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1

|reportingchecklistforlifesciencesarticles 1. How was the sample size chosen to ensure adequate power  

E-print Network

|reportingchecklistforlifesciencesarticles May 2013 i 1. How was the sample size chosen to ensure they are relevant: · the exact sample size (n) for each experimental group/condition, given as a number, not a range adequate power to detect a pre-specified effect size? For animal studies, include a statement about sample

Cai, Long

2

Barriers to adequate prenatal care utilization in American Samoa  

PubMed Central

Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; P<0.01) and improved adequacy of received services (95.04% versus 83.8%; P=0.02). Conclusion The poor prenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

2013-01-01

3

A high UV environment does not ensure adequate Vitamin D status  

NASA Astrophysics Data System (ADS)

Queensland has the highest rates of skin cancer in the world and due to the high levels of solar UV in this region it is assumed that incidental UV exposure should provide adequate vitamin D status for the population. This research was undertaken to test this assumption among healthy free-living adults in south-east Queensland, Australia (27°S), at the end of winter. This research was approved by Queensland University of Technology Human Research Ethics Committee and conducted under the guidelines of the Declaration of Helsinki. 10.2% of the sample had serum vitamin D levels below 25nm/L (deficiency) and a further 32.3% had levels between 25nm/L and 50nm/L (insufficiency). Vitamin D deficiency and insufficiency can occur at the end of winter, even in sunny climates. The wintertime UV levels in south-east Queensland (UV index 4-6) are equivalent to summertime UV levels in northern regions of Europe and the USA. These ambient UV levels are sufficient to ensure synthesis of vitamin D requirements. We investigated individual UV exposure (through a self reported sun exposure questionnaire) and found correlations between exposure and Vitamin D status. Further research is needed to explore the interactions between the solar UV environment and vitamin D status, particularly in high UV environments, such as Queensland.

Kimlin, M. G.; Lang, C. A.; Brodie, A.; Harrison, S.; Nowak, M.; Moore, M. R.

2006-12-01

4

Ensuring smokers are adequately informed: reflections on consumer rights, manufacturer responsibilities, and policy implications  

PubMed Central

The right to information is a fundamental consumer value. Following the advent of health warnings, the tobacco industry has repeatedly asserted that smokers are fully informed of the risks they take, while evidence demonstrates widespread superficial levels of awareness and understanding. There remains much that tobacco companies could do to fulfil their responsibilities to inform smokers. We explore issues involved in the meaning of "adequately informed" smoking and discuss some of the key policy and regulatory implications. We use the idea of a smoker licensing scheme—under which it would be illegal to sell to smokers who had not demonstrated an adequate level of awareness—as a device to explore some of these issues. We also explore some of the difficulties that addiction poses for the notion that smokers might ever voluntarily assume the risks of smoking. PMID:16046703

Chapman, S; Liberman, J

2005-01-01

5

Ensuring smokers are adequately informed: reflections on consumer rights, manufacturer responsibilities, and policy implications.  

PubMed

The right to information is a fundamental consumer value. Following the advent of health warnings, the tobacco industry has repeatedly asserted that smokers are fully informed of the risks they take, while evidence demonstrates widespread superficial levels of awareness and understanding. There remains much that tobacco companies could do to fulfil their responsibilities to inform smokers. We explore issues involved in the meaning of "adequately informed" smoking and discuss some of the key policy and regulatory implications. We use the idea of a smoker licensing scheme-under which it would be illegal to sell to smokers who had not demonstrated an adequate level of awareness-as a device to explore some of these issues. We also explore some of the difficulties that addiction poses for the notion that smokers might ever voluntarily assume the risks of smoking. PMID:16046703

Chapman, S; Liberman, J

2005-08-01

6

[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, Idê Gomes Dantas; Câmara Neto, Henrique Fernandes; de Melo, Carlos Henrique; Costa, André Monteiro

2012-06-01

7

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

8

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

9

The relationship between social capital, social support and the adequate use of prenatal care.  

PubMed

This study investigated the relationship between social capital and social support and the adequate use of prenatal care. A follow-up study involving 1,485 pregnant women was conducted in two cities in the Rio de Janeiro State, Brazil. Demographic and socioeconomic characteristics, social support and social capital data were collected during the first trimester of pregnancy. The post-partum period included information on levels of prenatal care utilization, social networks, parity, obstetric and gestational risk and prenatal care attendance. Hierarchized multinomial logistic regression was used in the statistical analysis. Prenatal care use above adequate levels was associated with high social capital at the city level (aggregated social capital), socioeconomic status and working during pregnancy. Lower non-aggregated contextual and compositional social capital, gestational risk and pattern of prenatal care were associated with inadequate prenatal care utilization. Contextual social capital and social support were found to be social determinants for the appropriate use of prenatal care. PMID:21789416

Leal, Maria do Carmo; Pereira, Ana Paula Esteves; Lamarca, Gabriela de Almeida; Vettore, Mario Vianna

2011-01-01

10

Blue Shield ensures uninterrupted access to quality medical care after Palm Drive Hospital ceases operations  

E-print Network

Blue Shield ensures uninterrupted access to quality medical care after Palm Drive Hospital ceases emergency care and in-patient care at Palm Drive. We are working with our members to ensure a smooth of California member in the Sonoma County area seeking emergency medical services or inpatient care, please

Ravikumar, B.

11

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.

12

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

13

Ensuring Patient Safety in Care Transitions: An Empirical Evaluation of a Handoff Intervention Tool  

PubMed Central

Successful handoffs ensure smooth, efficient and safe patient care transitions. Tools and systems designed for standardization of clinician handoffs often focuses on ensuring the communication activity during transitions, with limited support for preparatory activities such as information seeking and organization. We designed and evaluated a Handoff Intervention Tool (HAND-IT) based on a checklist-inspired, body system format allowing structured information organization, and a problem-case narrative format allowing temporal description of patient care events. Based on a pre-post prospective study using a multi-method analysis we evaluated the effectiveness of HAND-IT as a documentation tool. We found that the use of HAND-IT led to fewer transition breakdowns, greater tool resilience, and likely led to better learning outcomes for less-experienced clinicians when compared to the current tool. We discuss the implications of our results for improving patient safety with a continuity of care-based approach. PMID:23304268

Abraham, Joanna; Kannampallil, Thomas; Patel, Bela; Almoosa, Khalid; Patel, Vimla L.

2012-01-01

14

Ensuring patient safety in care transitions: an empirical evaluation of a Handoff Intervention Tool.  

PubMed

Successful handoffs ensure smooth, efficient and safe patient care transitions. Tools and systems designed for standardization of clinician handoffs often focuses on ensuring the communication activity during transitions, with limited support for preparatory activities such as information seeking and organization. We designed and evaluated a Handoff Intervention Tool (HAND-IT) based on a checklist-inspired, body system format allowing structured information organization, and a problem-case narrative format allowing temporal description of patient care events. Based on a pre-post prospective study using a multi-method analysis we evaluated the effectiveness of HAND-IT as a documentation tool. We found that the use of HAND-IT led to fewer transition breakdowns, greater tool resilience, and likely led to better learning outcomes for less-experienced clinicians when compared to the current tool. We discuss the implications of our results for improving patient safety with a continuity of care-based approach. PMID:23304268

Abraham, Joanna; Kannampallil, Thomas; Patel, Bela; Almoosa, Khalid; Patel, Vimla L

2012-01-01

15

Health Workforce: Ensuring Adequate Supply and Distribution Remains Challenging. Testimony before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives.  

ERIC Educational Resources Information Center

The General Accounting Office's (GAO's) director of health care-public health issues testified before Congress regarding growing concerns about the adequacy of the health care work force and lessons learned from the experience of the National Health Service Corps (NHSC) in addressing the maldistribution of health care professionals. The following…

Heinrich, Janet

16

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

Code of Federal Regulations, 2014 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,...

2014-01-01

17

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

Code of Federal Regulations, 2013 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,...

2013-01-01

18

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2014 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,...

2014-01-01

19

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

Code of Federal Regulations, 2012 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,...

2012-01-01

20

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

21

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2012 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,...

2012-01-01

22

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

Code of Federal Regulations, 2011 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,...

2011-01-01

23

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,...

2010-01-01

24

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2011 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,...

2011-01-01

25

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2013 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,...

2013-01-01

26

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. PMID:21099698

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

2010-01-01

27

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 valve’s body are presented.

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

2010-05-01

28

Early Care and Education: Policy Considerations for Ensuring High-Quality Pre-K Programs  

ERIC Educational Resources Information Center

Interest in early care and education (ECE), also referred to as an early childhood education, has escalated in recent years. The interest is bipartisan, as evidenced by the multiple ECE-related bills already introduced by the 113th Congress. Further, 39 states have implemented prekindergarten (pre-K) programs. In 2013, 27 governors mentioned ECE…

Best, Jane; Cohen, Courtney

2013-01-01

29

Infant Day Care and the Family: Regulatory Strategies to Ensure Parent Participation.  

ERIC Educational Resources Information Center

This paper examines federal requirements which promote parent involvement in day care, particularly in services for children under 3 years of age. The rationale for parent participation in poverty programs for children is discussed from three perspectives--political, economic, and socio-psychological--and Project Head Start's application of this…

Fein, Greta G.

30

Ensuring Appropriate Care for LGBT Veterans in the Veterans Health Administration.  

PubMed

Within health care systems, negative perceptions of lesbian, gay, bisexual, and transgender persons have often translated into denial of services, denial of visitation rights to same-sex partners, reluctance on the part of LGBT patients to share personal information, and failure of workers to assess and recognize the unique health care needs of these patients. Other bureaucratic forms of exclusion have included documents, forms, and policies that fail to acknowledge a patient's valued relationships because of, for example, a narrow definition of "spouse," "parent," or "family." Bureaucratic exclusion has taken a particularly prominent form in the U.S. military. Until its repeal and termination in 2011, the "Don't Ask, Don't Tell" policy had for eighteen years barred openly gay men and lesbians from serving in the military. Among the effects of DADT is a dearth of information about the number and needs of LGBT service members who transition to the Veterans Health Administration for health care at the end of their military service. The long-standing social stigma against LGBT persons, the silence mandated by DADT, and the often unrecognized bias built into the fabric of bureaucratic systems make the task of creating a welcoming culture in the VHA urgent and challenging. The VHA has accepted a commitment to that task. Its Strategic Plan for fiscal years 2013 through 2018 stipulates that "[v]eterans will receive timely, high quality, personalized, safe, effective and equitable health care irrespective of geography, gender, race, age, culture or sexual orientation." To achieve this goal, the VHA undertook a number of coordinated initiatives to create an environment and culture that is informed, welcoming, positive, and empowering for the LGBT veterans and families whom the agency serves. PMID:25231789

Sharpe, Virginia Ashby; Uchendu, Uchenna S

2014-09-01

31

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

32

Automated medical resident rotation and shift scheduling to ensure quality resident education and patient care.  

PubMed

At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms. PMID:25171938

Smalley, Hannah K; Keskinocak, Pinar

2014-08-30

33

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

34

Considering accreditation in gerontology: the importance of interprofessional collaborative competencies to ensure quality health care for older adults.  

PubMed

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 integral component of any program providing quality education on issues in aging. PMID:22289069

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

2012-01-01

35

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. PMID:22302094

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

2012-01-01

36

Grantee Spotlight: Isabel Scarinci, Ph.D., M.P.H. - Ensuring Latina Immigrants Have Equal Breast and Cervical Cancer Care  

Cancer.gov

A majority of Latinos living in Alabama face significant health disparities due to low-income, language barriers and cultural differences. Isabel C. Scarinci, Ph.D., MPH is a CRCHD U54 grantee who is ensuring that this population group has access to cancer prevention and treatment. In a recent interview, Scarinci explained that Latinos living in the region have limited access to health care. In 2011, the state of Alabama drew up legislation that has had impacted access to health services among Latino immigrants.

37

Sustaining a “culture of silence” in the neonatal intensive care unit during nonemergency situations: A grounded theory on ensuring adherence to behavioral modification to reduce noise levels  

PubMed Central

The aim of this study was to generate a substantive theory explaining how the staff in a resource-limited neonatal intensive care unit (NICU) of a developing nation manage to ensure adherence to behavioral modification components of a noise reduction protocol (NsRP) during nonemergency situations. The study was conducted after implementation of an NsRP in a level III NICU of south India. The normal routine of the NICU is highly dynamic because of various categories of staff conducting clinical rounds followed by care-giving activities. This is unpredictably interspersed with very noisy emergency management of neonates who suddenly fall sick. In-depth interviews were conducted with 36 staff members of the NICU (20 staff nurses, six nursing aides, and 10 physicians). Group discussions were conducted with 20 staff nurses and six nursing aides. Data analysis was done in line with the reformulated grounded theory approach, which was based on inductive examination of textual information. The results of the analysis showed that the main concern was to ensure adherence to behavioral modification components of the NsRP. This was addressed by using strategies to “sustain a culture of silence in NICU during nonemergency situations” (core category). The main strategies employed were building awareness momentum, causing awareness percolation, developing a sense of ownership, expansion of caring practices, evolution of adherence, and displaying performance indicators. The “culture of silence” reconditions the existing staff and conditions new staff members joining the NICU. During emergency situations, a “noisy culture” prevailed because of pragmatic neglect of behavioral modification when life support overrode all other concerns. In addition to this, the process of operant conditioning should be formally conducted once every 18 months. The results of this study may be adapted to create similar strategies and establish context specific NsRPs in NICUs with resource constraints. PMID:24646472

Swathi, S.; Ramesh, A.; Nagapoornima, M.; Fernandes, Lavina M.; Jisina, C.; Suman Rao, P. N.

2014-01-01

38

Sustaining a "culture of silence" in the neonatal intensive care unit during nonemergency situations: a grounded theory on ensuring adherence to behavioral modification to reduce noise levels.  

PubMed

The aim of this study was to generate a substantive theory explaining how the staff in a resource-limited neonatal intensive care unit (NICU) of a developing nation manage to ensure adherence to behavioral modification components of a noise reduction protocol (NsRP) during nonemergency situations. The study was conducted after implementation of an NsRP in a level III NICU of south India. The normal routine of the NICU is highly dynamic because of various categories of staff conducting clinical rounds followed by care-giving activities. This is unpredictably interspersed with very noisy emergency management of neonates who suddenly fall sick. In-depth interviews were conducted with 36 staff members of the NICU (20 staff nurses, six nursing aides, and 10 physicians). Group discussions were conducted with 20 staff nurses and six nursing aides. Data analysis was done in line with the reformulated grounded theory approach, which was based on inductive examination of textual information. The results of the analysis showed that the main concern was to ensure adherence to behavioral modification components of the NsRP. This was addressed by using strategies to "sustain a culture of silence in NICU during nonemergency situations" (core category). The main strategies employed were building awareness momentum, causing awareness percolation, developing a sense of ownership, expansion of caring practices, evolution of adherence, and displaying performance indicators. The "culture of silence" reconditions the existing staff and conditions new staff members joining the NICU. During emergency situations, a "noisy culture" prevailed because of pragmatic neglect of behavioral modification when life support overrode all other concerns. In addition to this, the process of operant conditioning should be formally conducted once every 18 months. The results of this study may be adapted to create similar strategies and establish context specific NsRPs in NICUs with resource constraints. PMID:24646472

Swathi, S; Ramesh, A; Nagapoornima, M; Fernandes, Lavina M; Jisina, C; Rao, P N Suman; Swarnarekha, A

2014-01-01

39

Identifying and ensuring optimal care for all children at risk of developing serious respiratory syncytial virus disease: a Canadian nurses' perspective.  

PubMed

Globally, respiratory syncytial virus (RSV) infection causes substantial morbidity in infants and young children, particularly those with specific risk factors (e.g., prematurity, chronic lung and congenital heart disease). Supportive measures are the mainstay of care for RSV-related disease. In the absence of medical treatments, RSV prophylaxis (RSVP) with palivizumab is recommended for high-risk patients to help reduce the risk of developing serious disease. Geographic distances, language and cultural barriers, and other factors can impede effective education of caregivers regarding the potential impact of RSV disease and benefits of RSVP compliance. We present our experiences developing successful Canadian RSVP programs, organized through a dedicated coordinator or small group of health care staff. These programs focus on identifying all infants and young children eligible for RSVP, effectively educating health care staff and family caregivers, developing educational tools that consider language and cultural factors, and interdisciplinary collaboration and networking throughout the health care system. PMID:23134644

Bracht, Marianne; Basevitz, Debbie; Cranis, Marilyn; Paulley, Rose; Paes, Bosco

2012-01-01

40

It's where strategies are launched to ensure families have access to quality healthcare. It's where a passion for patient care drives innovative medical  

E-print Network

a passion for patient care drives innovative medical discovery. It's where doctors and researchers work-955-4700 or visit www.mcw.edu/giving To find out how to begin your life-changing journey at MCW--whether you want-changing journey for our students, and for the patients whose lives they touch. Today, one-third of all physi

41

Does accreditation by the Association for Assessment and Accreditation of Laboratory Animal Care International (AAALAC) ensure greater compliance with animal welfare laws?  

PubMed

Accreditation of nonhuman animal research facilities by the Association for Assessment and Accreditation of Laboratory Animal Care International (AAALAC) is widely considered the "gold standard" of commitment to the well being of nonhuman animals used in research. AAALAC-accredited facilities receive preferential treatment from funding agencies and are viewed favorably by the general public. Thus, it bears investigating how well these facilities comply with U.S. animal research regulations. In this study, the incidences of noncompliance with the Animal Welfare Act (AWA) at AAALAC-accredited facilities were evaluated and compared to those at nonaccredited institutions during a period of 2 years. The analysis revealed that AAALAC-accredited facilities were frequently cited for AWA noncompliance items (NCIs). Controlling for the number of animals at each facility, AAALAC-accredited sites had significantly more AWA NCIs on average compared with nonaccredited sites. AAALAC-accredited sites also had more NCIs related to improper veterinary care, personnel qualifications, and animal husbandry. These results demonstrate that AAALAC accreditation does not improve compliance with regulations governing the treatment of animals in laboratories. PMID:25174609

Goodman, Justin R; Chandna, Alka; Borch, Casey

2015-01-01

42

Ensuring safe access to medication for palliative care while preventing prescription drug abuse: innovations for American inner cities, rural areas, and communities overwhelmed by addiction.  

PubMed

This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples); expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1) developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper-or abuse-resistant/deterrent drug formulations); and (2) expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse, misuse, or diversion). PMID:22312232

Francoeur, Richard B

2011-01-01

43

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

Code of Federal Regulations, 2013 CFR

...services. (4) Resource provider has personnel with documented training certification and degree experience (Naval Architecture, Fire Science, etc.). (5) Resource provider has 24-hour availability of personnel and...

2013-07-01

44

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

Code of Federal Regulations, 2012 CFR

...services. (4) Resource provider has personnel with documented training certification and degree experience (Naval Architecture, Fire Science, etc.). (5) Resource provider has 24-hour availability of personnel and...

2012-07-01

45

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

Code of Federal Regulations, 2014 CFR

...services. (4) Resource provider has personnel with documented training certification and degree experience (Naval Architecture, Fire Science, etc.). (5) Resource provider has 24-hour availability of personnel and...

2014-07-01

46

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

Code of Federal Regulations, 2010 CFR

...2) Resource provider has documented history of participation in successful salvage...experience (Naval Architecture, Fire Science, etc.). (5) Resource provider...availability of personnel and equipment, and history of response times compatible with...

2010-07-01

47

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

Code of Federal Regulations, 2011 CFR

...2) Resource provider has documented history of participation in successful salvage...experience (Naval Architecture, Fire Science, etc.). (5) Resource provider...availability of personnel and equipment, and history of response times compatible with...

2011-07-01

48

Ensuring Interoperability with Automated Interoperability Testing  

E-print Network

other domains, e.g., the Internet or health care applications, interoperability testing has beenEnsuring Interoperability with Automated Interoperability Testing Olaf Bergengruen, Rhode & Schwarz This white paper presents a new approach to achieve interoperability via the automation of interoperability

Grabowski, Jens

49

"Whatever my mother wants": barriers to adequate pain management.  

PubMed

Opioids are the preferred medications to treat cancer pain; however, several barriers to cancer pain management exist, including those related to the patient, health care provider, and family caregiver. We describe one such situation in which a family member prevents the patient from receiving adequate pain management at the end of life despite interdepartmental and interdisciplinary efforts. This case highlights the importance of understanding and addressing fears regarding opioid use and implementing an integrated approach including oncologists and palliative care physicians, along with early referrals to palliative care. PMID:22946542

Reddy, Akhila; Yennurajalingam, Sriram; Bruera, Eduardo

2013-06-01

50

Ensuring safer drinking water  

SciTech Connect

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 developed in the mid-1980s by an independent, voluntary consensus standards organization called NSF International (formerly known as the National Sanitation Foundation). This paper explains the need for and the structure of the Drinking Water Additives Program; the rationale for transferring responsibility for its execution from the EPA to the private sector; and the impact of its standards on users, manufacturers, and state and local regulatory bodies. Understanding the additives program is critically important to industry suppliers because, as it continues to gain greater awareness and acceptance, there are a growing number of manufacturers sourcing materials and products primarily from suppliers whose products meet the program's certification requirements.

Christensen, J. (Advanced Elastomer Systems, St. Louis, MO (United States). Fluid Delivery and Electrical Markets); Higgins, P. (PJ Higgins and Associates Inc., Frederick, MD (United States))

1994-09-01

51

29 CFR 452.110 - Adequate safeguards.  

Code of Federal Regulations, 2010 CFR

...DEPARTMENT OF LABOR LABOR-MANAGEMENT STANDARDS GENERAL STATEMENT CONCERNING THE ELECTION PROVISIONS OF THE LABOR-MANAGEMENT REPORTING AND DISCLOSURE ACT OF 1959 Election Procedures; Rights of Members § 452.110 Adequate...

2010-07-01

52

Developing a service model that integrates palliative care throughout cancer care: the time is now.  

PubMed

Palliative care is a fundamental component of cancer care. As part of the 2011 to 2012 Leadership Development Program (LDP) of the American Society of Clinical Oncology (ASCO), a group of participants was charged with advising ASCO on how to develop a service model integrating palliative care throughout the continuum of cancer care. This article presents the findings of the LDP group. The group focused on the process of palliative care delivery in the oncology setting. We identified key elements for models of palliative care in various settings to be potentially equitable, sustainable, feasible, and acceptable, and here we describe a dynamic model for the integrated, simultaneous implementation of palliative care into oncology practice. We also discuss critical considerations to better integrate palliative care into oncology, including raising consciousness and educating both providers and the public about the importance of palliative care; coordinating palliative care efforts through strengthening affiliations and/or developing new partnerships; prospectively evaluating the impact of palliative care on patient and provider satisfaction, quality improvement, and cost savings; and ensuring sustainability through adequate reimbursement and incentives, including linkage of performance data to quality indicators, and coordination with training efforts and maintenance of certification requirements for providers. In light of these findings, we believe the confluence of increasing importance of incorporation of palliative care education in oncology education, emphasis on value-based care, growing use of technology, and potential cost savings makes developing and incorporating palliative care into current service models a meaningful goal. PMID:25199756

Partridge, Ann H; Seah, Davinia S E; King, Tari; Leighl, Natasha B; Hauke, Ralph; Wollins, Dana S; Von Roenn, Jamie Hayden

2014-10-10

53

[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

López Soto, Rosa María

2009-12-01

54

Using microfiber and steam technology to improve cleaning outcomes in an intensive care unit.  

PubMed

The use of microfiber and steam technology may be seen as a novel cleaning method that can improve the outcome of cleaning. We describe its use in an intensive care setting, its impact on vancomycin-resistant enterococci acquisition, and the importance of ensuring adequate education of cleaning staff. Such new methods can have a significant impact on the transmission of multidrug-resistant organisms, provided systems are in place to ensure that the methodology is adhered to and that cleaning hours are adequate. PMID:25637118

Gillespie, Elizabeth; Williams, Natalie; Sloane, Tracy; Wright, Louise; Kotsanas, Despina; Stuart, Rhonda L

2015-02-01

55

29 CFR 505.5 - Adequate assurances.  

Code of Federal Regulations, 2010 CFR

...ENDOWMENTS FOR THE ARTS AND HUMANITIES § 505.5 Adequate assurances...hazardous or dangerous to the health and safety of the employees...National Endowment for the Humanities, as appropriate, Form ESA-38...the wages, hours, safety, health, and other...

2010-07-01

56

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

57

Ensuring ethical behavior in organizations  

SciTech Connect

This paper examines both the industrial-age and the information-age organization`s attempts to ensure ethical behavior. Organizational responses to deal with this task include establishing written codes, appointing ethics officers, developing ethics committees, training, and impacting educational systems.

Milter, R.G.

1994-12-31

58

Ensuring High Quality Research Services.  

ERIC Educational Resources Information Center

This paper discusses ensuring high quality research services that meet client needs, based on experiences at the Research and Information Services of the Ontario Legislative Library (Canada). The first section is an introduction that provides an overview of the Research and Information Services and summarizes factors related to quality control.…

Gardner, Bob

59

Radiology by Nonradiologists: Is Report Documentation Adequate?  

Microsoft Academic Search

Study Design: A retrospective nonblinded review of randomly selected chest and long bone x-ray reports by orthopedists and pri- mary care physicians compared with randomly selected imaging reports generated by radiologists. Methods: We randomly selected 1 report from each of 50 high self-referring physicians privileged by 2 metropolitan New York area health plans for both bone and joint studies and

Shelley Nan Weiner

60

HMBC-1,n-ADEQUATE spectra calculated from HMBC and 1,n-ADEQUATE spectra.  

PubMed

Unsymmetrical and generalized indirect covariance processing methods provide a means of mathematically combining pairs of 2D NMR spectra that share a common frequency domain to facilitate the extraction of correlation information. Previous reports have focused on the combination of HSQC spectra with 1,1-, 1,n-, and inverted (1)J(CC) 1,n-ADEQUATE spectra to afford carbon-carbon correlation spectra that allow the extraction of direct ((1)J(CC)), long-range ((n)J(CC), where n???2), and (1)J(CC)-edited long-range correlation data, respectively. Covariance processing of HMBC and 1,1-ADEQUATE spectra has also recently been reported, allowing convenient, high-sensitivity access to (n)J(CC) correlation data equivalent to the much lower sensitivity n,1-ADEQUATE experiment. Furthermore, HMBC-1,1-ADEQUATE correlations are observed in the F1 frequency domain at the intrinsic chemical shift of the (13)C resonance in question rather than at the double-quantum frequency of the pair of correlated carbons, as visualized by the n,1, and m,n-ADEQUATE experiments, greatly simplifying data interpretation. In an extension of previous work, the covariance processing of HMBC and 1,n-ADEQUATE spectra is now reported. The resulting HMBC-1,n-ADEQUATE spectrum affords long-range carbon-carbon correlation data equivalent to the very low sensitivity m,n-ADEQUATE experiment. In addition to the significantly higher sensitivity of the covariance calculated spectrum, correlations in the HMBC-1,n-ADEQUATE spectrum are again detected at the intrinsic (13)C chemical shifts of the correlated carbons rather than at the double-quantum frequency of the pair of correlated carbons. HMBC-1,n-ADEQUATE spectra can provide correlations ranging from diagonal ((0)J(CC) or diagonal correlations) to (4)J(CC) under normal circumstances to as much as (6)J(CC) in rare instances. The experiment affords the potential means of establishing the structures of severely proton-deficient molecules. PMID:23483673

Martin, Gary E; Blinov, Kirill A; Williamson, R Thomas

2013-05-01

61

Improving children's access to health care: the role of decategorization.  

PubMed Central

Far too many children in this country are unable to obtain the health care they need because of barriers that prohibit easy access. Among the most significant obstacles are financial barriers, including lack of adequate health insurance and inadequate funding of programs for low-income children and those with special health-care needs. Another set of "non-financial" barriers are related to the categorical nature of addressing children's health-care needs, which impedes access by increasing the complexity and burden of seeking care and discourages providers from providing care. Decategorization represents an appealing partial remedy to these problems because it can lead to fundamental and lasting changes in financing and delivering health services. The greatest appeal of decategorization is its potential to improve access to care with the expenditure of little or no new funds. Decategorization also holds considerable risk. Depending on how it is designed and implemented, decategorization may lead to diminished access to care by serving as a foil for budget cuts or by undermining essential standards of care. However, these risks do not negate the value of exploring decategorization as an approach that can be taken today to better organize services and ensure that existing resources adequately meet children's needs. In this report we examine the role of decategorization as a mechanism for removing the barriers to care that are created by categorical funding of health programs. PMID:8982519

Hughes, D. C.; Halfon, N.; Brindis, C. D.; Newacheck, P. W.

1996-01-01

62

Ensuring the Health of Refugees: Taking a Broader Vision.  

ERIC Educational Resources Information Center

Refugee assistance policies and programs should be reoriented to ensure both short- and long-term physical, social, and mental well-being. This approach must fully encompass primary health care and embrace a wide range of activities and programs that are not traditionally viewed as health-related. The refugee assistance community is sometimes…

Kuntz, Diane; And Others

63

Ensuring equal opportunity sprinkler irrigation  

Technology Transfer Automated Retrieval System (TEKTRAN)

Equal opportunity for plants to sprinkler irrigation water must be carefully considered by crop producers, irrigation consultants, and the industry that supplies the irrigation equipment. Equal opportunity can be negated by improper marketing, design, and installation, as well as through improper f...

64

[Neonatal asphyxia: a care experience using hypothermic therapy].  

PubMed

Hypothermia therapy, used to treat hypoxic-ischemic encephalopathy in neonates, has been shown to effectively decrease asphyxia complications and mortality. This article reports on an experience using this therapy approach to care for a neonatal asphyxic patient. Due to our lack of an appropriate cooling device, we adjusted the number of cool water bags to successfully perform hypothermic therapy. Despite this added procedural complication, we succeeded in saving the patient's life. The holistic care process for this type of case requires family-centered care to help family members deal with the critical condition and assist parents to face depression and guilt, reduce anxiety, and reaffirm the parent-child relationship. We used hypothermia in the initial stage. Relevant standards of critical care for this condition should be established to ensure adequate nursing care safety and quality. PMID:24310560

Wang, Mo-Mei; Wang, Mei-Hua

2013-12-01

65

Leveraging Community-Based Financing for Women's Nonmaternal Health Care: Experiences of Rural Indian Women.  

PubMed

Given the increasing need for mainstreaming household financing for women's nonmaternal health care and evidences on community-based financing's contribution to women's health care in general, this study explored their scope for nonmaternal health care in Orissa. A qualitative assessment conducted focus group discussions with rural women who met the eligibility criteria. Community-based financing provided financial access and risk protection for women's nonmaternal health care during the previous 1 year, though not adequately. Schemes covering outpatient care (or mild illnesses) provided relatively more financial access. The major determinants of their restricted financial access were limited sum assured, noncomprehensive coverage of services, exclusion of elderly women, and the lower priority households gave to nonmaternal health care. Community-based financing requires relevant structural changes along with demand-side behavioral modifications to ensure optimal attention to women's nonmaternal health care. PMID:22234831

Gopalan, Saji S; Durairaj, Varatharajan

2012-01-10

66

Adequate mathematical modelling of environmental processes  

NASA Astrophysics Data System (ADS)

In environmental observations and laboratory visualization both large scale flow components like currents, jets, vortices, waves and a fine structure are registered (different examples are given). The conventional mathematical modeling both analytical and numerical is directed mostly on description of energetically important flow components. The role of a fine structures is still remains obscured. A variety of existing models makes it difficult to choose the most adequate and to estimate mutual assessment of their degree of correspondence. The goal of the talk is to give scrutiny analysis of kinematics and dynamics of flows. A difference between the concept of "motion" as transformation of vector space into itself with a distance conservation and the concept of "flow" as displacement and rotation of deformable "fluid particles" is underlined. Basic physical quantities of the flow that are density, momentum, energy (entropy) and admixture concentration are selected as physical parameters defined by the fundamental set which includes differential D'Alembert, Navier-Stokes, Fourier's and/or Fick's equations and closing equation of state. All of them are observable and independent. Calculations of continuous Lie groups shown that only the fundamental set is characterized by the ten-parametric Galilelian groups reflecting based principles of mechanics. Presented analysis demonstrates that conventionally used approximations dramatically change the symmetries of the governing equations sets which leads to their incompatibility or even degeneration. The fundamental set is analyzed taking into account condition of compatibility. A high order of the set indicated on complex structure of complete solutions corresponding to physical structure of real flows. Analytical solutions of a number problems including flows induced by diffusion on topography, generation of the periodic internal waves a compact sources in week-dissipative media as well as numerical solutions of the same problems are constructed. They include regular perturbed function describing large scale component and a rich family of singular perturbed function corresponding to fine flow components. Solutions are compared with data of laboratory experiments performed on facilities USU "HPC IPMec RAS" under support of Ministry of Education and Science RF (Goscontract No. 16.518.11.7059). Related problems of completeness and accuracy of laboratory and environmental measurements are discussed.

Chashechkin, Yu. D.

2012-04-01

67

Two pathways ensuring social harmony.  

PubMed

Reproductive division of labour is a characteristic trait of social insects. The dominant reproductive individual, often the queen, uses chemical communication and/or behaviour to maintain her social status. Queens of many social insects communicate their fertility status via cuticle-bound substances. As these substances usually possess a low volatility, their range in queen-worker communication is potentially limited. Here, we investigate the range and impact of behavioural and chemical queen signals on workers of the ant Temnothorax longispinosus. We compared the behaviour and ovary development of workers subjected to three different treatments: workers with direct chemical and physical contact to the queen, those solely under the influence of volatile queen substances and those entirely separated from the queen. In addition to short-ranged queen signals preventing ovary development in workers, we discovered a novel secondary pathway influencing worker behaviour. Workers with no physical contact to the queen, but exposed to volatile substances, started to develop their ovaries, but did not change their behaviour compared to workers in direct contact to the queen. In contrast, workers in queen-separated groups showed both increased ovary development and aggressive dominance interactions. We conclude that T. longispinosus queens influence worker ovary development and behaviour via two independent signals, both ensuring social harmony within the colony. PMID:22806253

Konrad, Matthias; Pamminger, Tobias; Foitzik, Susanne

2012-08-01

68

Two pathways ensuring social harmony  

NASA Astrophysics Data System (ADS)

Reproductive division of labour is a characteristic trait of social insects. The dominant reproductive individual, often the queen, uses chemical communication and/or behaviour to maintain her social status. Queens of many social insects communicate their fertility status via cuticle-bound substances. As these substances usually possess a low volatility, their range in queen-worker communication is potentially limited. Here, we investigate the range and impact of behavioural and chemical queen signals on workers of the ant Temnothorax longispinosus. We compared the behaviour and ovary development of workers subjected to three different treatments: workers with direct chemical and physical contact to the queen, those solely under the influence of volatile queen substances and those entirely separated from the queen. In addition to short-ranged queen signals preventing ovary development in workers, we discovered a novel secondary pathway influencing worker behaviour. Workers with no physical contact to the queen, but exposed to volatile substances, started to develop their ovaries, but did not change their behaviour compared to workers in direct contact to the queen. In contrast, workers in queen-separated groups showed both increased ovary development and aggressive dominance interactions. We conclude that T. longispinosus queens influence worker ovary development and behaviour via two independent signals, both ensuring social harmony within the colony.

Konrad, Matthias; Pamminger, Tobias; Foitzik, Susanne

2012-08-01

69

Fundamentals of randomized clinical trials in wound care: design and conduct.  

PubMed

The care for chronic and acute wounds is a substantial problem around the world. This has led to a plethora of products to accelerate healing. Unfortunately, the quality of studies evaluating the efficacy of such wound care products is frequently low. Randomized clinical trials are universally acknowledged as the study design of choice for comparing treatment effects, as they eliminate several sources of bias. We propose a framework for the design and conduct of future randomized clinical trials that will offer strong scientific evidence for the effectiveness of wound care interventions. While randomization is a necessary feature of a robust comparative study, it is not sufficient to ensure a study at low risk of bias. Randomized clinical trials should also ensure adequate allocation concealment and blinding of outcome assessors, apply intention-to-treat analysis, and use patient-oriented outcomes. This article proposes strategies for improving the evidence base for wound care decision making. PMID:22642397

Eskes, Anne M; Brölmann, Fleur E; Sumpio, Bauer E; Mayer, Dieter; Moore, Zena; Agren, Magnus S; Hermans, Michel; Cutting, Keith; Legemate, Dink A; Ubbink, Dirk T; Vermeulen, Hester

2012-01-01

70

13 CFR 108.200 - Adequate capital for NMVC Companies.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Adequate capital for NMVC Companies. 108...Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications...Company § 108.200 Adequate capital for NMVC Companies....

2010-01-01

71

15 CFR 970.404 - Adequate exploration plan.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Adequate exploration plan. 970.404 Section 970...DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may...

2010-01-01

72

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 ...

73

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

PubMed

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 respondent's race, ethnicity, age, education, and country of birth. PMID:22658579

Goodman, Melody S; Gaskin, Darrell J; Si, Xuemei; Stafford, Jewel D; Lachance, Christina; Kaphingst, Kimberly A

2012-09-01

74

Quality of Care  

Cancer.gov

The Institute of Medicine (IOM) defines quality of care as "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." In 1999, the IOM issued Ensuring Quality Cancer Care, a report that documented significant gaps in the quality of cancer care in the United States.

75

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

76

Child Health USA 2013: Barriers to Prenatal Care  

MedlinePLUS

... Utilization > Barriers to Prenatal Care Barriers to Prenatal Care Narrative Early and adequate prenatal care is important ... Data Mothers Who Experienced Barriers to Receiving Prenatal Care as Early as Desired, by Maternal Age, 2009– ...

77

9 CFR 305.3 - Sanitation and adequate facilities.  

Code of Federal Regulations, 2013 CFR

...Animal Products 2 2013-01-01 2013-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals...WITHDRAWAL OF INSPECTION; REPORTS OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be...

2013-01-01

78

9 CFR 305.3 - Sanitation and adequate facilities.  

Code of Federal Regulations, 2012 CFR

...Animal Products 2 2012-01-01 2012-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals...WITHDRAWAL OF INSPECTION; REPORTS OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be...

2012-01-01

79

9 CFR 305.3 - Sanitation and adequate facilities.  

Code of Federal Regulations, 2014 CFR

...Animal Products 2 2014-01-01 2014-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals...WITHDRAWAL OF INSPECTION; REPORTS OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be...

2014-01-01

80

9 CFR 305.3 - Sanitation and adequate facilities.  

Code of Federal Regulations, 2011 CFR

...Animal Products 2 2011-01-01 2011-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals...WITHDRAWAL OF INSPECTION; REPORTS OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be...

2011-01-01

81

9 CFR 305.3 - Sanitation and adequate facilities.  

Code of Federal Regulations, 2010 CFR

...Animal Products 2 2010-01-01 2010-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals...WITHDRAWAL OF INSPECTION; REPORTS OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be...

2010-01-01

82

The role of corporations in ensuring biodiversity  

Microsoft Academic Search

Corporations own approximately 25% of all private land in the United States and, therefore, play an essential role in protecting biodiversity and maintaining natural habitats. The Wildlife Habitat Council (WHC) is a unique joint venture between conservation organizations and corporations to utilize corporate lands for ensuring biodiversity. The following case studies demonstrate how corporations have helped ensure healthy ecosystems and

Joyce M. Kelly; Michael R. Hodge

1996-01-01

83

Prioritization of inpatient hospital services to prisoners: a method for justifying care and costs.  

PubMed

As a response to rising health care costs and substantial cuts in state funding for correctional health care in Texas, we developed and applied a process framework for systematically prioritizing the provision of inpatient hospital services to prisoners. Specifically, all inpatient services provided from September 2009 through August 2011 at the University of Texas Medical Branch/Texas Department of Criminal Justice Hospital were sorted according to levels of care consistent with those previously defined by the Oregon Department of Corrections and the Federal Bureau of Prisons. Nearly all inpatient services (94%) were deemed medically mandatory (Level 1) or medically necessary (Level 2). These services must be funded to ensure an adequate level of care, and capitated-funding mechanisms may not be sufficiently flexible to cover their costs. Correctional health care systems may adapt the framework used here to inform state policymakers regarding provision of inpatient services and funding requirements. PMID:24858890

Schneider, Bryan C; Harzke, Amy Jo; Ivanitskaya, Lana; Murray, Owen J

2014-05-01

84

Ensuring patient choices about dignity and place of death are respected at the end of life.  

PubMed

Ensuring patient choice and dignity are priorities in providing high quality end of life care. This artide discusses the importance of psychosocial care when patients receive a terminal diagnosis, and the district nurse's role in ensuring their choices about place of death are respected. It examines some of the dilemmas nurses may face in respecting patients' preferences about place of care and death, and looks at how services may need to change in the future to meet the needs of the increasing ageing population. PMID:20593676

Bracegirdle, Lorna-Rose

85

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. PMID:11723597

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

2001-01-01

86

13 CFR 108.200 - Adequate capital for NMVC Companies.  

Code of Federal Regulations, 2014 CFR

...Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate...

2014-01-01

87

13 CFR 108.200 - Adequate capital for NMVC Companies.  

Code of Federal Regulations, 2011 CFR

...Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate...

2011-01-01

88

13 CFR 108.200 - Adequate capital for NMVC Companies.  

Code of Federal Regulations, 2013 CFR

...Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate...

2013-01-01

89

13 CFR 108.200 - Adequate capital for NMVC Companies.  

Code of Federal Regulations, 2012 CFR

...Companies. 108.200 Section 108.200 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate...

2012-01-01

90

34 CFR 200.13 - Adequate yearly progress in general.  

Code of Federal Regulations, 2011 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.13 ...academic achievement standards; while (2) Working toward the goal of narrowing the achievement gaps in the State, its...

2011-07-01

91

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2011 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.14 ...points in accordance with § 200.16. (c) Intermediate goals in accordance with § 200.17. (d) Annual measurable...

2011-07-01

92

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2012 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.14 ...points in accordance with § 200.16. (c) Intermediate goals in accordance with § 200.17. (d) Annual measurable...

2012-07-01

93

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2010 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.14 ...points in accordance with § 200.16. (c) Intermediate goals in accordance with § 200.17. (d) Annual measurable...

2010-07-01

94

34 CFR 200.13 - Adequate yearly progress in general.  

Code of Federal Regulations, 2013 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.13 ...academic achievement standards; while (2) Working toward the goal of narrowing the achievement gaps in the State, its...

2013-07-01

95

34 CFR 200.13 - Adequate yearly progress in general.  

Code of Federal Regulations, 2014 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.13 ...academic achievement standards; while (2) Working toward the goal of narrowing the achievement gaps in the State, its...

2014-07-01

96

34 CFR 200.13 - Adequate yearly progress in general.  

Code of Federal Regulations, 2012 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.13 ...academic achievement standards; while (2) Working toward the goal of narrowing the achievement gaps in the State, its...

2012-07-01

97

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2013 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.14 ...points in accordance with § 200.16. (c) Intermediate goals in accordance with § 200.17. (d) Annual measurable...

2013-07-01

98

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2014 CFR

...DISADVANTAGED Improving Basic Programs Operated by Local Educational Agencies Adequate Yearly Progress (ayp) § 200.14 ...points in accordance with § 200.16. (c) Intermediate goals in accordance with § 200.17. (d) Annual measurable...

2014-07-01

99

Broadband inversion of 1J(CC) responses in 1,n-ADEQUATE spectra.  

PubMed

Establishing the carbon skeleton of a molecule greatly facilitates the process of structure elucidation, both manual and computer-assisted. Recent advances in the family of ADEQUATE experiments demonstrated their potential in this regard. 1,1-ADEQUATE, which provides direct (13)C-(13)C correlation via (1)J(CC), and 1,n-ADEQUATE, which typically yields (3)J(CC) and (1)J(CC) correlations, are more sensitive and more widely applicable experiments than INADEQUATE and PANACEA. A recently reported modified pulse sequence that semi-selectively inverts (1)J(CC) correlations in 1,n-ADEQUATE spectra provided a significant improvement, allowing (1)J(CC) and (n)J(CC) correlations to be discerned in the same spectrum. However, the reported experiment requires a careful matching of the amplitude transfer function with (1)J(CC) coupling constants in order to achieve the inversion, and even then some (1)J(CC) correlations could still have positive intensity due to the oscillatory nature of the transfer function. Both shortcomings limit the practicality of the method. We now report a new, dual-optimized inverted (1)J(CC) 1,n-ADEQUATE experiment, which provides more uniform inversion of (1)J(CC) correlations across the range of 29-82 Hz. Unlike the original method, the dual optimization experiment does not require fine-tuning for the molecule's (1)J(CC) coupling constant values. Even more usefully, the dual-optimized version provides up to two-fold improvement in signal-to-noise for some long-range correlations. Using modern, cryogenically-cooled probes, the experiment can be successfully applied to samples of ~1 mg under favorable circumstances. The improvements afforded by dual optimization inverted (1)J(CC) 1,n-ADEQUATE experiment make it a useful and practical tool for NMR structure elucidation and should facilitate the implementation and utilization of the experiment. PMID:24035003

Reibarkh, Mikhail; Williamson, R Thomas; Martin, Gary E; Bermel, Wolfgang

2013-11-01

100

Contract litigation: prepare for war to ensure peace.  

PubMed

Contract litigation can prove devastating for all but the deepest of pockets. Physicians need to prepare for war to ensure the most favorable outcome. This includes identifying your risks, negotiating from strength, and hedging your bets. Negotiate and read your contracts carefully. Beware of critical loser pays provisions in your contracts that will require you to pay your adversary's fees in the event of an adverse ruling at trial or summary judgment. Keep your insurance portfolio up to date, including the latest risk management tools, such as contract litigation insurance. Protect yourself and your practice by planning ahead. PMID:21595375

Martin, Kevin; Amir, Michael M

2011-01-01

101

Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement  

PubMed Central

Background Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. Methods We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. Results The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as “too esoteric”, the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Conclusions Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and “fitness for purpose”, and avoid omission of vital knowledge. PMID:24555812

2014-01-01

102

Adequate Lymph Node Recovery Improves Survival in Colorectal Cancer Patients  

PubMed Central

Introduction Current recommendations suggest recovery of 12 lymph nodes during surgical resection for colorectal cancer (CRC) for proper staging and prognostication. Adequate lymph node recovery has been associated with improved patient survival, with results inconsistent. Methods We examined factors for association with adequate lymph node recovery and used findings to adjust survival analyses to clarify whether adequate lymph node examination is associated with CRC survival or associated with a subset of characteristics that biases lymph node recovery. Results In 74% of subjects (1036/1397) adequate number of lymph nodes were examined. A stepwise multivariate regression analysis showed procedure year, cancer stage, tumor size, and age at diagnosis were significantly associated with lymph node recovery. These and other factors associated with survival status were adjusted for in further analyses, revealing no difference in unadjusted overall survival by adequacy of lymph node recovery (HR=0.90, 95% CI 0.75–1.08, P=0.239). However, in adjusted Cox proportional hazards analysis, adequate lymph node recovery was associated with reduced risk for death (HR=0.71, 95% CI 0.57–0.89, P=0.002). Conclusion The current recommendation for retrieval and examination of at least 12 lymph nodes is appropriate for proper treatment and prognostication in patients undergoing surgical resection for CRC. PMID:23592545

ONITILO, ADEDAYO A.; STANKOWSKI, RACHEL V.; ENGEL, JESSICA M.; DOI, SUHAIL A. R.

2013-01-01

103

Tracking medical devices to ensure patient safety.  

PubMed

Registered nurses in perioperative settings and managers of perioperative departments must work together to implement policies and procedures to ensure compliance with these very important federal regulations. If the information is not recorded in the proper manner and shared with the manufacturer, patients' safety is at risk. Without the ability to contact physicians and patients, manufacturers cannot alert individuals appropriately if problems arise with a certain device. Tracking devices in the correct manner ensures that patients can be notified expediently. Nurses and managers should examine their current practices to ensure that they are consistent with federal regulations. A regular assessment should be conducted to ensure that tracking forms are completed in an accurate, timely manner, that permission to release a patient's social security number is obtained, and that the hospital is compliant with the FDA's most up-to-date list of devices that must be tracked. All perioperative staff members must receive education about the tracking process in their particular institution and receive updates when the process or FDA regulations change. Maintain patient safety by ensuring that the medical device tracking process is followed accurately and meets federal regulations. PMID:12575634

Beyea, Suzanne C

2003-01-01

104

Public managed care and service access in outpatient substance abuse treatment units.  

PubMed

The continued growth of public managed behavioral health care has raised concerns about possible effects on services provided. This study uses a national sample of outpatient substance abuse treatment units surveyed in 2005 to examine associations between public managed care and service access, measured as both the types of services provided and the amount of treatment received by clients. The percentage of clients funded through public managed care versus other types of public funding was positively associated with treatment units' odds of providing some types of resource-intensive services and with the odds of providing transportation to clients, but was negatively associated with the average number of individual therapy sessions clients received over the course of treatment. In general, public managed care does not appear to restrict access to outpatient substance abuse treatment, although states should monitor these contracts to ensure clients receive adequate courses of individual treatment. PMID:21184286

Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A

2011-10-01

105

Regulating electricity to ensure efficient competition  

Microsoft Academic Search

The European Commission's attempt to update the Electricity and Gas Directives to underwrite unbundling and full liberalisation coincides with the California electricity crisis. The paper argues that compared to the US, much of the EU lacks the necessary legislative and regulatory power to mitigate generator market power. Unless markets are made more contestable, transmission capacity expanded and adequate generation capacity

David M Newbery

2001-01-01

106

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

107

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

108

The Effects of Technically Adequate Instructional Data on Achievement.  

ERIC Educational Resources Information Center

Disabled students (N=117) reading three passages were ranked by degree of implementation of a curriculum-based measurement and evaluation system. Comparison of top and bottom 27 percent revealed score differences on all passages, suggesting that a high degree of implementation of a technically adequate data system leads to greater achievement. (CL)

Wesson, Caren; And Others

1984-01-01

109

Assessing Juvenile Sex Offenders to Determine Adequate Levels of Supervision.  

ERIC Educational Resources Information Center

This study analyzed the internal consistency of four inventories used by Utah probation officers to determine adequate and efficacious supervision levels and placement for juvenile sex offenders. Three factors accounted for 41.2 percent of variance (custodian's and juvenile's attitude toward intervention, offense characteristics, and historical…

Gerdes, Karen E.; And Others

1995-01-01

110

Comparability and Reliability Considerations of Adequate Yearly Progress  

ERIC Educational Resources Information Center

The purpose of this study is to develop an estimate of Adequate Yearly Progress (AYP) that will allow for reliable and valid comparisons among student subgroups, schools, and districts. A shrinkage-type estimator of AYP using the Bayesian framework is described. Using simulated data, the performance of the Bayes estimator will be compared to…

Maier, Kimberly S.; Maiti, Tapabrata; Dass, Sarat C.; Lim, Chae Young

2012-01-01

111

Cyber-Physical Systems -Are Computing Foundations Adequate?  

E-print Network

Cyber-Physical Systems - Are Computing Foundations Adequate? Edward A. Lee Department of EECS, UC Berkeley Position Paper for NSF Workshop On Cyber-Physical Systems: Research Motivation, Techniques and Roadmap October 16 - 17, 2006 Austin, TX 1 Summary Cyber-Physical Systems (CPS) are integrations

112

Ensuring message embedding in wet paper steganography  

E-print Network

Ensuring message embedding in wet paper steganography Daniel Augot1, Morgan Barbier1, and Caroline of this new scheme in the case of perfect codes. Keywords: steganography, syndrome coding problem, wet paper codes. 1 Introduction Hiding messages in innocuous-looking cover-media in a stealthy way, steganography

Paris-Sud XI, Université de

113

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...

114

Ensuring Compliance of Distributed and Collaborative Workflows  

E-print Network

a public process model with additional information about its execution behavior not observable fromEnsuring Compliance of Distributed and Collaborative Workflows David Knuplesch and Manfred Reichert and R¨udiger Pryss Institute of Databases and Information Systems Ulm University, Germany {david

Ulm, Universität

115

Electronic Information Delivery: Ensuring Quality and Value.  

ERIC Educational Resources Information Center

How do you judge the accuracy, reliability, and completeness of an electronic or online database? What measures do publishers and distributors employ to ensure that quality standards are met? Who is responsible for what part of the process? Eighteen contributors address these questions and more in their discussion of an important issue in today's…

Basch, Reva, Ed.

116

Subcutaneous immunoglobulin replacement therapy: ensuring success.  

PubMed

Subcutaneous immunoglobulin (SCIg) infusions are an option for patients requiring immunoglobulin therapy. Nurses are uniquely positioned to advocate for patients and to teach them how to successfully manage their infusions. The purpose of this review is to describe SCIg therapy and to provide teaching instructions as well as creative tips to ensure treatment success. PMID:25545976

Younger, M Elizabeth M; Blouin, William; Duff, Carla; Epland, Kristin Buehler; Murphy, Elyse; Sedlak, Debra

2015-01-01

117

[Is the patient with respiratory failure adequately cared for these days?].  

PubMed

Pulmonary function studies in 20,000 non-clinical probands throughout Austria showed abnormal findings in 20%. This is further evidence that chronic obstructive pulmonary disease (COPD) is epidemiologically similar to coronary heart disease. A staging classification of COPD has been proposed to facilitate a strategy for the prevention of the disease and to permit coordination among general practitioners, specialists and pulmonary function laboratories. This initiative aims to reduce the prevalence of advanced (stage IV) COPD. In the meantime long-term oxygen therapy and respirator therapy should be used increasingly to improve the quality of life of patients with advanced COPD. PMID:1290317

Harnoncourt, K

1992-01-01

118

Requirement and criteria of adequate vitamin supply in healthy newborns.  

PubMed

Studies of the relationship between urinary excretion of vitamins and their daily intake in healthy newborns showed that babies aged 3-10 days should receive 30 mg vitamin C, 0.24 mg vitamin B(2), and 0.13 mg vitamin B(1). The criteria of adequate vitamin C, B(1), and B(2) supply evaluated by their urinary excretion are 220.0, 0.7, and 1.4 mg/g excreted creatinine, respectively. PMID:15452605

Kodentsova, V M; Vrzhesinskaya, O A

2004-04-01

119

Ensuring Quality in AFRINEST and SATT  

PubMed Central

Background: Three randomized open-label clinical trials [Simplified Antibiotic Therapy Trial (SATT) Bangladesh, SATT Pakistan and African Neonatal Sepsis Trial (AFRINEST)] were developed to test the equivalence of simplified antibiotic regimens compared with the standard regimen of 7 days of parenteral antibiotics. These trials were originally conceived and designed separately; subsequently, significant efforts were made to develop and implement a common protocol and approach. Previous articles in this supplement briefly describe the specific quality control methods used in the individual trials; this article presents additional information about the systematic approaches used to minimize threats to validity and ensure quality across the trials. Methods: A critical component of quality control for AFRINEST and SATT was striving to eliminate variation in clinical assessments and decisions regarding eligibility, enrollment and treatment outcomes. Ensuring appropriate and consistent clinical judgment was accomplished through standardized approaches applied across the trials, including training, assessment of clinical skills and refresher training. Standardized monitoring procedures were also applied across the trials, including routine (day-to-day) internal monitoring of performance and adherence to protocols, systematic external monitoring by funding agencies and external monitoring by experienced, independent trial monitors. A group of independent experts (Technical Steering Committee/Technical Advisory Group) provided regular monitoring and technical oversight for the trials. Conclusions: Harmonization of AFRINEST and SATT have helped to ensure consistency and quality of implementation, both internally and across the trials as a whole, thereby minimizing potential threats to the validity of the trials’ results. PMID:23945575

2013-01-01

120

Achieve cost benefits with innovative care management.  

PubMed

Progressive care units (PCUs) are fast emerging to help relieve numerous demands on the health care industry. Complete this systematic development process to ensure a cost-effective startup PCU. PMID:11982131

Quintero, Juan R

2002-04-01

121

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 ...

122

Ensuring content integrity when using commercial support.  

PubMed

Preventing continuing education program bias when commercial support is used can be challenging. Standards have been developed by health care professional accreditation organizations that focus on independence, conflict of interest, appropriate management of commercial funds, content integrity, and disclosure to learners. Implementation of these standards can significantly reduce the risk of bias and improve dissemination of balanced clinical information. PMID:25280188

Lubejko, Barbara G

2014-10-01

123

Prenatal Care  

MedlinePLUS

... Our ePublications > Prenatal care fact sheet ePublications Prenatal care fact sheet Print this fact sheet Prenatal care ... More information on prenatal care What is prenatal care? Prenatal care is the health care you get ...

124

Availability of anesthesia equipment in Chinese hospitals: is the safety of anesthesia patient care assured?  

PubMed

Availability of physiologic monitoring equipment to ensure the safe administration of anesthesia is an expected standard in many parts of the world. Many hospitals in China may not have an adequate quantity and variety of anesthesia delivery and patient monitoring equipment to assure safe administration of anesthesia patient care. We present some typical cases of hospitals of different sizes and located in regions with different economic levels; our data demonstrate that there is a lack of available anesthesia administration and patient monitoring equipment in small hospitals and hospitals in economically underdeveloped regions. PMID:22467890

Juan, Xie; Xinqiao, Fu; Shanglong, Yao; Yuguang, Huang; Buwei, Yu; Shiying, Yuan; Pengqian, Fang; Hanqing, Zeng

2012-06-01

125

Future of Assurance: Ensuring that a System is Trustworthy  

NASA Astrophysics Data System (ADS)

Significant efforts are put in defining and implementing strong security measures for all components of the comput-ing environment. It is equally important to be able to evaluate the strength and robustness of these measures and establish trust among the components of the computing environment based on parameters and attributes of these elements and best practices associated with their production and deployment. Today the inventory of techniques used for security assurance and to establish trust -- audit, security-conscious development process, cryptographic components, external evaluation - is somewhat limited. These methods have their indisputable strengths and have contributed significantly to the advancement in the area of security assurance. However, shorter product and tech-nology development cycles and the sheer complexity of modern digital systems and processes have begun to decrease the efficiency of these techniques. Moreover, these approaches and technologies address only some aspects of security assurance and, for the most part, evaluate assurance in a general design rather than an instance of a product. Additionally, various components of the computing environment participating in the same processes enjoy different levels of security assurance, making it difficult to ensure adequate levels of protection end-to-end. Finally, most evaluation methodologies rely on the knowledge and skill of the evaluators, making reliable assessments of trustworthiness of a system even harder to achieve. The paper outlines some issues in security assurance that apply across the board, with the focus on the trustworthiness and authenticity of hardware components and evaluates current approaches to assurance.

Sadeghi, Ahmad-Reza; Verbauwhede, Ingrid; Vishik, Claire

126

The health care safety net: money matters but savvy leadership counts.  

PubMed

The nation's health care safety net--heavily reliant on external funding and support--is uniquely vulnerable to shifting and often adverse market and policy conditions. While adequate funding is essential to ensuring safety net providers can care for low-income people, the Center for Studying Health System Change (HSC) has identified a number of other factors key to building and maintaining viable community safety nets. Throughout the four rounds of HSC's Community Tracking Study (CTS) site visits, researchers have found that strong political and organizational leadership, community support, collaboration and business acumen have helped safety net providers build capacity and improve care coordination for low-income and uninsured people. These characteristics and business strategies have strengthened many community safety nets, better preparing them to weather current economic problems and providing a road map for the potentially tougher times ahead. PMID:12940280

Felland, Laurie E; Kinner, J Kyle; Hoadley, John F

2003-08-01

127

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

2007-08-17

128

36 CFR 13.960 - Who determines when there is adequate snow cover?  

Code of Federal Regulations, 2013 CFR

...false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks...960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use....

2013-07-01

129

36 CFR 13.960 - Who determines when there is adequate snow cover?  

Code of Federal Regulations, 2014 CFR

...false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks...960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use....

2014-07-01

130

36 CFR 13.960 - Who determines when there is adequate snow cover?  

Code of Federal Regulations, 2012 CFR

...false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks...960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use....

2012-07-01

131

36 CFR 13.960 - Who determines when there is adequate snow cover?  

Code of Federal Regulations, 2010 CFR

...false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks...960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use....

2010-07-01

132

36 CFR 13.960 - Who determines when there is adequate snow cover?  

Code of Federal Regulations, 2011 CFR

...false Who determines when there is adequate snow cover? 13.960 Section 13.960 Parks...960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use....

2011-07-01

133

76 FR 51041 - Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop  

Federal Register 2010, 2011, 2012, 2013, 2014

...Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop...Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors.'' The purpose...potential measures to maintain adequate iron stores in blood donors. The public...

2011-08-17

134

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.

135

Synergies between neutrino oscillation experiments: an `adequate' configuration for LBNO  

NASA Astrophysics Data System (ADS)

Determination of the neutrino mass hierarchy, octant of the mixing angle ? 23 and the CP violating phase ? CP are the unsolved problems in neutrino oscillation physics today. In this paper our aim is to obtain the minimum exposure required for the proposed Long Baseline Neutrino Oscillation (LBNO) experiment to determine the above unknowns. We emphasize on the advantage of exploiting the synergies offered by the existing and upcoming long-baseline and atmospheric neutrino experiments in economising the LBNO configuration. In particular, we do a combined analysis for LBNO, T2K, NO ?A and INO. We consider three prospective LBNO setups — CERN-Pyhäsalmi (2290 km), CERN-Slanic (1500 km) and CERN-Fréjus (130 km) and evaluate the adequate exposure required in each case. Our analysis shows that the exposure required from LBNO can be reduced considerably due to the synergies arising from the inclusion of the other experiments.

Ghosh, Monojit; Ghoshal, Pomita; Goswami, Srubabati; Raut, Sushant K.

2014-03-01

136

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 Enquête 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

137

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

PubMed

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 of treatment. Drugs were sold under a cost-recovery scheme. The programme was run in 1994 by the national malaria control centre (CNLP), and in 1995 it was developed to the provincial health team (PHT). Knowledge and awareness of malaria increased with the intervention. Drug consumption by age group was compatible with the distribution of disease, and no major problem of misuse emerged. The actual implementation costs of the intervention were US$ 0.06 per child living in the province. An evaluation of the impact of the intervention on the severity of malaria, using routine data from the health information system and taking as an indicator the proportion of malaria cases which were recorded as severe in health centres, was performed. In 1994, when the intervention was implemented on a provincial scale by CNLP, this proportion was lower than the average of the 4 preceding years (3.7% vs. 4.9%). In 1995, when the programme was implemented by the PHT, the proportion of severe cases was lower in health centres achieving a programme coverage of > or = 50% in their catchment area compared with the others (4.2% vs. 6.1%). Our experience shows that a low-cost, community-based intervention aimed at providing children with prompt and adequate treatment of presumptive episodes of clinical malaria is feasible, and suggests that it may lead to a reduction in the morbidity from severe malaria. PMID:9463653

Pagnoni, F; Convelbo, N; Tiendrebeogo, J; Cousens, S; Esposito, F

1997-01-01

138

[Bases for adequate complementary feeding in infants and young children].  

PubMed

Infants can be exclusively breast fed or formula fed for the first 6 months of life and their nutritional requirements are completely fulfilled. However, from 6 months onwards, human milk is not sufficient to supply all the nutrients necessary for infants and young children. Therefore, adequate supplementary feeding, in terms of both quantity and quality, should be provided. The present article aims to describe the scientific bases for practical recommendations on complementary feeding during infancy and early childhood, which may be useful to pediatricians and should serve to improve the health status of the infant population in Spain. In this sense, the new international recommendations for energy, protein and other nutrient requirements are reviewed. In Spain, the law applicable to manufacturing infant cereals and homogenized infant foods is that published by the European Union in specific directives. However, taking into consideration new advances in knowledge of nutritional requirements, we have considered a number of issues that could be relevant for the manufacture of these foods. Finally, we propose a series of basic principles that should serve as a guide for the complementary feeding of infants (whether breast fed, formula fed, or receiving mixed feeding) and young children. These recommendations are particularly addressed to pediatricians working in primary health services. PMID:17184608

Gil Hernández, A; Uauy Dagach, R; Dalmau Serra, J

2006-11-01

139

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

140

Can surface EMG be adequately described by digital sampling?  

PubMed

Surface electromyography (SEMG) is a common tool to evaluate muscle function in kinesiological studies, musculoskeletal rehabilitation, prosthetics, clinical research and neurological disease diagnosis. The acquisition of SEMG is a crucially basic issue to gain an insight into musculoskeletal system function. The aim of this study is to investigate if the sampled surface EMG signals can reflect adequately the neural activity of the underlying musculature. The surface EMG signals of four muscles (abductor pollicis muscles and abductor digiti minimi muscles of right hand and left hand) are studied on the amplitude, frequency and nonlinear measure based on symplectic geometry. There are obvious differences in nonlinear measures of the different sampled signals, although there are little significant changes in their amplitude and frequency measures. Meanwhile, surface EMG signals obviously differ from their surrogate data at higher sampling frequencies. The results indicate that surface EMG signals contain nonlinear components. To gather the sufficient information of surface EMG signal, the data acquisition should be required at the higher sampling frequency. Furthermore, the nonlinear measure based on symplectic geometry can be used as a sensitive index for evaluation of the activity of the human muscles. PMID:24894263

Min, Lei; Sarkar, Nilanjan; Guang, Meng; Yudong, Gu; Kaili, Zhang; Dong, Tian

2014-07-01

141

DARHT - an `adequate` EIS: A NEPA case study  

SciTech Connect

The Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility Environmental Impact Statement (EIS) provides a case study that is interesting for many reasons. The EIS was prepared quickly, in the face of a lawsuit, for a project with unforeseen environmental impacts, for a facility that was deemed urgently essential to national security. Following judicial review the EIS was deemed to be {open_quotes}adequate.{close_quotes} DARHT is a facility now being built at Los Alamos National Laboratory (LANL) as part of the Department of Energy (DOE) nuclear weapons stockpile stewardship program. DARHT will be used to evaluate the safety and reliability of nuclear weapons, evaluate conventional munitions and study high-velocity impact phenomena. DARHT will be equipped with two accelerator-driven, high-intensity X-ray machines to record images of materials driven by high explosives. DARHT will be used for a variety of hydrodynamic tests, and DOE plans to conduct some dynamic experiments using plutonium at DARHT as well.

Webb, M.D.

1997-08-01

142

DARHT -- an adequate EIS: A NEPA case study  

SciTech Connect

In April 1996 the US District Court in Albuquerque ruled that the Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility Environmental Impact Statement (EIS), prepared by the Los Alamos Area Office, US Department of Energy (DOE), was adequate. The DARHT EIS had been prepared in the face of a lawsuit in only 10 months, a third of the time usually allotted for a DOE EIS, and for only a small fraction of the cost of a typical DOE EIS, and for only a small fraction of the cost of a typical DOE EIS. It subject was the first major facility to be built in decades for the DOE nuclear weapons stockpile stewardship program. It was the first EIS to be prepared for a proposal at DOE`s Los Alamos National Laboratory since 1979, and the first ever prepared by the Los Alamos Area Office. Much of the subject matter was classified. The facility had been specially designed to minimize impacts to a nearby prehistoric Native American ruin, and extensive consultation with American Indian Pueblos was required. The week that the draft EIS was published Laboratory biologists identified a previously unknown pair of Mexican spotted owls in the immediate vicinity of the project, bringing into play the consultation requirements of the Endangered Species Act. In spite of these obstacles, the resultant DARHT EIS was reviewed by the court and found to meet all statutory and regulatory requirements; the court praised the treatment of the classified material which served as a basis for the environmental analysis.

Webb, M.D. [Los Alamos National Lab., NM (United States)

1997-08-01

143

Home care: products and techniques.  

PubMed

Periodontal disease is common in dogs and cats. Prevention and treatment is important for general health and well-being of our pets. Both prevention and treatment of periodontal disease have two components, namely maintenance of oral hygiene and professional periodontal therapy. Maintenance of oral hygiene is performed by the owner and is, therefore, also called home care. The preventions and long-term control of periodontal disease requires adequate home care. This chapter details home care techniques and available products. PMID:11269998

Gorrel, C

2000-11-01

144

Environmental education: Ensuring a sustainable future  

SciTech Connect

It is important to remember that personal actions and decisions have a significant impact on the environment. Although they may sometimes forget, today`s school children are the policy and decision makers of tomorrow. Today`s students must be exposed to factual information about the environment so they will be able to make responsible and informed ecological decisions. Since the National Environmental Education Act was signed into law in 1990, the Environmental Protection Agency (EPA) has taken an active role in ensuring a sustainable future through environmental education. Through its education programs, the EPA strives to increase environmental literacy throughout the country and encourages young people to pursue careers in math, science, engineering, communications, and other fields essential to a sustainable environment. The US Environmental Protection Agency`s Office of Air Quality Planning and Standards (OAQPS), located in Research Triangle Park, North Carolina, is an international center for air quality research and information. One of the ways OAQPS invests in the environmental preservation of the Nation is through unique environmental education programs that target teachers and students of all ages. To be sure that environmental education programs incorporate a complete look at the environment, including issues associated with air quality, the EPA works with North Carolina teachers and students through the Education and Outreach Group`s Environmental Education Program. The EPA recognizes that the key to a sustainable future is engaging teachers and others in significant environmental education experiences. They will in turn instill a sense of environmental stewardship in America`s young people. There is hope that by the year 2000, every citizen will be fluent in the principles of ecology.

Rogers, D.P. [Environmental Protection Agency, Research Triangle Park, NC (United States); Lee, J.C. [SAIC, Durham, NC (United States)

1997-12-31

145

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

146

Monitoring the eye lens: which dose quantity is adequate?  

PubMed

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 H(p)(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 H(p)(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 H(p)(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 H(p)(3) on a slab phantom should be used. As an alternative, dosemeters calibrated in terms of H(p)(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. PMID:20601777

Behrens, R; Dietze, G

2010-07-21

147

Ensuring That Cosmetics Used in the United States Are Safe  

MedlinePLUS Videos and Cool Tools

... Basics Video: Ensuring That Cosmetics Used in the United States Are Safe Dr. Linda Katz is the Director ... Her office ensures that cosmetics used in the United States are safe. Taking information from consumers, industry, and ...

148

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.; Dreß, P.; Schmalfuß, H.; Jonckheere, R.; Koolen-Hermkens, W.

2012-06-01

149

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 ...

150

When systems fail: improving care through technology can create risk.  

PubMed

Emerging medical technology is transforming the care of the modern-day patient. Hospital performance and patient safety is improving, lowering professional liability and medical malpractice costs. This advanced technology affects not only diagnosis and treatment but also hospital productivity and revenue. However, it also exposes hospitals and medical personnel to a number of unforeseeable risks. This article examines ongoing efforts to improve patient safety through the use of technology, automation and complex systems operations. It discusses the importance of skilled negotiation when vying for technology contracts and the value of maintaining a reliable data center to support it. Technology risk exposure is now a reality. A hospital needs to know how to protect itself from cyber liability, business interruption, and data loss and theft by ensuring that there is adequate coverage. PMID:20200890

Bagalio, Sharon A

2007-01-01

151

Ensuring US National Aeronautics Test Capabilities  

NASA Technical Reports Server (NTRS)

U.S. leadership in aeronautics depends on ready access to technologically advanced, efficient, and affordable aeronautics test capabilities. These systems include major wind tunnels and propulsion test facilities and flight test capabilities. The federal government owns the majority of the major aeronautics test capabilities in the United States, primarily through the National Aeronautics and Space Administration (NASA) and the Department of Defense (DoD). However, changes in the Aerospace landscape, primarily the decrease in demand for testing over the last 20 years required an overarching strategy for management of these national assets. Therefore, NASA established the Aeronautics Test Program (ATP) as a two-pronged strategic initiative to: (1) retain and invest in NASA aeronautics test capabilities considered strategically important to the agency and the nation, and (2) establish a strong, high level partnership with the DoD. Test facility utilization is a critical factor for ATP because it relies on user occupancy fees to recover a substantial part of the operations costs for its facilities. Decreasing utilization is an indicator of excess capacity and in some cases low-risk redundancy (i.e., several facilities with basically the same capability and overall low utilization). However, low utilization does not necessarily translate to lack of strategic importance. Some facilities with relatively low utilization are nonetheless vitally important because of the unique nature of the capability and the foreseeable aeronautics testing needs. Unfortunately, since its inception, the customer base for ATP has continued to shrink. Utilization of ATP wind tunnels has declined by more than 50% from the FY 2006 levels. This significant decrease in customer usage is attributable to several factors, including the overall decline in new programs and projects in the aerospace sector; the impact of computational fluid dynamics (CFD) on the design, development, and research process; and the reductions in wind tunnel testing requirements within the largest consumer of ATP wind tunnel test time, the Aeronautics Research Mission Directorate (ARMD). Retirement of the Space Shuttle Program and recent perturbations of NASA's Constellation Program will exacerbate this downward trend. Therefore it is crucial that ATP periodically revisit and determine which of its test capabilities are strategically important, which qualify as low-risk redundancies that could be put in an inactive status or closed, and address the challenges associated with both sustainment and improvements to the test capabilities that must remain active. This presentation will provide an overview of the ATP vision, mission, and goals as well as the challenges and opportunities the program is facing both today and in the future. We will discuss the strategy ATP is taking over the next five years to address the National aeronautics test capability challenges and what the program will do to capitalize on its opportunities to ensure a ready, robust and relevant portfolio of National aeronautics test capabilities.

Marshall, Timothy J.

2010-01-01

152

Bronchoalveolar Lavage (BAL) for Research; Obtaining Adequate Sample Yield  

PubMed Central

We describe a research technique for fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) using manual hand held suction in order to remove nonadherent cells and lung lining fluid from the mucosal surface. In research environments, BAL allows sampling of innate (lung macrophage), cellular (B- and T- cells), and humoral (immunoglobulin) responses within the lung. BAL is internationally accepted for research purposes and since 1999 the technique has been performed in > 1,000 subjects in the UK and Malawi by our group. Our technique uses gentle hand-held suction of instilled fluid; this is designed to maximize BAL volume returned and apply minimum shear force on ciliated epithelia in order to preserve the structure and function of cells within the BAL fluid and to preserve viability to facilitate the growth of cells in ex vivo culture. The research technique therefore uses a larger volume instillate (typically in the order of 200 ml) and employs manual suction to reduce cell damage. Patients are given local anesthetic, offered conscious sedation (midazolam), and tolerate the procedure well with minimal side effects. Verbal and written subject information improves tolerance and written informed consent is mandatory. Safety of the subject is paramount. Subjects are carefully selected using clear inclusion and exclusion criteria. This protocol includes a description of the potential risks, and the steps taken to mitigate them, a list of contraindications, pre- and post-procedure checks, as well as precise bronchoscopy and laboratory techniques. PMID:24686157

Collins, Andrea M.; Rylance, Jamie; Wootton, Daniel G.; Wright, Angela D.; Wright, Adam K. A.; Fullerton, Duncan G.; Gordon, Stephen B.

2014-01-01

153

End of life care.  

PubMed

NHS England is working with statutory and voluntary organisations to develop a five-year plan for end of life care. In the meantime, it has published a framework titled Actions for End of Life Care 2014-2016. This has four interdependent components aimed at ensuring that: individuals and carers are engaged and informed, by providing information and seeking feedback; health and care professionals are committed to partnership working by developing capability and communities of practice; processes provide more consistent, co-ordinated care; and resources and commissioning approaches that improve end of life care are developed. Specific actions to identify and address inequalities are included in each component. To read the document, go to tinyurl.com/p3dv4ce. PMID:25629343

2015-01-28

154

Preconception Care and Prenatal Care  

MedlinePLUS

... Clinical Trials Resources and Publications En Español Preconception Care and Prenatal Care: Condition Information Skip sharing on social media links Share this: Page Content What is preconception care? Preconception care is the care a woman receives ...

155

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

2013-01-01

156

Migrant-friendly hospitals: a paediatric perspective - improving hospital care for migrant children  

PubMed Central

Background The European Union (EU) Migrant-Friendly Hospital (MFH) Initiative, introduced in 2002, promotes the adoption of care approaches adapted to meet the service needs of migrants. However, for paediatric hospitals, no specific recommendations have been offered for MFH care for children. Using the Swiss MFH project as a case study, this paper aims to identify hospital-based care needs of paediatric migrants (PMs) and good service approaches. Methods Semi-structured interviews were conducted with principal project leaders of five paediatric hospitals participating in the Swiss MFH project. A review of the international literature on non-clinical hospital service needs and service responses of paediatric MFHs was conducted. Results Paediatric care can be complex, usually involving both the patient and the patient’s family. Key challenges include differing levels of acculturation between parents and children; language barriers; cultural differences between patient and provider; and time constraints. Current service and infrastructural responses include interpretation services for PMs and parents, translated information material, and special adaptations to ensure privacy, e.g., during breastfeeding. Clear standards for paediatric migrant-friendly hospitals (P-MFH) are lacking. Conclusions International research on hospital care for migrant children is scarce. The needs of paediatric migrants and their families may differ from guidance for adults. Paediatric migrant needs should be systematically identified and used to inform paediatric hospital care approaches. Hospital processes from admission to discharge should be revised to ensure implementation of migrant-sensitive approaches suitable for children. Staff should receive adequate support, such as training, easily available interpreters and sufficient consultation time, to be able to provide migrant-friendly paediatric services. The involvement of migrant groups may be helpful. Improving the quality of care for PMs at both policy and service levels is an investment in the future that will benefit native and migrant families. PMID:24093461

2013-01-01

157

21 CFR 314.126 - Adequate and well-controlled studies.  

Code of Federal Regulations, 2011 CFR

...false Adequate and well-controlled studies. 314.126 Section 314.126 Food...126 Adequate and well-controlled studies. (a) The purpose of conducting...effectiveness for new drugs. Therefore, the study report should provide sufficient...

2011-04-01

158

21 CFR 314.126 - Adequate and well-controlled studies.  

Code of Federal Regulations, 2010 CFR

...false Adequate and well-controlled studies. 314.126 Section 314.126 Food...126 Adequate and well-controlled studies. (a) The purpose of conducting...effectiveness for new drugs. Therefore, the study report should provide sufficient...

2010-04-01

159

21 CFR 801.5 - Medical devices; adequate directions for use.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Medical devices; adequate directions for use...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for...

2012-04-01

160

21 CFR 801.5 - Medical devices; adequate directions for use.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Medical devices; adequate directions for use...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for...

2010-04-01

161

21 CFR 801.5 - Medical devices; adequate directions for use.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Medical devices; adequate directions for use...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for...

2011-04-01

162

21 CFR 801.5 - Medical devices; adequate directions for use.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 2014-04-01 false Medical devices; adequate directions for use...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for...

2014-04-01

163

21 CFR 801.5 - Medical devices; adequate directions for use.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Medical devices; adequate directions for use...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for...

2013-04-01

164

32 CFR 732.13 - Sources of care.  

Code of Federal Regulations, 2010 CFR

...unavailable, ensure that members make initial application for emergency and nonemergency care to military facilities of the host country, or if applicable, to civilian sources under the NATO SOFA nation's health care program. When hospitalized...

2010-07-01

165

21 CFR 514.117 - Adequate and well-controlled studies.  

Code of Federal Regulations, 2011 CFR

...false Adequate and well-controlled studies. 514.117 Section 514.117 Food...117 Adequate and well-controlled studies. (a) Purpose . The primary purpose...conducting adequate and well-controlled studies of a new animal drug is to...

2011-04-01

166

Managed Care  

MedlinePLUS

... three types of managed care plans: Health Maintenance Organizations (HMO) usually only pay for care within the ... who coordinates most of your care. Preferred Provider Organizations (PPO) usually pay more if you get care ...

167

Palliative Care  

MedlinePLUS

... asked to make many difficult decisions about their child’s care. These decisions are especially urgent for parents of ... care can be an appropriate part of your child’s care plan. Palliative care will assist you in making ...

168

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 ...

169

Hospice Care  

MedlinePLUS

... Page Resize Text Printer Friendly 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 ...

170

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. PMID:21727276

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

2012-01-01

171

Tactical combat casualty care 2007: evolving concepts and battlefield experience.  

PubMed

The Tactical Combat Casualty Care (TCCC) project begun by the Naval Special Warfare Command and continued by the U.S. Special Operations Command developed a set of tactically appropriate battlefield trauma care guidelines that were initially published in 1996. Transition of these guidelines into use throughout the Department of Defense has been ongoing since that time. The need for updates to the TCCC guidelines was recognized early on and has been carried out by the Committee on Tactical Combat Casualty Care established and operated by the Naval Operational Medicine Institute. The evolution of these guidelines from the 1996 recommendations to the present is described. Numerous reports in the medical literature and collected from combat first responders have documented that TCCC is saving lives on the battlefield and improving the tactical flow of missions on which casualties have occurred. Present challenges to the optimized implementation of TCCC in U.S. combat units include the need to expedite transition of new TCCC techniques and technologies to deploying units, to provide TCCC training for all U.S. combatants, and to ensure adequate funding for the Committee on TCCC. PMID:18154234

Butler, Frank K; Holcomb, John B; Giebner, Stephen D; McSwain, Norman E; Bagian, James

2007-11-01

172

Partnership between pharmaceutical industry and RBS ensures relevant curriculum producing top-talent graduates pharma companies need  

E-print Network

Partnership between pharmaceutical industry and RBS ensures relevant curriculum producing top-talent, creating a new demand for talented, motivated individuals with a special knowledge of the healthcare of talented managers, well-versed in health-care and pharmaceutical issues. One of the strengths

Lin, Xiaodong

173

Skin care for the newborn  

Microsoft Academic Search

Skin of the newborn differs from that of an adult in several ways. It is more susceptible to trauma and infection and requires\\u000a special care. Certain principles of skin care have to be emphasized to the mother or caregiver such as gentle cleansing, adequate\\u000a hydration and moisturization of the skin, preventing friction and maceration in body folds, and protection from

Rashmi Sarkar; Srikanta Basu; R. K. Agrawal; Piyush Gupta

2010-01-01

174

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

175

[Opening up psychiatric care].  

PubMed

The post-war phase of the deinstitutionalisation of psychiatry, which led to the legal recognition of the sector, has been followed by the years of economic crisis. As in the past, such times favour the exclusion of the weakest. As resources dwindle, only the clinical meaning, the dynamism and creativity of the nursing teams can ensure the emergence of new solutions for complex care situations. PMID:23951739

Plas, Joël

2013-01-01

176

Reporting Animal Mistreatment or Animal Protocol Noncompliance The IACUC is responsible for ensuring that all animals used in research and teaching programs  

E-print Network

for ensuring that all animals used in research and teaching programs are treated in accordance with the Federal Research Council "Guide for the Care and Use of Laboratory Animals", and all other applicable government used in research or teaching activities at UNC Charlotte, please contact the Institutional Animal Care

Howitt, Ivan

177

Care of the patient in excited delirium.  

PubMed

Patients with excited delirium present a challenge to both law enforcement and health care personnel because handcuffs, the traditional method used to keep persons from harming themselves and others, may be fatal. The patient's survival depends upon rapid recognition and treatment, including chemical sedation, decreased environmental stimulation, intravenous fluids, and other supportive interventions. Excited delirium protocols should be established to ensure rapid and appropriate treatment to ensure patient survival and the safety of those caring for them. PMID:22766142

Gordon, Cheryl; Schmelzer, Marilee

2013-03-01

178

[The "Bolsa Família" 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 Família" 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 Irigonhé; Cuervo, Maria Rita Macedo

2012-08-01

179

Using the CER Hub to ensure data quality in a multi-institution smoking cessation study.  

PubMed

Comparative effectiveness research (CER) studies involving multiple institutions with diverse electronic health records (EHRs) depend on high quality data. To ensure uniformity of data derived from different EHR systems and implementations, the CER Hub informatics platform developed a quality assurance (QA) process using tools and data formats available through the CER Hub. The QA process, implemented here in a study of smoking cessation services in primary care, used the 'emrAdapter' tool programmed with a set of quality checks to query large samples of primary care encounter records extracted in accord with the CER Hub common data framework. The tool, deployed to each study site, generated error reports indicating data problems to be fixed locally and aggregate data sharable with the central site for quality review. Across the CER Hub network of six health systems, data completeness and correctness issues were prevalent in the first iteration and were considerably improved after three iterations of the QA process. A common issue encountered was incomplete mapping of local EHR data values to those defined by the common data framework. A highly automated and distributed QA process helped to ensure the correctness and completeness of patient care data extracted from EHRs for a multi-institution CER study in smoking cessation. PMID:24993545

Walker, Kari L; Kirillova, Olga; Gillespie, Suzanne E; Hsiao, David; Pishchalenko, Valentyna; Pai, Akshatha Kalsanka; Puro, Jon E; Plumley, Robert; Kudyakov, Rustam; Hu, Weiming; Allisany, Art; McBurnie, MaryAnn; Kurtz, Stephen E; Hazlehurst, Brian L

2014-01-01

180

Equity in health care.  

PubMed

It has long been known that a segment of the population enjoys distinctly better health status and higher quality of health care than others. To solve this problem, prioritization is unavoidable, and the question is how priorities should be set. Rational priority setting would seek equity amongst the whole population, the extent to which people receive equal care for equal needs. Equity in health care is an ethical imperative not only because of the intrinsic worth of good health, or the value that society places on good health, but because, without good health, people would be unable to enjoy life's other sources of happiness. This paper also argues the importance of the health care's efficiency, but at the same time, it highlights how any innovation and rationalization undertaken in the provision of the health system should be achieved from the consideration of human dignity, making the person prevail over economic criteria. Therefore, the underlying principles on which this health care equity paper is based are fundamental human rights. The main aim is to ensure the implementation of these essential rights by those carrying out public duties. Viewed from this angle, equity in health care means equality: equality in access to services and treatment, and equality in the quality of care provided. As a result, this paper attempts to address both human dignity and efficiency through the context of equity to reconcile them in the middle ground. PMID:18611079

La Rosa-Salas, Virginia; Tricas-Sauras, Sandra

2008-01-01

181

Manual for Evaluating Day Care Centers.  

ERIC Educational Resources Information Center

Procedures for evaluating day care centers are described, formulated specifically with regard to the information available through, and planning requirements of, the Syracuse Model City Agency. The first chapter discusses some problems involved in providing adequate day care services on the national level, the city level, and within the Syracuse…

Central New York Regional Planning and Development Board, Syracuse.

182

Beyond Care?  

ERIC Educational Resources Information Center

Care is a feature of all of our lives, all of the time. An analysis of Scotland's Curriculum for Excellence reveals that care and caring permeate complex dimensions of life in and after school and we ask here, if, on some accounts, care can do the work required of it. Acknowledging the significance of her contribution to care, we focus on the work…

Hedge, Nicki; Mackenzie, Alison

2012-01-01

183

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

Federal Register 2010, 2011, 2012, 2013, 2014

...DEFENSE NUCLEAR FACILITIES SAFETY BOARD [Recommendation 2010-1] Safety Analysis Requirements for Defining Adequate...Workers AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Notice, recommendation;...

2010-11-30

184

Lighting professionals have long struggled with ensuring proper integration  

E-print Network

Lighting professionals have long struggled with ensuring proper integration of daylighting, design engineers, building scientists, code developers, commissioning agents, and utility staff can take · Train user groups on SPOT operation · Demonstrate successful application in real-world projects

185

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 ...

186

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 ...

187

Respite Care  

MedlinePLUS

... Page Resize Text Printer Friendly 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 ...

188

Pin care  

MedlinePLUS

... bone - rod care; Broken bone - nail care; Broken bone - screw care ... Broken bones can be fixed in surgery with metal pins, screws, nails, rods, or plates. These metal pieces hold the bones in place while they heal. Sometimes, the ...

189

Lesbian and bisexual health care.  

PubMed Central

OBJECTIVE: To explore lesbian and bisexual women's experiences with their family physicians to learn about barriers to care and about how physicians can provide supportive care. DESIGN: Qualitative study that was part of a larger study of lesbian and bisexual women's health care. SETTING: The province of Nova Scotia, both urban and rural counties. PARTICIPANTS: Ninety-eight self-identified lesbian or bisexual women who volunteered through snowball sampling. Women were interviewed by lesbian, bisexual, or heterosexual female interviewers. METHOD: Semistructured, audiotaped, face-to-face interviews, exploring questions about demographic information, sexual orientation, general health care patterns, preferences for health care providers, disclosure issues, health care information, access issues, and important health care services. Transcription of audiotapes of interviews was followed by content, thematic, and discourse analyses. Thematic analysis is reported in this paper. MAIN OUTCOME FINDINGS: Three themes important for family physicians emerged: the importance of being gay positive, barriers to care, and strategies for providing appropriate care. CONCLUSIONS: Family physicians are in a pivotal position to ensure supportive care for lesbian and bisexual women. Physicians need to recognize barriers to care and to use gay-positive strategies, paying attention to self-education, health history, and clinic environment. PMID:9721419

Mathieson, C. M.

1998-01-01

190

Advance care planning along the continuum  

Microsoft Academic Search

What will happen if you experience a sudden illness that prevents you from making your own medical decisions? How will you ensure that you will receive the kind of care you want? Will your family or loved ones know enough about what you value and believe to feel comfortable making decisions about your care?

Patricia A. Bomba

2005-01-01

191

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. (Author)

Powers, Mary G.; Salvo, Joseph J.

1982-01-01

192

CARES Foundation  

MedlinePLUS

... HappyNewYear #2015 #CARES http://t.co/Jl8m2AU5VA 3 days ago Merry Christmas from CARES Foundation #CARES #CAH #Holidays #Christmas http://t.co/uzPbUUxIzM 1 week ago Sign Up for Our Newsletter Copyright 2014 CARES Foundation | All Rights Reserved | Website by Gattuso Media Design

193

Transitional Care  

ERIC Educational Resources Information Center

Transitional care encompasses a broad range of services and environments designed to promote the safe and timely passage of patients between levels of health care and across care settings. High-quality transitional care is especially important for older adults with multiple chronic conditions and complex therapeutic regimens, as well as for their…

Naylor, Mary; Keating, Stacen A.

2008-01-01

194

Setting priorities for mental health care in Nepal: a formative study  

PubMed Central

Background There is an urgent need to address the massive treatment gap for mental health problems, especially in low income settings. Packages of care integrated in routine primary health care are posited as a strategy to scale-up mental health care, yet more needs to be known about the most feasible and effective way to go about this. Methods The study follows a combined methods design that includes engaging an expert panel in a priority setting exercise, running workshops to develop a Theory of Change and conducting in-depth qualitative interviews and focus group discussions with key stakeholders. The results of each research step were taken forward to inform the subsequent one. Results There was strong endorsement for a system of care that encompasses both the perspectives of health facility and the community. Issues related to increasing access and demand, guaranteeing a sustainable supply of psychotropic medicine, adequate human resourcing, and ensuring positive family involvement came up as priority areas of attention. Conclusion The study underlines many of the known barriers in developing mental health services. At the same time it provides a distinct pathway and concrete recommendations for overcoming these challenges in Nepal. PMID:24305432

2013-01-01

195

Competency System-Based Practice Sub Domain Health Care Quality Improvement  

E-print Network

Competency System-Based Practice Sub Domain Health Care Quality Improvement Learning Objective 1 principles* (1) · Explains the value of interdisciplinary health care teams in improving patient care of an interdisciplinary health care team to ensure that care is continuous and reliable (3) · Describes strategies

Leistikow, Bruce N.

196

Improving bowel care after surgery for hip fracture.  

PubMed

Constipation is a common problem in older people with hip fracture because of immobility, opioid prescription and lack of privacy. There is a dearth of meaningful evidence about the way constipation is recognised and its subsequent treatment. The orthogeriatric team in a university hospital trust investigated the effectiveness of bowel care for older inpatients after hip fracture. Three audits followed a cohort of 40 people aged 60 and older after surgical fixation of hip fracture. After the initial audit in 2010, the expectation was that all hip fracture patients should be started on laxatives on the day of surgery and a chart used to document stool type. Nursing and medical staff needed to ensure that adequate pain control was maintained while opiate analgesia was given only when necessary. Patients with hip fracture are now significantly less constipated. There is improved patient satisfaction with analgesia provision. While laxative prescription is important, a motivated ward team encouraging its uptake is vital. All patients now have a comprehensive record of bowel movements. The improvements demonstrate the importance of a multidisciplinary approach when caring for these patients. PMID:25430842

Neighbour, Catherine

2014-11-28

197

Ethics of drug research in the pediatric intensive care unit.  

PubMed

Critical illness and treatment modalities change pharmacokinetics and pharmacodynamics of medications used in critically ill children, in addition to age-related changes in drug disposition and effect. Hence, to ensure effective and safe drug therapy, research in this population is urgently needed. However, conducting research in the vulnerable population of the pediatric intensive care unit (PICU) presents with ethical challenges. This article addresses the main ethical issues specific to drug research in these critically ill children and proposes several solutions. The extraordinary environment of the PICU raises specific challenges to the design and conduct of research. The need for proxy consent of parents (or legal guardians) and the stress-inducing physical environment may threaten informed consent. The informed consent process is challenging because emergency research reduces or even eliminates the time to seek consent. Moreover, parental anxiety may impede adequate understanding and generate misconceptions. Alternative forms of consent have been developed taking into account the unpredictable reality of the acute critical care environment. As with any research in children, the burden and risk should be minimized. Recent developments in sample collection and analysis as well as pharmacokinetic analysis should be considered in the design of studies. Despite the difficulties inherent to drug research in critically ill children, methods are available to conduct ethically sound research resulting in relevant and generalizable data. This should motivate the PICU community to commit to drug research to ultimately provide the right drug at the right dose for every individual child. PMID:25354987

Kleiber, Niina; Tromp, Krista; Mooij, Miriam G; van de Vathorst, Suzanne; Tibboel, Dick; de Wildt, Saskia N

2015-02-01

198

Care Transitions: A Systematic Review of Best Practices.  

PubMed

This article reports results from a systematic review used to inform the development of a best practice guideline to assist nurses in understanding their roles and responsibilities in promoting safe and effective client care transitions. A care transition is a set of actions designed to ensure safe and effective coordination and continuity of care as clients experience a change in health status, care needs, health care providers, or location. PMID:25470233

Dusek, Brenda; Pearce, Nancy; Harripaul, Anastasia; Lloyd, Monique

2014-12-01

199

Clinical guidelines for postpartum women and infants in primary care–a systematic review  

PubMed Central

Background While many women and infants have an uneventful course during the postpartum period, others experience significant morbidity. Effective postpartum care in the community can prevent short, medium and long-term consequences of unrecognised and poorly managed problems. The use of rigorously developed, evidence-based guidelines has the potential to improve patient care, impact on policy and ensure consistency of care across health sectors. This study aims to compare the scope and content, and assess the quality of clinical guidelines about routine postpartum care in primary care. Methods PubMed, the National Guideline Clearing House, Google, Google Scholar and relevant college websites were searched for relevant guidelines. All guidelines regarding routine postpartum care published in English between 2002 and 2012 were considered and screened using explicit selection criteria. The scope and recommendations contained in the guidelines were compared and the quality of the guidelines was independently assessed by two authors using the AGREE II instrument. Results Six guidelines from Australia (2), the United Kingdom (UK) (3) and the United States of America (USA) (1), were included. The scope of the guidelines varied greatly. However, guideline recommendations were generally consistent except for the use of the Edinburgh Postnatal Depression Scale for mood disorder screening and the suggested time of routine visits. Some recommendations lacked evidence to support them, and levels or grades of evidence varied between guidelines. The quality of most guidelines was adequate. Of the six AGREE II domains, applicability and editorial independence scored the lowest, and scope, purpose and clarity of presentation scored the highest. Conclusions Only one guideline provided comprehensive recommendations for the care of postpartum women and their infants. As well as considering the need for region specific guidelines, further research is needed to strengthen the evidence supporting recommendations made within guidelines. Further improvement in the editorial independence and applicability domains of the AGREE ll criteria would strengthen the quality of the guidelines. PMID:24475888

2014-01-01

200

Open access in the critical care environment.  

PubMed

Open access has become an important topic in critical care over the last 3 years. In the past, critical care had restricted access and set visitation guidelines to protect patients. This article provides a review of the literature related to open access in the critical care environment, including the impact on patients, families, and health care providers. The ultimate goal is to provide care centered on patients and families and to create a healing environment to ensure safe passage of patients through their hospital stays. This outcome could lead to increased patient/family satisfaction. PMID:25438894

South, Tabitha; Adair, Brigette

2014-12-01

201

[Medical consult before taking a plane: assessment and advice by the primary care physician].  

PubMed

Many of our patients travel by air. During the flight, they are exposed to specific physical conditions: decrease of the PaO2, increase of body gas volume and decrease in humidity. Depending on their illness, their tolerance to these conditions may vary. The primary care physician's role is to adequately counsel patients in order to ensure their security during and after the flight, as well as to prescribe additional therapies, when needed. Patients with a hypoxemic medical condition or patients that were recently operated deserve particular attention. Complications of common ear, nose and throat diseases should not be underestimated. Preventive recommendations for thromboembolic disease need to be addressed, while drug prophylaxis is not systematically recommended any more for patients with major thromboembolic risk factors. PMID:25369695

Butty, Anne-Virginie; Pala, Christophe; Dao, Melissa Dominicé

2014-09-24

202

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

Federal Register 2010, 2011, 2012, 2013, 2014

...evaluated, and that adequate commitments to achieve an appropriate...required safety posture. This acceptance of risk and commitment to future upgrades must be...must use to quantify the acceptance of risk for continued...

2010-11-15

203

Fan Aerodynamic Performance Guarantees: Do Your Policies, Procedures and Penalties Provide Adequate Certainty?  

E-print Network

FAN AERODYNAMIC PERFORMANCE GUARANTEES: Do Your Policies, Procedures and Penalties Provide Adequate Certainty? Steven G. Kaufman, P.Eng., Senior Staff Engineer Vern Martin, P.Eng., Senior Staff Engineer Mats A. Falk, P.Eng., Chief Engineer...

Kaufman, S. G.; Martin, V.; Falk, M. A.

2004-01-01

204

Sedation in the neurologic intensive care unit  

Microsoft Academic Search

Opinion statement  Providing adequate sedation in the neurologic intensive care unit (ICU) depends on determination of proper goals for sedation,\\u000a adequate assessment of the level of sedation, and appropriate choice of drug based on the patient’s physiology. The management\\u000a of sedation in the ICU will influence long-term outcome. Delirium, anxiety, and pain must be identified and treated separately.\\u000a The use of

Mark T. Keegan

2008-01-01

205

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

206

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

207

Ensuring Data Quality in Extension Research and Evaluation Studies  

ERIC Educational Resources Information Center

This article presents a checklist as a guide for Extension professionals to use in research and evaluation studies they carry out. A total of 40 statements grouped under eight data quality components--relevance, objectivity, validity, reliability, integrity, generalizability, completeness, and utility--are identified to ensure that research…

Radhakrishna, Rama; Tobin, Daniel; Brennan, Mark; Thomson, Joan

2012-01-01

208

Ensuring Good Character and Civic Education: Connecting through Service Learning  

ERIC Educational Resources Information Center

Character and citizenship education are part of the vision of many countries, including Singapore. Ensuring they are implemented in academic environments, service learning has been shown to be a natural bridge between the two. Research has shown that service learning, when done well, produces outcomes related to character development and…

Shumer, Robert; Lam, Carolina; Laabs, Bonnie

2012-01-01

209

INTRODUCTION Telomeres function to ensure the complete replication of  

E-print Network

INTRODUCTION Telomeres function to ensure the complete replication of chromosome ends, a task which can not be accomplished by conventional DNA polymerases. Telomeres are maintained by telomerase and Blackburn, 1985; reviewed by Nugent and Lundblad, 1998). Cells have mechanisms to monitor telomere length

de Lange, Titia

210

Improved molding process ensures plastic parts of higher tensile strength  

NASA Technical Reports Server (NTRS)

Single molding process ensures that plastic parts /of a given mechanical design/ produced from a conventional thermosetting molding compound will have a maximum tensile strength. The process can also be used for other thermosetting compounds to produce parts with improved physical properties.

Heier, W. C.

1968-01-01

211

26Connected Talented Innovative Ensure a sustainable environment  

E-print Network

26Connected Talented Innovative Ensure a sustainable environment Natural Landscape: Natural regions for the Native American village located between the Wabash and Tippecanoe Rivers estab- #12;Connected Talented staff. #12;28Connected Talented Innovative lished by Tecumseh. Prophetstown State Park was established

212

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 students…

Cone, Joan Kernan; And Others

213

Ensuring data storage security in cloud computing using Sobol Sequence  

Microsoft Academic Search

Cloud computing is the next stage in evolution of the internet, which provides large amount of computing and storage to customers provisioned as a service over the internet. However, cloud computing facing so many security challenges due to the possible compromise or byzantine failures. In this paper, we focus on Ensuring data storage security in cloud computing, which is an

P. Syam Kumar; R. Subramanian; D. Thamizh Selvam

2010-01-01

214

Ensuring Quality E-Learning: Creating Engaging Tasks.  

ERIC Educational Resources Information Center

Focuses on several examples of software design that have been pedagogically successful and have demonstrated what is possible in software design and online learning. Contrasts are made with some examples of the current push into e-learning and how best to structure learning environments to ensure student participation and high quality learning…

Hedberg, John G.

2003-01-01

215

INTRODUCTION Cell proliferation must be tightly regulated to ensure the  

E-print Network

INTRODUCTION Cell proliferation must be tightly regulated to ensure the development of properly proportioned organs and tissues. During development, most organ primordia grow by increasing in cell number until the appropriate organ size is attained. Cells then exit from the cell cycle and differentiate

Kango-Singh, Madhuri

216

WASC Standard 1. Defining Institutional Purposes and Ensuring Educational Opportunities  

E-print Network

WASC Standard 1. Defining Institutional Purposes and Ensuring Educational Opportunities UC Santa Cruz defines its purposes and establishes educational objectives aligned with its purposes and character. It has a clear and conscious sense of its essential values and character, its distinctive

California at Santa Cruz, University of

217

Fostering Fire: Cultural mentorship for Aboriginal girls in foster care on Vancouver Island.  

E-print Network

??Historically and currently, the federal and provincial or territorial governments of Canada have neglected to ensure that Aboriginal children in foster care receive genuine, Aboriginal-centered… (more)

Ritchie, Katherine

2015-01-01

218

HSQC-ADEQUATE correlation: a new paradigm for establishing a molecular skeleton.  

PubMed

Various experimental methods have been developed to unequivocally identify vicinal neighbor carbon atoms. Variants of the HMBC experiment intended for this purpose have included 2J3J-HMBC and H2BC. The 1,1-ADEQUATE experiment, in contrast, was developed to accomplish the same goal but relies on the (1) J(CC) coupling between a proton-carbon resonant pair and the adjacent neighbor carbon. Hence, 1,1-ADEQUATE can identify non-protonated adjacent neighbor carbons, whereas the 2J3J-HMBC and H2BC experiments require both neighbor carbons to be protonated to operate. Since 1,1-ADEQUATE data are normally interpreted with close reference to an HSQC spectrum of the molecule in question, we were interested in exploring the unsymmetrical indirect covariance processing of multiplicity-edited GHSQC and 1,1-ADEQUATE spectra to afford an HSQC-ADEQUATE correlation spectrum that facilitates the extraction of carbon-carbon connectivity information. The HSQC-ADEQUATE spectrum of strychnine is shown and the means by which the carbon skeleton can be conveniently traced is discussed. PMID:21400588

Martin, Gary E; Hilton, Bruce D; Blinov, Kirill A

2011-05-01

219

Tribal Child Care and Development Fund: Guide for New Administrators  

ERIC Educational Resources Information Center

Tribal Child Care and Development Fund administrators work each day to ensure that the children and families in tribal communities have the child care services that best meet their needs. The Child Care and Development Fund (CCDF), a federal block grant for States, Tribes, and Territories, is a key resource to help increase the availability,…

Child Care Bureau, 2008

2008-01-01

220

Representing Critical Care Data Using the Clinical Care Classification  

PubMed Central

Concept-oriented terminologies require the user to combine terms, making them awkward for their direct use as a documentation tool. Therefore, classification systems are needed to serve as interface terminologies between the user and the reference terminology used to organize the computer database system. Whether nursing classification systems provide sufficient granularity to adequately capture nursing practice is controversial. In addition, no nursing classification systems have been designed specifically for or evaluated in the critical care setting. The purpose of this study was to evaluate the ability of the Clinical Care Classification (CCC) to represent data in an intensive care setting and to provide recommendations for the expansion of this classification for its use in critical care documentation. PMID:16779099

Moss, Jacqueline; Damrongsak, Mantana; Gallichio, Kathleen

2005-01-01

221

Hospice Care  

MedlinePLUS

... your care. Other team members may include a music therapist, physical therapist, speech therapist or occupational therapist. ... eat enough to sustain life and post-stroke dementia . Levels of Care There are four levels of ...

222

The quality of nutrition at an intensive care unit  

Microsoft Academic Search

Adequate nutrition of patients remaining at an intensive care unit (ICU) is of great importance since both over- and undernutrition can lead to serious morbidity and even mortality. The aim of our study was to examine whether patients at an ICU are adequately fed. A prospective follow-up was performed in 39 surgical and medical mechanically ventilated patients who were at

M. M. P. M. Jansen; F. Heymer; J. A. Leusink; A. de Boer

2002-01-01

223

Leaders, managers, and employee care.  

PubMed

With the economic and market changes currently taking place, organizations cannot survive or prosper without quality employees. Key to employee loyalty, performance, and retention is the relationship between the leader, manager, and employee. Leaders are visionaries who make sure that the right things are done for the organization. Managers are in a position to make sure that things are done right within the organization. There are traits and qualities that good leaders and managers must possess to ensure organizational success. Displaying these characteristics will ensure that employees are taken care of, which will benefit both the employees and the organization. PMID:22282003

Stewart, Della W

2012-01-01

224

78 FR 6770 - Notice of Intent To Establish an Adequate Yearly Progress Negotiated Rulemaking Committee  

Federal Register 2010, 2011, 2012, 2013, 2014

...negotiation. We anticipate that negotiation will expedite a proposed rule and ultimately the acceptance of a final rule. 6. The BIE is making a commitment to ensure that the Committee has sufficient resources to complete its work in a timely...

2013-01-31

225

Cancer Care in the United States: What's Right, What's Wrong? - September 16, 1999  

Cancer.gov

CANCER CARE IN THE UNITED STATES: WHAT'S RIGHT, WHAT'S WRONG? ENSURING THE QUALITY OF CANCER CARE Robert Hiatt, M.D., Ph.D., Deputy Director of the Division of Cancer Control and Population Sciences National Cancer Institute National Institutes

226

An approach for representing and managing medical exceptions in care pathways based on  

E-print Network

An approach for representing and managing medical exceptions in care pathways based on temporal of a patient- centered care pathway. Personalized care pathways are generated auto- matically by means is evaluated with oncology care plans, seems to be an adequate exception recovery mechanism maintaining

Fernández Olivares, Juan

227

Duplex rolling element bearing mounting for ensuring preload control  

Microsoft Academic Search

An apparatus for mounting face-to-face angular contact bearings to ensure preload control is discussed. Face-to-face angular contact paired bearings have inner races and outer races. The inner races or the bearings are fitted on an element to be supported such as a shaft. The outer races of the bearings are fitted in a bearing housing with a first gap Al

Thomas L. Daugherty

1994-01-01

228

Defining Mental Retardation and Ensuring Access to the General Curriculum  

E-print Network

Defining Mental Retardation and Ensuring Access to the General Curriculum Michael L. Wehmeyer University of Kansas Abstract: Release of the most recent edition (2002) of the American Association on Mental Retardation’s terminology and classification... manual provides a point in time to consider ways in which mental retardation is understood and how that understanding contributes to educational practices to promote positive outcomes for students with mental retardation. Since release of the previous...

Wehmeyer, Michael L.

2003-01-01

229

Comprehensive care of amyotrophic lateral sclerosis patients: a care model.  

PubMed

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that presents with muscle weakness, causing progressive difficulty in movement, communication, eating and ultimately, breathing, creating a growing dependence on family members and other carers. The ideal way to address the problems associated with the disease, and the decisions that must be taken, is through multidisciplinary teams. The key objectives of these teams are to optimise medical care, facilitate communication between team members, and thus to improve the quality of care. In our centre, we have extensive experience in the care of patients with ALS through an interdisciplinary team whose aim is to ensure proper patient care from the hospital to the home setting. In this article, we describe the components of the team, their roles and our way of working. PMID:23540596

Güell, Maria Rosa; Antón, Antonio; Rojas-García, Ricardo; Puy, Carmen; Pradas, Jesus

2013-12-01

230

The Liverpool Care Pathway in intensive care: an exploratory study of doctor and nurse perceptions.  

PubMed

The Liverpool Care Pathway (LCP) provides an evidence-based framework of care for the dying patient and provides guidance on comfort measures, discontinuation of inappropriate interventions, anticipatory prescribing, holistic care and care of the family after death. End-of-life care is becoming an important issue in critical care, and the LCP has been adapted for use in intensive care units in the United Kingdom. A qualitative study using descriptive phenomenology was used to explore doctor and nurse experiences of the impact of the LCP in two intensive care units in a 1000-bed teaching hospital in the north-west Midlands. The staff experience of the LCP was dependent on their role, with mixed reports about frequency of use and level of education received on the LCP. Education and adequate support was identified as being pivotal to the successful implementation of any type of LCP. PMID:20925289

Walker, Ruth; Read, Sue

2010-06-01

231

Failures in transition: learning from incidents relating to clinical handover in acute care.  

PubMed

The appropriate handover of patients, whereby responsibility and accountability of care is transferred between healthcare providers, is a critical component of quality healthcare delivery. This paper examines data from recent incidents relating to clinical handover in acute care settings, in order to provide a basis for the design and implementation of preventive and corrective strategies. A sample of incidents (n = 459) relating to clinical handover was extracted from an Australian health service's incident reporting system using a manual search function. Incident narratives were subjected to classification according to the system safety and quality concepts of failure type, error type, and failure detection mechanism. The most prevalent failure types associated with clinical handover were those relating to the transfer of patients without adequate handover 28.8% (n = 132), omissions of critical information about the patient's condition 19.2% (n = 88), and omissions of critical information about the patient's care plan during the handover process 14.2% (n = 65). The most prevalent failure detection mechanisms were those of expectation mismatch 35.7% (n = 174), clinical mismatch 26.9% (n = 127), and mismatch with other documentation 24.0% (n = 117). The findings suggest the need for a structured approach to handover with a recording of standardized sets of information to ensure that critical components are not omitted. Limitations of existing reporting processes are also highlighted. PMID:22268639

Thomas, Matthew J W; Schultz, Timothy J; Hannaford, Natalie; Runciman, William B

2013-01-01

232

25 CFR 39.409 - How does the OIEP Director ensure accountability?  

Code of Federal Regulations, 2010 CFR

...false How does the OIEP Director ensure accountability...409 How does the OIEP Director ensure accountability? (a) The Director of OIEP must ensure accountability... (1) Conducting annual independent and random field...

2010-04-01

233

Leveraging resources improves care for seniors.  

PubMed

Wishard-Eskenazi Health in Indianapolis has developed the Geriatric Resources for Assessment and Care of Elders (GRACE) program in which hospital geriatricians collaborate with primary care providers to ensure that the elderly get the care they need. Patients in the program are evaluated in the home by a nurse practitioner and social worker who report back to a multidisciplinary geriatric team and develop a treatment plan. They share the plan with the patient's primary care provider, who can make changes and ultimately has final approval. They spend time with the patient and family members to discuss the plan and goals and go over the patient's medication regimen. PMID:24195137

2013-10-01

234

9 CFR 3.17 - Care in transit.  

Code of Federal Regulations, 2010 CFR

...Care, Treatment, and Transportation of Dogs and Cats 1 Transportation Standards...Animal Welfare regulations transporting dogs or cats in commerce must ensure that...accompanying the operator, observes the dogs or cats as often as...

2010-01-01

235

9 CFR 3.17 - Care in transit.  

Code of Federal Regulations, 2011 CFR

...Care, Treatment, and Transportation of Dogs and Cats 1 Transportation Standards...Animal Welfare regulations transporting dogs or cats in commerce must ensure that...accompanying the operator, observes the dogs or cats as often as...

2011-01-01

236

9 CFR 3.17 - Care in transit.  

Code of Federal Regulations, 2012 CFR

...Care, Treatment, and Transportation of Dogs and Cats 1 Transportation Standards...Animal Welfare regulations transporting dogs or cats in commerce must ensure that...accompanying the operator, observes the dogs or cats as often as...

2012-01-01

237

9 CFR 3.17 - Care in transit.  

Code of Federal Regulations, 2013 CFR

...Care, Treatment, and Transportation of Dogs and Cats 1 Transportation Standards...Animal Welfare regulations transporting dogs or cats in commerce must ensure that...accompanying the operator, observes the dogs or cats as often as...

2013-01-01

238

Policy on Compliance with ACGME General Competencies Programs sponsored by the WUSM/BJH/SLCH GME Consortium must ensure that each resident or  

E-print Network

Policy on Compliance with ACGME General Competencies Programs sponsored by the WUSM/BJH/SLCH GME Consortium must ensure that each resident or clinical fellow has achieved competence to the level expected for their residents to demonstrate competence in patient care, medical knowledge, practice-based learning

Kornfeld, S. Kerry

239

Ensuring the Health of America's Children: Progress and Opportunities  

Microsoft Academic Search

ehind the headlines of a weakened U.S. economy and rising unemployment are two related developments: the transformation of health care coverage into an issue of real salience to working families and the middle class, and the ways in which states have crafted, and will continue to craft, an effective response. Over the past decade, the number of uninsured Americans has

LIANE WONG

240

Smart Grid Embedded Cyber Security: Ensuring Security While Promoting Interoperability  

E-print Network

Smart Grid Embedded Cyber Security: Ensuring Security While Promoting Interoperability Communications and Embedded Systems Department Southwest Research Institute Gary Ragsdale, Ph.D., P.E. August 24 ? 25, 2010 ESL-HH-10-08-09 Proceedings of the 17... acres ? 170 buildings ? 2.1 million square feet ESL-HH-10-08-09 Proceedings of the 17th Symposium for Improving Building Systems in Hot and Humid Climates Austin Texas August 24-25, 2010 Presentation Objectives ? Report on the security posture...

Ragsdale, G.

241

Ensuring participant safety and trial integrity with clinical trials oversight.  

PubMed

Clinical trial oversight is a critical element that ensures the protection of research participants and integrity of the data collected. The trial sponsor, a local Institutional Review Board, and independent monitoring committees all contribute with complementary but overlapping responsibilities. Consistency among these groups is essential for the smooth conduct of a clinical trial but may be challenging in resource-limited settings (RLS). Capacity building and training for RLS may improve clinical trials oversight and ultimately medical management. In this article, we review the components necessary for optimal clinical trial oversight and the issues that arise in the RLS, with some suggested strategies for improvement. PMID:24321985

Godfrey, Catherine; Payton, Manizhe; Tasker, Sybil; Proestel, Scott; Schouten, Jeffrey T

2014-01-01

242

How NASA Utilizes Dashboards to Help Ensure Mission Success  

NASA Technical Reports Server (NTRS)

NASA is actively planning to expand human spaceflight and robotic exploration beyond low Earth orbit. To prepare for the challenge of exploring these destinations in space, NASA conducts missions here on Earth in remote locations that have physical similarities to extreme space environments. Program managers for the Advanced Exploration Systems program requested a simple way to track financial information to ensure that each task stayed within their budgetary constraints. Using SAP BusinessObjects Dashboards (Formerly Xcelsius), a dashboard was created to satisfy all of their key requirements. Lessons learned, along with some tips and tricks, will be highlighted during this session.

Blakeley, Chris

2013-01-01

243

Iterative usability testing: ensuring a usable clinical workstation.  

PubMed

Once the users' needs are determined, how does one ensure that the resulting software meets the users' needs? This paper describes our application of a process, usability testing, that is used to measure the usability of systems as well as guide modifications to address usability problems. Usability testing is not a method to elicit opinions about software, but rather a method to determine scientifically a product's level of usability. Our application of usability testing is designed to determine the current usability level of a workstation designed for the clinician's use, determine specific problems with the Clinical Workstation's usability, and then evaluate the effectiveness of changes that address those problems. PMID:9357724

Coble, J M; Karat, J; Orland, M J; Kahn, M G

1997-01-01

244

Estimates of Adequate School Spending by State Based on National Average Service Levels.  

ERIC Educational Resources Information Center

Proposes a method for estimating expenditures per student needed to provide educational adequacy in each state. Illustrates the method using U.S., Arkansas, New York, Texas, and Washington State data, covering instruction, special needs, operations and maintenance, administration, and other costs. Estimates ratios of "adequate" to actual spending…

Miner, Jerry

1983-01-01

245

Characteristics of Adequate and Inadequate Responders in a Multi-Tiered Model  

ERIC Educational Resources Information Center

This study is a secondary analysis on a larger study that was conducted by Al Otaiba and colleagues (2011). The participants include 170 students that participated in Tier 2 and 3 intervention during a school year. The primary purpose of this mixed methods study was to determine accuracy for group membership for adequate and inadequate responders…

Greulich, Luana L.

2012-01-01

246

The Relationship between Adequate Yearly Progress and the Quality of Professional Development  

ERIC Educational Resources Information Center

Based on publicly available data, the study examined the relationship between adequate yearly progress status and teachers' perceptions of the quality of their professional development. The sample included responses of 5,558 teachers who completed the questionnaire in the 2005-2006 school year. Results of the statistical analysis show a…

Wolff, Lori A.; McClelland, Susan S.; Stewart, Stephanie E.

2010-01-01

247

WAIS-R Performance Patterns of 565 Incarcerated Adults Characterized as Underachieving Readers and Adequate Readers.  

ERIC Educational Resources Information Center

Prison inmates (N=565) classified as underachievers or adequate readers were administered the Wechsler Adult Intelligence Scale-Revised. Analysis of recategorized WAIS-R scores suggested that, as a group, the underachieving readers exhibited a pattern different from that of genetic dyslexic Ss and different from that of reading and learning…

Kender, Joseph P.; And Others

1985-01-01

248

Adequate Yearly Progress for Students with Emotional and Behavioral Disorders through Research-Based Practices  

ERIC Educational Resources Information Center

Because schools are held accountable for the academic performance of all students, it is important to focus on academics and the need for effective teaching practices. Adequate yearly progress, a method of accountability that is part of the No Child Left Behind Act (2001), profoundly affects the education of students who have emotional and…

Vannest, Kimberly J.; Temple-Harvey, Kimberly K.; Mason, Benjamin A.

2009-01-01

249

Israel Moiseevitch Gelfand and the Search for an Adequate Language for Med-ical Diagnosis  

E-print Network

Israel Moiseevitch Gelfand and the Search for an Adequate Language for Med- ical Diagnosis bf Casimir Kulikowski Seventeen years ago, Saul Amarel and I received an unexpected invitation to meet Israel explored artificial intelligence in medicine; with Sholom Weiss we developed one of the first expert

250

Training reading comprehension in adequate decoders\\/poor comprehenders: Verbal versus visual strategies  

Microsoft Academic Search

Third through fifth grade adequate decoders who were poor comprehenders were trained for 10 weeks in either the verbally based reciprocal teaching (RT) program (n = 22) or the visually based visualizing\\/ verbalizing (V\\/V) program (n = 23), or they were assigned to an untreated control group (n = 14). Training reading comprehension strategies in small groups enhanced comprehension as

Mina C. Johnson-Glenberg

2000-01-01

251

Adequate Numerical Solution of Air Pollution Problems by positive Di#erence Schemes on  

E-print Network

Adequate Numerical Solution of Air Pollution Problems by positive Di#erence Schemes on unbounded In this work we deal with the numerical solution of some problems of air pollution. Since the problems) pollution. The e#ciency and accuracy of our method is illustrated by an example. Key words: air pollution

Ehrhardt, Matthias

252

Adequate Numerical Solution of Air Pollution Problems by positive Difference Schemes on  

E-print Network

Adequate Numerical Solution of Air Pollution Problems by positive Difference Schemes on unbounded In this work we deal with the numerical solution of some problems of air pollution. Since the problems) pollution. The efficiency and accuracy of our method is illustrated by an example. Key words: air pollution

Ehrhardt, Matthias

253

Evaluating the Reliability of Selected School-Based Indices of Adequate Reading Progress  

ERIC Educational Resources Information Center

The present study examined the stability (i.e., 4-month and 12-month test-retest reliability) of six selected school-based indices of adequate reading progress. The total sampling frame included between 3970 and 5655 schools depending on the index and research question. Each school had at least 40 second-grade students that had complete Oral…

Wheeler, Courtney E.

2010-01-01

254

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

255

Effect of tranquilizers on animal resistance to the adequate stimuli of the vestibular apparatus  

NASA Technical Reports Server (NTRS)

The effect of tranquilizers on vestibulospinal reflexes and motor activity was studied in 900 centrifuged albino mice. Actometric studies have shown that the tranquilizers have a group capacity for increasing animal resistance to the action of adequate stimuli to the vestibular apparatus.

Maksimovich, Y. B.; Khinchikashvili, N. V.

1980-01-01

256

ARE RADON GAS MEASUREMENTS ADEQUATE FOR EPIDEMIOLOGICAL STUDIES AND CASE CONTROL  

E-print Network

ARE RADON GAS MEASUREMENTS ADEQUATE FOR EPIDEMIOLOGICAL STUDIES AND CASE CONTROL STUDIES OF RADON 2004 The lung dose derived from radon is not attributed to the radon gas itself, but instead to its of the radon risk, the excess number of cancers are related to the radon gas exposure, and not to the radon

Yu, K.N.

257

MINI BAJA `10 Provide adequate flotation for correct tire depth, and driver com-  

E-print Network

Frame Drivetrain Controls Suspension Flotation MINI BAJA `10 Goals Provide adequate flotation a dual chain and sprocket setup. Engine 10 hp Briggs & Stratton Purchased through SAE Cannot be modified were left in tact that were required for mounts or as safety requirements by SAE Collision Load

New Hampshire, University of

258

fficient crop production requires an adequate supply of all essential plant nutrients. However,  

E-print Network

E fficient crop production requires an adequate supply of all essential plant nutrients. However, the use of commercial nitrogen (N) fertilizers to increase production, maintain profits and provide low in the greatest quantity of all plant nutrients. The environmental effect of nitrogen fertilizers has been a long

259

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

260

Adequate antiplatelet regimen in patients on chronic anti-vitamin K treatment undergoing percutaneous coronary intervention  

PubMed Central

AIM: To investigate the impact of dual antiplatelet therapy (DAT) in patients on anti-vitamin K (AVK) regimen requiring percutaneous coronary intervention (PCI). METHODS: Between February 2006 and February 2008, 138 consecutive patients under chronic AVK treatment were enrolled in this registry. Of them, 122 received bare metal stent implantation and 16 received drug eluting stent implantation. The duration of DAT, on top of AVK treatment, was decided at the discretion of the clinician. Adequate duration of DAT was defined according to type of stent implanted and to its clinical indication. RESULTS: The baseline clinical characteristics of patients reflect their high risk, with high incidence of comorbid conditions (Charlson score ? 3 in 89% of the patients). At a mean follow-up of 17 ± 11 mo, 22.9% of patients developed a major adverse cardiac event (MACE): 12.6% died from cardiovascular disease and almost 6% had an acute myocardial infarction. Major hemorrhagic events were observed in 7.4%. Adequate DAT was obtained in only 44% of patients. In the multivariate analysis, no adequate DAT and Charlson score were the only independent predictors of MACE (both P = 0.02). CONCLUSION: Patients on chronic AVK therapy represent a high risk population and suffer from a high MACE rate after PCI. An adequate DAT regimen and absence of comorbid conditions are strongly associated with better clinical outcomes. PMID:22125672

Brugaletta, Salvatore; Martin-Yuste, Victoria; Ferreira-González, Ignacio; Cola, Clarissa; Alvarez-Contreras, Luis; Antonio, Marta De; Garcia-Moll, Xavier; García-Picart, Joan; Martí, Vicens; Balcells-Iranzo, Jordi; Sabaté, Manel

2011-01-01

261

Leadership Style and Adequate Yearly Progress: A Correlational Study of Effective Principal Leadership  

ERIC Educational Resources Information Center

Principals are responsible for leading efforts to reach increasingly higher levels of student academic proficiency in schools associated with adequate yearly progress (AYP) requirements. The purpose of this quantitative, correlational study was to identify the degree to which perceptions of principal transformational, transactional, and…

Leapley-Portscheller, Claudia Iris

2008-01-01

262

A Model for Touch Technique and Computation of Adequate Cane Length.  

ERIC Educational Resources Information Center

This article presents a model for the motion of a long-cane executing the touch technique and presents formulas for the projected length of a cane adequate to protect an individual with blindness against wall-type and pole-type hazards. The paper concludes that the long-cane should reach from the floor to the user's armpit. (JDD)

Plain-Switzer, Karen

1993-01-01

263

Palliative Care  

MedlinePLUS

... potentially extend to years, palliative care includes symptom management, therapy aimed at restoring function, practical support, and psychological interventions. At all stages of the disease, effective palliative ...

264

36 CFR 79.9 - Standards to determine when a repository possesses the capability to provide adequate long-term...  

Code of Federal Regulations, 2010 CFR

...determine when a repository possesses the capability to provide adequate long-term curatorial...determine when a repository possesses the capability to provide adequate long-term curatorial...determine that a repository has the capability to provide adequate long-term...

2010-07-01

265

36 CFR 79.9 - Standards to determine when a repository possesses the capability to provide adequate long-term...  

Code of Federal Regulations, 2011 CFR

...determine when a repository possesses the capability to provide adequate long-term curatorial...determine when a repository possesses the capability to provide adequate long-term curatorial...determine that a repository has the capability to provide adequate long-term...

2011-07-01

266

Factors influencing intensive care nurses' knowledge and attitudes regarding ventilator-associated pneumonia and oral care practice in intubated patients in Croatia.  

PubMed

Adequate oral care in intubated patients may reduce occurrence of ventilator-associated pneumonia. The purpose of this study was to explore knowledge, attitudes, and oral care practice in Croatian intensive care units and influencing factors. Nurses' knowledge is insufficient; however, most of them reported positive attitude toward the importance of oral care. Performed oral hygiene measures are mostly inappropriate. There is a need to improve the knowledge of ventilator-associated pneumonia and oral care. PMID:25278406

Jordan, Ante; Badovinac, Ana; Spalj, Stjepan; Par, Matej; Slaj, Martina; Plan?ak, Darije

2014-10-01

267

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

268

Compassionate care.  

PubMed

After reading the CPD article, it is clear that compassionate care is fundamental to the nursing role. It engages nurses and service users and improves health outcomes physically and emotionally. The importance of compassionate care is emphasised on almost a daily basis during pre-registration nursing lectures. PMID:25585769

Verwoerd, Elly

2015-01-14

269

Racial Segregation and Disparities in Breast Cancer Care and Mortality  

PubMed Central

Objectives To examine whether residential segregation is a mediator of racial/ ethnic disparities in breast cancer care and breast cancer mortality, or has a differential effect by race/ ethnicity. Methods Data from the Surveillance, Epidemiology and End Results-Medicare database on white, black, and Hispanic women age 66 to 85 years with breast cancer were examined to look at the receipt of adequate breast cancer care. Results Blacks were less likely than whites to receive adequate breast cancer care (odds ratio {OR} 0.78; 95% confidence interval {CI} 0.71 - 0.86). Individuals, both black and white, who lived in areas with greater black segregation were less likely to receive adequate breast cancer care (0.73; 0.64 – 0.82). Black segregation was a mediator of the black/ white disparity in breast cancer care, explaining 8.9% of the difference. After adjustment, adequate care for Hispanics did not significantly differ from whites, but individuals, both Hispanic and white, who lived in areas with greater Hispanic segregation were less likely to receive adequate breast cancer care (0.73; 0.61 – 0.89). While Blacks experienced greater breast cancer mortality than whites, black segregation did not substantially mediate the black-white disparity in survival, and was not significantly associated with mortality (hazard ratio 1.03; CI 0.87– 1.21). Breast cancer mortality did not differ between Hispanics and whites. Conclusions Among seniors, segregation mediates some of the black-white disparity in breast cancer care, but not mortality. Individuals who live in more segregated areas are less likely to receive adequate breast cancer care. PMID:18798230

Haas, Jennifer S.; Earle, Craig C.; Orav, John E.; Brawarsky, Phyllis; Keohane, Marie; Neville, Bridget A.; Williams, David R.

2008-01-01

270

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. PMID:23899921

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

2013-01-01

271

Community Endowment Funds for Early Care and Education. Technical Report.  

ERIC Educational Resources Information Center

Noting that most early care and education programs do not have adequate resources to achieve high quality, this report examines the potential of community-based endowment funds for early care and education. Section 1 of the report provides general background information about endowments, their uses, characteristics of successful endowment-building…

Monroe, Helen

272

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

273

In-vitro analysis of the microbicidal activity of 6 contact lens care solutions  

PubMed Central

Background Contact lens-related infections are often associated with inadequate contact lens hygiene, and therefore, contact lens care products should be able to sufficiently minimise the amount of pathogens that are responsible for these infections. In 2001, the EN ISO 14729 was introduced to ensure adequate disinfection efficacy of contact lens care solutions, but this norm has recently been criticised. Methods In this study, six frequently used contact lens care solutions were retested according to the Stand Alone Test of the EN ISO 14729 (2001). The Stand Alone Test is a quantitative suspension test. In addition, the products were tested in a modified setting adding an organic load. The load was a mixture of human blood serum, lysozyme, and mucine, which resembles tear fluid. Results The criteria of the Stand Alone Test recommended in EN ISO 14729 were only met by Aosept Plus. This 3% hydrogen-peroxide-based contact lens care solution attained a reduction factor of > 5 log units for bacteria and > 4 for fungi in all cases. Two further contact lens care solutions, Blue Vision and Optifree Replenish, met the criteria of a reduction factor of > 3 log units for bacteria and > 1 log unit for fungi, but only in the presence of artificial tear fluid. The three remaining products did not exhibit adequate disinfecting efficacy, at least against one of the tested microorganisms. Conclusions Through the observation that the artificial tear fluid used in this study influences the disinfecting efficacy of contact lens care solutions, especially that of multi-purpose solutions, in a different way than does albumin, mucine, or even the organic load suggested in EN ISO 14729, it becomes obvious that the test conditions in the EN ISO 14729 should be revised in order to create more realistic conditions, e.g., by using a more realistic artificial tear fluid. Furthermore, we suggest adapting the EN ISO 14729 to the European test hierarchy for chemical disinfectants and antiseptics, which consists of three test phases and also requests meeting stricter criteria in order to pass the test. Unless the test conditions guarantee a sufficient reduction of potential pathogens, the risk of contact lens-related microbial keratitis and other infections will remain for the users. PMID:23033880

2012-01-01

274

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

275

Universal health care in India: Panacea for whom?  

PubMed

This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all. PMID:24351383

Qadeer, Imrana

2013-01-01

276

Retention in mental health care of Portuguese-speaking patients  

PubMed Central

We compared service outcomes of dedicated language and cultural competency services in adequacy of care, ER, and inpatient care among Portuguese-speaking patients in ethnic- and non-ethnic-specific behavioral health clinics. We assessed adequacy of mental health care, and use of inpatient emergency department among Portuguese-speaking patients, comparing individuals receiving care from a culturally and linguistically competent mental health care setting (the Portuguese Mental Health Program [PMHP]) with usual mental health care in a community health care system in the USA. Propensity score matching was used to balance patients in treatment and control groups on gender, marital status, age, diagnosis of mental disorder, and insurance status. We used de-identified, longitudinal, administrative data of 854 Portuguese-speaking patients receiving care from the PMHP and 541 Portuguese-speaking patients receiving usual care from 2005–2008. Adequate treatment was defined as receipt of at least eight outpatient psychotherapy visits, or at least four outpatient visits of which one was a psychopharmacological visit. PMHP patients were more likely to receive adequate care. No differences were found in rates of ER use or inpatient mental health care. The present study suggests increased quality of care for patients that have contact with a clinic that dedicates resources specifically to a minority/immigrant group. Advantages of this setting include greater linguistic and cultural concordance among providers and patients. Further research is warranted to better understand the mechanisms by which culturally appropriate mental health care settings benefit minority/immigrant patients. PMID:23427258

Gonçalves, Marta; Cook, Benjamin; Mulvaney-Day, Norah; Alegría, Margarita; Kinrys, Gustavo

2013-01-01

277

[Adequate measurement of artificial mineral fibers and evaluation of the biological effect].  

PubMed

Epidemiological and clinical medical examinations of exposed workers to man-made mineral fibers (MMF) to fix threshold limit values are presupposed by adequate measurements of MMF-dust. As yet are used technics which are unsatisfying. In consideration of the biological conditions in the breathing system a draft to measure MMF dust is introduced and proved. This draft based on the use of two-step-gravimetrical measurements together with membranous filter devices and evaluation by an electronic microscope. PMID:2552693

Ruppe, K; Werner, J; Thürmer, H; Lorenz, A

1989-07-01

278

Adequate Nutrition Followed by Revisional Bariatric Surgery to Optimize Homeostatic Eating Control  

Microsoft Academic Search

Terms as treatment failure or ineffective treatment after bariatric surgery are not clearly defined and difficult to handle.\\u000a About one third of all persons who were formerly treated with a Lapband have either mechanical problems or do not lose enough\\u000a weight. The current review argues in favor of adequate nutrition to suppress hunger and optimize satiety together with effective\\u000a but

Dave H. Schweitzer

2008-01-01

279

Adequate dosing of micronutrients for different age groups in the life cycle.  

PubMed

Many studies of micronutrient supplementation in developing countries have used single-nutrient supplements with either vitamins or minerals. However, people in these countries often suffer from multiple, rather than single, micronutrient deficiencies. The objective of this paper is to discuss the factors that go into determining the adequate dosing of vitamins and/or minerals for people of different ages. To elaborate on the adequacy of micronutrient doses in supplements, a model described by the US FNB was used, which calculates the difference between the mean observed intake for an individual and the estimated average requirement for a life stage and gender group. This model allows estimating the degree of confidence that a certain nutrient intake (from supplements and diet) is adequate. The US/Canadian DRI values have been used as the basis for these calculations, from which it can be concluded that a daily supplement of one RDA of each micronutrient is adequate to cover the personal requirements of all individuals in each respective age and gender group of the population, provided that 20 to 40% of an RDA is supplied by the diet--likely a realistic value for developing countries. DRI values vary significantly between different age groups, reflecting changing needs over a life cycle. With the objective of a supplement to be adequate and safe, the design of a one-for-all supplement covering all age groups is not realistic. Such a supplement would either underscore or surpass the required intake of some of the age groups. Additionally the dosage of certain micronutrients might exceed the upper level of intake for lower age groups. Therefore, it is suggested that three different supplements following the one RDA concept for all micronutrients be developed for research use in developing countries for the following age groups; 1 to 3 years, 4 to 13 years, and females > 14 years (excluding during pregnancy). PMID:14564938

Bienz, Denise; Cori, Hector; Hornig, Dietrich

2003-09-01

280

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

281

Overweight and Obese Patients Do not Seem to Adequately Recognize their Own Risk for Colorectal Cancer  

Microsoft Academic Search

Being overweight is a risk factor for colorectal cancer; patients' adequate perception of their risk may lead to better involvement\\u000a in management. The purpose of this study was to measure perception of risk for colorectal cancer in overweight and obese patients.\\u000a A consecutive sample of overweight adult patients (n?=?195) attending to nutritional counseling was submitted to clinical questionnaire addressing personal

Fernanda Leite-Pereira; Rui Medeiros; Mário Dinis-Ribeiro

282

42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.  

Code of Federal Regulations, 2010 CFR

...MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS...standardized definitions and accounting, statistics, and reporting practices that are widely...supplier services directly, it must furnish statistics that indicate the frequency and...

2010-10-01

283

Current strategies for the restoration of adequate lordosis during lumbar fusion  

PubMed Central

Not restoring the adequate lumbar lordosis during lumbar fusion surgery may result in mechanical low back pain, sagittal unbalance and adjacent segment degeneration. The objective of this work is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. Theoretical lordosis can be evaluated from the measurement of the pelvic incidence and from the analysis of spatial organization of the lumbar spine with 2/3 of the lordosis given by the L4-S1 segment and 85% by the L3-S1 segment. Technical aspects involve patient positioning on the operating table, release maneuvers, type of instrumentation used (rod, screw-rod connection, interbody cages), surgical sequence and the overall surgical strategy. Spinal osteotomies may be required in case of fixed kyphotic spine. AP combined surgery is particularly efficient in restoring lordosis at L5-S1 level and should be recommended. Finally, not one but several strategies may be used to achieve the need for restoration of adequate lordosis during fusion surgery. PMID:25621216

Barrey, Cédric; Darnis, Alice

2015-01-01

284

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

2013-04-01

285

Current strategies for the restoration of adequate lordosis during lumbar fusion.  

PubMed

Not restoring the adequate lumbar lordosis during lumbar fusion surgery may result in mechanical low back pain, sagittal unbalance and adjacent segment degeneration. The objective of this work is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. Theoretical lordosis can be evaluated from the measurement of the pelvic incidence and from the analysis of spatial organization of the lumbar spine with 2/3 of the lordosis given by the L4-S1 segment and 85% by the L3-S1 segment. Technical aspects involve patient positioning on the operating table, release maneuvers, type of instrumentation used (rod, screw-rod connection, interbody cages), surgical sequence and the overall surgical strategy. Spinal osteotomies may be required in case of fixed kyphotic spine. AP combined surgery is particularly efficient in restoring lordosis at L5-S1 level and should be recommended. Finally, not one but several strategies may be used to achieve the need for restoration of adequate lordosis during fusion surgery. PMID:25621216

Barrey, Cédric; Darnis, Alice

2015-01-18

286

ADEQUATE CR: 13C connectivity mapping in indirect detection mode with composite refocusing.  

PubMed

We report a novel rare spin correlation experiment termed ADEQUATE with composite refocusing (CR), which is the (1)H-detected version of 2D INADEQUATE CR. ADEQUATE CR begins with a polarization transfer from protons to the attached carbon, followed by (13)C-(13)C double-quantum (DQ) preparation. Unlike the ADEQUATE class of experiments, (13)C DQ coherence is converted after evolution to single-quantum single transitions (SQ-STs) by CR. (13)C SQ-ST is then transferred back to the coupled protons by a coherence order selective reconversion. The present sequence produces partial transition selectivity in the (1)H dimension as does (1)H Indirect detected (13)C Low-Abundance Single-transition correlation Spectroscopy (HICLASS), thereby mitigating the reduction in sensitivity enhancement because of the presence of homonuclear proton couplings. However, unlike HICLASS (which is an experiment that involves SQ-TS evolution), no homonuclear zero quantum mixing is required on the (13)C channel in the present experiment. Experimental results are demonstrated on a variety of samples, establishing the efficiency of the proposed method. PMID:24599710

George, Christy; Chandrakumar, N

2014-05-01

287

Utilization of dental care: An Indian outlook.  

PubMed

Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities. PMID:24082719

Gambhir, Ramandeep Singh; Brar, Prabhleen; Singh, Gurminder; Sofat, Anjali; Kakar, Heena

2013-07-01

288

Member Input Sought to Ensure AGU's Continued Success  

NASA Astrophysics Data System (ADS)

As an organization, AGU is indeed fortunate. Our Union has a growing membership worldwide with an average annual increase of 5.9% over the last 5 years. We are financially strong; we have planned carefully and managed our assets and our annual budgets so that we are able to navigate difficult times. Our Fall Meeting is ``the'' event for Earth and space scientists from more than 100 countries. Our publications continue to grow and evolve. Our outreach programs are gaining recognition in the communities we serve. Our development efforts are strengthening our ability to do more without taxing the revenues from meetings and publications. AGU is a preeminent scientific society.

Grove, Timothy L.

2008-11-01

289

Hospice Care  

MedlinePLUS

... coverage for Medicare, Medicaid, and private health plans http://www.caringinfo.org/i4a/ pages/index.cfm?pageid= ... for Medicare & Medicaid Services Information for Medicare beneficiaries http://www.medicare.gov/ coverage/hospice-and-respite- care. ...

290

Comprehensive Care  

MedlinePLUS

... Providing emotional support Comprehensive care includes attention to emotional health as well as physical health. Mental health professionals provide support and education, as well as diagnose and treat the depression, ...

291

Continuing Care  

MedlinePLUS

... In Search of an Alzheimer’s Cure New therapeutic target for Alzheimer’s could lead to drugs without side ... Fitness: Take Care of Your Core Fitness: Get Moving! How Meditation May Help Against Alzheimer’s Reducing Clutter ...

292

Vulvar Care  

MedlinePLUS

... care professionals to share with clients. Any other reproduction is sub- ject to the Journal of Midwifery & ... jelly keeps the area moist and soft . For Sexual Activity • Some birth control products you can get ...

293

Prenatal Care  

MedlinePLUS

... glucose level. Pregnancy can also make symptoms of low blood glucose hard to detect. During pregnancy, your diabetes control ... staying in your target range or have frequent low blood glucose levels, talk to your health care team about ...

294

Pregnancy care  

MedlinePLUS

... at least 0.4 milligrams (400 micrograms) of folic acid. Folic acid is needed to decrease the risk of certain ... been exposed to a sexually transmitted infection, chemicals, radiation, or unusual pollutants Call your health care provider ...

295

Residential Care  

MedlinePLUS

... to care for residents with behavioral needs and fees. When you visit a facility, ask for their ... types of facilities can include an initial entry fee with subsequent monthly fees or payment may be ...

296

Caring Encounters  

ERIC Educational Resources Information Center

Children with autism may seem to not care about things or have the same range of emotions as those of us who see them and care for them. But they do have empathy and they can be taught how to communicate it, says the author, a teacher of children with autism. We simply need to listen to them, watch them, and be with them in their moment.

Gunn, Alyson

2012-01-01

297

Ensuring privacy in the study of pathogen genetics.  

PubMed

Rapid growth in the genetic sequencing of pathogens in recent years has led to the creation of large sequence databases. This aggregated sequence data can be very useful for tracking and predicting epidemics of infectious diseases. However, the balance between the potential public health benefit and the risk to personal privacy for individuals whose genetic data (personal or pathogen) are included in such work has been difficult to delineate, because neither the true benefit nor the actual risk to participants has been adequately defined. Existing approaches to minimise the risk of privacy loss to participants are based on de-identification of data by removal of a predefined set of identifiers. These approaches neither guarantee privacy nor protect the usefulness of the data. We propose a new approach to privacy protection that will quantify the risk to participants, while still maximising the usefulness of the data to researchers. This emerging standard in privacy protection and disclosure control, which is known as differential privacy, uses a process-driven rather than data-centred approach to protecting privacy. PMID:24721230

Mehta, Sanjay R; Vinterbo, Staal A; Little, Susan J

2014-08-01

298

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.

299

Lifestyle interventions in primary care  

PubMed Central

ABSTRACT OBJECTIVE To determine whether lifestyle counseling interventions delivered in primary care settings by primary care providers to their low-risk adult patients are effective in changing factors related to cardiovascular risk. DATA SOURCES MEDLINE (PubMed), EMBASE, and CINAHL were searched from January 1985 to December 2007. The reference lists of all articles collected were checked to ensure that all suitable randomized controlled trials (RCTs) had been included. STUDY SELECTION We chose RCTs on lifestyle counseling in primary care for primary prevention of cardiovascular disease. The search was limited to English-language articles involving human subjects. Studies had to have been conducted within the context of primary care, and interventions had to have been carried out by primary care providers, such as family physicians or practice nurses. Studies had to have had a control group who were managed with usual care. Outcomes of interest were cardiovascular risk scores, blood pressure, lipid levels, weight or body mass index, and morbidity and mortality. SYNTHESIS Seven RCTs were included in the review. Only 4 studies showed any significant positive effect on the outcomes of interest, and only 2 of these showed consistent effects across several outcomes. The main effects were on blood pressure and lipid levels, but the size of these effects, while statistically significant, was small. There was no obvious benefit to one provider doing the intervention over another (eg, physician vs nurse), nor of the focus of the intervention (eg, on diet vs on exercise). CONCLUSION Lifestyle counseling interventions delivered by primary care providers in primary care settings to patients at low risk (primary prevention) appeared to be of marginal benefit. Resources and time in primary care might be better spent on patients at higher risk of cardiovascular disease, such as those with existing heart disease or diabetes. PMID:19074715

Fleming, Patrick; Godwin, Marshall

2008-01-01

300

Drugs Requiring Application to PharmaCare Special Authority  

E-print Network

OVER Drugs Requiring Application to PharmaCare Special Authority Program Drugs listed may cost and ensures the long-term sustainability of your PBC drug plan. When prescribed a drug below, you.* Regardless of PharmaCare's decision to cover the drug, a copy of the decision must be submitted to PBC

301

UNIVERSITY ANIMAL CARE COMMITTEE UACC Approved: November 2012  

E-print Network

UNIVERSITY ANIMAL CARE COMMITTEE UACC Approved: November 2012 Policy on Pedagogical Merit of Teaching Protocols It is the responsibility of the University Animal Care Committee (UACC) to ensure that no teaching program (including field studies) involving vertebrate animals be commenced and that no animals

Abolmaesumi, Purang

302

Childhood Maltreatment History, Posttraumatic Relational Sequelae, and Prenatal Care Utilization  

PubMed Central

Objective To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization. Design A post-hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes. Setting Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan. Participants This analysis included 467 diverse, nulliparous, English-speaking adult women expecting their first infants. Methods Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records. Results Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care. Conclusion When childhood maltreatment survivors were resilient or have used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD-affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted. PMID:23772546

Bell, Sue Anne; Seng, Julia

2015-01-01

303

XDS-I outsourcing proxy: ensuring confidentiality while preserving interoperability.  

PubMed

The interoperability of services and the sharing of health data have been a continuous goal for health professionals, patients, institutions, and policy makers. However, several issues have been hindering this goal, such as incompatible implementations of standards (e.g., HL7, DICOM), multiple ontologies, and security constraints. Cross-enterprise document sharing (XDS) workflows were proposed by Integrating the Healthcare Enterprise (IHE) to address current limitations in exchanging clinical data among organizations. To ensure data protection, XDS actors must be placed in trustworthy domains, which are normally inside such institutions. However, due to rapidly growing IT requirements, the outsourcing of resources in the Cloud is becoming very appealing. This paper presents a software proxy that enables the outsourcing of XDS architectural parts while preserving the interoperability, confidentiality, and searchability of clinical information. A key component in our architecture is a new searchable encryption (SE) scheme-Posterior Playfair Searchable Encryption (PPSE)-which, besides keeping the same confidentiality levels of the stored data, hides the search patterns to the adversary, bringing improvements when compared to the remaining practical state-of-the-art SE schemes. PMID:25014941

Ribeiro, Luís S; Viana-Ferreira, Carlos; Oliveira, José Luís; Costa, Carlos

2014-07-01

304

Telepsychiatry and e-Mental Health Services: Potential for Improving Access to Mental Health Care  

Microsoft Academic Search

Reforming mental health care is a focus of many ongoing initiatives in the United States, both at the national and state levels. Access to adequate mental health care services is one of the identified problems. Telepsychiatry and e-mental health services could improve access to mental health care in rural, remote and underserved areas. The authors discuss the required technology, common

Kaye L. McGinty; Sy Atezaz Saeed; Scott C. Simmons; Yilmaz Yildirim

2006-01-01

305

Maintaining technical quality of care in the introduction of Cyclofem in a national family planning program: findings from Indonesia.  

PubMed

This paper discusses the technical dimensions of "quality of care" in contraceptive service delivery in both the Cyclofem Introductory Trial, as well as in routine service delivery of other injectables in Indonesia. Although the quality of care in the Cyclofem trial was generally acceptable, substantial weaknesses in screening, clinical technique, the management of side-effects, and knowledge concerning re-injection time frames were identified in the provision of injectable contraceptives in routine service delivery. The findings suggest that in order for Cyclofem and other injectables to be delivered in the routine program with an adequate standard of care, considerable managerial adaptation and strengthening of providers' technical capabilities would be necessary prior to actual introduction. This would include providing training and updated technical guidelines concerning both Cyclofem and other contraceptives to providers, with an emphasis on technical issues including contraceptive indications and contraindications, re-injection time frames, maintenance of asepsis and the management of side-effects. Strengthening the existing management information system and logistics systems to facilitate differentiation between injectable contraceptives provided by the program so as to ensure sufficient supplies of both contraceptives and associated materials such as needles and syringes will also be necessary. PMID:8045136

Lubis, F; Fajans, P; Simmons, R

1994-05-01

306

Ebola virus disease cases among health care workers not working in Ebola treatment units--Liberia, June-August, 2014.  

PubMed

West Africa is experiencing the largest Ebola virus disease (Ebola) epidemic in recorded history. Health care workers (HCWs) are at increased risk for Ebola. In Liberia, as of August 14, 2014, a total of 810 cases of Ebola had been reported, including 10 clusters of Ebola cases among HCWs working in facilities that were not Ebola treatment units (non-ETUs). The Liberian Ministry of Health and Social Welfare and CDC investigated these clusters by reviewing surveillance data, interviewing county health officials, HCWs, and contact tracers, and visiting health care facilities. Ninety-seven cases of Ebola (12% of the estimated total) were identified among HCWs; 62 HCW cases (64%) were part of 10 distinct clusters in non-ETU health care facilities, primarily hospitals. Early recognition and diagnosis of Ebola in patients who were the likely source of introduction to the HCWs (i.e., source patients) was missed in four clusters. Inconsistent recognition and triage of cases of Ebola, overcrowding, limitations in layout of physical spaces, lack of training in the use of and adequate supply of personal protective equipment (PPE), and limited supervision to ensure consistent adherence to infection control practices all were observed. Improving infection control infrastructure in non-ETUs is essential for protecting HCWs. Since August, the Liberian Ministry of Health and Social Welfare with a consortium of partners have undertaken collaborative efforts to strengthen infection control infrastructure in non-ETU health facilities. PMID:25412067

Matanock, Almea; Arwady, M Allison; Ayscue, Patrick; Forrester, Joseph D; Gaddis, Bethany; Hunter, Jennifer C; Monroe, Benjamin; Pillai, Satish K; Reed, Christie; Schafer, Ilana J; Massaquoi, Moses; Dahn, Bernice; De Cock, Kevin M

2014-11-21

307

Alcoholic pancreatitis in rats fed ethanol in a nutritionally adequate liquid diet  

Microsoft Academic Search

Summary  In an effort to develop a model of chronic alcoholic pancreatitis in Sprague-Dawley rats fed a nutritionally adequate diet,\\u000a 3 groups of 15 animals each were fed Wayne Rodent-Blox ad libitum, Lieber-DeCarli diet with 40% of carbohydrate calories replaced\\u000a by ethanol ad libitum and isocaloric amounts of Lieber-DeCarli diet respectively for a period of 18 months. Rats were anesthetized\\u000a and

Manjit Singh

1987-01-01

308

Foster Care and Medicaid Managed Care.  

ERIC Educational Resources Information Center

Reviews issues surrounding the delivery of managed health care services to children in foster care. Details the unique characteristics of children in foster care, including limited medical histories upon entry into foster care, multiple health care needs, lack of a clearly identified medical care coordinator, and frequent placement changes.…

Leslie, Laurel K.; Kelleher, Kelly J.; Burns, Barbara J.; Landsverk, John; Rolls, Jennifer A.

2003-01-01

309

Differences in referral rates to specialised health care from four primary health care models in Klaipeda, Lithuania  

Microsoft Academic Search

BACKGROUND: Lithuanian primary health care (PHC) is undergoing changes from the systems prevalent under the Soviet Union, which ensured free access to specialised health care. Currently four different PHC models work in parallel, which offers the opportunity to study their respective effect on referral rates. Our aim was to investigate whether there were differences in referrals rates from different Lithuanian

Andrzej Zielinski; Anders Håkansson; Arnoldas Jurgutis; Ingvar Ovhed; Anders Halling

2008-01-01

310

Integrating Health Information Technology to Achieve Seamless Care Transitions.  

PubMed

Improving care transitions, or "handoffs" as patients migrate from one care setting to another, is a priority across stakeholder groups and health-care settings and additionally is included in national health-care goals set forth in the National Quality Strategy. Although many demonstrations of improved care transitions have succeeded, particularly for hospital discharges, ensuring consistent, high-quality, and safe transitions of care remains challenging. This paper highlights the potential for health information technology to become an increasing part of effective transitional care interventions, with the potential to reduce the resource burden currently associated with effective care transitions, the ability to spread improved practices to larger numbers of patients and providers efficiently and at scale, and, as health technology interoperability increases, the potential to facilitate critical information flow and feedback loops to clinicians, patients, and caregivers across disparate information systems and care settings. PMID:24522208

Marcotte, Leah; Kirtane, Janhavi; Lynn, Joanne; McKethan, Aaron

2014-02-11

311

Ensuring accurate testing for human immunodeficiency virus in Myanmar  

PubMed Central

Abstract Problem Until 2005, the quality of rapid diagnostic human immunodeficiency virus (HIV) testing was not monitored and no regular technical support was provided to hospital laboratories in Myanmar. Approach The national reference laboratory introduced a national external quality assessment scheme. The scheme involved (i) training laboratory technicians in HIV testing and in the requirements of the quality assessment system; (ii) implementing a biannual proficiency panel testing programme; (iii) on-site assessments of poorly-performing laboratories to improve testing procedures; and (iv) development of national guidelines. Local setting In 2011, a total of 422 public hospitals in Myanmar had laboratories providing HIV tests. In addition, private laboratories supported by nongovernmental organizations (NGOs) conducted HIV testing. Relevant changes The scheme was started in 65 public laboratories in 2005. In 2012, it had expanded nationwide to 347 laboratories, including 33 NGO laboratories. During the expansion of the scheme, laboratory response rates were greater than 90% and the proportion of laboratories reporting at least one aberrant result improved from 9.2% (6/65) in 2005 to 5.4% (17/316) in 2012. Lessons learnt National testing guidelines and a reference laboratory are needed to successfully implement quality assurance of HIV testing services. On-site assessments are crucial for all participating laboratories and the only source for insight on the causes of aberrant results; lessons that the reference laboratory can share nationally. Proficiency testing helps laboratory technicians to maintain HIV testing skills by ensuring that they regularly encountered HIV-positive samples. PMID:25558106

Kyaw, Latt Latt; Wada, Koji; Oo, Khin Yi; Tin, Htay Htay; Yoshihara, Namiko

2015-01-01

312

An approach to ensuring quality in environmental software  

SciTech Connect

Environmental software is often used to determine impacts to the public, workers, and the environment from environmental contamination. It is vital, therefore, that the modeling results, and the software that provides them, be scientifically defensible and capable of withstanding the most rigorous of technical reviews. The control and assurance of quality is a critical factor for the project team that develops environmental software at the Pacific Northwest National Laboratory. This document describes the philosophy, process, and activities that ensure a quality product throughout the life cycle of requirements analysis, design, programming, modification, testing, and implementation of environmental software. Environmental software developed by the project team is designed using an object-oriented approach. This software offers increased benefits, such as ease of maintenance and retention of the development and testing legacy of individual components, over traditional hard wired software. These benefits allow the design and testing of the models and future additions to be faster and less costly. This software is developed using a modular framework concept that allows a variety of models to work within a single construct. This software has two parts: an overall system framework and a set of modules. Each module has up to three components: a user interface, a scientific model, and pre/post-processors. Each of these pieces has a different set of quality criteria associated with it. However, whatever form this software might take for a particular client, standard processes apply to protect the information from inappropriate use. The information contained within this document can be applied to most environmental software to analyze risk in multiple environmental media.

Gelston, G.M.; Lundgren, R.E.; McDonald, J.P.; Hoopes, B.L.

1998-05-01

313

Ensuring medication adherence with direct oral anticoagulant drugs: lessons from adherence with vitamin K antagonists (VKAs).  

PubMed

Medication adherence (taking drugs properly) is uncommon among patients on warfarin. Poor adherence to warfarin leads to an increase in adverse medical events, including stroke in atrial fibrillation (AF). Factors related to patients, physicians and the health system account for poor adherence. Direct oral anticoagulants (DOACs) are easier to use than warfarin, with fewer drug and food interactions and no need for routine blood monitoring. A proper use of DOACs may reduce the risk of stroke in AF. However, in clinical settings where no laboratory monitoring is needed, a poor medication adherence is common and may impact clinical outcomes. In the management of chronic disorders, careful knowledge of the individual patient's attitudes and behaviors is a pre-requisite for a successful doctor-patient communication. To increase patient's awareness of the risks and benefits of DOACs and, in turn, increase medication adherence, at each follow-up visit physicians should screen for priorities and motivational problems; check for the lack of understanding and/or knowledge; assess any health system or personal barriers to medication adherence; identify appropriate interventions and provide tailored support to patient needs. Dissemination of guidelines to the health care chain (prescribing physician, general practitioners, caregivers, nurses, pharmacists) further encourages medication adherence. However, the long-term effect of some of these strategies is unknown; one tool may not fit all patients, and the prescribing physician should consider individualization of these aids to ensure medication adherence and persistence (continuing to take drugs properly in long-term treatments) for DOACs in every day practice. PMID:24525314

Di Minno, Alessandro; Spadarella, Gaia; Tufano, Antonella; Prisco, Domenico; Di Minno, Giovanni

2014-05-01

314

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 pump—the CentriMag® (Levitronix LLC; Waltham, Mass) centrifugal-flow ventricular assist device—in 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. PMID:18941648

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

315

A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems  

PubMed Central

Background A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to identify the key components of institutional care for people with longer term mental health problems and the effectiveness of these components. Methods We undertook a systematic review of the literature using comprehensive search terms in 11 electronic databases and identified 12,182 titles. We viewed 550 abstracts, reviewed 223 papers and included 110 of these. A "critical interpretative synthesis" of the evidence was used to identify domains of institutional care that are key to service users' recovery. Results We identified eight domains of institutional care that were key to service users' recovery: living conditions; interventions for schizophrenia; physical health; restraint and seclusion; staff training and support; therapeutic relationship; autonomy and service user involvement; and clinical governance. Evidence was strongest for specific interventions for the treatment of schizophrenia (family psychoeducation, cognitive behavioural therapy (CBT) and vocational rehabilitation). Conclusion Institutions should, ideally, be community based, operate a flexible regime, maintain a low density of residents and maximise residents' privacy. For service users with a diagnosis of schizophrenia, specific interventions (CBT, family interventions involving psychoeducation, and supported employment) should be provided through integrated programmes. Restraint and seclusion should be avoided wherever possible and staff should have adequate training in de-escalation techniques. Regular staff supervision should be provided and this should support service user involvement in decision making and positive therapeutic relationships between staff and service users. There should be clear lines of clinical governance that ensure adherence to evidence-based guidelines and attention should be paid to service users' physical health through regular screening. PMID:19735562

Taylor, Tatiana L; Killaspy, Helen; Wright, Christine; Turton, Penny; White, Sarah; Kallert, Thomas W; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kališová, Lucie; Onchev, Georgi; Dimitrov, Hristo; Mezzina, Roberto; Wolf, Kinou; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, José; Cardoso, Graça; King, Michael B

2009-01-01

316

Home Health Care  

MedlinePLUS

... Page Resize Text Printer Friendly Online Chat Home Health Care What is Home Health Care? How Do I ... More About Home Health Care? What is Home Health Care? Home health care helps seniors live independently for ...

317

Dementia - home care  

MedlinePLUS

... include in-home care, nursing homes, or adult day care. LONG-TERM CARE A person with dementia may ... or in an institution. Possible options include: Adult day care Boarding homes Convalescent homes In-home care Many ...

318

TRANSITIONS OF CARE/HANDOVER Purpose: The purpose of this policy is to establish standards within the Graduate Medical  

E-print Network

Page 167 ` TRANSITIONS OF CARE/HANDOVER Purpose: The purpose of this policy is to establish to ensure that Transitions of Care and Handover occur in such a manner that the quality and safety of patient care is not compromised. The term "Transitions of Care" refers to the movement patients make

Oliver, Douglas L.

319

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

Code of Federal Regulations, 2011 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...

2011-04-01

320

34 CFR 602.18 - Ensuring consistency in decision-making.  

Code of Federal Regulations, 2012 CFR

... Ensuring consistency in decision-making. 602.18 Section 602... Ensuring consistency in decision-making. The agency must...information the agency relies on for making accrediting decisions is accurate; and...

2012-07-01

321

34 CFR 602.18 - Ensuring consistency in decision-making.  

Code of Federal Regulations, 2010 CFR

... Ensuring consistency in decision-making. 602.18 Section 602... Ensuring consistency in decision-making. The agency must...information the agency relies on for making accrediting decisions is accurate; and...

2010-07-01

322

34 CFR 602.18 - Ensuring consistency in decision-making.  

Code of Federal Regulations, 2013 CFR

... Ensuring consistency in decision-making. 602.18 Section 602... Ensuring consistency in decision-making. The agency must...information the agency relies on for making accrediting decisions is accurate; and...

2013-07-01

323

34 CFR 602.18 - Ensuring consistency in decision-making.  

Code of Federal Regulations, 2011 CFR

... Ensuring consistency in decision-making. 602.18 Section 602... Ensuring consistency in decision-making. The agency must...information the agency relies on for making accrediting decisions is accurate; and...

2011-07-01

324

34 CFR 602.18 - Ensuring consistency in decision-making.  

Code of Federal Regulations, 2014 CFR

... Ensuring consistency in decision-making. 602.18 Section 602... Ensuring consistency in decision-making. The agency must...information the agency relies on for making accrediting decisions is accurate; and...

2014-07-01

325

General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients – is cultural competence adequately considered?  

PubMed Central

Background General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the disadvantage faced by vulnerable populations. PMID:25115609

2014-01-01

326

Transitional Care Strategies From Hospital to Home  

PubMed Central

Hospitals are challenged with reevaluating their hospital’s transitional care practices, to reduce 30-day readmission rates, prevent adverse events, and ensure a safe transition of patients from hospital to home. Despite the increasing attention to transitional care, there are few published studies that have shown significant reductions in readmission rates, particularly for patients with stroke and other neurologic diagnoses. Successful hospital-initiated transitional care programs include a “bridging” strategy with both predischarge and postdischarge interventions and dedicated transitions provider involved at multiple points in time. Although multicomponent strategies including patient engagement, use of a dedicated transition provider, and facilitation of communication with outpatient providers require time and resources, there is evidence that neurohospitalists can implement a transitional care program with the aim of improving patient safety across the continuum of care. PMID:25553228

Ranji, Sumant R.

2015-01-01

327

Ensuring confidence in radionuclide-based sediment chronologies and bioturbation rates  

USGS Publications Warehouse

Sedimentary records of naturally occurring and fallout-derived radionuclides are widely used as tools for estimating both the ages of recent sediments and rates of sedimentation and bioturbation. Developing these records to the point of data interpretation requires careful sample collection, processing, analysis and data modeling. In this work, we document a number of potential pitfalls that can impact sediment core records and their interpretation. This paper is not intended as an exhaustive treatment of these potential problems. Rather, the emphasis is on potential problems that are not well documented in the literature, as follows: (1) the mere sampling of sediment cores at a resolution that is too coarse can result in an apparent diffusive mixing of the sedimentary record at rates comparable to diffusive bioturbation rates observed in many locations; (2) 210Pb profiles in slowly accumulating sediments can easily be misinterpreted to be driven by sedimentation, when in fact bioturbation is the dominant control. Multiple isotopes of different half lives and/or origin may help to distinguish between these two possible interpretations; (3) apparent mixing can occur due simply to numerical artifacts inherent in the finite difference approximations of the advection diffusion equation used to model sedimentation and bioturbation. Model users need to be aware of this potential problem. Solutions to each of these potential pitfalls are offered to ensure the best possible sediment age estimates and/or sedimentation and bioturbation rates can be obtained.

Crusius, John; Kenna, Timothy C.

2007-01-01

328

Estimating the Cost of Adequate K-12 Educational Expenditure in Selected Midwestern States: An Adjusted Miner/McMahon Approach.  

ERIC Educational Resources Information Center

According to a formula developed to measure the adequacy of state educational finance levels, only three of six selected midwestern states provided adequate levels of expenditure per pupil in 1981-82. The formula for determining adequacy, developed by Jerry Miner and Walter McMahon, consists of totaling adequate levels of expenditure in seven…

Johnson, Wayne Paul; Hickrod, G. Alan

329

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. PMID:24014944

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

2013-01-01

330

48 CFR 52.216-29 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate...  

Code of Federal Regulations, 2010 CFR

...Item Acquisition With Adequate Price Competition. 52.216-29 Section 52.216-29...Item Acquisition With Adequate Price Competition. As prescribed in 16.601(e...Item Acquisition With Adequate Price Competition (FEB 2007) (a) The...

2010-10-01

331

48 CFR 52.216-29 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate...  

Code of Federal Regulations, 2013 CFR

...Item Acquisition With Adequate Price Competition. 52.216-29 Section 52.216-29...Item Acquisition With Adequate Price Competition. As prescribed in 16.601(f...Item Acquisition With Adequate Price Competition (FEB 2007) (a) The...

2013-10-01

332

Infant Care.  

ERIC Educational Resources Information Center

This new addition of a government pamphlet is a guide offering advice and information to new parents. Sections include: You and Your New Baby (handling the baby, care of the mother, feeding, etc.); First Weeks at Home (equipment, formula preparation, bathing, sleeping, crying, colic, etc.); After the First Weeks (temperament, "difficult" babies,…

North, A. Frederick

333

Prenatal Care.  

ERIC Educational Resources Information Center

This booklet is the first in a series of publications designed to provide parents with useful information about childrearing. Contents are organized into three parts. Part I focuses on the pregnancy, prenatal care, development of the baby, pregnant lifestyles, nutrition, common discomforts, and problems of pregnancy. Part II provides information…

Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Office for Maternal and Child Health Services.

334

Daily Care  

MedlinePLUS

... and support I have Alzheimer's I am a caregiver I am a care professional I am a physician I am a researcher Message boards Get the facts 10 warning signs & symptoms What is dementia What is Alzheimer's 7 stages of Alzheimer's Treatments Contact us 24/7 Helpline: 1-800-272-3900 ...

335

Critical care nurses' perceptions of preparedness and ability to care for the dying and their professional quality of life.  

PubMed

A study was undertaken to explore whether critical care nurses perceive that they have been adequately prepared during basic nursing education to care for the dying and their loved ones and to identify if there is a relation between their perceptions of preparedness and ability to provide end of life care and professional quality of life (PQOL). Findings indicate that there is a relationship between critical care nurse perceptions of preparedness and ability to care for the dying and their PQOL, with higher compassion satisfaction scores, lower compassion fatigue scores, and lower burnout scores for those who perceive themselves more prepared and better able to provide end of life care (N = 473). Thus, pedagogic interventions to enhance perceptions of preparedness and ability to care for the dying can potentially improved PQOL for nurses working in critical care areas, possibly diminishing the incidence of compassion fatigue and burnout. PMID:23759913

Todaro-Franceschi, Vidette

2013-01-01

336

Overcome of Carbon Catabolite Repression of Bioinsecticides Production by Sporeless Bacillus thuringiensis through Adequate Fermentation Technology  

PubMed Central

The overcoming of catabolite repression, in bioinsecticides production by sporeless Bacillus thuringiensis strain S22 was investigated into fully controlled 3?L fermenter, using glucose based medium. When applying adequate oxygen profile throughout the fermentation period (75% oxygen saturation), it was possible to partially overcome the catabolite repression, normally occurring at high initial glucose concentrations (30 and 40?g/L glucose). Moreover, toxin production yield by sporeless strain S22 was markedly improved by the adoption of the fed-batch intermittent cultures technology. With 22.5?g/L glucose used into culture medium, toxin production was improved by about 36% when applying fed-batch culture compared to one batch. Consequently, the proposed fed-batch strategy was efficient for the overcome of the carbon catabolite repression. So, it was possible to overproduce insecticidal crystal proteins into highly concentrated medium. PMID:25309756

Ben Khedher, Saoussen; Jaoua, Samir; Zouari, Nabil

2014-01-01

337

J-modulated ADEQUATE experiments using different kinds of refocusing pulses.  

PubMed

Owing to the recent developments concerning residual dipolar couplings (RDCs), the interest in methods for the accurate determination of coupling constants is renascenting. We intended to use the J-modulated ADEQUATE experiment by Kövér et al. for the measurement of (13)C - (13)C coupling constants at natural abundance. The use of adiabatic composite chirp pulses instead of the conventional 180 degrees pulses, which compensate for the offset dependence of (13)C 180 degrees pulses, led to irregularities of the line shapes in the indirect dimension causing deviations of the extracted coupling constants. This behaviour was attributed to coupling evolution, during the time of the adiabatic pulse (2 ms), in the J-modulation spin echo. The replacement of this pulse by different kinds of refocusing pulses indicated that a pair of BIPs (broadband inversion pulses), which behave only partially adiabatic, leads to correct line shapes and coupling constants conserving the good sensitivity obtained with adiabatic pulses. PMID:17729234

Thiele, Christina M; Bermel, Wolfgang

2007-10-01

338

Child Care: States Face Difficulties Enforcing Standards and Promoting Quality. Report to Congressional Requesters.  

ERIC Educational Resources Information Center

This report discusses efforts to ensure and promote quality child care through enforcement of state standards and other activities. The Child Care and Development Block Grant Act of 1990 authorized the dispersing of funds to states for child care services through the United States Department of Health and Human Services (HHS). These funds are used…

General Accounting Office, Washington, DC. Div. of Human Resources.

339

75 FR 65282 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services  

Federal Register 2010, 2011, 2012, 2013, 2014

...Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services AGENCY...requirements to ensure that long-term care (LTC) facilities (that is, SNFs and...to arrange for the provision of hospice care through an agreement with one or more...

2010-10-22

340

78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services  

Federal Register 2010, 2011, 2012, 2013, 2014

...Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services AGENCY...requirements will ensure that long-term care (LTC) facilities (that is, SNFs and...to arrange for the provision of hospice care through an agreement with one or more...

2013-06-27

341

New Faculty WorkshopNew Faculty Workshop Animal Care Services / Research Compliance Services / Sponsored Programs Services  

E-print Network

New Faculty WorkshopNew Faculty Workshop Animal Care Services / Research Compliance ServicesOffice of the Vice President for Research #12;Animal Care ServicesAnimal Care Services · PHONE: 8604862907 · FAX and scholarship to ensure that it meets all regulatory standards involving research with human subjects, animals

Alpay, S. Pamir

342

Transforming Data into Practical Information: Using Consumer Input to Improve Home-Care Services  

ERIC Educational Resources Information Center

Purpose: As funds have increased for the provision of in-home care, so too have concerns about the quality of services. In response, care management agencies and home-care providers have developed an array of monitoring activities designed to ensure the quality of services. In this article, we show how an area agency on aging both collected and…

Applebaum, Robert; Kunkel, Suzanne; Wilson, Ken

2007-01-01

343

Quality of Antenatal Care in Primary Health Care Centers of Bangladesh  

PubMed Central

Objective: To find out the quality of ANC in the Upazila Health Complexes (PHC centres) of Bangladesh. Materials and methods: This cross sectional study was done in purposively selected three upazilas among the clients receiving antenatal care (ANC). Data were collected with questionnaire cum checklist in the context of two aspects of quality issues, namely assessment of physical arrangements for ANC (input) and services rendered by the providers (process). Results: The mean age of respondents was 24.6±4.5 years. Majority of the respondents were with primary level education (60.3%). About half (52.8%) of the families had monthly income ranging from 3000-5000 taka (38-64 US$). Nearly half (48.9%) had no child, little more than one third (42.3%) were primigravida and 528 (57.7%) were multigravida. Out of 528 multigravid respondents 360 (68.2%) took ANC in their previous pregnancy whereas 168 (31.8%) did not take ANC Pregnancy outcome was found to be associated with receiving ANC (?2=73.599; p=0.000). Respondents receiving ANC had more good pregnancy outcome. The mean waiting time for receiving ANC was 0.77±.49 hours. Out of the 13 centers, only 3 (23.1%) have sufficient instruments to render ANC services. Findings showed that where the modes of ANC service delivery in the ANC centers are fairly satisfactory. Though some of the points of standard operation procedures (SOPs) on ANC are not covered by some ANC centers, those were not considered necessary. But, regarding the physical facilities available for rendering ANC services, it is seen that facilities are not quite satisfactory. Number of doctors and nurses are not very satisfactory. One of the centers under this study has no doctor, where ANC services are given by nurses. Conclusion: It can be concluded that the ANC services at the primary health care level is not adequate in Bangladesh. To ensure further improvement of the quality of ANC services, instruments used in logistics and supplies should be enhanced.

Mansur, Ahmed M. S. A.; Rezaul, Karim M.; Mahmudul, Hoque. M.; S, Chowdhury

2014-01-01

344

Sporadic adenoma in ulcerative colitis: endoscopic resection is an adequate treatment  

PubMed Central

Background and aims In studies with small numbers of cases, it has been shown that endoscopic resection of adenomas in ulcerative colitis represents adequate treatment. In a larger study cohort with more prolonged follow up, we assessed the reliability of this finding. Methods Between 1988 and 2002, 148 consecutive patients, mainly from private gastroenterologists' practices, with ulcerative colitis were diagnosed as having an adenoma. In 60 patients, histological diagnosis was established in biopsies and in 87 patients in polypectomy specimens; one patient underwent proctocolectomy following diagnosis. The outcome of these patients was analysed after a mean follow up period of 6.0 (3.63)?years. Results Among 60 patients, surprisingly without endoscopic treatment, 48.3% developed ulcerative colitis associated neoplasia in the same colon segment (23.3% low grade intraepithelial neoplasia; 8.3% high grade intraepithelial neoplasia; 16.7% carcinoma). Among 87 patients undergoing polypectomy of the adenoma, follow up revealed colitis associated neoplasia in other segments of colon in 4.6% of cases. Conclusion Development of adenocarcinomas in a total of 6.7% of the overall patient group, and in 2.3% of those undergoing polypectomy, indicates that biopsy based diagnosis of an adenoma in ulcerative colitis must be considered to mandate endoscopic resection of the lesion; 40% of affected patients did not receive any form of endoscopic removal of the lesion. This shows that the most recent guidelines are not followed in a considerable number of patients with ulcerative colitis in private practice in Germany. Although polypectomy of the adenoma represents adequate therapy, further regular follow up examinations are nevertheless necessary. PMID:16423892

Vieth, M; Behrens, H; Stolte, M

2006-01-01

345

Three monthly doses of palivizumab are not adequate for 5-month protection: a population pharmacokinetic analysis.  

PubMed

Recent guidelines in British Columbia, Canada have suggested that the use of a maximum of 3 monthly doses of palivizumab 15 mg/kg intramuscularly for RSV immunoprophylaxis of high risk infants born prior to the RSV season is adequate to provide protection against severe RSV disease for a 5-month RSV season. Efficacy was established, however, with 2 large, randomized controlled clinical studies using 5 monthly doses of immunoprophylaxis. To evaluate the differences in expected palivizumab exposures between the 2 dosing regimens (3 vs 5 monthly doses across a 5-month period), we used a population pharmacokinetic (PK) model that was developed using palivizumab PK data collected from 22 clinical studies with a total of 1800 subjects. This model adequately described observed palivizumab concentrations from the different pediatric studies and was subsequently used to simulate expected palivizumab serum concentrations for 3 monthly doses compared with 5 monthly doses in children younger than 24 months with chronic lung disease of prematurity and infants younger than 6 months postnatal age who were born at ? 35 weeks gestational age. Results from the population PK model indicated lower serum concentrations of palivizumab during the fourth and fifth months, after an abbreviated 3-monthly-dose regimen when compared with the mean trough concentrations seen with the 5-monthly-dose regimen studied in the pivotal clinical trials in premature infants. Specifically, during the fourth and fifth months, 52% and 85%, respectively, would have levels below the lowest concentration (fifth percentile) in those receiving the 5-monthly-dose regimen. Simulations using this model did not support a 3-monthly-dose regimen to protect against severe RSV disease during the typical 5-month season. PMID:23523663

La Via, William V; Notario, Gerard F; Yu, Xiang-Qing; Sharma, Shringi; Noertersheuser, Peter A; Robbie, Gabriel J

2013-12-01

346

Choosing Your Prenatal Care Provider  

MedlinePLUS

... Prenatal care > Choosing your prenatal care provider Prenatal care Prenatal care is the care you get while ... been added to your dashboard . Choosing your prenatal care provider Prenatal care is medical care you get ...

347

The rising number of uninsured Americans: how adequate is our health system?  

Microsoft Academic Search

A primary reason for the increase in uninsured Americans is due to the rising costs of health care that has caused a decline of employment-based coverage for individuals working for small firms. According to the 1997 US Census Bureau figures, 43 percent of uninsured worked full-time, and eight out of ten of the uninsured or their dependents were full-time workers.

Saundra H. Glover; Karl J. McCleary; Patrick A. Rivers; Raymond A. Waller

2003-01-01

348

Early and Adequate Antibiotic Therapy in the Treatment of Severe Sepsis and Septic Shock  

Microsoft Academic Search

Severe sepsis and septic shock are conditions that pose difficult challenges to physicians and the health care system. In\\u000a the past 10 years, a number of retrospective and prospective observational studies have shed light on the importance of a\\u000a rapid and systematic approach to treatment of these conditions. A key component is early and appropriate use of antibiotics.\\u000a Delay of even

John D. Dickinson; Marin H. Kollef

349

The need for rehabilitation of lost skills in health care delivery.  

PubMed

During the last 40 years or so when African nations started regaining their independence from colonial rule, vigorous programmes were initiated for education and training in all sectors of national development. The leaders of these independent nations set their goals on the elimination of ignorance, poverty and disease. Thus matters of health have been a priority over these years. Health care personnel have been trained in all the relevant areas such as medicine, pharmacy, nursing, dentistry and all other allied professions. However, the maximum utilisation of the trained health care manpower has not kept pace with the rapid needs of development in these nations. This deficiency has been compounded by the rapid advancements in medical science and technology. Thus in the under-utilisation of these graduates from tertiary educational institutions, the graduate becomes professionally obsolete due to the fact that he/she has not been adequately utilized, or due to lack of continuing education, or due to some othef reasons. The medical doctor, dentist, pharmacist, nurse, clinical officer or laboratory technologist may have lost the special skills that were acquired during college education and may therefore become professionally and functionally senescent and obsolete. So there is need to habilitate those skills in order to serve efficiently in the provision of health care. I am afraid that some of the personnel did not have sufficient background education and hence would not benefit from rehabilitation programmes, let alone training in newer technologies. Similarly, I dare say that in the university faculties and departments and polytechnics that educate and train the prospective health care personnel, many of the teaching staff would also require rehabilitation of their skills that may have become obsolete. There is also need for such rehabilitation in the health research institutes in order to provide the relevant answers for the solution of national health problems. Thus as we move into the next millennium, there is dire need to rehabilitate our health personnel in the skills that have been lost in order to re-train them to be able to apply contemporary methods of health care provision. In the present state of affairs, the use of modern technological methods are essential in providing health care because these new technologies are more effective and therefore ultimately more cost-effective. Hence the need for rehabilitation of lost skills as a pre notrequisite for re-training is a priority. I call on all the health policy makers as well as those who are concerned with the improvement of health care delivery to take some critical and decisive steps to ensure that health care providers are adequately educated and properly trained. Continuing medical education as well as continuing education in other health professions should incorporate rehabilitation of lost skills as well as retraining on newer and more appropriate methods for the provision of good quality health care delivery services are important and urgent. Continuing education therefore should be a condition for continued registration and certification if we are to achieve meaningful quality health care delivery. PMID:17581008

Koech, D K

1998-01-01

350

Health Care and Dependent Care Flexible  

E-print Network

Health Care and Dependent Care Flexible Spending Accounts Discovery Benefits, Inc. (866) 451 for certain health care and child care expenses with pre-tax dollars. FSA's may allow you to save money of money that is withheld from your pay on a pre-tax basis. Note: Health Care Reform extends medical FSA

351

42 CFR 482.57 - Condition of participation: Respiratory care services.  

Code of Federal Regulations, 2010 CFR

...offered. (1) There must be a director of respiratory care services who is a doctor of medicine... (2) There must be adequate numbers of respiratory therapists, respiratory therapy technicians, and other personnel who...

2010-10-01

352

Ensuring Biosecurity and Biosafety Ensuring Biosecurity and Biosafety Ensuring Biosecurity and Biosafety Ensuring Biosecurity and Biosafety Ensuring Biosecurity and Biosafety through Biopolicy Mechanisms: through Biopolicy Mechanisms: through Biopolicy Mechanisms: through Biopolicy Mechanisms: through Biopolicy Mechanisms: Addressing Threats of Bioterrorism and Biowarfare  

Microsoft Academic Search

Biosecurity has emerged as a critical measure that laboratories possessing dangerous pathogens must take to protect against terrorists from acquiring biothreat agents. Nations need to consider establishing biopolicy mechanisms for ensuring biosafety and biosecurity. Effective biosecurity and biosafety guidelines require international inputs and international harmonization to reduce the threat of bioterrorism. In the United States, several laws now restrict who

Ronald M. Atlas

353

Hospice Care  

Microsoft Academic Search

A crisis is looming in the American health care system. The population of the United States is ageing. Over the next quarter\\u000a century, the number of people older than 85 years will double. The massive generation of baby boomers is moving rapidly toward\\u000a old age, and the reality that 65 million Americans will grow old and face the end of

Carolyn Cassin

354

The National Palliative Care Research Center and the Center to Advance Palliative Care: a partnership to improve care for persons with serious illness and their families.  

PubMed

The elimination of suffering and the cure of disease are the fundamental goals of medicine. While medical advances have transformed previously fatal conditions such as cancer and heart disease into illnesses that people can live with for many years, they have not been accompanied by corresponding improvements in the quality of life for these patients and their families. Living with a serious illness should not mean living in pain or experiencing symptoms like shortness of breath, nausea, or fatigue. Yet, multiple studies over the past decade suggest that medical care for patients with advanced illness is characterized by inadequately treated physical distress; fragmented care systems; poor communication between doctors, patients, and families; and enormous strains on family caregiver and support systems. Palliative care is interdisciplinary care focused on relief of pain and other symptoms and support for best possible quality of life for patients with serious illness, and their families. It is appropriate at the point of diagnosis of a serious illness. It goes beyond hospice care to offer patients and their families treatments focused on improving quality of life while they are receiving life-prolonging and curative treatments. Palliative care programs have been shown to reduce symptoms, improve doctor-patient-family communication and satisfaction with care, as well as enhance the efficiency and effectiveness of hospital services. In the last 5 years alone the number of palliative care programs has more than doubled. This growth is in response to the increasing numbers and needs of Americans living with serious, complex and chronic illnesses, and the realities of the care responsibilities faced by their families. In order to ensure that all persons with serious illness and their families receive the quality of care they deserve, palliative care must become an integral part of the U.S. healthcare landscape. Specifically, persons facing serious illness and their families must know to request palliative care, medical professionals must have the knowledge and skills to provide palliative care, and hospitals and other healthcare institutions must be equipped to deliver and support palliative care services. The Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center (NPCRC) are accomplishing this three-part mission by working in partnership to: 1) Develop research to serve as the knowledge base for quality clinical care and the foundation on which to build palliative care programs and systems; 2) Disseminate this knowledge to patients, families, professionals, and institutions throughout the United States and ensure that it is integrated within mainstream healthcare; and 3) Influence and collaborate with policy makers , regulatory bodies, and federal funding agencies to ensure that the healthcare infrastructure supports the continued growth and development of palliative care. PMID:21952569

Morrison, R Sean; Meier, Diane E

2011-10-01

355

Preventive Care for Children (Affordable Care Act)  

MedlinePLUS

... Myspace Close Text Size: A A A Preventive Care for Children Many insurers are now required to ... Services Task Force Recommendations . Fact Sheet: The Affordable Care Act and Immunization Fact Sheet: The Affordable Care ...

356

Smooth Transitions into Medi-Cal: Ensuring Continuity of Coverage for Low Income Health Program Enrollees  

E-print Network

3. Managed Care Plan and Medical Home Transition Plan:The transition plan aims to promote continuity of care withCare Services has made considerable efforts to involve stakeholders in the planning process for the transition.

Lytle, Elizabeth C.; Roby, Dylan H.; Lucia, Laurel; Jacobs, Ken; Cabezas, Livier; Pourat, Nadereh

2013-01-01

357

Reflections on curative health care in Nicaragua.  

PubMed Central

Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID:2705603

Slater, R G

1989-01-01

358

The Affordable Care Act and emergency care.  

PubMed

The Affordable Care Act (ACA) will have far-reaching effects on the way health care is designed and delivered. Several elements of the ACA will directly affect both demand for ED care and expectations for its role in providing coordinated care. Hospitals will need to employ strategies to reduce ED crowding as the ACA expands insurance coverage. Discussions between EDs and primary care physicians about their respective roles providing acute unscheduled care would promote the goals of the ACA. PMID:25121814

McClelland, Mark; Asplin, Brent; Epstein, Stephen K; Kocher, Keith Eric; Pilgrim, Randy; Pines, Jesse; Rabin, Elaine Judith; Rathlev, Niels Kumar

2014-10-01

359

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

360

Palliative care in the intensive care unit.  

PubMed

Most patients who receive terminal care in the intensive care setting die after withdrawing or limiting of life-sustaining measures provided in the intensive care setting. The integration of palliative care into the intensive care unit (ICU) provides care, comfort, and planning for patients, families, and the medical staff to help decrease the emotional, spiritual, and psychological stress of a patient's death. Quality measures for palliative care in the ICU are discussed along with case studies to demonstrate how this integration is beneficial for a patient and family. Integrating palliative care into the ICU is also examined in regards to the complex adaptive system. PMID:25438896

Restau, Jame; Green, Pamela

2014-12-01

361

HIV: challenging the health care delivery system.  

PubMed Central

HIV offers a lens through which the underlying problems of the US health care system can be examined. New treatments offer the potential of prolonged quality of life for people living with HIV if they have adequate access to health care. However, increasing numbers of new cases of HIV occur among individuals with poor access to health care. Restrictions on eligibility for Medicaid (and state-by-state variability) contribute to uneven access to the most important safety net source of HIV care financing, while relatively modest discretionary programs attempt to fill in the gap with an ever-increasing caseload. Many poor people with HIV are going without care, even though aggregate public spending on HIV-related care will total $7.7 billion in fiscal year 2000, an amount sufficient to cover the care costs of one half of those living with HIV. But inefficiencies and inequities in the system (both structural and geographic) require assessment of the steps that can be taken to create a more rational model of care financing for people living with HIV that could become a model for all chronic diseases. PMID:10897178

Levi, J; Kates, J

2000-01-01

362

Are we missing the Institute of Medicine’s mark? A systematic review of patient-reported outcome measures assessing quality of patient-centred cancer care  

PubMed Central

Background The Institute of Medicine (IOM) has endorsed six dimensions of patient-centredness as crucial to providing quality healthcare. These dimensions outline that care must be: 1) respectful to patients’ values, preferences, and expressed needs; 2) coordinated and integrated; 3) provide information, communication, and education; 4) ensure physical comfort; 5) provide emotional support—relieving fear and anxiety; and 6) involve family and friends. However, whether patient-reported outcome measures (PROMs) comprehensively cover these dimensions remains unexplored. This systematic review examined whether PROMs designed to assess the quality of patient-centred cancer care addressed all six IOM dimensions of patient-centred care and the psychometric properties of these measures. Methods Medline, PsycINFO, Current Contents, Embase, CINAHL and Scopus were searched to retrieve published studies describing the development and psychometric properties of PROMs assessing the quality of patient-centred cancer care. Two authors determined if eligible PROMs included the six IOM dimensions of patient-centred care and evaluated the adequacy of psychometric properties based on recommended criteria for internal consistency, test-retest reliability, face/content validity, construct validity and cross-cultural adaptation. Results Across all 21 PROMs, the most commonly included IOM dimension of patient-centred care was “information, communication and education” (19 measures). In contrast, only five measures assessed the “involvement of family and friends.” Two measures included one IOM-endorsed patient-centred care dimension, two measures had two dimensions, seven measures had three dimensions, five measures had four dimensions, and four measures had five dimensions. One measure, the Indicators (Non-small Cell Lung Cancer), covered all six IOM dimensions of patient-centred care, but had adequate face/content validity only. Eighteen measures met the recommended adequacy criteria for construct validity, 15 for face/content validity, seven for internal consistency, three for cross-cultural adaptation and no measure for test-retest reliability. Conclusions There are no psychometrically rigorous PROMs developed with cancer patients that capture all six IOM dimensions of patient-centred care. Using more than one measure or expanding existing measures to cover all six patient-centred care dimensions could improve assessment and delivery of patient-centred care. Construction of new comprehensive measures with acceptable psychometric properties that can be used with the general cancer population may also be warranted. PMID:24460829

2014-01-01

363

Sedation analgesia in pediatric intensive care  

Microsoft Academic Search

Provision of optimum comfort control to a critically ill child, in Pediatric Intensive Care Unit (PICU) requires a great degree\\u000a of skill and planning and should be a prime concern for all practising paediatricians. Failure to provide adequate sedation\\u000a and analgesia to control the stress response has been seen to be associated with increased complications and mortality. Sedation\\/analgesia\\u000a in PICU

M. N. G. Nair; S. K. Jatana

2004-01-01

364

Gaussian membership functions are most adequate in representing uncertainty in measurements  

NASA Technical Reports Server (NTRS)

In rare situations, like fundamental physics, we perform experiments without knowing what their results will be. In the majority of real-life measurement situations, we more or less know beforehand what kind of results we will get. Of course, this is not the precise knowledge of the type 'the result will be between alpha - beta and alpha + beta,' because in this case, we would not need any measurements at all. This is usually a knowledge that is best represented in uncertain terms, like 'perhaps (or 'most likely', etc.) the measured value x is between alpha - beta and alpha + beta.' Traditional statistical methods neglect this additional knowledge and process only the measurement results. So it is desirable to be able to process this uncertain knowledge as well. A natural way to process it is by using fuzzy logic. But, there is a problem; we can use different membership functions to represent the same uncertain statements, and different functions lead to different results. What membership function do we choose? In the present paper, we show that under some reasonable assumptions, Gaussian functions mu(x) = exp(-beta(x(exp 2))) are the most adequate choice of the membership functions for representing uncertainty in measurements. This representation was efficiently used in testing jet engines to airplanes and spaceships.

Kreinovich, V.; Quintana, C.; Reznik, L.

1992-01-01

365

Determination of the need for selenium by chicks fed practical diets adequate in vitamin E  

SciTech Connect

Experiments were conducted to compare the dietary needs for selenium (Se) by chicks fed either purified (amino acid-based) or practical (corn- and soy-based) diets that were adequate with respect to vitamin E (i.e., contained 100 IU/kg) and all other known nutrients with the single exception of Se (i.e., contained only 0.10 ppm Se). Studies were conducted in Ithaca using Single Comb White Leghorn chicks fed the purified basal diet and in Beijing using chicks of the same breed fed either the same purified basal diet or the practical diet formulated to be similar to that used in poultry production in some parts of China and the US. Results showed that each basal diet produced severe depletion of Se-dependent glutathione peroxidase (SeGSHpx) in plasma, liver and pancreas according to the same time-course, but that other consequences of severe uncomplicated Se deficiency were much more severe among chicks fed the purified diet (e.g., growth depression, pancreatic dysfunction as indicated by elevated plasma amylase and abnormal pancreatic histology). Chicks fed the practical Se-deficient diet showed reduced pancreas levels of copper, zinc and molybdenum and elevated plasma levels of iron; they required ca. 0.10 ppm dietary Se to sustain normal SeGSHpx in several tissues and to prevent elevated amylase in plasma. The dietary Se requirement of the chick is, therefore, estimated to be 0.10 ppm.

Combs, G.F. Jr.; Su, Q.; Liu, C.H.; Sinisalo, M.; Combs, S.B.

1986-03-01

366

Informed consent for biobanking: consensus-based guidelines for adequate comprehension.  

PubMed

Purpose:Federal regulations and best practice guidelines identify categories of information that should be communicated to prospective biobank participants during the informed consent process. However, uncertainty remains about which of this information participants must understand to provide valid consent.Methods:We conducted a Delphi process to define "adequate comprehension" in the context of biobanking consent. The process involved an iterative series of three online surveys of a diverse panel of 51 experts, including genome scientists, biobank managers, ethics and policy experts, and community and participant representatives. We sought consensus (>70% agreement) concerning what specific details participants should know about 16 biobank consent topics.Results:Consensus was achieved for 15 of the 16 consent topics. The exception was the comprehension needed regarding the Genetic Information Nondiscrimination Act.Conclusion:Our Delphi process was successful in identifying a concise set of key points that prospective participants must grasp to provide valid consent for biobanking. Specifying the level of knowledge sufficient for individuals to make an informed choice provides a basis for improving consent forms and processes, as well as an absolute metric for assessing the effectiveness of other interventions to improve comprehension.Genet Med advance online publication 21 August 2014Genetics in Medicine (2014); doi:10.1038/gim.2014.102. PMID:25144889

Beskow, Laura M; Dombeck, Carrie B; Thompson, Cole P; Watson-Ormond, J Kemp; Weinfurt, Kevin P

2014-08-21

367

The rat adequately reflects human responses to exercise in blood biochemical profile: a comparative study.  

PubMed

Animal models are widely used in biology and the findings of animal research are traditionally projected to humans. However, recent publications have raised concerns with regard to what extent animals and humans respond similar to physiological stimuli. Original data on direct in vivo comparison between animals and humans are scarce and no study has addressed this issue after exercise. We aimed to compare side by side in the same experimental setup rat and human responses to an acute exercise bout of matched intensity and duration. Rats and humans ran on a treadmill at 86% of maximal velocity until exhaustion. Pre and post exercise we measured 30 blood chemistry parameters, which evaluate iron status, lipid profile, glucose regulation, protein metabolism, liver, and renal function. ANOVA indicated that almost all biochemical parameters followed a similar alteration pattern post exercise in rats and humans. In fact, there were only 2/30 significant species × exercise interactions (in testosterone and globulins), indicating different responses to exercise between rats and humans. On the contrary, the main effect of exercise was significant in 15/30 parameters and marginally nonsignificant in other two parameters (copper, P = 0.060 and apolipoprotein B, P = 0.058). Our major finding is that the rat adequately mimics human responses to exercise in those basic blood biochemical parameters reported here. The physiological resemblance of rat and human blood responses after exercise to exhaustion on a treadmill indicates that the use of blood chemistry in rats for exercise physiology research is justified. PMID:25677548

Goutianos, Georgios; Tzioura, Aikaterini; Kyparos, Antonios; Paschalis, Vassilis; Margaritelis, Nikos V; Veskoukis, Aristidis S; Zafeiridis, Andreas; Dipla, Konstantina; Nikolaidis, Michalis G; Vrabas, Ioannis S

2015-02-01

368

A test of the cerebellar hypothesis of dyslexia in adequate and inadequate responders to reading intervention  

PubMed Central

The cerebellar hypothesis of dyslexia posits that cerebellar deficits are associated with reading disabilities and may explain why some individuals with reading disabilities fail to respond to reading interventions. We tested these hypotheses in a sample of children who participated in a grade 1 reading intervention study (n = 174) and a group of typically achieving children (n = 62). At posttest, children were classified as adequately responding to the intervention (n = 82), inadequately responding with decoding and fluency deficits (n = 36), or inadequately responding with only fluency deficits (n = 56). Based on the Bead Threading and Postural Stability subtests from the Dyslexia Screening Test-Junior, we found little evidence that assessments of cerebellar functions were associated with academic performance or responder status. In addition, we did not find evidence supporting the hypothesis that cerebellar deficits are more prominent for poor readers with “specific” reading disabilities (i.e., with discrepancies relative to IQ) than for poor readers with reading scores consistent with IQ. In contrast, measures of phonological awareness, rapid naming, and vocabulary were strongly associated with responder status and academic outcomes. These results add to accumulating evidence that fails to associate cerebellar functions with reading difficulties. PMID:20298639

Barth, Amy E.; Denton, Carolyn A.; Stuebing, Karla K.; Fletcher, Jack M.; Cirino, Paul T.; Francis, David J.; Vaughn, Sharon

2013-01-01

369

Pediatric treatment 2.0: ensuring a holistic response to caring for HIV-exposed and infected children.  

PubMed

Treatment 2.0 is an initiative launched by UNAIDS and WHO in 2011 to catalyze the next phase of treatment scale-up for HIV. The initiative defines strategic activities in 5 key areas, drugs, diagnostics, commodity costs, service delivery and community engagement in an effort to simplify treatment, expand access and maximize program efficiency. For adults, many of these activities have already been turned into treatment policies. The recent WHO recommendation to use a universal first line regimen regardless of gender, pregnancy and TB status is a treatment simplification very much in line with Treatment 2.0. But despite that fact that Treatment 2.0 encompasses all people living with HIV, we have not seen the same evolution in policy development for children. In this paper we discuss how Treatment 2.0 principles can be adapted for the pediatric population. There are several intrinsic challenges. The need for distinct treatment regimens in children of different ages makes it hard to define a one size fits all approach. In addition, the fact that many providers are reluctant to treat children without the advice of specialists can hamper decentralization of service delivery. But at the same time, there are opportunities that can be availed now and in the future to scale up pediatric treatment along the lines of Treatment 2.0. We examine each of the five pillars of Treatment 2.0 from a pediatric perspective and present eight specific action points that would result in simplification of pediatric treatment and scale up of HIV services for children. PMID:24361631

Essajee, Shaffiq M; Arpadi, Stephen M; Dziuban, Eric J; Gonzalez-Montero, Raul; Heidari, Shirin; Jamieson, David G; Kellerman, Scott E; Koumans, Emilia; Ojoo, Atieno; Rivadeneira, Emilia; Spector, Stephen A; Walkowiak, Helena

2013-11-01

370

Proper Care for Wounds  

MedlinePLUS Videos and Cool Tools

... Motor Vehicle Safety En Español About Emergencies Wound Care Proper Care For Wounds Most cuts are minor but it is still important to properly care for them. Wound Care Dr. David Ross, emergency ...

371

Home Care Services  

MedlinePLUS

Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with ...

372

Health Care Team  

MedlinePLUS

... Story About the NKF You are here Home » Health Care Team Good health care is always a team effort - especially for people ... chronic kidney failure. Since each member of the health care staff contributes to your care, it is important ...

373

About Critical Care Nursing  

MedlinePLUS

About Critical Care Nursing Definition of Critical Care Nursing Critical care nursing is that specialty within nursing that deals specifically with human responses to life-threatening problems. A critical care nurse ...

374

Adult Day Care  

MedlinePLUS

... Resize Text Printer Friendly Online Chat Adult Day Care What is Adult Day Care? How Do Adult ... More About Local Services? What is Adult Day Care? Adult Day Care Centers are designed to provide ...

375

Community-Based Care  

MedlinePLUS

... providing important healthcare or personal care support. Adult Day Care Adult day care is a community-based option that has become ... support services in a group setting. Most adult day care centers are either in churches or community centers. ...

376

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?  

Code of Federal Regulations, 2010 CFR

...State determine whether my system's watershed control requirements are adequate...Fewer Than 10,000 People Additional Watershed Control Requirements for Unfiltered Systems...State determine whether my system's watershed control requirements are...

2010-07-01

377

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?  

Code of Federal Regulations, 2012 CFR

...State determine whether my system's watershed control requirements are adequate...Fewer Than 10,000 People Additional Watershed Control Requirements for Unfiltered Systems...State determine whether my system's watershed control requirements are...

2012-07-01

378

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?  

Code of Federal Regulations, 2011 CFR

...State determine whether my system's watershed control requirements are adequate...Fewer Than 10,000 People Additional Watershed Control Requirements for Unfiltered Systems...State determine whether my system's watershed control requirements are...

2011-07-01

379

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?  

Code of Federal Regulations, 2013 CFR

...State determine whether my system's watershed control requirements are adequate...Fewer Than 10,000 People Additional Watershed Control Requirements for Unfiltered Systems...State determine whether my system's watershed control requirements are...

2013-07-01

380

Heightened Scrutiny of the Fourth Branch: Separation of Powers and the Requirement Of Adequate Reasons for Agency Decisions  

E-print Network

In recent years, the requirement that administrative agencies provide adequate reasons for their decisions has come to play a central role in judicial review of agency decisions. While the increasing importance of this ...

Levy, Richard E.; Shapiro, Sidney A.

1987-01-01

381

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

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Labeling of cosmetic products for which adequate substantiation of safety...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements...

2012-04-01

382

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

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Labeling of cosmetic products for which adequate substantiation of safety...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements...

2013-04-01

383

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

Code of Federal Regulations, 2014 CFR

...2014-04-01 2014-04-01 false Labeling of cosmetic products for which adequate substantiation of safety...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements...

2014-04-01

384

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

Code of Federal Regulations, 2011 CFR

...NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping Requirements...adequate and proper documentation, agencies must prescribe the creation and maintenance of records that: (a) Document the...

2011-07-01

385

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

Code of Federal Regulations, 2012 CFR

...NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping Requirements...adequate and proper documentation, agencies must prescribe the creation and maintenance of records that: (a) Document the...

2012-07-01

386

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

Code of Federal Regulations, 2013 CFR

...NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping Requirements...adequate and proper documentation, agencies must prescribe the creation and maintenance of records that: (a) Document the...

2013-07-01

387

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

Code of Federal Regulations, 2010 CFR

...NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping Requirements...adequate and proper documentation, agencies must prescribe the creation and maintenance of records that: (a) Document the...

2010-07-01

388

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

Code of Federal Regulations, 2014 CFR

...NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping Requirements...adequate and proper documentation, agencies must prescribe the creation and maintenance of records that: (a) Document the...

2014-07-01

389

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

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Labeling of cosmetic products for which adequate substantiation of safety...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements...

2010-04-01

390

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

Code of Federal Regulations, 2011 CFR

...2011-04-01 2010-04-01 true Labeling of cosmetic products for which adequate substantiation of safety...DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements...

2011-04-01

391

Constraining canopy biophysical simulations with daily MODIS reflectance data ensuring pixel-target adequacy  

NASA Astrophysics Data System (ADS)

Modern vegetation models incorporate ecophysiological details that allow for accurate estimates of carbon dioxide uptake, water use and energy exchange, but require knowledge of dynamic structural and biochemical traits. Variations in these traits are controlled by genetic factors as well as growth stage and nutrient and moisture availability, making them difficult to predict and prone to significant error. Here we explore the use of daily MODIS optical reflectance data for constraining key canopy- and leaf-level traits required by forward biophysical models. A multi-objective optimization algorithm is used to invert the PROSAIL canopy radiation transfer model against MODIS optical reflectance observations. PROSAIL accounts for the effects of leaf-level optical properties, foliage distribution and orientation on canopy reflectance across the optical range. Inversions are conducted for several growing seasons for both soybean and maize at multiple sites across the Central US agro-ecosystem. These inversions provide estimates of seasonal variations, and associated uncertainty, of variables such as leaf area index (LAI). The inversion-derived canopy properties are used to examine the ability of MODIS data to characterize seasonal variations in these states relative to field observations. The canopy properties are then used as inputs into the MLCan biophysical model to conduct forward simulations. MLCan characterizes the ecophysiological functioning of a plant canopy at a half-hourly timestep, and has been rigorously validated for both C3 and C4 crops against observations of canopy CO2 uptake, evapotranspiration and sensible heat exchange. By utilizing the inverted canopy states to drive MLCan over several growing seasons, we are able to assess the impact of uncertainty in the MODIS inversion procedure on uncertainties in forward model flux estimates. This work requires the use of instant (non-composited) observations obtained at a daily frequency from both Terra and Aqua platforms. As a whiskbroom imaging instrument, MODIS has a complex viewing geometry which affects its spatial response, i.e. the way the electromagnetic radiation reflected from the surface is ultimately encoded in the remotely-sensed image. A model of this spatial response is used here to ensure that the footprint of the satellite observations matches adequately with the coupled model simulations of the target fields. The relationship between the purity of the remote sensing observation, with respect to the target field, and the quality of the biophysical variable inversion is also investigated.

Drewry, D.; Duveiller, G.

2013-12-01

392

A review of recent literature - nurse case managers in diabetes care: equivalent or better outcomes compared to primary care providers.  

PubMed

Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers. PMID:24816751

Watts, Sharon A; Lucatorto, Michelle

2014-07-01

393

Movement and spawning migration patterns suggest small marine reserves can offer adequate protection for exploited emperorfishes  

NASA Astrophysics Data System (ADS)

A critical feature of effective marine reserves is to be large enough to encompass home ranges of target species, thereby allowing a significant portion of the population to persist without the threat of exploitation. In this study, patterns of movement and home range for Lethrinus harak and Lethrinus obsoletus were quantified using an array of 33 acoustic receivers that covered approximately three quarters of Piti Marine Reserve in the Pacific island of Guam. This array was designed to ensure extensive overlap of receiver ranges throughout the study area. Eighteen individuals (12 L. harak and 6 L. obsoletus) were surgically implanted with ultrasonic transmitters and passively tracked for 4 months. Both species displayed high site fidelity and had relatively small home ranges. The home ranges of L. harak expanded with increasing body size. Feeding of fish by humans, which was common but restricted to a small area within the study site, had little effect on the distribution of the resident populations. L. harak made nightly spawning migrations within the reserve between full moon and last quarter moon of each lunar cycle, coinciding with a strong ebbing tide. Results indicate that even small reserves can include many individual home ranges of these emperorfishes and can protect spawning sites for L. harak. These species are heavily targeted in Guam, and there are major demographic differences between fished and protected sites. This study shows the potential for protected areas to sustain reproductive viability in exploited populations.

Taylor, B. M.; Mills, J. S.

2013-12-01

394

Mandatory influenza vaccination for health care workers as the new standard of care: a matter of patient safety and nonmaleficent practice.  

PubMed

A growing body of literature defends the efficacy of seasonal influenza vaccination for health care workers in reducing the mortality of hospitalized patients. I review the evidence concerning influenza vaccination, concluding that universal vaccination of health care workers against influenza should be considered standard patient care and that nonvaccination represents maleficent care. I further argue that the ethical responsibility to ensure universal vaccination of staff against seasonal influenza lies not only with individual health care providers but with each individual health care institution. PMID:24328628

Cortes-Penfield, Nicolas

2014-11-01

395

Physician reimbursement for critical care services integrating palliative care for patients who are critically ill.  

PubMed

Patients with advanced illness often spend time in an ICU, while nearly one-third of patients with advanced cancer who receive Medicare die in hospitals, often with failed ICU care. For most, death occurs following the withdrawal or withholding of life-sustaining treatments. The integration of palliative care is essential for high-quality critical care. Although palliative care specialists are becoming increasingly available, intensivists and other physicians are also expected to provide basic palliative care, including symptom treatment and communication about goals of care. Patients who are critically ill are often unable to make decisions about their care. In these situations, physicians must meet with family members or other surrogates to determine appropriate medical treatments. These meetings require clinical expertise to ensure that patient values are explored for medical decision making about therapeutic options, including palliative care. Meetings with families take time. Issues related to the disease process, prognosis, and treatment plan are complex, and decisions about the use or limitation of intensive care therapies have life-or-death implications. Inadequate reimbursement for physician services may be a barrier to the optimal delivery of high-quality palliative care, including effective communication. Appropriate documentation of time spent integrating palliative and critical care for patients who are critically ill can be consistent with the Current Procedural Terminology codes (99291 and 99292) for critical care services. The purpose of this article is to help intensivists and other providers understand the circumstances in which integration of palliative and critical care meets the definition of critical care services for billing purposes. PMID:22396564

Lustbader, Dana R; Nelson, Judith E; Weissman, David E; Hays, Ross M; Mosenthal, Anne C; Mulkerin, Colleen; Puntillo, Kathleen A; Ray, Daniel E; Bassett, Rick; Boss, Renee D; Brasel, Karen J; Campbell, Margaret L; Cortez, Therese B; Curtis, J Randall

2012-03-01

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

2012-01-01

397

The adequate stimulus for avian short latency vestibular responses to linear translation  

NASA Technical Reports Server (NTRS)

Transient linear acceleration stimuli have been shown to elicit eighth nerve vestibular compound action potentials in birds and mammals. The present study was undertaken to better define the nature of the adequate stimulus for neurons generating the response in the chicken (Gallus domesticus). In particular, the study evaluated the question of whether the neurons studied are most sensitive to the maximum level of linear acceleration achieved or to the rate of change in acceleration (da/dt, or jerk). To do this, vestibular response thresholds were measured as a function of stimulus onset slope. Traditional computer signal averaging was used to record responses to pulsed linear acceleration stimuli. Stimulus onset slope was systematically varied. Acceleration thresholds decreased with increasing stimulus onset slope (decreasing stimulus rise time). When stimuli were expressed in units of jerk (g/ms), thresholds were virtually constant for all stimulus rise times. Moreover, stimuli having identical jerk magnitudes but widely varying peak acceleration levels produced virtually identical responses. Vestibular response thresholds, latencies and amplitudes appear to be determined strictly by stimulus jerk magnitudes. Stimulus attributes such as peak acceleration or rise time alone do not provide sufficient information to predict response parameter quantities. Indeed, the major response parameters were shown to be virtually independent of peak acceleration levels or rise time when these stimulus features were isolated and considered separately. It is concluded that the neurons generating short latency vestibular evoked potentials do so as "jerk encoders" in the chicken. Primary afferents classified as "irregular", and which traditionally fall into the broad category of "dynamic" or "phasic" neurons, would seem to be the most likely candidates for the neural generators of short latency vestibular compound action potentials.

Jones, T. A.; Jones, S. M.; Colbert, S.

1998-01-01

398

Commentary: Health care reform and primary care: training physicians for tomorrow's challenges.  

PubMed

Although Congress recently passed health insurance reform legislation, the real catalyst for change in the health care delivery system, the author's argue, will be changes to the reimbursement model. To rein in increasing costs, the Centers for Medicare and Medicaid aims to move Medicare from the current fee-for-service model to a reimbursement approach that shifts the risk to providers and encourages greater accountability both for the cost and the quality of care. This level of increased accountability can only be achieved by clinical integration among health care providers. Central to this reorganized delivery model are primary care providers who coordinate and organize the care of their patients, using best practices and evidence-based medicine while respecting the patient's values, wishes, and dictates. Thus, the authors ask whether primary care physicians will be available in sufficient numbers and if they will be adequately and appropriately trained to take on this role. Most workforce researchers report inadequate numbers of primary care doctors today, a shortage that will only be exacerbated in the future. Even more ominously, the authors argue that primary care physicians being trained today will not have the requisite skills to fulfill their contemplated responsibilities because of a variety of factors that encourage fragmentation of care. If this training issue is not debated vigorously to determine new and appropriate training approaches, the future workforce may eventually have the appropriate number of physicians but inadequately trained individuals, a situation that would doom any effort at system reform. PMID:21270552

Caudill, T Shawn; Lofgren, Richard; Jennings, C Darrell; Karpf, Michael

2011-02-01

399

Specialty Care Use in US Patients with Chronic Diseases  

PubMed Central

Despite efforts to eliminate health disparities, racial, ethnic, and geographic groups continue lag behind their counterparts in health outcomes in the United States. The purpose of this study is to determine variation in specialty care utilization by chronic disease status. Data were extracted from the Commonwealth Fund 2006 Health Care Quality Survey (n = 2475). A stratified minority sample design was employed to ensure a representative sample. Logistic regression was used in analyses to predict specialty care utilization in the sample. Poor perceived health, minority status, and lack of insurance was associated with reduced specialty care use and chronic disease diagnosis. PMID:20617013

Bellinger, Jessica D; Hassan, Rahnuma M; Rivers, Patrick A; Cheng, Qiang; Williams, Edith; Glover, Saundra H

2010-01-01

400

Update of recommendations for analgosedation in pediatric intensive care unit.  

PubMed

Effective and adequate therapy to control pain and stress are essential in managing children in Pediatric Intensive Care Unit (PICU) undergoing painful invasive procedures, this should be, but is not yet, one of our main aims. Aware that this difficult mission must be pursued in a systematic, multimodal and multitasking way, the Studying Group on Analgosedation in PICU from the Italian Society of Neonatal and Paediatric Anesthesia and Intensive Care (SARNePI) is providing its recommendations. PMID:24292259

Mondardini, M C; Vasile, B; Amigoni, A; Baroncini, S; Conio, A; Mantovani, A; Corolli, E; Ferrero, F; Stoppa, F; Vigna, G; Lampugnani, E; L'Erario, M

2014-09-01

401

Postpartum care of a woman with cerebral palsy and deep vein thrombosis: a case study.  

PubMed

Pregnancy can be challenging for women with cerebral palsy. Physical limitations and comorbidities can predispose them to complications during pregnancy, such as deep vein thrombosis and pulmonary embolism, making their care needs more complex. A multidisciplinary care plan, as well as clear and effective communication among different health care providers, will help ensure safe and optimal postpartum care of women with cerebral palsy and their newborns. PMID:22900725

Phillips, Cathi; Bulmer, Jean

2012-01-01

402

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

... How will we determine whether a State's work verification procedures ensure an accurate work participation measurement? 261.64 Section...AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Do We Ensure the Accuracy of Work...

2012-10-01

403

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

Code of Federal Regulations, 2013 CFR

... How will we determine whether a State's work verification procedures ensure an accurate work participation measurement? 261.64 Section...AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Do We Ensure the Accuracy of Work...

2013-10-01

404

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

Code of Federal Regulations, 2014 CFR

... How will we determine whether a State's work verification procedures ensure an accurate work participation measurement? 261.64 Section...AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Do We Ensure the Accuracy of Work...

2014-10-01

405

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

Code of Federal Regulations, 2010 CFR

... How will we determine whether a State's work verification procedures ensure an accurate work participation measurement? 261.64 Section...AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Do We Ensure the Accuracy of Work...

2010-10-01

406

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

... How will we determine whether a State's work verification procedures ensure an accurate work participation measurement? 261.64 Section...AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Do We Ensure the Accuracy of Work...

2011-10-01

407

Defining the Animal Care and Use Program.  

PubMed

An effective Animal Care and Use Program is critical to an institution's ability to ensure that animal research is conducted humanely and follows all applicable regulations and guidelines; however, no straightforward definition of the fundamentals of such a Program now exists. The author provides a global view of the key programmatic components, which can be used to improve existing programs or implement new programs. PMID:16261152

Sandgren, Eric P

2005-11-01

408

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

409

Global Uranium And Thorium Resources: Are They Adequate To Satisfy Demand Over The Next Half Century?  

NASA Astrophysics Data System (ADS)

This presentation will consider the adequacy of global uranium and thorium resources to meet realistic nuclear power demand scenarios over the next half century. It is presented on behalf of, and based on evaluations by, the Uranium Group - a joint initiative of the OECD Nuclear Energy Agency and the International Atomic Energy Agency, of which the author is a Vice Chair. The Uranium Group produces a biennial report on Uranium Resources, Production and Demand based on information from some 40 countries involved in the nuclear fuel cycle, which also briefly reviews thorium resources. Uranium: In 2008, world production of uranium amounted to almost 44,000 tonnes (tU). This supplied approximately three-quarters of world reactor requirements (approx. 59,000 tU), the remainder being met by previously mined uranium (so-called secondary sources). Information on availability of secondary sources - which include uranium from excess inventories, dismantling nuclear warheads, tails and spent fuel reprocessing - is incomplete, but such sources are expected to decrease in market importance after 2013. In 2008, the total world Reasonably Assured plus Inferred Resources of uranium (recoverable at less than 130/kgU) amounted to 5.4 million tonnes. In addition, it is clear that there are vast amounts of uranium recoverable at higher costs in known deposits, plus many as yet undiscovered deposits. The Uranium Group has concluded that the uranium resource base is more than adequate to meet projected high-case requirements for nuclear power for at least half a century. This conclusion does not assume increasing replacement of uranium by fuels from reprocessing current reactor wastes, or by thorium, nor greater reactor efficiencies, which are likely to ameliorate future uranium demand. However, progressively increasing quantities of uranium will need to be mined, against a backdrop of the relatively small number of producing facilities around the world, geopolitical uncertainties and strong opposition to growth of nuclear power in a number of quarters - it is vital that the market provides incentives for exploration and development of environmentally sustainable mining operations. Thorium: World Reasonably Assured plus Inferred Resources of thorium are estimated at over 2.2 million tonnes, in hard rock and heavy mineral sand deposits. At least double this amount is considered to occur in as yet undiscovered thorium deposits. Currently, demand for thorium is insignificant, but even a major shift to thorium-fueled reactors would not make significant inroads into the huge resource base over the next half century.

Lambert, I. B.

2012-04-01

410

Human milk feeding supports adequate growth in infants ? 1250 grams birth weight  

PubMed Central

Background Despite current nutritional strategies, premature infants remain at high risk for extrauterine growth restriction. The use of an exclusive human milk-based diet is associated with decreased incidence of necrotizing enterocolitis (NEC), but concerns exist about infants achieving adequate growth. The objective of this study was to evaluate growth velocities and incidence of extrauterine growth restriction in infants ? 1250 grams (g) birth weight (BW) receiving an exclusive human milk-based diet with early and rapid advancement of fortification using a donor human milk derived fortifier. Methods In a single center, prospective observational cohort study, preterm infants weighing ? 1250 g BW were fed an exclusive human milk-based diet until 34 weeks postmenstrual age. Human milk fortification with donor human milk derived fortifier was started at 60 mL/kg/d and advanced to provide 6 to 8 additional kilocalories per ounce (or 0.21 to 0.28 kilocalories per gram). Data for growth were compared to historical growth standards and previous human milk-fed cohorts. Results We consecutively evaluated 104 infants with mean gestational age of 27.6 ± 2.0 weeks and BW of 913 ± 181 g (mean ± standard deviation). Weight gain was 24.8 ± 5.4 g/kg/day with length 0.99 ± 0.23 cm/week and head circumference 0.72 ± 0.14 cm/week. There were 3 medical NEC cases and 1 surgical NEC case. 22 infants (21%) were small for gestational age at birth. Overall, 45 infants (43%) had extrauterine growth restriction. Weight velocity was affected by day of fortification (p = 0.005) and day of full feeds (p = 0.02). Our cohort had significantly greater growth in weight and length compared to previous entirely human milk-fed cohorts. Conclusions A feeding protocol for infants ? 1250 g BW providing an exclusive human milk-based diet with early and rapid advancement of fortification leads to growth meeting targeted standards with a low rate of extrauterine growth restriction. Consistent nutritional policies using this approach may be considered for this population. PMID:24220185

2013-01-01

411

Seeking a standard for adequate pathologic lymph node staging in primary bladder carcinoma.  

PubMed

The purposes of this study are to evaluate the adequacy of pathologic lymph node (LN) staging in radical cystectomy specimens from patients with urothelial carcinoma of the bladder and to analyze the frequency of LN metastases among different anatomic regions. All radical cystectomies performed for primary urothelial bladder cancer over a 5-year period (January 2007-September 2012) at a single institution were reviewed. Particular attention was paid to the total number of LNs examined, the number and location of LNs with metastases (positive LNs), and the presence or absence of extranodal tumor extension and/or lymphovascular invasion in the cystectomy specimen. Results and data were analyzed with Origin 6.0 and Microsoft Office Excel 2007 software. A total of 248 radical cystectomies with 8,432 LNs were reviewed. A total of 60 (24 %) cases, with 274 positive LNs out of the 1,982 total (13.8 %), were identified with a male to female ratio of 6.5:1 (52 male, 8 female patients). The average number of LNs examined in each case was 33.0?±?20.9 (range 5-112). The average number of positive LNs identified in each case was 4.5?±?4.8 (range 1-26). Among all of the LNs, the hypogastric/obturator (internal iliac) LNs were the most commonly submitted (35.2 %) and also yielded the highest number of positive LNs (46.0 %). On average, for cases staged pN1 and pN2, there was one positive LN per 17.8 and 8.9 LNs examined from the primary drainage LNs, respectively. For pN3 cases, one out of 4.4 secondary drainage LNs was found to be positive. Similarly, one out of 4.0 distant LNs was found to be positive in cases with pM1 staging. Our study suggests that, on average, 23 LNs (including 18 primary drainage LNs and five secondary drainage LNs) should be submitted for optimal pN staging. For adequate pM1 staging, an average of four distal LNs should be evaluated. In total, an average of 27 LNs (23 for pN staging and 4 for pM staging) should be examined in radical cystectomy specimens. We also propose to stratify the number of positive LNs according to the drainage area. PMID:24699919

Wang, Lu; Mudaliar, Kumaran; Mehta, Vikas; Barkan, Güliz A; Quek, Marcus L; Flanigan, Robert C; Picken, Maria M

2014-05-01

412

Brain tumours in Sweden 1996: care and costs  

PubMed Central

OBJECTIVES—Brain tumours cause considerable concern due to a high mortality and there are increasing efforts to provide adequate care, sometimes outside hospitals. Health care utilisation, direct costs of care, and the indirect social cost of morbidity and early mortality caused by brain tumours in Sweden in the year 1996 was analysed.?METHODS—Quantification of ambulatory care, care in hospital, long term and palliative/terminal care, drug consumption, temporary as well as long term morbidity, and mortality from comprehensive national data sources. Direct costs were calculated using 1996charges. Indirect costs were calculated by sex and age specific salaries. A sensitivity analysis considered the impact of alternative estimates of each item.?RESULTS—Indirect costs were 75% of the total and were caused mainly by early mortality. Direct costs were predominantly for care in hospital, long term care, and home health care. Among direct costs, astrocytomas III-IV and meningiomas accounted for 42% and 30% respectively.?CONCLUSIONS—The cost of illness from brain tumours reflects the characteristics of these malignancies. Despite their low incidence rate, the economic impact caused by high mortality among young persons is a predominant trait. Costs of acute hospital care and also long term care and home care are considerable.?? PMID:11080235

Blomqvist, P; Lycke, J; Strang, P; Tornqvist, H; Ekbom, A

2000-01-01

413

Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?  

PubMed Central

The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

Bustreo, Flavia; Harding, April; Axelsson, Henrik

2003-01-01

414

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

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false How does Job Corps ensure that contract disputes will...ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT...Management Provisions § 670.993 How does Job Corps ensure that contract disputes...

2011-04-01

415

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

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 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...

2012-04-01

416

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

417

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

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false How does Job Corps ensure that contract disputes will...ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT...Management Provisions § 670.993 How does Job Corps ensure that contract disputes...

2010-04-01

418

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

Code of Federal Regulations, 2014 CFR

...2014-04-01 2014-04-01 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...

2014-04-01

419

76 FR 2581 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...  

Federal Register 2010, 2011, 2012, 2013, 2014

...County, Kentucky to issue preconstruction PSD...Ensure Authority to Issue Permits under the...of Greenhouse Gas Emissions: Finding of Substantial...Wood product, paper manufacturing...Ensure Authority to Issue Permits under the...of Greenhouse Gas Emissions: Federal...

2011-01-14

420

75 FR 82246 - Action To Ensure Authority To Issue Permits Under the Prevention of Significant Deterioration...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Ensure Authority to Issue Permits under the...of Greenhouse Gas Emissions: Finding of Substantial...permit that contains emission limitations that...Wood product, paper manufacturing...Ensure Authority to Issue Permits under the...of Greenhouse Gas Emissions: Federal...

2010-12-30

421

New Techniques for Ensuring the Long Term Integrity of Digital Archives  

E-print Network

New Techniques for Ensuring the Long Term Integrity of Digital Archives Sangchul Song Department today needs to be archived and preserved for future use of periods ranging from a few years to decades and sometimes centuries. A fundamental requirement of a long term archive is to ensure the integrity of its

JaJa, Joseph F.

422

Effects of resource constraint on health care services.  

PubMed

Starting with the duty of Governments to provide adequate resources for the establishment and development of health services, this paper draws on experiences in four developed countries to illustrate the problems and their outcomes. The examples chosen demonstrate the contrast in philosophies and approach to resource allocation for health care. PMID:17639847

Matta, A M

2007-06-01

423

Atrial fibrillation anticoagulation care in a large urban family medicine practice  

PubMed Central

Abstract Objective To determine the proportion of patients with atrial fibrillation (AF) in primary care achieving guideline-concordant stroke prevention treatment based on both the previous (2010) and the updated (2012) Canadian guideline recommendations. Design Retrospective chart review. Participants Primary care patients (N = 204) with AF. The mean age was 71.3 years and 53.4% were women. Setting Large urban community family practice in Toronto, Ont. Main outcome measures Patient demographic characteristics such as sex and age; a list of current cardiac medications including anticoagulants and antiplatelets; the total number of medications; relevant current and past medical history including presence of diabetes, stroke or transient ischemic attack, hypertension, and vascular disease; number of visits to the family physician and cardiologist in the past year and past 5 years, and how many of these were for AF; the number of visits to the emergency department or hospitalizations for AF, congestive heart failure, or stroke; if patients were taking warfarin, how often their international normalized ratios were recorded, and how many times they were in the reference range; CHADS2 (congestive heart failure, hypertension, age ? 75, diabetes mellitus, and stroke or transient ischemic attack) score, if recorded; and reason for not taking oral anticoagulants when they should have been, if recorded. Results Among those who had CHADS2 scores of 0, 64 patients (97.0%) were receiving appropriate stroke prevention in AF (SPAF) treatment according to the 2010 guidelines. When the 2012 guidelines were applied, 39 patients (59.1%) were receiving appropriate SPAF treatment (P < .001). For those with CHADS2 scores of 1, 88.4% of patients had appropriate SPAF treatment according to the 2010 guidelines, but only 55.1% were adequately treated according to the 2012 guidelines (P < .001). Of the patients at the highest risk (CHADS2 score > 1), 68.1% were adequately treated with anticoagulation and an additional 8.7% (6 of 69) had documented reasons why they were not taking anticoagulants. Conclusion When assessed using the 2012 Canadian Cardiovascular Society AF guidelines, the proportion of patients receiving appropriate SPAF therapy in this primary care setting decreased substantially. All patients with CHADS2 scores of 0 or 1 should be reassessed to ensure that they are receiving optimal stroke prevention treatment. PMID:24627401

Valentinis, Alissia; Ivers, Noah; Bhatia, Sacha; Meshkat, Nazanin; Leblanc, Kori; Ha, Andrew; Morra, Dante

2014-01-01

424

About Skin-to-Skin Care (Kangaroo Care)  

MedlinePLUS

... Care Ages & Stages Listen About Skin-to-Skin Care Article Body You may be able to hold ... care, also called kangaroo care. What is Kangaroo Care? Kangaroo care was developed in South America as ...

425

76 FR 9503 - Medicare and Medicaid Programs; Requirements for Long-Term Care (LTC) Facilities; Notice of...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Programs; Requirements for Long-Term Care (LTC) Facilities; Notice of Facility...amends the requirements that a long- term care (LTC) facility must meet in order to...implement section 6113 of the Affordable Care Act to ensure that, among other...

2011-02-18

426

78 FR 16795 - Medicare and Medicaid Programs; Requirements for Long-Term Care (LTC) Facilities; Notice of...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Programs; Requirements for Long-Term Care (LTC) Facilities; Notice of Facility...revised the requirements that a long-term care (LTC) facility must meet in order to...of the Patient Protection and Affordable Care Act to ensure that, among other...

2013-03-19

427

78 FR 46421 - Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per...  

Federal Register 2010, 2011, 2012, 2013, 2014

...State Homes; Per Diem for Adult Day Care of Veterans in State Homes...ensure that nursing home and adult day health care facilities are providing high quality...providing nursing home and adult day health care to furnish an application for...

2013-07-31

428

77 FR 45719 - Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per...  

Federal Register 2010, 2011, 2012, 2013, 2014

...State Homes; Per Diem for Adult Day Care of Veterans in State Homes...ensure that nursing home and adult day health care facilities are providing high quality...providing nursing home and adult day health care to furnish an application for...

2012-08-01

429

The International Conference on Malignant Bowel Obstruction: A Meeting of the Minds to Advance Palliative Care Research  

Microsoft Academic Search

There is a dearth of well-designed clinical research focusing on palliative care in cancer patients, especially those who are near the end of life. Reasons for this include ethical dilemmas in conducting such trials, communication barriers between specialties, and unclear standards for best care practices. To ensure that patients with incurable illnesses are offered the best available care, it is

Robert S. Krouse

2007-01-01

430

Critical care during epidemics  

PubMed Central

We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving critical care. The toll of death may be inversely proportional to the ability to augment critical care capacity, so critical care health care professionals must take the lead for planning and preparing to care for numbers of seriously ill patients that far exceed available ICU beds. PMID:16137366

Rubinson, Lewis; O'Toole, Tara

2005-01-01

431

Designing a Household Survey to Address Seasonality in Child Care Arrangements  

ERIC Educational Resources Information Center

In household telephone surveys, a long field period may be required to maximize the response rate and achieve adequate sample sizes. However, long field periods can be problematic when measures of seasonally affected behavior are sought. Surveys of child care use are one example because child care arrangements vary by season. Options include…

Schmidt, Stefanie R.; Wang, Kevin H.; Sonenstein, Freya L.

2008-01-01

432

Health Literacy: Critical Opportunities for Social Work Leadership in Health Care and Research  

ERIC Educational Resources Information Center

One-third of U. S. adults do not have adequate health literacy to manage their health care needs; and low health literacy is a major concern due to its association with poor health outcomes, high health care costs, and health communication problems. Low health literacy is a potential driver of health disparities, and its alleviation is central to…

Liechty, Janet M.

2011-01-01

433

Adequate margins for random setup uncertainties in head-and-neck IMRT  

SciTech Connect

Purpose: To investigate the effect of random setup uncertainties on the highly conformal dose distributions produced by intensity-modulated radiotherapy (IMRT) for clinical head-and-neck cancer patients and to determine adequate margins to account for those uncertainties. Methods and materials: We have implemented in our clinical treatment planning system the possibility of simulating normally distributed patient setup displacements, translations, and rotations. The planning CT data of 8 patients with Stage T1-T3N0M0 oropharyngeal cancer were used. The clinical target volumes of the primary tumor (CTV{sub primary}) and of the lymph nodes (CTV{sub elective}) were expanded by 0.0, 1.5, 3.0, and 5.0 mm in all directions, creating the planning target volumes (PTVs). We performed IMRT dose calculation using our class solution for each PTV margin, resulting in the conventional static plans. Then, the system recalculated the plan for each positioning displacement derived from a normal distribution with {sigma} = 2 mm and {sigma} = 4 mm (standard deviation) for translational deviations and {sigma} = 1 deg for rotational deviations. The dose distributions of the 30 fractions were summed, resulting in the actual plan. The CTV dose coverage of the actual plans was compared with that of the static plans. Results: Random translational deviations of {sigma} = 2 mm and rotational deviations of {sigma} = 1 deg did not affect the CTV{sub primary} volume receiving 95% of the prescribed dose (V{sub 95}) regardless of the PTV margin used. A V{sub 95} reduction of 3% and 1% for a 0.0-mm and 1.5-mm PTV margin, respectively, was observed for {sigma} = 4 mm. The V{sub 95} of the CTV{sub elective} contralateral was approximately 1% and 5% lower than that of the static plan for {sigma} = 2 mm and {sigma} = 4 mm, respectively, and for PTV margins < 5.0 mm. An additional reduction of 1% was observed when rotational deviations were included. The same effect was observed for the CTV{sub elective} ipsilateral but with smaller dose differences than those for the contralateral side. The effect of the random uncertainties on the mean dose to the parotid glands was not significant. The maximal dose to the spinal cord increased by a maximum of 3 Gy. Conclusions: The margins to account for random setup uncertainties, in our clinical IMRT solution, should be 1.5 mm and 3.0 mm in the case of {sigma} = 2 mm and {sigma} = 4 mm, respectively, for the CTV{sub primary}. Larger margins (5.0 mm), however, should be applied to the CTV{sub elective}, if the goal of treatment is a V{sub 95} value of at least 99%.

Astreinidou, Eleftheria [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands)]. E-mail: e.astreinidou@azu.nl; Bel, Arjan [Nucletron B.V., Veenendaal (Netherlands); Raaijmakers, Cornelis P.J. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Terhaard, Chris H.J. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Lagendijk, Jan J.W. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands)

2005-03-01

434

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

435

Ensuring survival.  

PubMed

The global population growth rate has been 1.7% since 1975, while for developing countries it is 2.1%. UN projections are for population to grow from 5.5 billion in 1992 to 10 billion by 2050. Sustainable development is only possible when population growth is balanced with available resources. UN medium population projections of 7.8 billion by 2050 can be reached with 187 million more couples practicing family planning (FP) by the year 2000. Within the past 20 years, 1 billion people, mostly from developed countries, have enjoyed economic growth, but have contributed polluting technologies, excessive waste, and environmentally dangerous economic practices. The generations to come will be affected by the continuance of these practices by the 1 billion affluent population. The bottom billion are mired in poverty and high population growth and survival, needs that hinder their country's economic development, upset fragile ecosystems, and destroy the balance between human beings and the environment. International migration on a large scale could be the by-product of population growth. Progress has been made since the 1974 UN Conference on Population in Bucharest. There are still, however, vulnerable populations, the poorest households, the landless and small-holder families, urban squatters and slum dwellers, those living in low lying deltas and along coasts, and women. Women control family resources and their micro environment. Sustainable development is not possible without the elimination of prejudice against women. Reproductive freedom for women must be a priority. High quality, readily available FP services are also needed for those desiring this. The difficulty is in providing FP services that conform to a woman's social and cultural background and personal needs; success is dependent on involving women in the process and holding men more responsible for FP. Development means allowing for the legitimate aspirations of the majority not just the specialized concerns of the destitute. The environmental cost of development must be reduced and there must be a more equitable distribution of benefits. Borders do not confine problems and governments must work together. 1 billion of the global budget of 4.5 billion dollars is contributed by developed countries, and that amount needs to be increased by 50%. Population aid should be 4% not 2% of all assistance. PMID:12317825

Sadik, N

1992-12-01

436

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

Microsoft Academic Search

BackgroundBuruli 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

Jordi Landier; Pascal Boisier; Félix Fotso Piam; Blanbin Noumen-Djeunga; Joseph Simé; Fidèle Gaetan Wantong; Laurent Marsollier; Arnaud Fontanet; Sara Eyangoh

2011-01-01

437

Do the UK government's new Quality and Outcomes Framework (QOF) scores adequately measure primary care performance? A cross-sectional survey of routine healthcare data  

Microsoft Academic Search

BACKGROUND: General practitioners' remuneration is now linked directly to the scores attained in the Quality and Outcomes Framework (QOF). The success of this approach depends in part on designing a robust and clinically meaningful set of indicators. The aim of this study was to assess the extent to which measures of health observed in practice populations are correlated with their

Amy Downing; Gavin Rudge; Yaping Cheng; Yu-Kang Tu; Justin Keen; Mark S Gilthorpe

2007-01-01

438

Best practice eye care models  

PubMed Central

Since the launching of Global Initiative, VISION 2020 “the Right to Sight” many innovative, practical and unique comprehensive eye care services provision models have evolved targeting the underserved populations in different parts of the World. At places the rapid assessment of the burden of eye diseases in confined areas or utilizing the key informants for identification of eye diseases in the communities are promoted for better planning and evidence based advocacy for getting / allocation of resources for eye care. Similarly for detection and management of diabetes related blindness, retinopathy of prematurity and avoidable blindness at primary level, the major obstacles are confronted in reaching to them in a cost effective manner and then management of the identified patients accordingly. In this regard, the concept of tele-ophthalmology model sounds to be the best solution. Whereas other models on comprehensive eye care services provision have been emphasizing on surgical output through innovative scales of economy that generate income for the program and ensure its sustainability, while guaranteeing treatment of the poorest of the poor. PMID:22944741

Qureshi, Babar M; Mansur, Rabiu; Al-Rajhi, Abdulaziz; Lansingh, Van; Eckert, Kristen; Hassan, Kunle; Ravilla, Thulasiraj; Muhit, Mohammad; Khanna, Rohit C; Ismat, Chaudhry

2012-01-01

439

The importance of nutritional care in HIV-infected children in resource-limited settings.  

PubMed

Renewed efforts to provide proper nutritional care are essential for appropriate pediatric HIV management. Current studies support the use of vitamin A and macronutrients that increase caloric and protein intake. With additional research on key issues such as the needed composition and timing for nutritional supplementation, we can determine the best strategies to support the growth and development of HIV-infected children in resource-limited settings. Malnutrition among children is common in the resource-limited settings where HIV infection is most prevalent. While malnutrition is associated with higher morbidity and mortality for HIV-infected children, there is only limited evidence to guide the use of nutritional support for HIV-infected children. The best studied is vitamin A, which is associated with improved mortality and clinical outcomes. Zinc and multivitamin supplementation have not consistently been associated with clinical benefits. Limited research suggests macronutrient supplementation, which typically uses enriched formulas or foods, improves key anthropometrics for HIV-infected children, but the optimal composition of nutrients for supplementation has not been determined. More research is needed to understand the most efficient and sustainable ways to ensure adequate nutrition in this vulnerable population. PMID:25371264

McHenry, Megan S; Apondi, Edith; Vreeman, Rachel C

2014-12-01

440

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

441

Willingness to Pay for Annual Health Care Services in Small Ruminants: The Case of South India  

NASA Astrophysics Data System (ADS)

A study was undertaken in southern peninsular State of India, the Tamil Nadu State, to assess the farmers Willingness To Pay` (WTP) for annual health care services in small ruminants. The districts of the State were categorized as Livestock Developed (LD) and Livestock Under Developed (LUD) based on initial base line developed. Contingent Valuation (CV) approach was used to study the farmers maximum WTP value for two types of health care services: (a) providing animal health care services at government veterinary centres, (b) extending animal health care services at farmers door steps. A Payment Card (PC) format was used to assess the farmers` maximum WTP for ensuring health care services to sheep and goat. The Maximum Likelihood technique was used on interval midpoints. The study revealed that the farmers were willing to pay a maximum of INR 56.34 and INR 61.61 for availing health services to their sheep and goat, respectively, by in-centre services, while they were ready to offer INR 87.49 and INR 95.27 for the animal health services delivered at doorsteps. The mean maximum WTP value was found to be more for goats than sheep, postulated both in-centre and home services. Of the factors incorporated in the in-centre service model for sheep, age of respondent, livelihood share of livestock, number of sheep and VLU owned and distance from nearest public veterinary centre were found to significantly influence the WTP values. Unlike sheep, age of respondent, VLU possession, distance of the public veterinary centre and district versatility had a significant role in determining WTP values for goats. WTP values in sheep for home service were found to be significantly predisposed by all the significant factors of in-centre services model, except number of sheep owned. Similarly, in goat, the age of respondent turned to be insignificant in home services model. The results indicated that the people were willing to pay more for getting their small ruminants adequately protected from diseases and treated at once with quality services.

Kathiravan, G.; Thirunavukkarasu, M.; Michealraj, P.

442

Lack of adequate sun protection for children with oculocutaneous albinism in South Africa  

PubMed Central

Background Childhood is a high risk time for ultraviolet induced skin damage as this age group has more time and opportunity to be outdoors in the sun. Children in Africa with the inherited condition oculocutaneous albinism (OCA) are especially vulnerable due to their lack of protective melanin. They are highly susceptible to developing skin lesions that have both cosmetic and health complications, with a high risk of developing skin cancers. The study aimed to explore the adequacy of sun protection strategies of children with albinism in order to inform future provision. Methods Community based participatory research methods were employed to investigate sun protection strategies in 90 pupils with OCA (40 female and 50 male) boarding at a special school educating pupils with visual impairment in a rural area of northern South Africa. Hats worn and sunscreen preparations used were examined during semi-structured face to face interviews conducted in small peer groups. The resident nurse interpreted if necessary and provided additional information on monitoring and treatment of skin lesions. Results Participants with albinism in this study were exposed to high levels of ultraviolet radiation throughout the year and showed skin damage despite wearing protective head gear. All except one pupil possessed at least one hat, with a mean brim width of 5.4 cm. Gender differences in sun avoidance behaviour were documented, with females seeking shade during recreational periods and males playing soccer outside. Although 38% of pupils were using a sunscreen with a sun protection factor (SPF) rating, only 12% had government sponsored tubes of SPF15 cream. Government sponsored sunscreen preparations were only provided if actively sought, involving time consuming trips to regional hospitals, with inadequate availability and insufficient supply. Conclusion Children with albinism living away from home in rural areas appear to have inadequate sun protection strategies. Changes in health policy could address these deficiencies. We recommend providing more detailed health care information, giving advice on appropriate styles of hat to wear and how to assess commercial SPF products. Health promotional material should also be evaluated to determine its effectiveness among user groups. PMID:18590551

Lund, Patricia M; Taylor, Julie S

2008-01-01

443

Wound care centers  

MedlinePLUS

A wound care center, or clinic, is a medical facility for treating wounds that don't heal. You have a ... a team of health care providers trained in wound care. Your team may include: Physicians who oversee your ...

444

Unplanned health care tourism.  

PubMed

Health care tourism is often a preplanned event carefully laying out all the details. Sometimes, when one least expects it, medical care is needed outside of the mainland. This Editorial speaks to an unplanned experience. PMID:25436438

Powell, Suzanne K

2015-01-01

445

Treatment Approaches (Palliative Care)  

MedlinePLUS

... about such topics as religion, death, and afterlife. Palliative Care Websites American Academy of Hospice and Palliative Medicine ... Life Physician Education Resource Center European Association for Palliative Care Growth House, Inc. Hospice Cares International Hospice Institute & ...

446

National Health Care Survey  

Cancer.gov

The National Health Care Survey (NHCS) encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

447

Advance Care Planning  

MedlinePLUS

... burden off family and friends. What Is Advance Care Planning? Advance care planning involves learning about the ... change in your health. Medical Research and Advance Care Planning Medical research plays an important role in ...

448

Skin care and incontinence  

MedlinePLUS

Incontinence - skin care ... in a wheelchair, regular chair, or bed TAKING CARE OF THE SKIN Using diapers and other products ... skin. Over time, the skin breaks down. Special care must be taken to keep the skin clean ...

449

Babysitters and Child Care  

MedlinePLUS

... information in Spanish ( en español ) Babysitters and child care Related information Child care provider checklist (PDF, 197 ... proofing Return to top Choosing and using child care Many moms go back to work after having ...

450

Your Dialysis Care Team  

MedlinePLUS

... the NKF You are here Home » Your Dialysis Care Team Good health care is always a team ... your family improve your quality of life. Patient Care Technician and Biomedical Technician There are two kinds ...

451

Office of Child Care  

MedlinePLUS

... the Policy Statement > What is the Office of Child Care (OCC)? The Office of Child Care supports low-income working families through child care financial assistance and promotes children's learning by improving ...

452

Child Care Aware  

MedlinePLUS

... learn about high-quality child care. Welcome to Child Care Aware® E-Mail Print Share Tweet Military Child ... 2246 Call TTY#: 1-866-278-9428 Free Child Care Search Please enter your zip code. Your local ...

453

Caring for Yourself  

MedlinePLUS

... help out, doing things you enjoy, using adult day care services, or getting help from a local home ... for help from home health care or adult day care services when you need it. To find providers ...

454

Pharmaceutical care in Kuwait: hospital pharmacists' perspectives.  

PubMed

Background Pharmaceutical care practice has been championed as the primary mission of the pharmacy profession, but its implementation has been suboptimal in many developing countries including Kuwait. Pharmacists must have sufficient knowledge, skills, and positive attitudes to practise pharmaceutical care, and barriers in the pharmacy practice model must be overcome before pharmaceutical care can be broadly implemented in a given healthcare system. Objective To investigate hospital pharmacists' attitudes towards pharmaceutical care, perceptions of their preparedness to provide pharmaceutical care, and the barriers to its implementation in Kuwait. Setting Six general hospitals, eight specialized hospitals and seven specialized health centers in Kuwait. Method A descriptive, cross-sectional survey was distributed to all pharmacists working in the governmental hospitals in Kuwait (385 pharmacists). Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (standard deviations) were calculated and compared using statistical package for social sciences, version 20. Statistical significance was accepted at a p value of <0.05. Main outcome measure Pharmacists' attitudes towards pharmaceutical care, perceptions of their preparedness to provide pharmaceutical care competencies, and the barriers to its implementation in Kuwait. Results Completed surveys were received from 250 (64.9 %) of the 385 pharmacists. Pharmacists expressed overall positive attitudes towards pharmaceutical care. They felt well prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Pharmacists with more practice experience expressed significantly more positive attitudes towards pharmaceutical care (p = 0.001) and they felt better prepared to provide pharmaceutical care competencies (p < 0.001) than those with less experience as practitioners. The respondents agreed/strongly agreed that the most significant barriers to the integration of pharmaceutical care into practice were lack of private counseling areas or inappropriate pharmacy layout (87.6 %), organizational obstacles (81.6 %), inadequate staff (79.6 %), and lack of pharmacist time and adequate technology (76.0 %). Conclusion Hospital pharmacists in Kuwait advocate implementation of pharmaceutical care while also appreciating the organizational, technical and professional barriers to its widespread adoption. Collaborative efforts between health authorities and educational institutions, and the integration of innovative approaches in pharmacy management and education could overcome these barriers and achieve the transition towards pharmaceutical care practice. PMID:25204259

Katoue, Maram G; Awad, Abdelmoneim I; Schwinghammer, Terry L; Kombian, Samuel B

2014-12-01

455

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

456

Recentring care: interrogating the commodification of care  

Microsoft Academic Search

We trace how the category of care comes to be constituted historically and in social theory in ways that privilege the autonomous individual as economic agent and, in the process, renders care a problematic residual to social order and social theory. We investigate how theoretical categories, social relations, institutional orders and discursive practices separate care and economy in ways that

Maia Green; Victoria Lawson

2011-01-01

457

Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods  

PubMed Central

Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk–benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR) and above the Tolerable Upper Intake Level (UL) are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk–benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk–benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods. PMID:25630617

Bruins, Maaike J.; Mugambi, Gladys; Verkaik-Kloosterman, Janneke; Hoekstra, Jeljer; Kraemer, Klaus; Osendarp, Saskia; Melse-Boonstra, Alida; Gallagher, Alison M.; Verhagen, Hans

2015-01-01

458

Pediatric emergency and critical care in low-income countries.  

PubMed

The United Nations' Millennium Development Goal 4 is to reduce the global under-five mortality rate by two-thirds by 2015. Achieving this goal requires substantial strengthening of health systems in low-income countries. Emergency and critical care services are often one of the weakest parts of the health system and improving such care has the potential to significantly reduce mortality. Introducing effective triage and emergency treatments, establishing hospital systems that prioritize the critically ill and ensuring a reliable oxygen delivery system need not be resource intensive. Improving intensive care units, training health staff in the fundamentals of critical care concentrating on ABC - airway, breathing, and circulation - and developing guidelines for the management of common medical emergencies could all improve the quality of inpatient pediatric care. Integration with obstetrics, adult medicine and surgery in a combined emergency and critical care service would concentrate resources and expertise. PMID:19076498

Baker, Tim

2009-01-01

459

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

2008-01-01

460

Using Fuzzy Logic to Identify Schools Which May Be Misclassified by the No Child Left Behind Adequate Yearly Progress Policy  

ERIC Educational Resources Information Center

This investigation developed, tested, and prototyped a Fuzzy Inference System (FIS) that would assist decision makers in identifying schools that may have been misclassified by existing Adequate Yearly Progress (AYP) methods. This prototype was then used to evaluate Louisiana elementary schools using published school data for Academic Year 2004. …

Yates, Donald W.

2009-01-01

461

How Many Schools Have Not Made Adequate Yearly Progress under the No Child Left Behind Act? August 2010 Update  

ERIC Educational Resources Information Center

Drawing on data from state departments of education and other public sources, this report estimates the number and percentage of public schools that did not make adequate yearly progress. The report finds that approximately one-third of the nation's public schools did not make AYP in school year 2008-09, although the number varied greatly by…

Dietz, Shelby

2010-01-01

462

Students' Use of Tutoring Services, by Adequate Yearly Progress Status of School. Statistics in Brief. NCES 2010-023  

ERIC Educational Resources Information Center

This Statistics in Brief contributes to current research by investigating the use of tutoring services among a nationally representative group of public school students enrolled in grades K-12. The report compares students in schools that have not made Adequate Yearly Progress (AYP) for 3 or more years, and were thereby enrolled in schools that…

Warkentien, Siri; Grady, Sarah

2009-01-01

463

Targeting adequate thermal stability and fire safety in selecting ionic liquid-based electrolytes for energy storage  

E-print Network

1 Targeting adequate thermal stability and fire safety in selecting ionic liquid-based electrolytes electrolyte solutions with nonvolatile and nonflammable ionic liquids instead of actual carbonate mixtures could be safer. However, few definitions of thermal stability of electrolytes based on ionic liquids

Paris-Sud XI, Université de

464

BARRICADES AND PROTECTION OF OPENINGS Barricades and warnings are required around all construction sites. In addition, adequate  

E-print Network

construction sites. In addition, adequate protection must be given to excavations, holes, or openings in floors/fence for the duration of the construction project. Warning sign verbiage shall be coordinated through EH&IS. Open Pits work. Simple barricades are not enough protection in high traffic areas near sidewalks and road ways

de Lijser, Peter

465

When preparing for a disaster, it is important to provide for an adequate supply of water for drinking and cook-  

E-print Network

When preparing for a disaster, it is important to provide for an adequate supply of water water supply is likely to be disrupted. Ice storms and other emergencies can cause a loss of electrical power, leaving well pumps unable to function. Planning for Emergency Water Supplies Each person

Liskiewicz, Maciej

466

Autonomous Medical Care for Exploration  

NASA Technical Reports Server (NTRS)

The goal of Autonomous Medical Care (AMC) is to ensure a healthy, well-performing crew which is a primary need for exploration. The end result of this effort will be the requirements and design for medical systems for the CEV, lunar operations, and Martian operations as well as a ground-based crew health optimization plan. Without such systems, we increase the risk of medical events occurring during a mission and we risk being unable to deal with contingencies of illness and injury, potentially threatening mission success. AMC has two major components: 1) pre-flight crew health optimization and 2) in-flight medical care. The goal of pre-flight crew health optimization is to reduce the risk of illness occurring during a mission by primary prevention and prophylactic measures. In-flight autonomous medical care is the capability to provide medical care during a mission with little or no real-time support from Earth. Crew medical officers or other crew members provide routine medical care as well as medical care to ill or injured crew members using resources available in their location. Ground support becomes telemedical consultation on-board systems/people collect relevant data for ground support to review. The AMC system provides capabilities to incorporate new procedures and training and advice as required. The on-board resources in an autonomous system should be as intelligent and integrated as is feasible, but autonomous does not mean that no human will be involved. The medical field is changing rapidly, and so a challenge is to determine which items to pursue now, which to leverage other efforts (e.g. military), and which to wait for commercial forces to mature. Given that what is used for the CEV or the Moon will likely be updated before going to Mars, a critical piece of the system design will be an architecture that provides for easy incorporation of new technologies into the system. Another challenge is to determine the level of care to provide for each mission type. The level of care refers to the amount and type of care one will render based on perceived need and ability. This is in contrast to the standard of care which is the benchmark by which that care is provided. There are certainly some devices and procedures that have unique microgravity or partial gravity requirements such that terrestrial methods will not work. For example, performing CPR on Mars cannot be done in exactly the same way as on Earth because the reduced gravity causes too large a reduction in the forces available for effective compression of the chest. Likewise, fluid behavior in microgravity may require a specialized water filtration and mixing system for the creation of intravenous fluids. This paper will outline the drivers for the design of the medical care systems, prioritization and planning techniques, key system components, and long term goals.

Johnson-Throop, Kathy A.; Polk, J. D.; Hines, John W.; Nall, Marsha M.

2005-01-01

467

The right to adequate housing viewed through the lens of Grootboom Decision of the South African Constitutional Court  

Microsoft Academic Search

Prezentul articol încearca o analiza a impactului pe care Decizia Curtii Constitutionale a Africii de Sud în cazul ‘Grootboom’, l-a avut asupra implementarii si aplicarii coerente a dreptului la locuinta corespunzatoare, si nu numai. În acest sens, contextul istoric, social, politic, economic etc. în care cazul de fata a fost solutionat si-a pus în mod evident amprenta asupra respectarii drepturilor

CATALIN STEFAN RUSU

2004-01-01

468

Telepsychiatry and e-mental health services: potential for improving access to mental health care.  

PubMed

Reforming mental health care is a focus of many ongoing initiatives in the United States, both at the national and state levels. Access to adequate mental health care services is one of the identified problems. Telepsychiatry and e-mental health services could improve access to mental health care in rural, remote and underserved areas. The authors discuss the required technology, common applications and barriers associated with the implementation of telepsychiatry and e-mental health services. PMID:16927161

McGinty, Kaye L; Saeed, Sy Atezaz; Simmons, Scott C; Yildirim, Yilmaz

2006-01-01

469

The Current State of Intervention Research for Posttraumatic Stress Disorder Within the Primary Care Setting  

Microsoft Academic Search

Posttraumatic Stress Disorder (PTSD) is common among primary care patients and is associated with significant functional impairment,\\u000a physical health concerns, and mental health comorbidities. Significant barriers to receiving adequate treatment often exist\\u000a for primary care patients with PTSD. Mental health professionals operating as part of the primary care team have the potential\\u000a to provide effective brief intervention services. While good

Kyle Possemato

470

COMMUNICATION ABOUT SEXUAL HEALTH AND DECISION MAKING WITH ADOLESCENTS IN FOSTER CARE  

E-print Network

Regarding their Sexual Health and Decision Making………………………………………………………………………... 1 Foster Care in the United States…………………………………………………………….. 3 The Orphan Train……………………………………………………………………....... 4 Protection for Children at the Federal... including: physical, mental and sexual abuse, neglect, or due to the inability of their parent or guardian to adequately care for them. Of the approximately 500,000 children residing in foster care nearly half of these are children aged 12 – 17 years...

Pilgrim, Sarah Irene

2012-08-31

471

Florida Atlantic University Institutional Animal Care and Use Committee  

E-print Network

AND PROCEDURES University faculty and students use fish as a research animal, to feed other research animals the responsibility of ensuring that all animals are humanely and legally cared for when used for research or teaching. In following the Institute for Laboratory Animal Research (ILAR) Guidelines, the estimate of numbers becomes

Fernandez, Eduardo

472

Transition from Long Day Care to Kindergarten: Continuity or Not?  

ERIC Educational Resources Information Center

Transition practices that ensure continuity between early childhood settings have been shown to be important in assisting children's short-term and long-term growth and development (Vogler, Cravello & Woodhead, 2008). In Western Australia many young children move from and between long day care (LDC) settings to kindergarten. In that state,…

Barblett, Lennie; Barratt-Pugh, Caroline; Kilgallon, Pam; Maloney, Carmel

2011-01-01

473

Page 2--Caring Headlines --September 3, 2009 Jeanette Ives Erickson  

E-print Network

. These councils ad- vise hospital leadership on matters relating to patient- provider relationships, safety Jeanette Ives Erickson, RN, senior vice president for Patient Care and chief nurse Patient and family advisory councils one more way to ensure the patient's voice is heard Patient and family advisory councils

Mootha, Vamsi K.

474

28 CFR 115.122 - Policies to ensure referrals of allegations for investigations.  

Code of Federal Regulations, 2012 CFR

...for investigations. 115.122 Section 115.122 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Responsive Planning § 115.122 Policies to ensure...

2012-07-01

475

7 CFR 799.9 - Ensuring that environmental factors are considered in agency decisionmaking.  

Code of Federal Regulations, 2011 CFR

...2011-01-01 2011-01-01 false Ensuring that environmental factors are considered in agency decisionmaking...SERVICE AGENCY, DEPARTMENT OF AGRICULTURE ENVIRONMENTAL PROTECTION ENVIRONMENTAL QUALITY AND RELATED ENVIRONMENTAL...

2011-01-01

476

7 CFR 799.9 - Ensuring that environmental factors are considered in agency decisionmaking.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 2013-01-01 false Ensuring that environmental factors are considered in agency decisionmaking...SERVICE AGENCY, DEPARTMENT OF AGRICULTURE ENVIRONMENTAL PROTECTION ENVIRONMENTAL QUALITY AND RELATED ENVIRONMENTAL...

2013-01-01

477

7 CFR 799.9 - Ensuring that environmental factors are considered in agency decisionmaking.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Ensuring that environmental factors are considered in agency decisionmaking...SERVICE AGENCY, DEPARTMENT OF AGRICULTURE ENVIRONMENTAL PROTECTION ENVIRONMENTAL QUALITY AND RELATED ENVIRONMENTAL...

2010-01-01

478

7 CFR 799.9 - Ensuring that environmental factors are considered in agency decisionmaking.  

Code of Federal Regulations, 2012 CFR

...2012-01-01 2012-01-01 false Ensuring that environmental factors are considered in agency decisionmaking...SERVICE AGENCY, DEPARTMENT OF AGRICULTURE ENVIRONMENTAL PROTECTION ENVIRONMENTAL QUALITY AND RELATED ENVIRONMENTAL...

2012-01-01

479

7 CFR 799.9 - Ensuring that environmental factors are considered in agency decisionmaking.  

Code of Federal Regulations, 2014 CFR

...2014-01-01 2014-01-01 false Ensuring that environmental factors are considered in agency decisionmaking...SERVICE AGENCY, DEPARTMENT OF AGRICULTURE ENVIRONMENTAL PROTECTION ENVIRONMENTAL QUALITY AND RELATED ENVIRONMENTAL...

2014-01-01

480

75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations  

Federal Register 2010, 2011, 2012, 2013, 2014

The Federal Emergency Management Agency (FEMA) is accepting comments on RP9525.4, Emergency Medical Care and Medical Evacuations. This is an existing policy that is scheduled for review to ensure that the Recovery Directorate policies are consistent with current laws and regulations. This policy identifies the extraordinary emergency medical care and medical evacuation expenses that are eligible......

2010-08-13

481

Health care in the information society. A prognosis for the year 2013  

Microsoft Academic Search

Our society is increasingly influenced by modern information and communication technology (ICT). Health care has profited greatly by this development. How could health care provision look in the near future, in 10 years, or more precisely, in the year 2013? What measures must be undertaken by political and self-governing health institutions, and by medical informatics research, to ensure an efficient,

Reinhold Haux; Elske Ammenwerth; Werner Herzog; Petra Knaup

2002-01-01

482

DNA Fingerprinting Reveals Female Preference for Male Parental Care in Savannah Sparrows  

Microsoft Academic Search

According to sexual selection theory, females choose mates to ensure access to high quality resources, male parental care, or good genes. This last hypothesis has been hotly debated on both theoretical and empirical grounds. In contrast, female preference for male parental care has received less attention, primarily because the potential benefits of paternal effort seem obvious. The fitness relations are

Corey R. Freeman-Gallant

1996-01-01

483

Study Shows Importance of Early End-of-Life Care Discussions  

Cancer.gov

Discussions about palliative and end-of-life care are often delayed until late in a patient's life, if they take place at all. Earlier discussions may help to ensure that the care delivered at the end of life is consistent with a patient's preferences.

484

UK HealthCare HIPAA Education Page 1 September 1, 2009 HIPAA Education Level One  

E-print Network

UK HealthCare HIPAA Education Page 1 September 1, 2009 HIPAA Education ­ Level of an individual's health information Ensures physical and technical security of an individual's health HealthCare HIPAA Education Page 2 September 1, 2009 ~ Who is required to comply

MacAdam, Keith

485

Health Care Reform: How Will It Affect Nursing?--Nursing Education.  

ERIC Educational Resources Information Center

Nursing educators have the opportunity to advance nursing's agenda for health care reform to ensure effective health care for all members of society. They have a key role in fostering the political involvement of student nurses and nurses who have returned to school for baccalaureate or graduate education. Role modeling is critical to increasing…

Zalon, Margarete Lieb

486

Pain management in the pediatric intensive care unit.  

PubMed

Critically ill pediatric patients are frequently exposed to acute, established, and chronic pain as a result of their disease processes or intensive care therapies. Despite the availability of many drugs and techniques for providing analgesia, these painful conditions are not adequately treated in a large proportion of children. This article reviews some of the reasons for provision of adequate analgesia and sedation, describes the various classes of drugs commonly used in the pediatric intensive care unit, and lists the techniques and indications for regional and topical anesthesia as well as specific clinical applications for adjuvant analgesic agents. Analgesic approaches that do not have an established record of safety and efficacy in pediatric patients are not reviewed. We propose that adequate and early analgesic interventions will minimize patient's discomfort, maintain metabolic homeostasis, and improve a patient's tolerance of intensive care unit therapies and nursing interventions. Adequate analgesia can be provided to even the sickest child using the drugs, techniques, and novel approaches reviewed. PMID:9229164

Chambliss, C R; Anand, K J

1997-06-01

487

[Paediatric palliative care in Denmark should be strengthened.  

PubMed

Paediatric palliative care is the total care for the child's body, mind and spirit, and involves support to the family. It begins when a life-threatening disease is diagnosed and depends on an interdisciplinary team approach. In 2013, 295 children under the age of 16 years died in Denmark. Of these, 195 were less than one year old. Most children and their families may prefer death at home if possible. Early planning allows for better integration of home-care services and ensures that death occurs at the place that is best for the child and family. PMID:25353997

Jespersen, Bodil Abild; Clausen, Niels; Sjøgren, Per

2014-10-27

488

Beyond Romanow: the future of women's health care in Canada.  

PubMed

In November 2002, the Royal Commission on the Future of Health Care in Canada, headed by Mr. Roy J. Romanow, will deliver its final report to the Governor-in-Council of Canada. In October 2001 the Society of Obstetricians and Gynaecologists (SOGC) submitted to Mr. Romanow concrete ideas and proposed actions to improve the health of Canadian women and their families, and to sustain and strengthen Canada's publicly funded health care system, in its report Ensuring Women's Health: Options for the Future of Canada's Health Care System. This Commentary brings to you the thoughts that the SOGC will continue to forward after the Romanow Commission's report is delivered next month. PMID:12399808

Lalonde, André B

2002-10-01

489

Health Facilities for Primary Eye Care in Sultanate of Oman  

PubMed Central

Objective: Endeavor to improve (i) the quality of Primary Eye Care with the aid of an Eye Health Care Programme and (ii) the resourcing Primary Eye Care in Ministry of Health Institutions in 2001. Method: In this descriptive study, staff were randomly selected from 84 health institutions and representing 136 primary health institutions to carry out quality assurance procedures. Ophthalmologists trained in this evaluation were field staff who evaluated the resource status, such as health staff, space for eye care delivery, instruments, materials for health education, referring cases (for continuous medical education of the primary health staff), drugs for eye care, etc., in each health institution. In addition to availability, the standards of eye care delivery were also estimated. Results: The health institutes of Oman have adequate resources for Primary Eye Care. Additional requirement of ophthalmic loupes and medicaments would further improve Primary Eye Care in Oman. Conclusion: It is recommended that such a review of the health care programme and its resources and quality be periodically conducted as a part of a system of quality assurance in primary health care. PMID:21748123

Khandekar, Rajiv; Mohammed, Ali J

2006-01-01

490

Issues in Health Care of Middle Eastern Patients  

PubMed Central

Relationships between Middle Eastern patients and Western health care professionals are often troubled by mutual misunderstanding of culturally influenced values and communication styles. Although Middle Easterners vary ethnically, they do share a core of common values and behavior that include the importance of affiliation and family, time and space orientations, interactional style and attitudes toward health and illness. Problems in providing health care involve obtaining adequate information, “demanding behavior” by a patient's family, conflicting beliefs about planning ahead and differing patterns of communicating grave diagnoses or “bad news.” There are guidelines that will provide an understanding of the cultural characteristics of Middle Easterners and, therefore, will improve rather than impede their health care. A personal approach and continuity of care by the same health care professional help to bridge the gap between Middle Eastern cultures and Western medical culture. In addition, periodic use of cultural interpreters helps ameliorate the intensity of some cultural issues. PMID:6364575

Lipson, Juliene G.; Meleis, Afaf I.

1983-01-01

491

The use of socially assistive robots for dementia care.  

PubMed

Innovative solutions for dementia care are required to address the steady rise in adults living with dementia, lack of adequate staffing to provide high-quality dementia care, and the need for family caregivers to provide care for their loved ones in the home. This article provides an overview of the use of socially assistive robots (SARs) to offer support as therapists, companions, and educators for people living with dementia. Social, ethical, and legal challenges associated with the use of robotic technology in patient care and implications for the use of SARs by nurses are discussed. These items considered, the authors conclude that SARs should be considered as a viable way to assist people living with dementia to maintain their highest possible level of independence, enhance their quality of life, and provide support to overburdened family caregivers. Further research is needed to evaluate the merits of this technological approach in the care of adults with dementia. PMID:22998095

Huschilt, Julie; Clune, Laurie

2012-10-01

492

Infant Group Care Risks.  

ERIC Educational Resources Information Center

Children under 3 years of age who are in group care face special health risks. The U.S. Centers for Disease Control indicate the existence of a causal relationship between infant group day care and certain diseases that are spread through contact at day care centers. Children in group care who are still in diapers are especially vulnerable to…

Kendall, Earline D.

493

Caring for the Caregiver  

Cancer.gov

Caring for the Caregiver “You need to learn ways to take care of yourself. Because if you’re not taking care of yourself, you can’t take care of anyone else. Don’t be afraid to ask questions. Don’t be afraid to ask for help.” —Jane Inside This Booklet Who Is a Caregiver?

494

Caring Communities in Germany  

ERIC Educational Resources Information Center

"Caring communities" is a great sounding line, but what does it really mean? There are many ways that communities which present themselves as caring make life easier or worse for those who live there. For centuries in Germany, there have been religious groups who claim to care for each member. By definition, this is circumscribed caring as it…

Kreisle, Beate

2012-01-01

495

Health care informatics  

Microsoft Academic Search

The health care industry is currently experiencing a fundamental change. Health care organizations are reorganizing their processes to reduce costs, be more competitive, and provide better and more personalized customer care. This new business strategy requires health care organizations to implement new technologies, such as Internet applications, enterprise systems, and mobile technologies in order to achieve their desired business changes.

Keng Siau

2003-01-01

496

THE INVERSE CARE LAW  

Microsoft Academic Search

care tends to vary inversely with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced. The market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exag-

JULIAN TUDOR HART

497

For Health Care Providers  

Cancer.gov

For Health Care Providers Training Categories Palliative Care Clinical Trials Translational Research Palliative Care Education in Palliative and End-of-Life Care For Oncology (EPEC™-O )Format: Web-based self-study, 3 plenary sessions and 15 content

498

Managed Care Plans: Getting Good Care for Your Child  

MedlinePLUS

... Good Care for Your Child Family Life Listen Managed Care Plans: Getting Good Care for Your Child Article Body Many Americans receive their health care in managed care plans. These plans, typically offered by employers and ...

499

Pediatric Palliative Care  

PubMed Central

Pediatric palliative care provides benefit to children living with life-threatening or terminal conditions. Palliative care should be available to all seriously ill children. Palliative care includes the treatment of symptoms such as pain, nausea, dyspnea, constipation, anorexia, and sialorrhea. This care can occur in a variety of settings, from home to hospice to hospital, and must include bereavement care and follow up after the death of a child. There are many challenges in pediatric palliative care, but continued research into this important area of pediatrics will lead to improvements in the care of children with life-threatening illnesses. PMID:23118638

Johnston, Donna L.; Hentz, Tracy A.; Friedman, Debra L.

2005-01-01

500

The Leap of a Provincial SME into the Global Market Using E-commerce: The Success of Adequate Planning  

NASA Astrophysics Data System (ADS)

The leap into the global market is not easy when it involves a provincial family business. This article demonstrates how adequate planning is fundamental in a small and medium-sized enterprise (SME) with the tight budget they have available to them, in order to be able to differentiate themselves in a highly competitive market, taking into accounts the benefits and risks involved. The Information Technology (IT) tools put in place will give the necessary support and allow for the possibility of increasing and improving the infrastructure as the company requires. An adequate strategy for the future to increases sales would be e-marketing techniques as well as the current promotions which contribute to diffusing the brand.

Sainz de Abajo, Beatriz; García Salcines, Enrique; Burón Fernández, F. Javier; López Coronado, Miguel; de Castro Lozano, Carlos