. The Institute of Medicine (IOM) report, Crossing the Quality Chasm, identified the primary goal

Anne Rossier Markus; Sara Rosenbaum

2010-01-01

288

An assessment of routine primary care health information system data quality in Sofala Province, Mozambique  

PubMed Central

Background Primary health care is recognized as a main driver of equitable health service delivery. For it to function optimally, routine health information systems (HIS) are necessary to ensure adequate provision of health care and the development of appropriate health policies. Concerns about the quality of routine administrative data have undermined their use in resource-limited settings. This evaluation was designed to describe the availability, reliability, and validity of a sample of primary health care HIS data from nine health facilities across three districts in Sofala Province, Mozambique. HIS data were also compared with results from large community-based surveys. Methodology We used a methodology similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria data verification bottom-up audit to assess primary health care HIS data availability and reliability. The quality of HIS data was validated by comparing three key indicators (antenatal care, institutional birth, and third diptheria, pertussis, and tetanus [DPT] immunization) with population-level surveys over time. Results and discussion The data concordance from facility clinical registries to monthly facility reports on five key indicators--the number of first antenatal care visits, institutional births, third DPT immunization, HIV testing, and outpatient consults--was good (80%). When two sites were excluded from the analysis, the concordance was markedly better (92%). Of monthly facility reports for immunization and maternity services, 98% were available in paper form at district health departments and 98% of immunization and maternity services monthly facility reports matched the Ministry of Health electronic database. Population-level health survey and HIS data were strongly correlated (R = 0.73), for institutional birth, first antenatal care visit, and third DPT immunization. Conclusions Our results suggest that in this setting, HIS data are both reliable and consistent, supporting their use in primary health care program monitoring and evaluation. Simple, rapid tools can be used to evaluate routine data and facilitate the rapid identification of problem areas.

2011-01-01

289

Challenges in care of the child with special health care needs in a resource limited environment.  

PubMed

To identify challenges encountered in the care of children with special health care needs in a resource limited environment a 10 year-old child with a diagnosis of Tuberous Sclerosis was studied. Challenges identified were in: making a definitive diagnosis, provision of adequate care, cost of care, meeting parental expectations and accessing community support for the child and family. Available specialist health care and related services, including community rehabilitation, were provided for the child and family. The study highlights the need for improved community awareness, development in the provision of specialist health care services and institution of governmental policies that identify, support and protect children with special health care needs. PMID:23914107

Eseigbe, Edwin Ehi; Taju, Nuhu Folorunsho; Lateef, Sheikh Taiwo

2013-04-01

290

Residential Care  

MedlinePLUS

... will not sell or share your name. Residential Care Tweet Bookmark this page | Email | Print If the ... setting Care facility checklist Costs Types of residential care A good long-term care facility should feel ...

291

Preconception Care  

MedlinePLUS

... should speak with your healthcare provider about preconception care. Preconception care is care you receive before you get pregnant. It involves finding and taking care of any problems that might affect you and ...

292

Hospice Care  

MedlinePLUS

... Text Printer Friendly Download Reader Online Chat Hospice Care What is Hospice Care? When is Hospice Care ... Family Counseling and Support Services What is Hospice Care? Hospice programs are available to help terminally ill ...

293

Are we failing to provide adequate rescue medication to children at risk of prolonged convulsive seizures in schools?  

PubMed Central

Objective This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK. Situation analysis Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5?min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. Recommendations A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. Implications Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall.

Cross, J Helen; Wait, Suzanne; Arzimanoglou, Alexis; Beghi, Ettore; Bennett, Christine; Lagae, Lieven; Mifsud, Janet; Schmidt, Dieter; Harvey, Gordon

2013-01-01

294

A non-linear model for farm optimization with adequate and limited water supplies  

Microsoft Academic Search

This paper develops a non-linear optimization model for the determination of optimum cropping pattern, water amount and farm income under adequate and limited water supply conditions. The objective function of the model is based on crop water-benefit functions. The model is solved using Ms Excel Solver package for conditions existing in South-east Anatolian Region of Turkey. The model gives the

Bogachan Benli; Suleyman Kodal

2003-01-01

295

Is adequate and balanced nutrition during pregnancy more effective than iron and folic acid supplements?  

Microsoft Academic Search

To provide instruction for pregnant women regarding adequate and balanced nutrition and determine whether iron and folic acid\\u000a supplementation is essential. The research was an experimental clinical intervention. The study was conducted between March\\u000a 2004 and May 2005 with 80 pregnant volunteers. The study participants were in their 16th to 24th weeks of pregnancy; all participants\\u000a were healthy, carried only

Funda Elmacioglu; Bulent Surucu; Tayfun Alper; Aliye Ozenoglu; Serdal Ugurlu

2010-01-01

296

Oil & gas in the 1990`s and beyond: Adequate supplies, growing demand, flat prices  

SciTech Connect

Long term petroleum market fundamentals are clear: supplies are adequate and world demand will continue to grow steadily. Adequate supplies insure that prices will not increase significantly, on average, till the end of the 1990`s, probably much beyond. Despite plentiful supply and modest price increases, there will be peaks and valleys in the price graph as productive capacity is used up, then expanded. Tens of billions of dollars will be needed over the next decade to expand producing capacity. World oil consumption will increase at about 1.5% per year, at least for the next decade. Demand in Asia and Latin America will grow several times faster than this average world rate. World natural gas demand will grow at more then 2% per year well past 2000. Oil and gas companies around the world have changed the way they operate to survive the market realities of the 1990`s. restructuring, outsourcing, and partnering will continue as increasing costs and flat prices squeeze profits. Energy use patterns will change. Fuel and other product specifications will change. Market shares of oil and gas will shift. But opportunities abound in this new market environment. Growing markets always provide opportunities. Technology has helped operators dramatically lower finding, developing, and producing costs. The petroleum age is far from being over. Growing markets, adequate supply, affordable products, and a 60% market share. Those are the signs of an industry with a bright future.

Kennedy, J.L. [Oil & Gas Journal, Houston, TX (United States)

1995-06-01

297

A Conflict Between Nutritionally Adequate Diets and Meeting the 2010 Dietary Guidelines for Sodium  

PubMed Central

Background Compliance with dietary guidelines means incorporating multiple foods and nutrients into everyday diets, to be consumed in smaller or larger amounts. Feasibility studies can help determine whether one nutrient guideline comes into conflict with another. For one half of the U.S. population, the 2010 dietary guidelines for sodium were set at 1500 mg/d. Purpose To test the compatibility of the 1500mg/d sodium goal with nutrient-adequate diets. Methods Analyses, conducted in 2010, used U.S. federal nutrient composition and dietary intake databases to create modeled food patterns for six genderage groups using linear programming techniques. The food patterns were designed to meet nutritional standards for 27 nutrients as the mean sodium content was progressively reduced from levels observed in the 20012002 National Health and Nutrition Examination Survey (NHANES) down to 1500 mg/day. Results For adults aged <50 years, the 2300 mg/day sodium goal was consistent with nutrient-adequate diets but required large deviations from current eating patterns. The 1500 mg/day goal was not feasible and no mathematical solution was obtained. The lowest-sodium food patterns that were nutrient-adequate and theoretically achievable were very high in fruit juices, nuts, and seeds but were low in grains and meats. Conclusions Compliance with the 2010 sodium guidelines will require large deviations from current eating behaviors and/or a profound modification of the U.S. food supply.

Maillot, Matthieu; Drewnowski, Adam

2012-01-01

298

A test for adequate wastewater treatment based on glutathione S transferase isoenzyme profile.  

PubMed

Discharge to the environment of treated or non-treated municipal wastewater imposes several threats to coastal and estuarine ecosystems which are difficult to assess. In our study we evaluate the use of the isoenzyme profile of glutathione S transferase (GST) in combination with the kinetic characteristics of the whole enzyme and of heme peroxidase, as a test of adequate treatment of municipal wastewater. For this reason, Artemia nauplii were incubated in artificial seawater prepared by wastewater samples, such as secondary municipal effluents produced by a conventional activated sludge unit and advanced treated effluents produced by the employment of coagulation, activated carbon adsorption and chlorination as single processes or as combined ones. Characteristic changes of the isoenzyme pattern and the enzymes' kinetic properties were caused by chlorinated secondary municipal effluent or by secondary non-chlorinated effluent. Advanced treatment by combination of coagulation and/or carbon adsorption resulted to less prominent changes, suggesting more adequate treatment. Our results suggest that GST isoenzyme profile in combination with the kinetic properties of the total enzyme family is a sensitive test for the evaluation of the adequateness of the treatment of reclaimed wastewater and the reduction of potentially harmful compounds. Potentially, it may offer a 'fingerprint' characteristic of a particular effluent and probably of the treatment level it has been subjected. PMID:23313117

Grammou, A; Samaras, P; Papadimitriou, C; Papadopoulos, A I

2013-01-11

299

Ensuring Quality  

ERIC Educational Resources Information Center

|This article discusses why building commissioning for education institutions is needed. School facilities owners and operators should confirm whether their building systems are performing as expected. The more comprehensive the confirmation process, the greater opportunity there is for reducing operations and maintenance costs, and improving

Erickson, Paul W.

2009-01-01

300

Adequate trust avails, mistaken trust matters: on the moral responsibility of doctors as proxies for patients' trust in biobank research.  

PubMed

In Sweden, most patients are recruited into biobank research by non-researcher doctors. Patients' trust in doctors may therefore be important to their willingness to participate. We suggest a model of trust that makes sense of such transitions of trust between domains and distinguishes adequate trust from mistaken trust. The unique position of doctors implies, we argue, a Kantian imperfect duty to compensate for patients' mistaken trust. There are at least three kinds of mistaken trust, each of which requires a different set of countermeasures. First, trust is mistaken when necessary competence is lacking; the competence must be developed or the illusion dispelled. Second, trust is irrational whenever the patient is mistaken about his actual reasons for trusting. Care must therefore be taken to support the patient's reasoning and moral agency. Third, some patients inappropriately trust doctors to recommend only research that will benefit them directly. Such trust should be counteracted by nurturing a culture where patients expect to be asked occasionally to contribute to the common good. PMID:22681564

Johnsson, Linus; Helgesson, Gert; Hansson, Mats G; Eriksson, Stefan

2012-06-10

301

3 CFR 13535 - Executive Order 13535 of March 24, 2010. Ensuring Enforcement and Implementation of Abortion...  

Code of Federal Regulations, 2010 CFR

...Restrictions in the Patient Protection and Affordable Care Act 13535 Order...Restrictions in the Patient Protection and Affordable Care Act By the authority...including the Patient Protection and Affordable Care Act (Public...

2011-01-01

302

75 FR 15597 - Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection and...  

Federal Register 2010, 2011, 2012, 2013

...Restrictions in the Patient Protection and Affordable Care Act Presidential Documents...Restrictions in the Patient Protection and Affordable Care Act By the authority...including the ``Patient Protection and Affordable Care Act'' (Public...

2010-03-29

303

Meeting the Health Care Needs of Children in the Foster Care System  

Microsoft Academic Search

In the Winter\\/Spring 2000 issue of Permanency Planning Today, authors Sheryl Dicker and Elysa Gordon described the special health care needs of children in foster care, their vulnera-bility to health problems, the stress on care-givers who care for children with serious health conditions, and the important role child welfare professionals play in ensuring their healthy development. They cited the critical

Jan Mccarthy

304

Effective Marketing of Quality Child Care.  

ERIC Educational Resources Information Center

|Identifies negative public and professional attitudes that lie beneath the contemporary negative image of quality child care. Argues that concepts and principles of marketing are appropriate for influencing parents to choose high quality services and helping ensure that supplementary care is of sufficient quality to enhance, not inhibit, the

Caldwell, Bettye M.; Boyd, Harper W., Jr.

1984-01-01

305

Effective Marketing of Quality Child Care.  

ERIC Educational Resources Information Center

Identifies negative public and professional attitudes that lie beneath the contemporary negative image of quality child care. Argues that concepts and principles of marketing are appropriate for influencing parents to choose high quality services and helping ensure that supplementary care is of sufficient quality to enhance, not inhibit, the

Caldwell, Bettye M.; Boyd, Harper W., Jr.

1984-01-01

306

Mental health care: Access, stigma, and effectiveness  

Microsoft Academic Search

Discusses the lack of commitment by the US as a nation to ensure that high-quality mental health care will be provided to all who are in need. The mental health benefits under Medicare and Medicaid programs are meager at best. Psychologists and other nonphysician health care providers are not considered bona fide professionals. Prevention, program evaluation efforts, and the use

Daniel K. Inouye

1983-01-01

307

Ensuring Vitamin D Supplementation in Nursing Home PatientsA Quality Improvement Project  

Microsoft Academic Search

Randomized controlled trials have shown that adequate vitamin D supplementation in nursing home (NH) residents reduces the rates of falls and fractures. In our NH, review of medication administration records of all patients (n=101) revealed that only 34.6% of the patients were currently prescribed adequate doses of vitamin D, revealing a need for intervention. We designed a Quality Improvement (QI)

Mamata Yanamadala; Mitchell T. Heflin; Heidi K. White; Gwendolen T. Buhr

2012-01-01

308

Pre-Operative Assessment and Post-Operative Care in Elective Shoulder Surgery  

PubMed Central

Pre-operative assessment is required prior to the majority of elective surgical procedures, primarily to ensure that the patient is fit to undergo surgery, whilst identifying issues that may need to be dealt with by the surgical or anaesthetic teams. The post-operative management of elective surgical patients begins during the peri-operative period and involves several health professionals. Appropriate monitoring and repeated clinical assessments are required in order for the signs of surgical complications to be recognised swiftly and adequately. This article examines the literature regarding pre-operative assessment in elective orthopaedic surgery and shoulder surgery, whilst also reviewing the essentials of peri- and post-operative care. The need to recognise common post-operative complications early and promptly is also evaluated, along with discussing thromboprophylaxis and post-operative analgesia following shoulder surgery.

Akhtar, Ahsan; MacFarlane, Robert J; Waseem, Mohammad

2013-01-01

309

45 CFR 261.70 - What safeguards are there to ensure that participants in work activities do not displace other...  

Code of Federal Regulations, 2011 CFR

... 2011-10-01 2011-10-01 false What safeguards are there to ensure that participants...SERVICES ENSURING THAT RECIPIENTS WORK What Nondisplacement Rules Apply in TANF? § 261.70 What safeguards are there to ensure that...

2011-10-01

310

45 CFR 261.64 - How will we determine whether a State's work verification procedures ensure an accurate work...  

Code of Federal Regulations, 2012 CFR

...verification procedures ensure an accurate work participation measurement? 261.64 Section...How Do We Ensure the Accuracy of Work Participation Information? § 261.64 How...procedures ensure an accurate work participation measurement? (a) We will...

2012-10-01

311

45 CFR 261.64 - How will we determine whether a State's work verification procedures ensure an accurate work...  

Code of Federal Regulations, 2011 CFR

...verification procedures ensure an accurate work participation measurement? 261.64 Section...How Do We Ensure the Accuracy of Work Participation Information? § 261.64 How...procedures ensure an accurate work participation measurement? (a) We will...

2011-10-01

312

48 CFR 52.222-23 - Notice of Requirement for Affirmative Action To Ensure Equal Employment Opportunity for...  

Code of Federal Regulations, 2012 CFR

... Notice of Requirement for Affirmative Action To Ensure Equal Employment... Notice of Requirement for Affirmative Action To Ensure Equal Employment... Notice of Requirement for Affirmative Action To Ensure Equal...

2012-10-01

313

Percentage of Adults with High Cholesterol Whose LDL Cholesterol Levels Are Adequately Controlled  

MedlinePLUS

... System Measurement Project Search string Home Topical Areas Measures Data Sources Help About Hello, Unknown User Administration ... health care (TRICARE, VA, or CHAMP-VA). This measure is calculated by the Centers for Disease Control ...

314

20 CFR 670.993 - How does Job Corps ensure that contract disputes will be resolved?  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false How does Job Corps ensure that contract disputes will...DEPARTMENT OF LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT...Management Provisions § 670.993 How does Job Corps ensure that contract disputes...

2013-04-01

315

24 CFR 903.25 - How does HUD ensure PHA compliance with its plan?  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false How does HUD ensure PHA compliance with its plan? ...PLANS PHA Plans § 903.25 How does HUD ensure PHA compliance with its plan? ...standards adopted in the plan approved by HUD, HUD shall, as it deems...

2013-04-01

316

Developing a training plan to ensure employees keep up with the dynamics of facility management  

Microsoft Academic Search

Facility management departments are under constant pressure to adapt to ensure that their primary functions are supported in the best possible way and are aligned with the overall goals of the business. Given the multitude of pressures at work, the speed at which they are forced to adapt is relentless. The question is: How does one ensure employees are able

Agnita D. Korsten

2003-01-01

317

75 FR 54292 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...  

Federal Register 2010, 2011, 2012, 2013

...FRL-9197-2] RIN 2060-AQ45 Action To Ensure Authority To...Federal Implementation Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of public hearing...making a correction to the Action to Ensure Authority To...Federal Implementation Plan; Public Hearing to...

2010-09-07

318

Care of the infant of the diabetic mother.  

PubMed

Gestational diabetes mellitus (GDM) from all causes of diabetes is the most common medical complication of pregnancy and is increasing in incidence, particularly as type 2 diabetes continues to increase worldwide. Despite advances in perinatal care, infants of diabetic mothers (IDMs) remain at risk for a multitude of physiologic, metabolic, and congenital complications such as preterm birth, macrosomia, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia and hyperviscosity, hypertrophic cardiomyopathy, and congenital anomalies, particularly of the central nervous system. Overt type 1 diabetes around conception produces marked risk of embryopathy (neural tube defects, cardiac defects, caudal regression syndrome), whereas later in gestation, severe and unstable type 1 maternal diabetes carries a higher risk of intrauterine growth restriction, asphyxia, and fetal death. IDMs born to mothers with type 2 diabetes are more commonly obese (macrosomic) with milder conditions of the common problems found in IDMs. IDMs from all causes of GDM also are predisposed to later-life risk of obesity, diabetes, and cardiovascular disease. Care of the IDM neonate needs to focus on ensuring adequate cardiorespiratory adaptation at birth, possible birth injuries, maintenance of normal glucose metabolism, and close observation for polycythemia, hyperbilirubinemia, and feeding intolerance. PMID:22094826

Hay, William W

2012-02-01

319

Ethical guidance in the era of managed care: an analysis of the American College of Healthcare Executives' Code of Ethics.  

PubMed

Market competition and the rise of managed care are transforming the healthcare system from a physician-dominated cottage industry into a manager-dominated corporate enterprise. The managed care revolution is also undermining the safe-guards offered by medical ethics and raising serious public concerns. These trends highlight the growing importance of ethical standards for managers. The most comprehensive ethical guidance for health service managers is contained in the American College of Healthcare Executives' (ACHE) Code of Ethics. An analysis of the ACHE Code suggests that it does not adequately address several ethical concerns associated with managed care. The ACHE may wish to develop a supplemental statement regarding ethical issues in managed care. A supplemental statement that provides more specific guidance in the areas of financial incentives to reduce utilization, social mission, consumer/patient information, and the health service manager's responsibility to patients could be extremely valuable in today's complex and rapidly changing environment. More specific ethical guidelines would not ensure individual or organizational compliance. However, they would provide professional standards that could guide decision making and help managers evaluate performance in managed care settings. PMID:11066951

Higgins, W

320

Selenium incorporation into selenoproteins in the Se-adequate and Se-deficient rat  

SciTech Connect

To rapidly discriminate between selenoproteins and Se-binding proteins, SDS + 2-mercaptoethanol treatment and then gradient SDS-slab gel electrophoresis was used to remove loosely bound Se from proteins while separating protein subunits according to molecular weight. This technique was used to study the nature and time course of /sup 75/Se incorporation into selenoproteins. Male weanling rats were fed either a Se-adequate (0.35 ppm Se) or a Se-deficient (less than 0.02 ppm Se) diet for 20-41 days, injected iv with 50 microCi (/sup 75/Se)selenite (100 microCi/micrograms Se), and sacrificed 1, 3, 24, or 72 hr after /sup 75/Se injection. At 1 and 3 hr, a 55-kDa plasma /sup 75/Se protein contained the most /sup 75/Se of any /sup 75/Se protein observed in any tissue in either Se-adequate or Se-deficient rats. At 24 and 72 hr, a 23-kDa /sup 75/Se protein (glutathione peroxidase subunit) in liver cytosol was the second-most labeled /sup 75/Se protein observed in Se-adequate rats. The second-most labeled /sup 75/Se protein in Se-deficient rats was a 17-kDa /sup 75/Se protein in testes at 24 and 72 hr. /sup 75/Se proteins of 10, 14, 45, and 65 kDa as well as lesser amounts of other /sup 75/Se proteins were also detected. In a separate experiment, cycloheximide pretreatment eliminated /sup 75/Se labeling of any of the /sup 75/Se proteins, demonstrating that protein synthesis is required for Se incorporation. The rise and fall of various /sup 75/Se proteins with time suggests that these seleno-proteins may be important in the flux of Se between tissues.

Evenson, J.K.; Sunde, R.A.

1988-02-01

321

The KCNQ1-KCNE2 K+ channel is required for adequate thyroid I? uptake  

PubMed Central

The KCNQ1 ? subunit and the KCNE2 ? subunit form a potassium channel in thyroid epithelial cells. Genetic disruption of KCNQ1-KCNE2 causes hypothyroidism in mice, resulting in cardiac hypertrophy, dwarfism, alopecia, and prenatal mortality. Here, we investigated the mechanistic requirement for KCNQ1-KCNE2 in thyroid hormone biosynthesis, utilizing whole-animal dynamic positron emission tomography. The KCNQ1-specific antagonist (?)-[3R,4S]-chromanol 293B (C293B) significantly impaired thyroid cell I? uptake, which is mediated by the Na+/I? symporter (NIS), in vivo (dSUV/dt: vehicle, 0.0280.004 min?1; 10 mg/kg C293B, 0.0090.006 min?1) and in vitro (EC50: 9910 ?M C293B). Na+-dependent nicotinate uptake by SMCT, however, was unaffected. Kcne2 deletion did not alter the balance of free vs. thyroglobulin-bound I? in the thyroid (distinguished using ClO4?, a competitive inhibitor of NIS), indicating that KCNQ1-KCNE2 is not required for Duox/TPO-mediated I? organification. However, Kcne2 deletion doubled the rate of free I? efflux from the thyroid following ClO4? injection, a NIS-independent process. Thus, KCNQ1-KCNE2 is necessary for adequate thyroid cell I? uptake, the most likely explanation being that it is prerequisite for adequate NIS activity.Purtell, K., Paroder-Belenitsky, M., Reyna-Neyra, A., Nicola, J. P., Koba, W., Fine, E., Carrasco, N., Abbott, G. W. The KCNQ1-KCNE2 K+ channel is required for adequate thyroid I? uptake.

Purtell, Kerry; Paroder-Belenitsky, Monika; Reyna-Neyra, Andrea; Nicola, Juan P.; Koba, Wade; Fine, Eugene; Carrasco, Nancy; Abbott, Geoffrey W.

2012-01-01

322

Adequate Systemic Perfusion Maintained by a CentriMag during Acute Heart Failure  

PubMed Central

Mechanical circulatory support during severe acute heart failure presents options for myocardial recovery or cardiac replacement. Short-term circulatory support with the newest generation of magnetically levitated centrifugal-flow pumps affords several potential advantages. Herein, we present our experience with such a pumpthe CentriMag (Levitronix LLC; Waltham, Mass) centrifugal-flow ventricular assist devicein 4 critically ill patients who were in cardiogenic shock. From November 2007 through March 2008, 3 patients were supported after cardiac surgery, and 1 after chronic heart failure worsened. Two patients were bridged to heart transplantation, and 2 died during support. Perfusion during support was evaluated in terms of serum lactic acid levels and oxygenation values. In all of the patients, the CentriMag's pump flow was adequate, and continuous mechanical ventilation support was provided. Lactic acid levels substantially improved with CentriMag support and were maintained at near-normal levels throughout. At the same time, arterial pH, PO2, and carbon dioxide levels remained within acceptable ranges. No thromboembolic events or mechanical failures occurred. Our experience indicates that short-term use of the CentriMag ventricular assist device during acute heart failure can restore and adequately support circulation until recovery or until the application of definitive therapy.

Favaloro, Roberto R.; Bertolotti, Alejandro; Diez, Mirta; Favaloro, Liliana; Gomez, Carmen; Peradejordi, Margarita; Trentadue, Julio; Hellman, Lorena; Arzani, Yanina; Otero, Pilar Varela

2008-01-01

323

Can Earth Materials BE Adequately Covered in a - or Two-Semester Course?  

NASA Astrophysics Data System (ADS)

Traditional geology programs offer courses in mineralogy, optical mineralogy, igneous petrology, metamorphic petrology, sedimentology and economic geology. At many universities this suite of mineralogy/petrology courses has been supplanted by a one-semester or two-semester Earth Materials course. This interactive poster poses five questions to faculty and students related to the means by which Earth Materials can be delivered: 1) Available online syllabi demonstrate a wide variation in the topics addressed in Earth Materials courses; is there a standard core of key topics that must be covered and in what level of detail? 2) Can a one-semester or two- semester Earth Materials course adequately cover these topics? 3) Excellent textbooks exist in both mineralogy and in petrology; what textbooks, if any, adequately encompass Earth Materials? 4) How has the online environment changed the way in which we use textbooks in the classroom? 5) Given the evolution of geology programs, higher education and the global economy in the past twenty years, what additional changes can be anticipated with respect to delivery and demand of Earth Materials topics? Answers-- or at least related discussions-- to these questions are encouraged via verbal dialogue among participants and/or by comments written on the poster. Our goal is to solicit faculty, student and industry feedback to create a textbook, curricula and online materials that support an Earth Materials course.

Hefferan, K. P.; O'Brien, J.

2007-12-01

324

America's Child Care Crisis: A Crime Prevention Tragedy.  

ERIC Educational Resources Information Center

|This report presents findings relating the reduction of crime and violence with access to good educational child care programs. The report discusses the affordability of such programs, suggests that federal and state governments are not adequately funding educational child care programs, and argues that investing in high-quality child care and

Newman, Sanford; Brazelton, T. Berry; Zigler, Edward; Sherman, Lawrence W.; Bratton, William; Sanders, Jerry; Christeson, William

325

Utilisation of postnatal care among rural women in Nepal  

Microsoft Academic Search

BACKGROUND: Postnatal care is uncommon in Nepal, and where it is available the quality is often poor. Adequate utilisation of postnatal care can help reduce mortality and morbidity among mothers and their babies. Therefore, our study assessed the utilisation of postnatal care at a rural community level. METHODS: A descriptive, cross-sectional study was carried out in two neighbouring villages in

Sulochana Dhakal; Glyn N Chapman; Padam P Simkhada; Edwin R van Teijlingen; Jane Stephens; Amalraj E Raja

2007-01-01

326

Health Care Reform Act is Constitutional and Necessary  

Microsoft Academic Search

It has been nearly a year since President Obama signed into law the most important piece of civil and social rights legislation since the 1960s. The Patient Protection and Affordable Care Act not only offers responsible solutions to our impending national health care crisis, it also protects the right to adequate health care for our most physically, financially and politically

Ian C. Bartrum

2011-01-01

327

Fertility and Child Care Arrangements as Mechanisms of Status Articulation.  

ERIC Educational Resources Information Center

|Examined the relationship among employment preferences, child care arrangements of mothers of young children, and fertility expectations. Findings indicated that future fertility expectations were influenced by: (1) whether mothers wanted to be employed, given adequate child care, and (2) by whether they currently used regular child care.

Powers, Mary G.; Salvo, Joseph J.

1982-01-01

328

U.S. Health Care Policy and the Rising Uninsured  

Microsoft Academic Search

The lack of adequate health insurance affects one's ability to access care, which directly affects one's health. In the 21st century, there are 44 million people in the United States without health care insurance. The majority of people without health care insurance are working people under age 65, because most people over age 65 are retired and have health insurance

Thomas Falen

2005-01-01

329

Medical care behind bars: Maryland prison system.  

PubMed

The inmate population in the Maryland prison system has increased dramatically over the past 10 years due to changes in sentencing by the courts. At the same time, costs of inmate health care have increased markedly following court cases mandating adequate care, an amelioration of prior inadequate standards of care. The unique demographic and disease risk characteristics of inmates predispose them to a distinct set of health problems. The state is legally obligated to provide health care to individuals sentenced to confinement in state prisons. It is often the first care these individuals have received in many years. PMID:2927268

Salive, M E; Brewer, T F

1989-03-01

330

Obstetric Care Provider Density and Pregnancy Outcomes. Abstract, Executive Summary and Final Report.  

National Technical Information Service (NTIS)

Local physician shortages may impede efforts to improve prenatal care in the U.S. The authors used Tennessee vital records to conduct a retrospective cohort study of the association between obstetrician density and adequate prenatal care (Kessner index), ...

W. A. Ray

1995-01-01

331

Community-Directed Consortium and Its Management System for Health Manpower Education and Health Care Delivery.  

National Technical Information Service (NTIS)

A consortium of health care consumers and providers, consisting of 11 institutions and agencies in Alabama and Tennessee, which represents an alliance of health and education interests to produce adequate health manpower and improve health care delivery i...

1973-01-01

332

Managed Care  

MedlinePLUS

Managed care plans are a type of health insurance. They have contracts with health care providers and medical ... probably cost more. There are three types of managed care plans: Health Maintenance Organizations (HMO) usually only pay ...

333

Palliative Care  

MedlinePLUS

Palliative care is treatment of the discomfort, symptoms, and stress of serious illness. It provides relief from distressing symptoms ... of the medical treatments you're receiving. Hospice care, care at the end of life, always includes ...

334

Palliative Care  

MedlinePLUS

... Patients and Families Take the Quiz What Is Palliative Care? Palliative care (pronounced pal-lee-uh-tiv) is specialized medical ... life for both the patient and the family. Palliative care is provided by a team of doctors, nurses ...

335

Critical Care  

MedlinePLUS

Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications from surgery, ... attention by a team of specially-trained health care providers. Critical care usually takes place in an ...

336

Respite Care  

MedlinePLUS

... Text Printer Friendly Download Reader Online Chat Respite Care What is Respite Care? How Do You Pay ... Learn More About Respite Services? What is Respite Care? Millions of Americans provide unpaid assistance each year ...

337

Principles of health care financing.  

PubMed

The American Academy of Pediatrics advocates that all children must have health insurance coverage that ensures them access to affordable and comprehensive quality care. Access to care depends on the design and implementation of payment systems that ensure the economic viability of the medical home; support and grow the professional pediatric workforce; promote the adoption and implementation of health information technology; enhance medical education, training, and research; and encourage and reward quality-improvement programs that advance and strengthen the medical home. Health insurance plans must be portable from state to state, with administrative procedures to eliminate breaks and gaps in coverage to ensure continuous coverage from year to year. Plans should ensure free choice of clinicians and foster coordination with public and private community-based programs for infants, children, and adolescents through the age of 26. The scope of services provided by all health plans must include preventive, acute and chronic illness, behavioral, inpatient, emergency, and home health care. These plans must be affordable and have cost-sharing policies that protect patients and families from financial strain and are without risk of loss of benefits because of plan design, current illness, or preexisting condition. PMID:20974786

Libby, Russell

2010-10-25

338

Managing in the trenches of consumer care: the challenges of understanding and initiating the advance care planning process.  

PubMed

To better understand how community-based long-term care providers define advance care planning and their role in the process, we conducted 8 focus groups with 62 care managers (social workers and registered nurses) providing care for Ohio's Medicaid waiver program. Care managers shared that most consumers had little understanding of advance care planning. The care managers defined it broadly, including legal documentation, social aspects, medical considerations, ongoing communication, and consumer education. Care managers saw their roles as information providers, healthcare team members, and educators/coaches. Better education, resources, and coordination are needed to ensure that consumer preferences are realized. PMID:23078607

Baughman, Kristin R; Aultman, Julie; Hazelett, Susan; Palmisano, Barbara; O'Neill, Anne; Ludwick, Ruth; Sanders, Margaret

2012-01-01

339

Providing free maternal health care: ten lessons from an evaluation of the national delivery exemption policy in Ghana  

PubMed Central

Background There is a growing movement, globally and in the Africa region, to reduce financial barriers to health care generally, but with particular emphasis on high priority services and vulnerable groups. Objective This article reports on the experience of implementing a national policy to exempt women from paying for delivery care in public, mission and private health facilities in Ghana. Design Using data from a complex evaluation which was carried out in 20052006, lessons are drawn which can inform other countries starting or planning to implement similar service-based exemption policies. Results On the positive side, the experience of Ghana suggests that delivery exemptions can be effective and cost-effective, and that despite being universal in application, they can benefit the poor. However, certain negative lessons are also drawn from the Ghana case study, particularly on the need for adequate funding, and for strong institutional ownership. It is also important to monitor the financial transfers which reach households, to ensure that providers are passing on benefits in full, while being adequately reimbursed themselves for their loss of revenue. Careful consideration should also be given to staff motivation and the role of different providers, as well as quality of care constraints, when designing the exemptions policy. All of this should be supported by a proactive approach to monitoring and evaluation. Conclusion The recent movement towards making delivery care free to all women is a bold and timely action which is supported by evidence from within and beyond Ghana. However, the potential for this to translate into reduced mortality for mothers and babies fundamentally depends on the effectiveness of its implementation.

Witter, Sophie; Adjei, Sam; Armar-Klemesu, Margaret; Graham, Wendy

2009-01-01

340

Do US Emergency Medicine Residency Programs Provide Adequate Training for Bioterrorism?  

Microsoft Academic Search

Currently, there is no standardized curriculum for training of emergency physicians about the health hazards related to weapons of mass destruction. Opportunities for the widespread teaching of this material have remained limited, and the range of knowledge regarding even general disaster medical care is also variable among most residency training programs in the United States. We developed a survey to

Nicki Pesik; Mark Keim; Tomoko Rie Sampson

1999-01-01

341

Are single species toxicity tests alone adequate for estimating environmental hazard?  

Microsoft Academic Search

Most biologists agree that at each succeeding level of biological organization new properties appear that would not have been evident even by the most intense and careful examination of lower levels of organization. These levels might be crudely characterized as subcellular, cellular, organ, organism, population, multispecies, community, and ecosystem. The field of ecology developed because even the most meticulous study

1983-01-01

342

Are single species toxicity tests alone adequate for estimating environmental hazard?  

Microsoft Academic Search

Most biologists agree that at each succeeding level of biological organization new properties appear that would not have been evident by even the most intense and careful examination of lower levels of organization. These levels might be crudely characterized as subcellular, cellular, organ, organism, population, multispecies, community, and ecosystem. The field of ecology developed because even the most meticulous study

1984-01-01

343

21 CFR 314.126 - Adequate and well-controlled studies.  

Code of Federal Regulations, 2013 CFR

...claims of effectiveness. Such studies carefully conducted and documented...support of well-controlled studies regarding efficacy and may...safety of the test drug. Such studies will be considered on their...subjects with controls. Isolated case reports, random...

2013-04-01

344

AHRQ (Agency for Healthcare Research and Quality) Tools for Managed Care. Research in Action Issue 11.  

National Technical Information Service (NTIS)

Managed care organizations (MCOs) are responsible for ensuring that persons enrolled in their plans receive quality health care. In addition, MCOs publicly funded through the Medicare and Medicaid programs are required by State and Federal governments to ...

2003-01-01

345

Ensuring Safe Exploration: Ares Launch Vehicle Integrated Vehicle Ground Vibration Testing.  

National Technical Information Service (NTIS)

Integrated vehicle ground vibration testing (IVGVT) will be a vital component for ensuring the safety of NASA's next generation of exploration vehicles to send human beings to the Moon and beyond. A ground vibration test (GVT) measures the fundamental dyn...

D. J. Chenevert M. L. Tuma

2010-01-01

346

OSHA's Voluntary Protection Programs: Improved Oversight and Controls Would Better Ensure Program Quality.  

National Technical Information Service (NTIS)

The Department of Labor's Occupational Safety and Health Administration (OSHA) is responsible for ensuring workplace safety. OSHA has established a number of programs, including the Voluntary Protection Programs (VPP), that take a cooperative approach to ...

2009-01-01

347

FDA Safe Use Initiative: invitation to help ensure the save use ...  

Center for Drug Evaluation (CDER)

Text Version... We at FDA's Safe Use Initiative are asking for your help in ensuring the safe use and disposal of fentanyl transdermal system patches (Duragesic ... More results from www.fda.gov/downloads/drugs/drugsafety

348

Time To Care: Redesigning Child Care To Promote Education, Support Families, and Build Communities.  

ERIC Educational Resources Information Center

Refuting the widely held belief that the child care crisis in America is irresolvableor that it can be resolved by simply relying on market forcesthis book presents an alternative vision for ensuring that American families with children will have access to high-quality, affordable child care, shifting the perception of the issue as primarily one

Lombardi, Joan

349

Time To Care: Redesigning Child Care To Promote Education, Support Families, and Build Communities.  

ERIC Educational Resources Information Center

|Refuting the widely held belief that the child care crisis in America is irresolvableor that it can be resolved by simply relying on market forcesthis book presents an alternative vision for ensuring that American families with children will have access to high-quality, affordable child care, shifting the perception of the issue as primarily one

Lombardi, Joan

350

Persistence of energy savings: What do we know and how can it be ensured  

SciTech Connect

This paper presents a conceptual framework for analyzing persistence of energy savings, summarizes the limited experience of what we know about persistence, provides guidance for conducting retrospective and prospective persistence studies, and suggests strategies for ensuring persistence. Because this area of research is in its infancy, unequivocal conclusions about persistence would be premature. Accordingly, this paper provides guidance for both conducting research in this area and developing policies and mechanisms to help ensure the persistence of energy savings.

Vine, E.

1992-05-01

351

Persistence of energy savings: What do we know and how can it be ensured?  

SciTech Connect

This paper presents a conceptual framework for analyzing persistence of energy savings, summarizes the limited experience of what we know about persistence, provides guidance for conducting retrospective and prospective persistence studies, and suggests strategies for ensuring persistence. Because this area of research is in its infancy, unequivocal conclusions about persistence would be premature. Accordingly, this paper provides guidance for both conducting research in this area and developing policies and mechanisms to help ensure the persistence of energy savings.

Vine, E.

1992-05-01

352

Do measures commonly used in body image research perform adequately with African American college women?  

PubMed

This study examines reliability and validity estimates for 3 widely used measures in body image research in a sample of African American college women (N = 278). Internal consistency estimates were adequate (? coefficients above .70) for all measures, and evidence of convergent and discriminant validity was found. Confirmatory factor analyses failed to replicate the hypothesized factor structures of these measures. Exploratory factor analyses indicated that 4 factors found for the Sociocultural Attitudes Toward Appearance Questionnaire were similar to the hypothesized subscales, with fewer items. The factors found for the Multidimensional Body-Self Relations Questionnaire-Appearance Scales and the Body Dissatisfaction subscale of the Eating Disorders Inventory-3 were not similar to the subscales developed by the scale authors. Validity and reliability evidence is discussed for the new factors. PMID:23731233

Kashubeck-West, Susan; Coker, Angela D; Awad, Germine H; Stinson, Rebecca D; Bledman, Rashanta; Mintz, Laurie

2013-06-03

353

A new model of active avoidance conditioning adequate for pharmacological studies.  

PubMed

A model of rapid learning (active avoidance conditioning), using rats, is described which induces retention depending on the number of trials to which the animals are submitted. For 3 trials (double stimulation) adequately spaced, the memory trace lasts for 48 hr, whilst 6 trails induce a trace for 10 days. One single application of the double stimulation does not give any apparent retention in normal rats for 24 hr. This experimental fact is used to study and screen the activity of substances on the learning process. Animals treated with piracetam, pemoline, methamphetamin, strychnine, pyritinol and meclofenoxate before this single trial, display evidence of retention 24 hr later. Other substances, with known clinical CNS activites, eg, tranquillizers, analgesics, etc... show no positive effect on the mnesic trace. PMID:999398

Greindl, M G; Preat, S

1976-09-01

354

Adequate vitamin D status and adiposity contribute to bone health in peripubertal nonobese children.  

PubMed

The dietary reference intake (DRI) of vitamin D for Korean children was reduced from 400 IU/day in 2005 to 200 IU/day in 2010. We evaluated the risk factors for low 25-hydroxyvitamin D [25(OH)D] status and its relationships with bone health in peripubertal nonobese children living in Seoul or Gyeonggi-do. One hundred children (9.3 1.9 years, 71 prepubertal, 45 boys) participated in the winter (n = 38, December through March) and summer (June through September). Bone mineral content (Z_BMC), fat mass (Z_FM), lean mass (Z_LM), and bone mineral density for the total body (Z_TB) and lumbar spine (Z_L1-4) were measured using dual-energy X-ray absorptiometry. Twenty-nine percent of children (47.4 % in winter, 17.7 % in summer) were vitamin D deficient (25(OH)D level of <20 ng/mL). The winter season (P = 0.008) and low vitamin D intake (P = 0.044) were associated with low 25(OH)D level. The 25(OH)D level correlated positively with Z_BMC (P = 0.040), Z_TB (P = 0.027), and Z_L1-4 (P = 0.045) independently of sex, puberty, Z_FM, Z_LM, physical activity level, and calcium intake. Z_FM correlated independently with Z_BMC (P < 0.001), Z_TB (P = 0.037), and Z_L1-4 (P < 0.001). In conclusion, almost half of peripubertal nonobese children were vitamin D deficient in winter. Adequate vitamin D status and adiposity contributed to good bone health in nonobese children. Considering the beneficial effects of adequate vitamin D status on bone health, the current DRI may be insufficient for preventing vitamin D deficiency in winter among Korean children. PMID:23371560

Lee, Young Ah; Kim, Ji Young; Kang, Min Jae; Chung, Seung Joon; Shin, Choong Ho; Yang, Sei Won

2013-01-31

355

Metabolic effects of oral contraceptives in monkeys fed adequate protein & low proein diets.  

PubMed

The effects of 2 oral contraceptives, Ovulen and Norlestrin, were studied in monkeys fed adequate protein and low protein diets. The experiment was carried out in parts. In the first one, the administration of contraceptives was cyclic and similar to that employed in human subjects. In the other experiments, the contraceptives were given continuously and an attempt was made to exaggerate the deleterious effects of the oral contraceptive on the liver by including small doses of a known hepatotoxic agent, aflatoxin (AT). In Experiment 1, 45 female monkeys were divided into 2 groups of 20 and 25 and received an adequate protein (16%) and low protein diet (4%) respectively. Each monkey was fed 1/5 of a tablet of Ovulen or Norlestrin orally for 3 weeks, and then administration was discontinued for 1 week. In Experiment 2, 35 female monkeys were divided into 7 groups of 5 each. All the animals recieved 4% protein diet. 5 groups were tube fed at the rate of 100 cal/kg body weight, while 2 groups were given diet ad libitum. Group I received the diet alone while groups II-V received 10 mcg AT, 25 mcg AT, 10 mcg AT plus 1/5 Ovulen tablets, and 25 mcg AT plus 1/5 Ovulen tablet respectively daily. Groups VI and VII received the diet ad libitum but were orally fed 75 mcg AT and 75 mcg AT plus 1/5 Ovulen tablet respectively. Serum glutamic-oxalacetic transaminase activity and alkaline phosphatase activity were studied at regular intervals after the administation of oral contraceptives in the experiments. Serum proteins and hemoglobin were also determined. Monkeys fed oral contraceptives showed increased serum glutamic-oxalacetic transaminase and alkaline phosphatase activities irrespective of the level of protein in the diet. Livers of animals receiving oral contraceptives were morphologically similar to the controls fed respective diets. The experiments were conducted for a period of almost 2 years. PMID:4205142

Belavady, B; Krishnamurthi, D; Mohiuddin, S M; Rao, P U

1973-01-01

356

When one is not enough: prevalence and characteristics of homes not adequately protected by smoke alarms  

PubMed Central

Objective: The National Fire Protection Association (NFPA) has specific recommendations about the number, location, and type of smoke alarms that are needed to provide maximum protection for a household. No previous studies have examined whether or not homes are completely protected according to these guidelines. The authors describe the prevalence and home characteristics associated with compliance to recommendations for smoke alarm installation by the NFPA. Design, setting, and subjects: Data are from the baseline on-site survey of a randomized trial to measure smoke alarm effectiveness. The trial was housed in a longitudinal cohort study in a rural Iowa county. Of 1005 homes invited, 691 (68.8%) participated. Main outcome measures: Information about smoke alarm type, placement, and function, as well as home and occupant characteristics, was collected through an on-site household survey. Results: Although 86.0% of homes had at least one smoke alarm, only 22.3% of homes (approximately one in five) were adequately protected according to NFPA guidelines. Fourteen percent of homes had no functioning smoke alarms. More than half of the homes with smoke alarms did not have enough of them or had installed them incorrectly, and 42.4% of homes with alarms had at least one alarm that did not operate. Homes with at least one high school graduate were nearly four times more likely to be fully protected. Homes that had multiple levels, a basement, or were cluttered or poorly cleaned were significantly less likely to be fully protected. Conclusion: These findings indicate that consumers may not be knowledgeable about the number of alarms they need or how to properly install them. Occupants are also not adequately maintaining the alarms that are installed.

Peek-Asa, C; Allareddy, V; Yang, J; Taylor, C; Lundell, J; Zwerling, C

2005-01-01

357

Intensive care unit delirium.  

PubMed

Once considered a benign iatrogenic consequence of intensive care unit (ICU) admission, ICU delirium is now recognized as a prominent disorder that negatively affects patient morbidity and mortality. The primary goal in the detection and treatment of ICU delirium is to ensure the safety of the patient and caregiver(s). Most critically ill patients possess 1 or more risk factors for the development of delirium; therefore, interventions that target delirium assessment and prevention are essential. This article highlights some of the recent data that have emerged regarding ICU delirium, including its definition, incidence, risk factors, diagnostic tools, and treatment. PMID:20541065

Bruno, Jeffrey J; Warren, Mary Lou

2010-06-01

358

Does Group Prenatal Care Affect Satisfaction And Prenatal Care Utilization in Iranian Pregnant Women?  

PubMed Central

Background: The need to provide high quality prenatal care services, which take account of womens views and specifically address their need for information, support and communication, has been advocated and group prenatal care, had been suggested as one of the ways to achieve this objective. The purpose of this study was to examine the impact of group versus individual prenatal care on satisfaction and prenatal care use. Methods: This was a cluster-randomized controlled trial with the health center as the randomization unit that conducted in 2007. Satisfaction was measured through a standardized questionnaire, and the Kotelchuck Adequacy of Prenatal Care Utilization Index was used to measure prenatal care utilization. Results: We recruited 678 women (group prenatal care, (N= 344) and individual prenatal care, (N=334) in the study. Women in group prenatal care model were more satisfied than women in individual prenatal care model in all areas evaluated, including information, communication, co-ordination and quality of care. Group care women were significantly more likely to have adequate prenatal care than individual care women were (OR=1.35 95% CI=1.261.44). Conclusions: Group prenatal care was associated with a significant improvement in client satisfaction and prenatal care utilization. This model of care has implications for the planning and provision of prenatal services within public health system, which is moving toward a better quality health care, and increasing use of services.

Jafari, F; Eftekhar, H; Mohammad, K; Fotouhi, A

2010-01-01

359

Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care  

PubMed Central

Introduction Primary care has a central role in integrating care within a health system. However, conceptual ambiguity regarding integrated care hampers a systematic understanding. This paper proposes a conceptual framework that combines the concepts of primary care and integrated care, in order to understand the complexity of integrated care. Methods The search method involved a combination of electronic database searches, hand searches of reference lists (snowball method) and contacting researchers in the field. The process of synthesizing the literature was iterative, to relate the concepts of primary care and integrated care. First, we identified the general principles of primary care and integrated care. Second, we connected the dimensions of integrated care and the principles of primary care. Finally, to improve content validity we held several meetings with researchers in the field to develop and refine our conceptual framework. Results The conceptual framework combines the functions of primary care with the dimensions of integrated care. Person-focused and population-based care serve as guiding principles for achieving integration across the care continuum. Integration plays complementary roles on the micro (clinical integration), meso (professional and organisational integration) and macro (system integration) level. Functional and normative integration ensure connectivity between the levels. Discussion The presented conceptual framework is a first step to achieve a better understanding of the inter-relationships among the dimensions of integrated care from a primary care perspective.

Valentijn, Pim P.; Schepman, Sanneke M.; Opheij, Wilfrid; Bruijnzeels, Marc A.

2013-01-01

360

Deliberate Self-Harm Patients Who Discharge Themselves from the General Hospital Without Adequate Psychosocial Assessment  

Microsoft Academic Search

Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more

Rachel Crowder; Rohan Van Der Putt; Ceri-Anne Ashby; Andrew Blewett

2004-01-01

361

Are the News Media Providing Adequate Information about Medical Computing? A Panel Discussion  

PubMed Central

In theory, the news media covering medical computing discover and report in a timely and accurate manner every significant new development in the application of information technology to health care. In practice, news coverage falls short of the theoretical ideal. What are the systematic factors that limit the scope and depth of coverage of new developments by the media? What are realistic expectations of what the media can do?

Heffernan, Henry G.; Golin, Milton; Grams, Ralph R.; Nathanson, Michael

1983-01-01

362

Palliative Care in Children With Cancer: Which Child and When?  

Microsoft Academic Search

At a time of increasing interest in palliative care in pediat- rics, pediatric oncology programs may be failing to deliver adequate palliation to children with cancer. In a recent study, parents of children who died on a pediatric oncology service reported that despite treatment at the end of life, their children's suffering was not adequately relieved and that parents were

Michael B. Harris

2004-01-01

363

Barriers to Prenatal Care for Mexican and Mexican American Women  

Microsoft Academic Search

Despite the presumed health benefits, Latinas are less likely than women from other ethnic groups to receive adequate prenatal care during their pregnancy. However, it is unclear whether this trend is the result of political economic conditions that limit access of many Latinos in the United States to adequate health services in general, or of sociocultural conditions that restrict the

Ippolytos Kalofonos; Lawrence A. Palinkas

1999-01-01

364

Challenging Australia's "closed" model of neonatal care: the need for reform following Re baby D (No 2).  

PubMed

The withdrawal or withholding of life-sustaining treatment to compromised newborns is a subject of controversy in countries where there is now highly advanced neonatal care to keep such newborns alive. The topic has generated comparatively less debate in Australia, where case law is sparse and parents and clinicians themselves make decisions regarding the cessation of care, largely free from extemal oversight. The recent case of Re Baby D (No 2) [2011] FamCA 176 endorses this "closed" approach to neonatal decision-making. This article critically discusses some of its implications and makes suggestions for reform to ensure meaningful oversight of decisions to withdraw or withhold treatment. The authors argue that the judgment fails to address some fundamental issues, such as ensuring that those with the responsibility to make decisions are doing so on a "best interests" basis. This is important because, in a society where disability remains stigmatised and poorly understood, there is no opportunity under the approach adopted in Baby D to guarantee adequate protection of the rights of individuals born with physical or intellectual impairments. PMID:22908623

Williams, Michael; Chesterman, John; Grano, Philip

2012-06-01

365

Process utility from providing informal care: the benefit of caring.  

PubMed

Though economics is usually outcome-oriented, it is often argued that processes matter as well. Utility is not only derived from outcomes, but also from the way this outcome is accomplished. Providing care on a voluntary basis may especially be associated with such process utility. In this paper, we discuss the process utility from providing informal care. We test the hypothesis that informal caregivers derive utility not only from the outcome of informal care, i.e. that the patient is adequately cared for, but also from the process of providing informal care. We present empirical evidence of process utility on the basis of a large sample of Dutch caregivers (n=950). We measure process utility as the difference in happiness between the current situation in which the care recipient is cared for by the caregiver and the hypothetical situation that someone else takes over the care tasks, all other things equal. Other background characteristics on patient and caregiver characteristics, objective and subjective caregiver burden and quality of life are also presented and related to process utility. Our results show that process utility exists and is substantial and therefore important in the context of informal care. Almost half of the caregivers (48.2%) derive positive utility from informal care and on average happiness would decline if informal care tasks were handed over to someone else. Multivariate regression analysis shows that process utility especially relates to caregiver characteristics (age, gender, general happiness, relation to patient and difficulties in performing daily activities) and subjective caregiver burden, whereas it also depends on the number of hours of care provided (objective burden). These results strengthen the idea of supporting the use of informal care, but also that of keeping a close eye on the position of carers. PMID:16098415

Brouwer, Werner B F; van Exel, N Job A; van den Berg, Bernard; van den Bos, Geertruidis A M; Koopmanschap, Marc A

2005-01-08

366

42 CFR 441.155 - Individual plan of care.  

Code of Federal Regulations, 2010 CFR

...plans and coordination of inpatient services with partial discharge plans and related community services to ensure continuity of care with the recipient's family, school, and community upon discharge. (c) The plan must be reviewed every...

2010-10-01

367

42 CFR 441.155 - Individual plan of care.  

Code of Federal Regulations, 2010 CFR

...plans and coordination of inpatient services with partial discharge plans and related community services to ensure continuity of care with the recipient's family, school, and community upon discharge. (c) The plan must be reviewed every...

2009-10-01

368

42 CFR 494.100 - Condition: Care at home.  

Code of Federal Regulations, 2010 CFR

...back-up dialysis services when needed. (2) The dialysis facility must maintain a recordkeeping system that ensures continuity of care and patient privacy. This includes items and services furnished by durable medical equipment (DME) suppliers...

2010-10-01

369

Patient Telephone Appointment System for High Volume Primary Care Sites.  

National Technical Information Service (NTIS)

The purpose of this research is to design a patient telephone appointment system for use in the Naval Medical Center San Diego's high volume Primary Care sites, which will reduce variation and ensure efficient, timely, convenient, and appropriate access t...

F. M. Worthington

2000-01-01

370

Task Force Report on Care for Victims of Sexual Assault.  

National Technical Information Service (NTIS)

The Department of Defense is unequivocal in its commitment to ensure that victims of sexual assault be protected, treated with dignity and respect, provided proper medical and psychological care, and that the perpetrators of such assaults be held accounta...

2004-01-01

371

Coercion and compulsion in community mental health care.  

PubMed

There is ongoing debate in the UK as to the place of coercion and compulsion in community mental health care. Recent changes in service provision and amendments to the Mental Health Act in England and Wales have increased the scope for compulsion in the community. This has intensified the debate revealing fault lines in the psychiatric and legal professions. Despite powerful arguments from all sides there is little empirical evidence to inform this debate at a clinical or a theoretical level. This review utilizes evidence from articles in peer reviewed journals. Papers were identified from electronic databases, the authors' databases of relevant literature and personal correspondence with experts in the field. The evidence base is relatively small but is expanding. It has been demonstrated that informal coercion is common in USA mental health services and can be experienced negatively by patients. There is evidence that powers of compulsion in community mental health care are used frequently when available and their availability is generally seen as positive by clinicians when practice becomes embedded. The evidence for the effectiveness of compulsion in community mental health care is patchy and conflicting, with randomized or other trials failing to show significant benefits overall even if secondary analyses may suggest positive outcomes in some subgroups. There are widespread regional and international differences in the use of community compulsion. Research examining treatment pressures (or 'leverage') and the subjective patient experience of them appears to be expanding and is increasing our awareness and understanding of these complex issues. There is an urgent need for evidence regarding the usefulness and acceptability of compulsion in the community now that powers have been made available. Trials of the effectiveness of compulsion are needed as is qualitative work examining the experiences of those involved in the use of such orders. These are needed to help clinicians utilize the powers available to them in an informed and judicious fashion and to ensure adequate training. PMID:20501486

Molodynski, Andrew; Rugksa, Jorun; Burns, Tom

2010-05-25

372

Model of Chronic Care Enabled with Information Technology  

Microsoft Academic Search

The increase in prevalence of chronic disorders in modern societies has resulted in increasing organizational and financial\\u000a pressure on healthcare systems. The challenge of adequate care delivered to patients with chronic conditions, who want to\\u000a remain in their social context, promotes the search for effective models of care. Adequate use of information and communication\\u000a technology may be an appropriate response

Mariusz Duplaga; Ole Martin Winnem

373

Can the ASAR Global Monitoring Mode Product Adequately Capture Spatial Soil Moisture Variability?  

NASA Astrophysics Data System (ADS)

Global soil moisture (SM) monitoring in the past several decades has been undertaken mainly at coarse spatial resolution, which is not adequate for addressing small-scale phenomena and processes. The currently operational Advanced Microwave Scanning Radiometer (NASA) and future planned missions such as the Soil Moisture and Ocean Salinity (ESA) and the Soil Moisture Active Passive (NASA) will remain resolution limited. Finer scale soil moisture estimates can be achieved either by down-scaling the available coarse resolution radiometer and scatterometer (i.e. ERS1/2, ASCAT) observations or by using high resolution active microwave SAR type systems (typical resolution is in the order of meters). Considering the complex land surface - backscatter signal interaction, soil moisture inversion utilizing active microwave observations is difficult and generally needs supplementary data. Algorithms based on temporal change detection offer an alternative less complex approach for deriving (and disaggregating coarse) soil moisture estimates. Frequent monitoring and low frequency range along with a high pixel resolution are essential preconditions when characterizing spatial and temporal soil moisture variability. An alternative active system that meets these requirements is the Advance Synthetic Aperture Radar (ASAR) on ENVISAT [C-band, global, 1 km in Global Monitoring (GM) Mode]. The Vienna University of Technology (TU Wien) has developed a 1 km soil moisture product using the temporal change detection approach and the ASAR GM. The TU Wien SM product sensitivity was evaluated at two scales: point (using in situ data from permanent soil moisture stations) and regional [using ground measured data and aircraft estimates derived from the Polarimetric L-band Microwave Radiometer (PLMR)] over the National Airborne Field Experiment (NAFE'05) area located in the Goulburn catchment, SE Australia. The month long (November 2005) campaign was undertaken in a region predominantly covered by grasslands and partly by forests and croplands. Point scale analysis revealed high ASAR sensitivity and adequate response to changes in moisture conditions (R = 0.69 and RMSE = 0.08 v/v). Regional analysis was performed at several different spatial resolutions (1 km to 25 km). ASAR exhibited high noise level and significant wet bias. Increase in pixel size resulted in improving R and RMSE from R = 0.59 and RMSE = 0.14 to R = 0.91 and RMSE = 0.05 at 1 km and 25 km respectively; however, despite the reasonable statistical agreement at 1 km, the soil moisture spatial patterns clearly visible in the PLMR images, the later were verified with ground data, were lacking in the ASAR product.

Mladenova, I.; Lakshmi, V.; Walker, J.; Panciera, R.; Wagner, W.; Doubkova, M.

2008-12-01

374

Health care in Moscow.  

PubMed Central

In the Russian Federation privatisation is affecting the health care sector as much as it is industry and commerce. That the general public support the transfer of state clinics to the private sector is a mark of their dissatisfaction with the old state run system. Doctors too see better opportunities to practise good medicine and be paid better for doing so. In Moscow the health department has set up a commission to license all clinics providing treatment, which should ensure standards of safety, training, and equipment. The Russian Federation is also trying to establish a medical insurance system to cover its citizens for health care, but in Moscow and elsewhere its implementation has been delayed by arguments and bureaucracy. In the meantime the health of Muscovites remains poor, with a high incidence of birth defects, and illnesses among the young. Images p783-a

Ryan, M

1993-01-01

375

[Experiences of caring for patients with lymphedema and dementia].  

PubMed

Recently, the importance of prevention and care of lymphedema patients has been recognized. To improve edema reduction and skin condition, continued care is necessary. However, everyday care requires time and effort, and patients may neglect the required routine. Therefore, it is necessary for patients to recognize the importance of lymphedema and acquire the knowledge and skills to care for their condition. In the case of patients with dementia, it is important to ensure 1) comfortable care for the patients, 2) flexibility of care according to the physical and mental state of the patients, and 3) education of visiting home care staff. PMID:23268922

Yokoyama, Akiko; Yokoyama, Kenzo; Matsumoto, Kazuyo; Kubota, Yuko

2012-12-01

376

A MATURITY MODEL FOR THE INTERNATIONALIZATION OF CUSTOMER CARE IN THE AUTOMOTIVE INDUSTRY  

Microsoft Academic Search

In the context of customer relationship management, customer care management takes the role of dealing with customer requests as well as complaints. Organizations have to ensure that service quality in customer care centers meets the customers' expectations to ensure customer satisfaction. The maturity model developed in this paper aims to support a global automotive manufacturer in his activities to identify

Bernhard Schindlholzer; Lukas Gysi; Michael Klaas; Walter Brenner

377

Centralized assessment of early developmental delays in children in foster care: A program that works  

Microsoft Academic Search

While children in out-of-home care are disproportionately at risk for early developmental delays, historically, child welfare systems have poor track records of ensuring that children entering care are assessed for developmental delays and, where necessary, are referred for and linked with appropriate early intervention services. Recent studies have demonstrated that programs of comprehensive assessment, or those that ensure that all

Christina M. Bruhn; Denise Duval; Richard Louderman

2008-01-01

378

Factors contributing to antenatal care and delivery practices in village development committees of ilam district, Nepal.  

PubMed

Background Proper antenatal care and good delivery practice helps to prevent the complications of childbirth and ensures a wholesome maternal and child health in the future. Almost half of the births in the developing countries take place without a skilled birth attendant. Objectives To assess the antenatal care (ANC) and delivery practices in the Village Development Committees (VDC) of Ilam district, Nepal and to identify the relationship with the socio-demographic factors. Method Cross sectional study of 262 mothers of reproductive age group having at least one child of less than five years of age, selected by simple random sampling, was carried out over different VDCs of Ilam by face to face interview using semi-structured questionnaire. Results Among 262 mothers, 34.7% were married before the age of 18 years. 69.5% of the mothers had attended four antenatal care visits. Nearly 47% of the deliveries were conducted at home out of which only 33.6% were conducted by skilled birth attendant. Number of children and maternal education were found to significantly affect the ANC visit and place of delivery. Age at marriage and age at first pregnancy were significantly associated with the place of delivery. Conclusion Large proportion of mothers still do not have adequate antenatal visits and this is supported by the fact that nearly half of the deliveries were conducted at home. Motivation and incentives are required for pregnant mothers especially in rural areas regarding importance of adequate antenatal visits and delivery in health institutions. Population policies should be aimed at reducing proportion of women marrying and giving birth in their teens. PMID:23774416

Pradhan, Pm S; Bhattarai, S; Paudel, I S; Gaurav, K; Pokharel, P K

379

Quantification of gold nanoparticle cell uptake under controlled biological conditions and adequate resolution.  

PubMed

Aim: We examined cellular uptake mechanisms of fluorescently labeled polymer-coated gold nanoparticles (NPs) under different biological conditions by two quantitative, microscopic approaches. Materials & methods: Uptake mechanisms were evaluated using endocytotic inhibitors that were tested for specificity and cytotoxicity. Cellular uptake of gold NPs was analyzed either by laser scanning microscopy or transmission electron microscopy, and quantified by means of stereology using cells from the same experiment. Results: Optimal inhibitor conditions were only achieved with chlorpromazine (clathrin-mediated endocytosis) and methyl-?-cyclodextrin (caveolin-mediated endocytosis). A significant methyl-?-cyclodextrin-mediated inhibition (63-69%) and chlorpromazine-mediated increase (43-98%) of intracellular NPs was demonstrated with both imaging techniques, suggesting a predominant uptake via caveolin-medicated endocytois. Transmission electron microscopy imaging revealed more than 95% of NPs localized in intracellular vesicles and approximately 150-times more NP events/cell were detected than by laser scanning microscopy. Conclusion: We emphasize the importance of studying NP-cell interactions under controlled experimental conditions and at adequate microscopic resolution in combination with stereology. Original submitted 10 July 2012; Revised submitted 23 January 2013. PMID:23738633

Rothen-Rutishauser, Barbara; Kuhn, Dagmar A; Ali, Zulqurnain; Gasser, Michael; Amin, Faheem; Parak, Wolfang J; Vanhecke, Dimitri; Fink, Alke; Gehr, Peter; Brandenberger, Christina

2013-06-01

380

Are image quality metrics adequate to evaluate the quality of geometric objects?  

NASA Astrophysics Data System (ADS)

Geometric objects are often represented by many millions of triangles or polygons, which limits the ease with which they can be transmitted and displayed electronically. This has lead to the development of many algorithms for simplifying geometric models, and to the recognition that metrics are required to evaluate their success. The goal is to create computer graphic renderings of the object that do not appear to be degraded to a human observer. The perceptual evaluation of simplified objects is a new topic. One approach has been to sue image-based metrics to predict the perceived degradation of simplified 3D models. Since that 2D images of 3D objects can have significantly different perceived quality, depending on the direction of the illumination, 2D measures of image quality may not adequately capture the perceived quality of 3D objects. To address this question, we conducted experiments in which we explicitly compared the perceived quality of animated 3D objects and their corresponding 2D still image projections. Our results suggest that 2D judgements do not provide a good predictor of 3D image quality, and identify a need to develop 'object quality metrics.'

Rogowitz, Bernice E.; Rushmeier, Holly E.

2001-06-01

381

Hydrological functional unit identification - linking observables and concepts towards a minimal adequate catchment representation  

NASA Astrophysics Data System (ADS)

Understanding catchment structures and properties as most probable result of past work during their evolution under the continuous depletion of gradients opens a connection of landscape properties to dominating processes. While a qualitative description from the expert's perspective can comprehend most of these; a distinct objective delineation into functional units, their topology and their connectivity appears far more problematic as a) spatio-temporal scale, b) degrees of freedom and c) aspects of self-organisation have to be brought in accordance. Our study highlights several conceptual approaches aiming to link hydrological landscape understanding, observation and modelling. Moreover, a GIS-based case study for the Attert basin is presented, which shows that from a multitude of possible class combinations, already very few cover the vast majority of the catchment. Consequently, dominating processes, prevailing topologies, most insightful data demands and possible non ad hoc model representations are outlined. The result is a step towards a minimal adequate catchment representation. To base this on physical descriptions with truly observable parameters, we further revise most insightful data for functional unit identification and observation and if and how it can be derived in the landscape and from products available.

Jackisch, C.

2012-04-01

382

PG medical training and accreditation: responsibility of the government for the adequate health service delivery.  

PubMed

On one hand there is obvious inadequate health coverage to the rural population and on the other hand the densely populated urban area is facing the triple burden of increasing non-communicable and communicable health problems and the rising health cost. The postgraduate medical training is closely interrelated with the adequate health service delivery and health economics. In relation to the prevailing situation, the modern medical education trend indicates the five vital issues. These are i). Opportunity needs to be given to all MBBS graduates for General Specialist and Sub-Specialist Training inside the country to complete their medical education, ii). Urgent need for review of PG residential training criteria including appropriate bed and teacher criteria as well as entry criteria and eligibility criteria, iii). Involvement of all available units of hospitals fulfilling the requirements of the residential PG training criteria, iv). PG residential trainings involve doing the required work in the hospitals entitling them full pay and continuation of the service without any training fee or tuition fee, and v). Planning of the proportions of General Specialty and Sub-Specialty Training fields, particularly General Practice (GP) including its career and female participation. With increased number of medical graduates, now it seems possible to plan for optimal health coverage to the populations with appropriate postgraduate medical training. The medical professionals and public health workers must make the Government aware of the vital responsibility and the holistic approach required. PMID:24047029

Bhattarai, M D

2012-09-01

383

Exploring workplace violence among home care workers in a consumer-driven home health care program.  

PubMed

Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed. [Workplace Health Saf 2013;61(10):441-450.]. PMID:24053217

Nakaishi, Lindsay; Moss, Helen; Weinstein, Marc; Perrin, Nancy; Rose, Linda; Anger, W Kent; Hanson, Ginger C; Christian, Mervyn; Glass, Nancy

2013-09-23

384

The Evaluation of the National Long Term Care Demonstration: Final Report. Executive Summary.  

ERIC Educational Resources Information Center

|This report describes the evaluation of the National Long-Term Care (Channeling) Demonstration, a rigorous test of comprehensive case management of community care as a way of containing long-term care costs for the impaired elderly while providing adequate care to those in need. The evaluation process is presented as an experimental design with

Mathematica Policy Research, Inc., Plainsboro, NJ.

385

Navigating an Educational Program through the Treacherous 90s: Dynamics of the Health Care System.  

ERIC Educational Resources Information Center

Health care system changes since 1965 are reviewed. Areas in which hospital dental care can contribute to improved dental services are discussed, including the promotion of dentistry as primary care, progress in obtaining adequate reimbursement for oral health care, integration with other health professions, and improvement of credentialing and

Van Ostenburg, Paul

1991-01-01

386

Outcomes of a quality improvement project integrating mental health into primary care  

Microsoft Academic Search

Objective: Depression is commonly seen, but infrequently adequately treated, in primary care clinics. Improving access to depression care in primary care clinics has improved outcomes in clinical trials; however, these interventions are largely unstudied in clinical settings. This study examined the effectiveness of a quality improvement project improving access to mental healthcare in a large primary care clinic.Methods: A beforeafter

Bradley V Watts; Brian Shiner; Andrew Pomerantz; Patricia Stender

2007-01-01

387

Glucksberg, the putative right to adequate pain relief, and death with dignity.  

PubMed

This Article focuses on the legality of the aggressive use of analgesics and deep sedation for terminally ill patients. The author analyzes the 1997 Supreme Court decisions on physician-assisted suicide, examines the tension between controversial palliative care practices and the traditional legal framework, and explores the contours of an emerging constitutional right to avoid suffering at the end of life. In addition, the author argues that deep sedation together with withholding of artificial nutrition and hydration should be an option for dying patients suffering from severe physical or emotional pain. PMID:11571891

Cantor, N L

2001-01-01

388

Ensuring the Security and Availability of a Hospital Wireless LAN System.  

PubMed

Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. Herein we discuss security countermeasures that must be taken and issues concerning availability that must be considered to ensure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at a university hospital. Security countermeasures differ according to their purpose, such as preventing illegal use or ensuring availability, both of which are discussed. The main focus of the availability discussion is on signal reach, electromagnetic noise elimination, and maintaining power supply to the network apparatus. It is our hope that this information will assist others in their efforts to ensure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety. PMID:23920537

Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku

2013-01-01

389

Pain management in neurocritical care.  

PubMed

The core challenge of pain management in neurocritical care is to keep the patient comfortable without masking or overlooking any neurological deterioration. Clearly in patients with a neurological problem there is a conflict of clinical judgement and adequate pain relief. Here we review the presentation, assessment, and development of pain in the clinical spectrum of patients with associated neurological problems seen in a general intensive care setting. Many conditions predispose to the development of chronic pain. There is evidence that swift and targeted pain management may improve the outcome. Importantly pain management is multidisciplinary. The available non-invasive, pharmacological, and invasive treatment strategies are discussed. PMID:23893074

Petzold, Axel; Girbes, Armand

2013-10-01

390

Navy Joint Acquisition Program Managers: Is Their Training Adequate for the Job They are Tasked to Do.  

National Technical Information Service (NTIS)

This study investigated the question of whether the training Navy joint program managers receive adequately prepares them for the unique problems associated with joint acquisition programs. Literature was reviewed to determine the common problems confront...

R. H. Rhea

1989-01-01

391

End-of-Life Care in the Intensive Care Unit  

PubMed Central

The incidence and costs of critical illness are increasing in the United States at a time when there is a focus both on limiting the rising costs of healthcare and improving the quality of end-of-life care. More than 25% of healthcare costs are spent in the last year of life, and approximately 20% of deaths occur in the intensive care unit (ICU). Consequently, there has been speculation that end-of-life care in the ICU represents an important target for cost savings. It is unclear whether efforts to improve end-of-life care in the ICU could significantly reduce healthcare costs. Here, we summarize recent studies suggesting that important opportunities may exist to improve quality and reduce costs through two mechanisms: advance care planning for patients with life-limiting illness and use of time-limited trials of ICU care for critically ill patients. The goal of these approaches is to ensure patients receive the intensity of care that they would choose at the end of life, given the opportunity to make an informed decision. Although these mechanisms hold promise for increasing quality and reducing costs, there are few clearly described, effective methods to implement these mechanisms in routine clinical practice. We believe basic science in communication and decision making, implementation research, and demonstration projects are critically important if we are to translate these approaches into practice and, in so doing, provide high-quality and patient-centered care while limiting rising healthcare costs.

Engelberg, Ruth A.; Bensink, Mark E.; Ramsey, Scott D.

2012-01-01

392

Ultrasound elicits tonic responses and diminishes the phasic responses to adequate stimuli in thread-hair mechanoreceptors of Acheta domesticus  

Microsoft Academic Search

Single mechanoreceptor cells in filiform hair sensilla on the cercus of Acheta domesticus were stimulated adequately by steplike deflections in their plane of least restraint and inadequately by ultrasound. Ultrasound was fed either into the cercus or into the thread-hair as substrate-borne sound of 110120 kHz. The receptor responds to deflections of the thread-hair (adequate stimuli) with phasic receptor potentials

J. Gdde

1983-01-01

393

Adequate antigen availability: a key issue for novel approaches to tumor vaccination and tumor immunotherapy.  

PubMed

A crucial parameter for activation of the anti-tumor immune response is an adequate antigen availability (AAA) defined here as the optimal tumor antigen dose and related antigen processing and MHC-II-restricted presentation necessary to efficiently trigger tumor-specific TH cells. We will discuss two distinct experimental systems: a) a preventive anti-tumor vaccination system; b) a therapy-induced anti-tumor vaccination approach. In the first case tumor cells are rendered constitutively MHC-II+ by transfecting them with the MHC-II transcriptional activator CIITA. Here AAA is generated by the function of tumor's newly expressed MHC-II molecules to present tumor-associated antigens to tumor-specific TH cells. In the second case, AAA is generated by treating established tumors with neovasculature-targeted TNF?. In conjuction with Melphalan, targeted TNF? delivery produces extensive areas of tumor necrosis that generate AAA capable of optimally activate tumor-specific TH cells which in turn activate CTL immune effectors. In both experimental systems tumor rejection and persistent and long-lived TH cell anti-tumor memory, responsible of defending the animals from subsequent challenges with tumor cells, are achieved. Based on these and other investigators' results we propose that AAA is a key element for triggering adaptive immune functions resulting in subversion from a pro-tumor to an anti-tumor microenvironment, tumor rejection and acquisition of anti-tumor immune memory. Hypotheses of neuro-immune networks involved in these approaches are discussed. These considerations are important also for the comprehension of how chemotherapy and/or radiation therapies may help to block and/or to eradicate the tumor and for the construction of suitable anti-tumor vaccine strategies. PMID:23224729

Accolla, Roberto S; Tosi, Giovanna

2012-12-07

394

Oxygen uptake-to-delivery relationship: a way to assess adequate flow  

PubMed Central

Invasive and noninvasive monitoring facilitates clinical evaluation when resuscitating patients with complex haemodynamic disorders. If the macrocirculation is to be stable, then it must adapt to blood flow or blood flow must be optimized. The objective of flow monitoring is to assist with matching observed oxygen consumption (VO2) to pathophysiological needs. If an adequate balance cannot be maintained then dysoxia occurs. In this review we propose a simple schema for global reasoning; we discuss the limitations of VO2 and arterial oxygen delivery (DaO2) assessment; and we address concerns about increasing DaO2 to supranormal values or targeting pre-established levels of DaO2, cardiac output, or mixed venous oxygen saturation. All of these haemodynamic variables are interrelated and limited by physiological and/or pathological processes. A unique global challenge, and one that is of great prognostic interest, is to achieve rapid matching between observed and needed VO2 no more and no less. However, measuring or calculating these two variables at the bedside remains difficult. In practice, we propose a distinction between three situations. Clinical and blood lactate clearance improvements can limit investigations in simple cases. Intermediate cases may be managed by continuous monitoring of VO2-related variables such as DaO2, cardiac output, or mixed venous oxygen saturation. In more complex cases, three methods can help to estimate the needed VO2 level: comparison with expected values from past physiological studies; analysis of the relationship between VO2 and oxygen delivery; and use of computer software to integrate the preceding two methods.

2006-01-01

395

Prioritising pharmaceuticals for environmental risk assessment: Towards adequate and feasible first-tier selection.  

PubMed

The presence of pharmaceuticals in the aquatic environment, and the concerns for negative effects on aquatic organisms, has gained increasing attention over the last years. As ecotoxicity data are lacking for most active pharmaceutical ingredients (APIs), it is important to identify strategies to prioritise APIs for ecotoxicity testing and environmental monitoring. We have used nine previously proposed prioritisation schemes, both risk- and hazard-based, to rank 582 APIs. The similarities and differences in overall ranking results and input data were compared. Moreover, we analysed how well the methods ranked seven relatively well-studied APIs. It is concluded that the hazard-based methods were more successful in correctly ranking the well-studied APIs, but the fish plasma model, which includes human pharmacological data, also showed a high success rate. The results of the analyses show that the input data availability vary significantly; some data, such as logP, are available for most API while information about environmental concentrations and bioconcentration are still scarce. The results also suggest that the exposure estimates in risk-based methods need to be improved and that the inclusion of effect measures at first-tier prioritisation might underestimate risks. It is proposed that in order to develop an adequate prioritisation scheme, improved data on exposure such as degradation and sewage treatment removal and bioconcentration ability should be further considered. The use of ATC codes may also be useful for the development of a prioritisation scheme that includes the mode of action of pharmaceuticals and, to some extent, mixture effects. PMID:22361586

Roos, V; Gunnarsson, L; Fick, J; Larsson, D G J; Rudn, C

2012-02-22

396

Defining an adequate sample of earlywood vessels for retrospective injury detection in diffuse-porous species.  

PubMed

Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding. PMID:22761707

Arbellay, Estelle; Corona, Christophe; Stoffel, Markus; Fonti, Patrick; Decaulne, Armelle

2012-06-26

397

Health care and the elderly.  

PubMed

America's health care crisis is hitting our elderly and threatens to cripple Medicare, the elderly's financial support system. Medicare was designed to ensure that every elderly American would be protected against the destruction of life savings as a result of illness. Elderly Americans would be able to enjoy their golden years without the financial burden of medical bills. Today, this vision is almost extinct. Medicare has been placed on the endangered species list. Market predictions indicate that Medicare's Hospital insurance Trust Fund will be depleted by 1988 if current trends continue. The elderly presently must pay on the average about 14% of their health care bill. In addition, Medicare pays little for long-term care; and about 45% of long-term care is paid for out-of-pocket by the elderly and their families. Alternative approaches are desperately needed of Medicare if our elderly are to survive. PMID:10311941

Eisdorfer, C

1985-01-01

398

Genetically Modified Foods: Experts View Regimen of Safety Tests as Adequate, but FDA's Evaluation Process Could Be Enhanced.  

National Technical Information Service (NTIS)

Proponents and opponents of modern agricultural biotechnology hold passionate views about the benefits and risks of using this technology to produce genetically modified (GM) food. To ensure public confidence in GM foods, the U.S. biotechnology industry r...

2002-01-01

399

40 CFR 142.306 - What are the responsibilities of the public water system, State and the Administrator in ensuring...  

Code of Federal Regulations, 2010 CFR

...the public water system, State and the Administrator in ensuring that...the public water system, State and the Administrator in ensuring that...the State or the Administrator to issue a small system variance in...

2010-07-01

400

45 CFR 264.30 - What procedures exist to ensure cooperation with the child support enforcement requirements?  

Code of Federal Regulations, 2011 CFR

...procedures exist to ensure cooperation with the child support enforcement requirements? 264...ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND...procedures exist to ensure cooperation with the child support enforcement requirements?...

2011-10-01

401

45 CFR 264.30 - What procedures exist to ensure cooperation with the child support enforcement requirements?  

Code of Federal Regulations, 2012 CFR

...procedures exist to ensure cooperation with the child support enforcement requirements? 264...ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND...procedures exist to ensure cooperation with the child support enforcement requirements?...

2012-10-01

402

45 CFR 90.43 - What specific responsibilities do agencies and recipients have to ensure compliance with the Act?  

Code of Federal Regulations, 2011 CFR

...What specific responsibilities do agencies and recipients have to ensure compliance with the Act? 90...NONDISCRIMINATION ON THE BASIS OF AGE...What specific responsibilities do agencies and recipients have to ensure compliance with the Act?...

2011-10-01

403

45 CFR 90.43 - What specific responsibilities do agencies and recipients have to ensure compliance with the Act?  

Code of Federal Regulations, 2012 CFR

...What specific responsibilities do agencies and recipients have to ensure compliance with the Act? 90...NONDISCRIMINATION ON THE BASIS OF AGE...What specific responsibilities do agencies and recipients have to ensure compliance with the Act?...

2012-10-01

404

42 CFR 457.535 - Cost-sharing protection to ensure enrollment of American Indians and Alaska Natives.  

Code of Federal Regulations, 2012 CFR

...ensure enrollment of American Indians and Alaska Natives. 457.535 Section 457...ensure enrollment of American Indians and Alaska Natives. States may not impose premiums...on children who are American Indians or Alaska Natives, as defined in §...

2012-10-01

405

30 CFR 227.500 - What functions may a State perform to ensure that reporters correct erroneous report data?  

Code of Federal Regulations, 2010 CFR

...functions may a State perform to ensure that reporters correct erroneous report data? 227...functions may a State perform to ensure that reporters correct erroneous report data...missing; (c) Contacting production reporters or royalty reporters about missing...

2009-07-01

406

30 CFR 227.500 - What functions may a State perform to ensure that reporters correct erroneous report data?  

Code of Federal Regulations, 2010 CFR

...functions may a State perform to ensure that reporters correct erroneous report data? 227...functions may a State perform to ensure that reporters correct erroneous report data...missing; (c) Contacting production reporters or royalty reporters about missing...

2010-07-01

407

30 CFR 1227.500 - What functions may a State perform to ensure that reporters correct erroneous report data?  

Code of Federal Regulations, 2013 CFR

...functions may a State perform to ensure that reporters correct erroneous report data? 1227...functions may a State perform to ensure that reporters correct erroneous report data...missing; (c) Contacting production reporters or royalty reporters about missing...

2013-07-01

408

41 CFR 301-71.304 - Are we responsible for ensuring the collection of outstanding travel advances?  

Code of Federal Regulations, 2012 CFR

... Are we responsible for ensuring the collection of outstanding travel advances? 301-71...Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... Are we responsible for ensuring the collection of outstanding travel advances?...

2012-07-01

409

41 CFR 301-71.304 - Are we responsible for ensuring the collection of outstanding travel advances?  

Code of Federal Regulations, 2011 CFR

... Are we responsible for ensuring the collection of outstanding travel advances? 301-71...Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES... Are we responsible for ensuring the collection of outstanding travel advances?...

2011-07-01

410

Attitudes towards vaccination against seasonal influenza of health-care workers in primary health-care settings in Greece  

Microsoft Academic Search

Vaccination of health-care workers (HCWs) against seasonal influenza has been consistently recommended worldwide in order to prevent nosocomial transmission and ensure delivery of health-care services during outbreaks. We describe the effects of a nationwide campaign to promote influenza vaccination among HCWs working in primary health-care centers in Greece. During 20082009 the mean vaccination rate among HCWs in primary health-care centers

Xanthi Dedoukou; Georgios Nikolopoulos; Antonios Maragos; Sophia Giannoulidou; Helena C. Maltezou

2010-01-01

411

Caring for Latino patients.  

PubMed

Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Barriers to care have resulted in striking disparities in quality of health care for these patients. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Other health problems include stress, neurocysticercosis, and tuberculosis. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. Many-but not all-folk and herbal treatments can be safely accommodated with conventional therapy. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). The LEARN technique can facilitate cross-cultural interviews. Some cultural barriers may be overcome by using the "teach back" technique to ensure that directions are correctly understood and by creating a welcoming health care environment for Latino patients. PMID:23317025

Juckett, Gregory

2013-01-01

412

Determinants of adequate follow-up of an abnormal Papanicolaou result among Jamaican women in Portland, Jamaica  

PubMed Central

Background Among Jamaican women, cervical cancer is the second leading cause of cancer mortality but factors that facilitate follow-up of women receiving abnormal Pap smear results are not known. We examined whether socio-demographic factors, factors reported by the women, and assistance received for follow-up facilitate adequate follow-up of abnormal Pap smears. Methods One hundred-and-twenty-one women who had abnormal Pap results during June 1998September 2005 in Portland, Jamaica were interviewed to identify determinants of adequate follow-up. Chi-square, t-test and multivariable logistic regression analysis were used to identify determinants. Results Only half of the women in this sample sought adequate follow-up. These women had a lower number of surviving children, higher monthly income, and perceived the cost of services to be inexpensive. Advice about the timing of the follow-up activity and the next step to take by the healthcare workers were significant determinants of adequate follow-up. Women who received advice on the timing of follow-up were almost six times (adjusted OR: 5.99, 95% CI: 1.17, 30.66, p<0.05) more likely to seek adequate follow-up after adjusting for other factors. Conclusions Perceived low cost of services as well as assistance provided by healthcare workers regarding follow-up action helps to facilitate adequate follow-up of abnormal Pap smear results.

Jeong, Su Jin; Saroha, Ekta; Knight, Jeremy; Roofe, Michele; Jolly, Pauline E.

2010-01-01

413

Healthcare as a commodity a financing mechanism to control costs and ensure access  

Microsoft Academic Search

The US healthcare system is experiencing a funding shortfall that constrains efforts to provide healthcare to our citizens. Patients are no longer sure they will receive adequate healthcare during their senior years. One solution is to create an annuity at birth for each individual. This annuity will mature at age 65, with proceeds used for healthcare for the rest of

Aaron Liberman; Timothy Rotarius

2006-01-01

414

Burn Dressings: A Critical Indicator for Patient Care Classification in Burn Units. (Reannouncement with New Availability Information).  

National Technical Information Service (NTIS)

Nursing services consume approximately 60% of a hospital personnel budget, requiring justification for staffing levels and manpower expenses. The lack of an adequate level of nursing care affects the operation of the entire health care team. The purpose o...

D. M. Driscoll

1991-01-01

415

Preventive care  

Microsoft Academic Search

OBJECTIVE: To examine the impact of provider continuity on preventive care among adults who have a regular site of care.\\u000a \\u000a \\u000a DESIGN: Logistic regression analyses were conducted to explore whether continuity, categorized as having no regular care, site continuity,\\u000a or provider continuity, was associated with receipt of 3 preventive care services (influenza vaccination, receipt of a mammogram,\\u000a and smoking cessation advice),

Mark P. Doescher; Barry G. Saver; Kevin Fiscella; Peter Franks

2004-01-01

416

Staying Healthy: Strategies for Helping Parents Ensure Their Children's Health and Well-Being.  

ERIC Educational Resources Information Center

|Presents strategies for Head Start programs to use to help parents ensure their children's health, safety, and well-being. Recommends creative approaches such as lending libraries, bulletin boards, displays, take-home information sheets, conferences, small group discussions, and newsletters. Describes the parent health education program at the

Hendricks, Charlotte; Russell, Mary; Smith, Connie Jo

1997-01-01

417

The Crucial Role of School Nurses: Ensuring Immunization Compliance, Education, and Documentation.  

ERIC Educational Resources Information Center

|Discusses the current status of immunizations, the latest immunization recommendations, and the important role of school nurses in ensuring that all students are properly immunized with the correct immunizations at the correct time. An alphabetical listing of immunizations provides specific details. The paper also discusses myths versus facts

Dychkowski, Linda

2000-01-01

418

25 CFR 36.120 - What type of reporting is required to ensure accountability?  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false What type of reporting is required to ensure...Section 36.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM...report within 45 days following the end of the school year consisting...

2011-04-01

419

25 CFR 36.120 - What type of reporting is required to ensure accountability?  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false What type of reporting is required to ensure...Section 36.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM...report within 45 days following the end of the school year consisting...

2013-04-01

420

Do Fixation Cues Ensure Fixation Accuracy in Split-Fovea Studies of Word Recognition?  

ERIC Educational Resources Information Center

Many studies have claimed that hemispheric processing is split precisely at the foveal midline and so place great emphasis on the precise location at which words are fixated. These claims are based on experiments in which a variety of fixation procedures were used to ensure fixation accuracy but the effectiveness of these procedures is unclear. We

Jordan, Timothy R.; Paterson, Kevin B.; Kurtev, Stoyan; Xu, Mengyun

2009-01-01

421

Ensuring Comfort in Office Buildings: Designing a KNX Monitoring and Control System  

Microsoft Academic Search

As a first stage task, this paper presents the study on what represents and how it is possible to ensure the indoor office comfort, which are the most important types of comfort (thermal, visual, acoustic, air quality, etc.) and how each of them could be analyzed (characterized). Few of them have a mathematical interpretation, more or less precise, which permits

Catalin Bujdei; Sorin Aurel Moraru

2011-01-01

422

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...  

Code of Federal Regulations, 2013 CFR

...counseling, placement assistance, and teaching support that will help to ensure that...scholarship recipients are able to secure teaching positions in high-need schools of high-need...assistance during their first three years of teaching; (b) Provide LEAs with which...

2013-07-01

423

Low-intensity conditioning is sufficient to ensure engraftment in matched unrelated bone marrow transplantation  

Microsoft Academic Search

ObjectiveMatched unrelated bone marrow transplantation (BMT) for patients with hematological malignancies is associated with a high incidence of transplant-related complications due to high doses of chemoradiotherapy administered pre-BMT to ensure engraftment. The aim of this study was to investigate the feasibility of low-intensity conditioning for BMT from matched unrelated donors.

Arnon Nagler; Memet Aker; Elizabeth Naparstek; Gabor Varadi; Chaim Brautbar; Shimon Slavin

2001-01-01

424

Learning to Ensure the Success of Students of Color: A Systemic Approach to Effecting Change  

ERIC Educational Resources Information Center

|For more than three decades, American colleges and universities have made determined efforts to increase their numbers of students of color, particularly African-American and Hispanic students. But bringing students into higher education is not the same as ensuring that they succeed. The persistence rates of African Americans and Hispanics

Kezar, Adrianna; Eckel, Peter

2007-01-01

425

7 CFR 1940.317 - Methods for ensuring proper implementation of categorical exclusions.  

Code of Federal Regulations, 2013 CFR

...Program § 1940.317 Methods for ensuring proper...consider the following two elements in addition to the specific...review required for the elements or the size of...agencies, the size and elements of the entire project...filling or clearing the natural vegetation; (3)...

2013-01-01

426

Are Your S's in Effect? Ensuring Culturally Responsive Physical Education Environments  

ERIC Educational Resources Information Center

|Schools are rapidly becoming a kaleidoscope of ethnicities and cultures represented by demographic changes in America's schools. As educators in this era of change, a unique opportunity exists to ensure quality physical education for all students. Culturally responsive practices in the classroom can assist in minimizing students' alienation as

Culp, Brian

2010-01-01

427

Ensuring America's Future by Increasing Latino College Completion: Latino College Completion in 50 States. Executive Summary  

ERIC Educational Resources Information Center

In 2009, Excelencia in Education launched the Ensuring America's Future initiative to inform, organize, and engage leaders in a tactical plan to increase Latino college completion. This initiative included the release of a benchmarking guide for projections of degree attainment disaggregated by race/ethnicity that offered multiple metrics to track

Santiago, Deborah; Soliz, Megan

2012-01-01

428

Using Evacuation Simulations to Ensure the Safety and Security of the 2012 Olympic Venues  

Microsoft Academic Search

In July 2005, London was awarded the right to host the 2012 Olympic and Paralympic Games. The decision of the International Olympic Committee triggered considerable public enthusiasm across the UK. At the same time, it also created a host of logistical and technical challenges. Amongst these the first concern is to ensure the safety and security of competitors and of

Chris. W. Johnson

429

A comparison of the in vivo antibacterial effects of 'OpSite', 'Tegaderm' and 'Ensure' dressings.  

PubMed

Three semi-permeable polyurethane dressings, 'Ensure', 'OpSite' and 'Tegaderm', were tested for their ability to prevent the increase in bacterial population under naturally hydrated, occluded volar forearm skin. Only 'OpSite' inhibited the bacterial multiplication in these tests. It is concluded that in the practical situation, 'OpSite' could well confer a greater margin of safety. PMID:2865296

Holland, K T; Harnby, D; Peel, B

1985-09-01

430

The Challenges of Ensuring Protection to Unaccompanied and Separated Children in Composite Flows in Europe  

Microsoft Academic Search

To identify and ensure the protection of persons in need of international protection in the context of composite flows of people is one of the major challenges facing Governments in Europe today. The Office of the United Nations High Commissioner for Refugees (UNHCR) cooperates closely with national authorities throughout Europe, in particular in the Mediterranean region, in designing comprehensive strategies

Liv Feijen

2008-01-01

431

Beyond Professional Preparation Programs: The Role of Professional Associations in Ensuring a High Quality Workforce  

ERIC Educational Resources Information Center

|Professional associations have an obligation to ensure the quality of professional preparation and practice, to provide continuing professional education, and to recognize those practitioners who take steps to improve their knowledge and practice. To date, no student affairs association has fully operationalized or embraced these ideas. The

Janosik, Steven M.; Carpenter, Stan; Creamer, Don G.

2006-01-01

432

Ensuring Accommodations Used in Content Assessments Are Responsive to English-Language Learners  

ERIC Educational Resources Information Center

|This column offers an overview of the requirements for including and accommodating English-language learners (ELLs) in content assessments and an explanation of how accommodations for ELLs work. It concludes with recommendations drawn from research and practice to ensure accommodations are assigned and implemented in ways that are likely to

Willner, Lynn Shafer; Rivera, Charlene; Acosta, Barbara D.

2009-01-01

433

Modern Project Management: A New Forecasting Model to Ensure Project Success  

Microsoft Academic Search

This paper presents a new forecasting model to ensure project success. This new model is based on improvement on earned value (EV) method. This model improves earned value management system (EVMS) and forecasting time and cost for projects. These method use established consists of four variables: scheduled performance index (SPI), cost performance index (CPI), cost variance (CV), schedule variance (SV).

Iman Attarzadeh

2009-01-01

434

Ensuring a Stable Level of Product Manufacturing Quality at the Yaroslavl Engine Plant.  

National Technical Information Service (NTIS)

The report presents the methods used at the Yaroslav'l Motor Plant, to ensure stable product quality. Details are given of incentive methods used during production and results of these incentives. There is detail of the various organizations, within the p...

R. N. Arseniev

1974-01-01

435

Rapid checks on sanitized surfaces ensure microbial-free food processing in industry  

Microsoft Academic Search

An effective monitoring of microbial contamination on surfaces and plant components is of fundamental importance in food industry, refectories and work canteens to ensure products quality and safety. The classic microbiological tests inform about the sanitization procedures effectiveness at least after 1-2 days, the rapid luminescent ATP assay after about 5 minutes, on site. In this study the presence of

Pasquale CAPUTO; Elida FERRI; Gianluca GUARNIERI; Graziella LASI; Simone GOZZI; Fabio Milesi; Stefano GIROTTI

436

A predictive Bayesian approach to risk analysis in health care  

PubMed Central

Background The Bayesian approach is now widely recognised as a proper framework for analysing risk in health care. However, the traditional text-book Bayesian approach is in many cases difficult to implement, as it is based on abstract concepts and modelling. Methods The essential points of the risk analyses conducted according to the predictive Bayesian approach are identification of observable quantities, prediction and uncertainty assessments of these quantities, using all the relevant information. The risk analysis summarizes the knowledge and lack of knowledge concerning critical operations and other activities, and give in this way a basis for making rational decisions. Results It is shown that Bayesian risk analysis can be significantly simplified and made more accessible compared to the traditional text-book Bayesian approach by focusing on predictions of observable quantities and performing uncertainty assessments of these quantities using subjective probabilities. Conclusion The predictive Bayesian approach provides a framework for ensuring quality of risk analysis. The approach acknowledges that risk cannot be adequately described and evaluated simply by reference to summarising probabilities. Risk is defined by the combination of possible consequences and associated uncertainties.

Aven, Terje; Eidesen, Karianne

2007-01-01

437

Prenatal Care.  

ERIC Educational Resources Information Center

|Initially published by the Children's Bureau in 1913, this pamphlet has been revised frequently. Its purpose is to point out the importance of medical care during pregnancy. Comfortable pregnancies, easy labor, and better care for their new infants are the usual concerns of prospective mothers. Consequently, this 1962 edition of "Prenatal Care"

Office of Child Development (DHEW), Washington, DC.

438

Space medicine innovation and telehealth concept implementation for medical care during exploration-class missions  

NASA Astrophysics Data System (ADS)

Medical care on the International Space Station (ISS) is provided using real-time communication with limited medical data transmission. In the occurrence of an off-nominal medical event, the medical care paradigm employed is stabilization and transportation, involving real-time management from ground and immediate return to Earth in the event that the medical contingency could not be resolved in due time in space. In preparation for future missions beyond Low-Earth orbit (LEO), medical concepts of operations are being developed to ensure adequate support for the new mission profiles: increased distance, duration and communication delays, as well as impossibility of emergency returns and limitations in terms of medical equipment availability. The current ISS paradigm of medical care would no longer be adequate due to these new constraints. The Operational Space Medicine group at the Canadian Space Agency (CSA) is looking towards synergies between terrestrial and space medicine concepts for the delivery of medical care to deal with the new challenges of human space exploration as well as to provide benefits to the Canadian population. Remote and rural communities on Earth are, in fact, facing similar problems such as isolation, remoteness to tertiary care centers, resource scarcity, difficult (and expensive) emergency transfers, limited access to physicians and specialists and limited training of medical and nursing staff. There are a number of researchers and organizations, outside the space communities, working in the area of telehealth. They are designing and implementing terrestrial telehealth programs using real-time and store-and-forward techniques to provide isolated populations access to medical care. The cross-fertilization of space-Earth research could provide support for increased spin-off and spin-in effects and stimulate telehealth and space medicine innovations to engage in the new era of human space exploration. This paper will discuss the benefits of space-Earth research projects for the advancement of both terrestrial and space medicine and will use examples of operational space medicine projects conducted at the CSA in areas such as remote training, tele-mentoring and remote control of an ultrasound.

Martin, Annie; Sullivan, Patrick; Beaudry, Catherine; Kuyumjian, Raffi; Comtois, Jean-Marc

2012-12-01

439

Can loss of balance from mesoscale eddies adequately power deep ocean mixing?  

NASA Astrophysics Data System (ADS)

The global ocean thermohaline circulation is partly composed of the sinking of dense surface waters at high latitudes. But in order to close the circulation and maintain the abyssal stratification, the dense waters must rise up again through vertical mixing. This process requires a source of energy roughly estimated to be 2 TW. Previous work has concluded that tides and winds may adequately supply the required power, but the conceivable role of loss of balance from mesoscale eddies, resulting in the generation of internal inertia-gravity waves and associated vertical mixing, has hitherto been considered to be 'of unknown importance' (Wunsch and Ferrari, 2004). We investigate the potential role of loss of balance, by studying the generation of internal inertia-gravity waves by balanced flow in a rotating two-layer annulus laboratory experiment (Williams et al., 2008). A photograph from the experiment is shown in the figure. As the Rossby number of the balanced flow decreases, the amplitude of the emitted inertia-gravity waves also decreases, but much less rapidly than is predicted by several dynamical theories. This finding suggests that inertia-gravity waves might be far more energised than previously thought. The balanced flow leaks roughly one per cent of its energy each rotation period into internal inertia-gravity waves at the peak of their generation. Crude extrapolation of this result to the global ocean suggests that the flux of energy from mesoscale eddies into internal waves may be as large as 1.5 TW. We claim no accuracy for this figure which is only indicative. Nevertheless, we are persuaded that generation of inertia-gravity waves from the balanced mesoscale flow may be an important source of energy for deep interior mixing, and deserves further study. Reference Williams, PD, Haine, TWN and Read, PL (2008) Inertia-Gravity Waves Emitted from Balanced Flow: Observations, Properties, and Consequences. Journal of the Atmospheric Sciences, 65(11), pp 3543-3556. doi:10.1175/2008JAS2480.1 Photograph showing internal inertia-gravity waves generated by loss of balance from the large-scale flow in a rotating two-layer annulus experiment in the laboratory.

Williams, P. D.; Haine, T. W.; Read, P. L.

2009-12-01

440

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

National Technical Information Service (NTIS)

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

J. P. Kimball

1993-01-01

441

Role of Quality in the Demand for Health Care Cebu, Philippines. Small Applied Research Paper No. 12.  

National Technical Information Service (NTIS)

A mixed multinominal logit model is used in this document to estimate the effects of quality, price, distance, and individual demand for health care on Cebu Island in the Philippines. Data collected from both households and health care facilities ensures ...

D. Hotchkiss

1993-01-01

442

Ensuring sexual and reproductive health for people living with HIV: an overview of key human rights, policy and health systems issues.  

PubMed

Despite rhetorical attention there is little programmatic guidance as to how best to ensure that women and men living with HIV have access to sexual and reproductive health services that help them realise their reproductive goals, while ensuring their human rights. A dynamic relationship exists between the manner in which health services and programmes are delivered, and the individuals who seek these services. A review of the literature shows clear gaps and highlights areas of concern not yet sufficiently addressed. The delivery and use of health services and programmes is shaped by the underlying determinants of people's access to and use of these services, the health systems in place at community and country level, and the legal and policy environment these systems operate in. Few governments can provide the full range of services that might be required by their populations. In most places, people access health services from a variety of formal and informal providers, and health-related behaviour is influenced from many directions. The synergistic roles of health systems, law and policy and underlying social determinants in helping or hindering the development and delivery of adequate programmes and services for HIV positive people must be addressed. PMID:17531746

Gruskin, Sofia; Ferguson, Laura; O'Malley, Jeffrey

2007-05-01

443

[Providing care and promoting health among prisoners].  

PubMed

Any health care facility is the stage for a specific kind of relationship between a person requiring care and a caregiver qualified to give it. When this place is enclosed, because the hospitalised patients also happen to be prisoners, does the nursing relationship exist with the same authenticity? This is what Michle Trguer works to ensure on a daily basis at the national public health facility of Fresnes. An interview with a nurse of conviction. PMID:23477086

Warnet, Sylvie

2013-02-01

444

Physician Migration, Education, and Health Care  

ERIC Educational Resources Information Center

Physician migration is a complex and multifaceted phenomenon that is intimately intertwined with medical education. Imbalances in the production of physicians lead to workforce shortages and surpluses that compromise the ability to deliver adequate and equitable health care to large parts of the world's population. In this overview, we address a

Norcini, John J.; Mazmanian, Paul E.

2005-01-01

445

Integrating psychosocial care into cancer services.  

PubMed

Despite substantial evidence that patients with cancer commonly have significant psychosocial problems, for which we have evidence-based treatments, many patients still do not receive adequate psychosocial care. This means that we risk prolonging life without adequately addressing the quality of that life. There are many challenges to improving the current situation, the major one of which is organizational. Many cancer centers lack a system of psychosocial care that is integrated with the cancer care of the patient. Psychosocial care encompasses a range of problems (emotional, social, palliative, and logistical). The integration must occur with the cancer care of the patient at all stages (from screening to palliative care) and across all clinical sites of care (inpatient and outpatient cancer services as well as primary care). In this article, we consider the challenges we face if we are to provide such integrated psychosocial services. We focus on the collaborative care service model. This model comprises systematic identification of need, integrated delivery of care by care managers, appropriate specialist supervision, and the stepping of care based on systematic measurement of outcomes. Several trials of this approach to the management of depression in patients with cancer have found it to be both feasible to deliver and effective. It provides a model for services to meet other psychosocial needs. We conclude by proposing the key components of an integrated psychosocial service that could be implemented now and by considering what we need to do next if we are to succeed in providing better and more comprehensive care to our patients. PMID:22412139

Fann, Jesse R; Ell, Kathleen; Sharpe, Michael

2012-03-12

446

Types of Care  

MedlinePLUS

... Guardians Home Child Care Providers Home Child Care 101 5 Steps To Choosing Care Types of Care ... Parent Archives Home Parents And Guardians Child Care 101 Types of Care Types of Care How do ...

447

Racial Differences in Perceived Barriers to Prenatal Care  

Microsoft Academic Search

Objectives: It is well known that black women are less likely to receive adequate prenatal care than white women. This study examines whether there are differences in barriers to prenatal care reported by black and white mothers. Method: Data from the 1988 National Maternal and Infant Health Survey were used to measure relationships between race and reported financial, service, and

Sylva A. Tossounian; Kenneth C. Schoendorf; John L. Kiely

1997-01-01

448

The Care and Feeding of a Computer System.  

ERIC Educational Resources Information Center

Provides guidelines for proper computer environment, care, and handling. Successful implementation of equipment and programs depends on adequate electrical circuitry, antistatic carpeting, and proper lighting and room temperature, among other factors. Hints are also provided concerning computer furniture, care of software, and personnel

Valesky, Thomas C.; Connors, Eugene T.

1987-01-01

449

38 CFR 59.140 - Nursing home care requirements.  

Code of Federal Regulations, 2013 CFR

...equipped for adequate nursing care, comfort, and...resident; (7) Except in private rooms, each...provide total visual privacy in combination with adjacent...size and height for the safety of the resident; ...care for patients, a nursing home project...

2013-07-01

450

Practical Guidelines for Health Care Management in Secondary School Athletics.  

ERIC Educational Resources Information Center

|Offers advice to schools that need to provide adequate health care for student athletes without benefit of a certified athletic trainer. Covers written policy concerning athletic trauma, maintenance of playing fields, medical records and consent forms, and equipment needed for injury prevention and care. Includes samples of forms and procedures.

Laire, Dean E.

1981-01-01

451

Suicide and the Standard of Care: Optimal vs. Acceptable.  

ERIC Educational Resources Information Center

Discusses accepted standards of care for suicidal patients from the perspectives of the law, malpractice insurance claims, the mental health professions, and the ideal. A review of decisions of professional liability provides guidelines for what the court considers to be adequate care, suggesting an acceptance of minimal standards. (JAC)

Berman, Alan L.; Cohen-Sandler, Roni

1982-01-01

452

Involving Parents in Their Children's Dental Care.  

ERIC Educational Resources Information Center

|Asserts that parent education is vital to good dental hygiene for the whole family. Discusses what Head Start staffers can do to ensure that children's dental needs are being met, particularly in assisting parents with taking responsibility for children's dental hygiene. Covers dental care tips for parents, questions and answers about dental

Becker, Donna

1998-01-01

453

Lots of Funds for Dependent Care.  

ERIC Educational Resources Information Center

Corporate funding is now being used to invest in the improvement of community dependent care. This strategy benefits the firms by: (1) ensuring that employees will be absent from work less frequently due to childcare responsibilities; (2) providing a flexible strategy for meeting a variety of community needs; (3) improving community-firm

Friedman, Dana E.

454

Involving Parents in Their Children's Dental Care.  

ERIC Educational Resources Information Center

Asserts that parent education is vital to good dental hygiene for the whole family. Discusses what Head Start staffers can do to ensure that children's dental needs are being met, particularly in assisting parents with taking responsibility for children's dental hygiene. Covers dental care tips for parents, questions and answers about dental

Becker, Donna

1998-01-01

455

Positive rights, negative rights and health care  

Microsoft Academic Search

In the current debate about healthcare reform in the USA, advocates for government-ensured universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts negative rights as legitimate rights. Negative rights, the argument goes,

Andrew Bradley

2010-01-01

456

How to ensure sustainable interoperability in heterogeneous distributed systems through architectural approach.  

PubMed

A major obstacle in ensuring ubiquitous information is the utilization of heterogeneous systems in eHealth. The objective in this paper is to illustrate how an architecture for distributed eHealth databases can be designed without lacking the characteristic features of traditional sustainable databases. The approach is firstly to explain traditional architecture in central and homogeneous distributed database computing, followed by a possible approach to use an architectural framework to obtain sustainability across disparate systems i.e. heterogeneous databases, concluded with a discussion. It is seen that through a method of using relaxed ACID properties on a service-oriented architecture it is possible to achieve data consistency which is essential when ensuring sustainable interoperability. PMID:21685592

Pape-Haugaard, Louise; Frank, Lars

2011-01-01

457

Adaptive processing to ensure practical application of a multiple hypothesis tracking system  

NASA Astrophysics Data System (ADS)

Modern computational capabilities allow the practical application of Multiple Hypothesis Tracking (MHT) for difficult tracking conditions. However, even in typical expected scenarios, periods of unusually high target and / or clutter density may occur that stress the ability of MHT to operate in real-time and under the constraints of limited computer memory. This paper outlines methods that are being developed to ensure practical application, even though some performance degradation must be accepted, during these difficult conditions. These methods include the adaptive choice of track and hypothesis pruning parameters, IMM filtering models and new track initiation strategies as a function of the latency between the time that current observations are received and the track processing time. Methods to ensure that memory constraints are satisfied are also discussed. The methods are illustrated with examples from simulated missile defense scenarios where periods of very high target density are expected and a ground target tracking scenario with real radar data.

Norman, Bradley K.; Cronin, Brian A.; Blackman, Samuel S.; Dempster, Robert J.

2006-06-01

458

Mismatch repair ensures fidelity of replication and recombination in the radioresistant organism Deinococcus radiodurans  

Microsoft Academic Search

We have characterized the mismatch repair system (MMR) of the highly radiation-resistant type strain of Deinococcus radiodurans, ATCC 13939. We show that the MMR system is functional in this organism, where it participates in ensuring the fidelity of DNA replication and recombination. The system relies on the activity of two key proteins, MutS1 and MutL, which constitute a conserved core

S. Mennecier; G. Coste; P. Servant; A. Bailone; S. Sommer

2004-01-01

459

Ensuring reliability in B2B services: Fault tolerant inter-organizational workflows  

Microsoft Academic Search

In the age of Business-to-Business (B2B) collaboration, ensuring reliability of workflows underlying inter-organizational\\u000a business processes is of significant importance. There are, however, quite a few challenges towards achieving seamless operation.\\u000a Such challenges arise from heterogeneity in infrastructure and coordination mechanism at participant organizations, as well\\u000a as time and cost associated with recovery from failure. Our research presents foundations for a

Haluk Demirkan; Sagnika Sen; Michael Goul; Jason Nichols

460

Lean and mean: the quality of care in the era of managed care.  

PubMed

This paper reviews the genesis of managed care and the reasons for its rapid growth. The effects of the differing incentives of traditional and managed-care plans on quality of care are described. There is an urgent need for federal, state and local health departments to monitor and regulate the quantity and quality of health care provided by all types of insurance plans. The elements of such a program are outlined, and the need for adequate funding as well as political and technical leadership is emphasized. This should become a major priority issue for the public health movement in the United States. PMID:9581426

Terris, M

1998-01-01

461

Fetal deaths in Mexican-American, black, and white non-Hispanic women seeking government-funded prenatal care.  

PubMed

Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of 80,431 patients attending federally funded prenatal care clinics in California from 1984 through 1989. The fetal death rate per 1,000 live births and fetal deaths was 7.8 for Hispanic, 8.4 for white non-Hispanic and 20.5 for black non-Hispanic women. These rates indicated favorable reproductive outcomes for Mexican Americans despite their social risk profile. An analysis of stillbirths by gestational age showed that Hispanic women stood a significantly lower risk of short-gestational stillbirths than non-Hispanics. In contrast, Hispanic women had a higher proportion of term stillbirths. Hispanic acculturation was a significant predictor of short-term gestation fetal deaths only. The inability to pay for health care was a strong predictor of fetal deaths for all ethnic groups, underscoring the need to ensure adequate access to maternity care for low-income women. PMID:7836554

Guendelman, S; Chavez, G; Christianson, R

1994-10-01

462

Effective population management practices in diabetes care - an observational study  

Microsoft Academic Search

BACKGROUND: Ensuring that evidence based medicine reaches patients with diabetes in the US and internationally is challenging. The chronic care model includes evidence based management practices which support evidence based care. However, despite numerous studies, it is unclear which practices are most effective. Few studies assess the effect of simultaneous practices implemented to varying degrees. The present study evaluates the

Anne Frlich; Jim Bellows; Bo Friis Nielsen; Per Bruun Brockhoff; Martin Hefford

2010-01-01

463

Recommendations for Long Term Care in an Elderly Medicaid Population.  

ERIC Educational Resources Information Center

The State of Virginia has had a statewide nursing home preadmission screening program since 1977 and has made efforts to ensure appropriate placement of individuals in long term care settings. In a major effort to divert certain individuals from institutionalization, a personal care option has been provided. Using data from the Preadmission

Travis, Shirley S.; McAuley, William J.

464

Chemical Safety in Animal Care, Use, and Research  

Microsoft Academic Search

Chemical safety is an essential element of an effective oc- cupational health and safety program. Controlling expo- sures to chemical agents requires a careful process of hazard recognition, risk assessment, development of control mea- sures, communication of the risks and control measures, and training to ensure that the indicated controls will be utilized. Managing chemical safety in animal care and

Wayne R. Thomann

465

Self-care behaviors among patients with heart failure  

Microsoft Academic Search

Background: One way to prevent frequent hospitalizations and promote positive health outcomes among patients with heart failure (HF) is to ensure that the amount and quality of self-care used is appropriate to the patient's situation. Objectives: The following are the purposes of this study: (a) examine the frequency of performance of self-care behaviors, (b) describe personal and environmental factors (basic

Nancy T. Artinian; Morris Magnan; Michelle Sloan; M. Patricia Lange

2002-01-01

466

Pschiatric nurses in the age of health care reform.  

PubMed

With the March 2010 passage of the health care reform law, the Patient Protection and Affordable Care Act, the U.S Congress completely transformed the health care industry and fundamentally altered how hospitals will deliver and receive payment for care. The purpose of this article is to examine the provisions of the Affordable Care Act and its significance for behavioral healthcare. Key components of health care reform ( i.e., measuring and benchmarking quality patient care outcomes; payment reform; and the reorganization of the health care delivery system to ensure accountable, accessible, patient-centred, coordinated care) are reviewed with regard to their impact on behavioral health. The challenges, opportunities, and implications of health care reform are examined for the nursing field in general and psychiatric nursing practice specifically. PMID:22783561

Wilson, Denise A

2012-06-01

467

Oral Care  

Microsoft Academic Search

Adequate dental and oral hygiene may become a challenge for all users and especially for elderly people and young children because of their limited motor skills. The same holds true for patients undergoing\\/recovering from chemo-\\/radiotherapy with accompanying sensitive mucosal conditions. Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath (halitosis), fungal infection and gum diseases.

Irne Hitz Lindenmller; J. Thomas Lambrecht

2011-01-01

468

Hospital discharge planning and continuity of care for aged people in an Italian local health unit: does the care-home model reduce hospital readmission and mortality rates?  

Microsoft Academic Search

BACKGROUND: Hospital discharge planning is aimed to decrease length of stay in hospitals as well as to ensure continuity of health care after being discharged. Hospitalized patients in Turin, Italy, who are in need of medical, social and rehabilitative care are proposed as candidates to either discharge planning relying on a care-home model (DPCH) for a period of about 30

Gianfranco Damiani; Bruno Federico; Antonella Venditti; Lorella Sicuro; Silvia Rinaldi; Franco Cirio; Cristiana Pregno; Walter Ricciardi

2009-01-01

469

Le care  

Microsoft Academic Search

Il est de important de distinguer entre une acception domestique et une acception publique de type socio-conomique du care, cette acception permettant de fonder la relation de service par rfrence une pratique du taking care qui rapproche le care public du stewardship ou encore une relecture de la conception de l'efficacit en la focalisant sur l'attention et non

Yvon Pesqueux

2011-01-01

470

Three not adequately understood lunar phenomena investigated by the wave planetology  

NASA Astrophysics Data System (ADS)

Three not adequately understood lunar phenomena investigated by the wave planetology G. Kochemasov IGEM of the Russian Academy of Sciences, Moscow, Russia, kochem.36@mail.ru The lunar science notwithstanding rather numerous researches of the last 50 years still debates some important issues. Three of them concern an origin of mascons, the deepest but low ferruginous South Pole-Aitken depression, a strange character of the frequency-crater size curve. Prevailing approaches are mainly based on impacts having made the present geomorphology of the Moon. However practically are ignored the fact of antipodality of basins and marea, a complex character of the frequency-crater size curve obviously implying an involvement of different sources and reasons responsible for crater formation. Attempts to find impactor sources in various sometimes very remote parts of the Solar system are too artificial, besides they do not explain very intensive, like lunar cratering of Mercury. Saturation of the lunar surface by ~70-km diameter craters is very strange for random impacts from any source; to find a time interval for this saturation is difficult if not possible because it affects formations of various ages. Lunar basins and marea completely contradict to a classical frequency- crater size curve. Their presumed ( and measured) different ages make dubious existence of one specialized impactor source. So, if one accepts an impact process as the only process responsible for cratering (ring forms development) then the real mess in crater statistics and timing never will be overcome. The wave planetology [1-3 & others] examined by many planets and satellites of the Solar system proved to be real. In a case of the Moon it can help in answering the above questions. First of all it should be admitted that the complex lunar crater (ring forms) statistics is due to a superposition and mixing of two main processes (a minor involvement of volcanic features is also present): impacts and wave warping. "Orbits make structures" - this is to say that keplerian elliptic orbits and thus periodically changing accelerations is the reason of warping waves affecting celestial bodies. In rotating bodies (but all bodies rotate!) this warpings are decomposed in 4 ortho- and diagonal directions. Interfering these directions give ring (polygonal) forms often observed in crater walls. Sizes of these ring forms depend on the warping wavelengths. The fundamental wave 1 gives ubiquitous tectonic dichotomy (in the lunar case, the near subsided and the far uplifted - bulged hemispheres - segments). The wave 2 divides these segments in uplifted and subsided tectonic sectors (The SPA basin is one of these sectors). All this already complex lunar morphology is complicated by tectonic granulation. Sizes of granules are inversely proportion to orbital frequencies. As the Moon as a satellite has two frequencies thus it has two sizes of granules. The larger one is due to common with Earth a yearlong orbit, the smaller one due to a monthly orbit. These two sizes (70-100 and 600-1000 km) complicate the classic impact curve by a surplus of craters of these sizes (the 70-km crater saturation is easily explained). The wave nature of basin formation explains why some of them are with mascon and others without. Uplifted ones (thus more eroded and seemingly older) acquired additional angular momentum and do not need additional dense roots. Subsided ones loosing in planetary radius need additional dense masses (mascons) to restore angular momentum. So, two varieties of basins are links of one wave chain (the wave nature is also proved by their "mysterious' antipodality). The low-Fe of SPA is due to its belonging to the uplifted far side segment mantle of which is lighter (that is richer in Mg, with increased Mg/Fe) than mantle of the subsided near side segment where Fe-rich mare basalts are typical. References: [1]. Kochemasov G.G. Concerted wave supergranulation of the solar system bodies // 16th Russian-American microsymposium on planetology, Abstracts, Moscow, Vern

Kochemasov, G. G.

2009-04-01

471

Rehabilitating care.  

PubMed

The feminist ethic of care has often been criticized for its inability to address four problems--the problem of exploitation as it threatens care givers, the problem of sustaining care-giver integrity, the dangers of conceiving the mother-child dyad normatively as a paradigm for human relationships, and the problem of security social justice on a broad scale among relative strangers. We argue that there are resources within the ethic of care for addressing each of these problems, and we sketch strategies for developing the ethic more fully. PMID:10157549

Carse, A L; Nelson, H L

1996-03-01

472

Clinical review: Moral assumptions and the process of organ donation in the intensive care unit  

PubMed Central

The objective of the present article is to review moral assumptions underlying organ donation in the intensive care unit. Data sources used include personal experience, and a Medline search and a non-Medline search of relevant English-language literature. The study selection included articles concerning organ donation. All data were extracted and analysed by the author. In terms of data synthesis, a rational, utilitarian moral perspective dominates, and has captured and circumscribed, the language and discourse of organ donation. Examples include "the problem is organ shortage", "moral or social duty or responsibility to donate", "moral responsibility to advocate for donation", "requesting organs" or "asking for organs", "trained requesters", "pro-donation support persons", "persuasion" and defining "maximising donor numbers" as the objective while impugning the moral validity of nonrational family objections to organ donation. Organ donation has recently been described by intensivists in a morally neutral way as an "option" that they should "offer", as "part of good end-of-life care", to families of appropriate patients. In conclusion, the review shows that a rational utilitarian framework does not adequately encompass interpersonal interactions during organ donation. A morally neutral position frees intensivists to ensure that clinical and interpersonal processes in organ donation are performed to exemplary standards, and should more robustly reflect societal acceptability of organ donation (although it may or may not "produce more donors").

Streat, Stephen

2004-01-01

473

Health care cost containment experiments: policy, individual rights, and the law.  

PubMed

In a climate of increasing pressure to contain health care costs, legislators and health services researchers from time to time have proposed experiments involving reductions in benefits currently authorized under the Medicare and Medicaid programs. This paper examines three court challenges to the conduct of such experiments in California, New York, and Georgia. The rulings on the California and New York cases were in favor of continuing the experiments on the grounds that the Secretary of Health, Education, and Welfare had judged the projects to be helpful in promoting the objectives of Titles XIX and IV-A, respectively, of the Social Security Act. In the Georgia case, however, the plaintiffs contended that federal regulations protecting human subjects were applicable to the experiment at issue. While the precedent of past cases upholding the Secretary's authority to approve benefit-reducing experiments was not overturned in Georgia, the Court held that the human subjects regulations were applicable and, consequently, that such experiments must be reviewed prior to implementation by an Institutional Review Board. If the experiment places human subjects at risk, the regulations require that informed consent be obtained from participating subjects. The paper concludes by examining the implications of the Georgia ruling in terms of future efforts to contain health care costs while ensuring that the rights of individual beneficiaries are adequately safeguarded. PMID:365931

Galblum, T W

1978-01-01

474

Hospital missions and the education of our future health care workforce.  

PubMed

Today's U.S. health care industry is facing unprecedented shortages of health personnel in a great variety of disciplines and locations. An adequate supply of well-educated and trained health professionals is imperative to ensure sufficient access to health care for our citizenry. Hospital mission statements reflect the character, strategic direction, and priorities of the organization; thus, we might expect these statements to address the position and strategy of the organizations in regard to education of future health professionals. To investigate hospitals' publicly stated attention and commitment to the education of health professionals, we analyzed publicly available mission statements from a random stratified sample of 402 hospitals. The hospitals were stratified on the basis of teaching status, rural or urban, and profit status. The percentage of hospitals mentioning an education-related keyword was estimated using a 95% confidence interval with a finite population correction factor on the proportion within each stratum. As expected, teaching hospitals were significantly more likely to include language about education in their mission statements than nonteaching hospitals, with 74% of teaching hospitals mentioning education at least once. We found no significant difference in the use of education language among the mission statements of nonteaching hospitals, where 20% mentioned education at least once. From these findings, we conclude that despite the key importance of health professionals, strategies and policy regarding the education of future health personnel have not yet become "mission level" in importance to hospitals. PMID:18847108

Wiggins, Carla; Hatzenbuehler, Linda; Peterson, Teri

2008-01-01

475

Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94  

SciTech Connect

Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, and delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% {+-} 7.8%; inadequate RT, 21.2% {+-} 5.6%; adequate RT, 6.8% {+-} 1.4%; p = 0.0001) and DFS (no RT, 55.1% {+-} 9.1%; inadequate RT, 57.4% {+-} 6.3%; adequate RT, 69.1% {+-} 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender.

Fietkau, Rainer [Department of Radiation Therapy, University of Rostock, Rostock (Germany)]. E-mail: rainer.fietkau@med.uni-rostock.de; Roedel, Claus [Departments of Radiation Therapy and Surgery, University of Erlangen, Erlangen (Germany); Hohenberger, Werner [Departments of Radiation Therapy and Surgery, University of Erlangen, Erlangen (Germany); Raab, Rudolf [Department of Surgery, Klinikum Oldenburg, Oldenburg (Germany); Hess, Clemens [Departments of Radiation Therapy and General Surgery, University of Goettingen, Goettingen (Germany); Liersch, Torsten [Departments of Radiation Therapy and General Surgery, University of Goettingen, Goettingen (Germany); Becker, Heinz [Departments of Radiation Therapy and General Surgery, University of Goettingen, Goettingen (Germany); Wittekind, Christian [Institute of Pathology, University of Leipzig, Leipzig (Germany); Hutter, Matthias [Department of Radiation Therapy, Krankenhaus Nordwest Frankfurt, Frankfurt (Germany); Hager, Eva [Department of Radiation Therapy, Krankenhaus Klagenfurt, Klagenfurt (Austria); Karstens, Johann [Department of Radiation Therapy, University of Hannover, Hannover (Germany); Ewald, Hermann [Department of Radiation Therapy, University of Schleswig-Holstein, Campus Kiel, Kiel (Germany); Christen, Norbert [Department of Radiation Therapy, Krankenhaus Dresden-Friedrichstadt, Dresden (Germany); Jagoditsch, Michael [Department of Surgery, Klinikum St. Veit, St. Veit (Austria); Martus, Peter [Institute of Biostatistics and Clinical Epidemiology, Charite Universitary Medicine Berlin, Berlin (Germany); Sauer, Rolf [Departments of Radiation Therapy and Surgery, University of Erlangen, Erlangen (Germany)

2007-03-15

476

Foster Care: State Practices for Assessing Health Needs, Facilitating Service Delivery, and Monitoring Children's Care. Report to the Chairman, Subcommittee on Income Security and Family Support, Committee on Ways and Means, House of Representatives. GAO-09-26  

ERIC Educational Resources Information Center

Providing health care services for foster children, who frequently have significant health care needs, can be challenging. The Administration for Children and Families (ACF) oversees foster care, but state child welfare agencies are responsible for ensuring that these children receive health care services, which are often financed by Medicaid. In

Brown, Kay; Bascetta, Cynthia A.

2009-01-01

477

The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence.  

PubMed

A fixed-dose combination of artemether-lumefantrine (AL, Coartem(R)) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat.As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals) supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans) and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30-60 g/person/day across the whole population (average 43 g/person/day). Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15-30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat) or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5-59 months have shown similar high cure rates to those observed in older populations, indicating that food consumption is adequate post-weaning. In conclusion, it appears that only a very small amount of dietary fat is necessary to ensure optimal efficacy with AL and that the fat content of standard meals or breast milk in sub-Saharan Africa is adequate. PMID:19032767

Premji, Zulfiqarali G; Abdulla, Salim; Ogutu, Bernhards; Ndong, Alice; Falade, Catherine O; Sagara, Issaka; Mulure, Nathan; Nwaiwu, Obiyo; Kokwaro, Gilbert

2008-11-25

478

A Descriptive Study of Exceptional Children Teacher Practices in Select North Carolina Middle Schools Making Adequate Yearly Progress  

ERIC Educational Resources Information Center

Rural, middle schools in North Carolina have struggled with the Students with Disabilities subgroup in making Adequate Yearly Progress (AYP) in reading since No Child Left Behind (NCLB) was passed. Consequences could be dire for a school and principal with a subgroup of these children who were unable to show growth each year toward total

Franklin, Carolyn Tweed

2010-01-01

479

A Descriptive Study of Exceptional Children Teacher Practices in Select North Carolina Middle Schools Making Adequate Yearly Progress  

ERIC Educational Resources Information Center

|Rural, middle schools in North Carolina have struggled with the Students with Disabilities subgroup in making Adequate Yearly Progress (AYP) in reading since No Child Left Behind (NCLB) was passed. Consequences could be dire for a school and principal with a subgroup of these children who were unable to show growth each year toward total

Franklin, Carolyn Tweed