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1

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

Code of Federal Regulations, 2014 CFR

... false Ensuring that the salvors and marine firefighters are adequate. 155.4050...REGULATIONS FOR VESSELS Salvage and Marine Firefighting § 155.4050 Ensuring that the salvors and marine firefighters are adequate....

2014-07-01

2

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

Code of Federal Regulations, 2013 CFR

... false Ensuring that the salvors and marine firefighters are adequate. 155.4050...REGULATIONS FOR VESSELS Salvage and Marine Firefighting § 155.4050 Ensuring that the salvors and marine firefighters are adequate....

2013-07-01

3

ENSURING ADEQUATE SAFETY WHEN USING HYDROGEN AS A FUEL  

SciTech Connect

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

Coutts, D

2007-01-22

4

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

5

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

PubMed

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

Liu, Tsai-Ching; Chen, Chin-Shyan

2004-01-01

6

Role of primary health care in ensuring access to medicines.  

PubMed

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

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

2010-06-01

7

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

8

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2010 CFR

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

2010-01-01

9

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2014 CFR

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

2014-01-01

10

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

Code of Federal Regulations, 2013 CFR

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

2013-01-01

11

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

Code of Federal Regulations, 2012 CFR

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

2012-01-01

12

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

Code of Federal Regulations, 2014 CFR

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

2014-01-01

13

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

Code of Federal Regulations, 2010 CFR

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

2010-01-01

14

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2011 CFR

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

2011-01-01

15

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2012 CFR

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

2012-01-01

16

9 CFR 2.33 - Attending veterinarian and adequate veterinary care.  

Code of Federal Regulations, 2013 CFR

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

2013-01-01

17

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

Code of Federal Regulations, 2011 CFR

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

2011-01-01

18

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

19

Individual and contextual determinants of adequate maternal health care services in kenya.  

PubMed

This study aimed to examine individual and community level factors associated with adequate use of maternal antenatal health services in Kenya. Individual and community level factors associated with adequate use of maternal health care (MHC) services were obtained from the 2008-09 Kenya Demographic and Health Survey data set. Multilevel partial-proportional odds logit models were fitted using STATA 13.0 to quantify the relations of the selected covariates to adequate MHC use, defined as a three-category ordinal variable. The sample consisted of 3,621 women who had at least one live birth in the five-year period preceding this survey. Only 18 percent of the women had adequate use of MHC services. Greater educational attainment by the woman or her partner, higher socioeconomic status, access to medical insurance coverage, and greater media exposure were the individual-level factors associated with adequate use of MHC services. Greater community ethnic diversity, higher community-level socioeconomic status, and greater community-level health facility deliveries were the contextual-level factors associated with adequate use of MHC. To improve the use of MHC services in Kenya, the government needs to design and implement programs that target underlying individual and community level factors, providing focused and sustained health education to promote the use of antenatal, delivery, and postnatal care. PMID:25774561

Achia, Thomas N O; Mageto, Lillian E

2015-01-01

20

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.

21

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

PubMed

Attempts to improve patient care, its increasing cost and the aggressive malpractice environment have highlighted the need for standards of professional accountability. However, current measures of quality of care have mostly been met with skepticism by the medical community. These measures have been criticized for their uncertain validity and for focusing on secondary aspects of service that measure what is minimally acceptable. The objective of this essay is to review quality improvement methods that have been reported to be feasible, effective and acceptable by practicing physicians. The successful implementation of these methods seems to be related to their being nonintrusive, nonthreatening, and based on agreed upon standards of care. We believe that these three features are essential for a continuous quality improvement process in health care. PMID:10185317

Benbassat, J; Taragin, M

1998-01-01

22

Unbearable Pain: India's Obligation to Ensure Palliative Care  

NSDL National Science Digital Library

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

23

Regulation: An Imperative for Ensuring Quality Child Care. Working Paper Series.  

ERIC Educational Resources Information Center

The demand for quality child care services from low- and middle-income families continues to increase. Government regulation is one means to ensure a basic threshold of high-quality care; however, political support for effective, comprehensive regulation of child care is declining. For example, few states require licensing staff to possess a…

Gazan, Harold S.

24

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

NASA Technical Reports Server (NTRS)

This audit was initiated in response to a hotline complaint regarding the review, approval, and release of scientific and technical information (STI) at Johnson Space Center. The complainant alleged that Johnson personnel conducting export control reviews of STI were not fully qualified to conduct those reviews and that the reviews often did not occur until after the STI had been publicly released. NASA guidance requires that STI, defined as the results of basic and applied scientific, technical, and related engineering research and development, undergo certain reviews prior to being released outside of NASA or to audiences that include foreign nationals. The process includes technical, national security, export control, copyright, and trade secret (e.g., proprietary data) reviews. The review process was designed to preclude the inappropriate dissemination of sensitive information while ensuring that NASA complies with a requirement of the National Aeronautics and Space Act of 1958 (the Space Act)1 to provide for the widest practicable and appropriate dissemination of information resulting from NASA research activities. We focused our audit on evaluating the STI review process: specifically, determining whether the roles and responsibilities for the review, approval, and release of STI were adequately defined and documented in NASA and Center-level guidance and whether that guidance was effectively implemented at Goddard Space Flight Center, Johnson Space Center, Langley Research Center, and Marshall Space Flight Center. Johnson was included in the review because it was the source of the initial complaint, and Goddard, Langley, and Marshall were included because those Centers consistently produce significant amounts of STI.

2008-01-01

25

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

26

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

Microsoft Academic Search

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

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

2011-01-01

27

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

28

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

29

Palliative care nursing: Ensuring competent care at the end of life  

Microsoft Academic Search

Major advances in enabling function and symptom management have occurred in the past decade. Older adults who would have been bed-bound at the end of life now can be offered interventions to help them live well until they die. People who once would have suffered from pain can expect to be kept comfortable with aggressive symptom management. Palliative care nursing

Marianne L. Matzo; Deborah Witt Sherman

2001-01-01

30

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

31

Public Health Implications for Adequate Transitional Care for HIV-Infected Prisoners: Five Essential Components  

PubMed Central

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

Spaulding, Anne C.; Meyer, Jaimie P.; Altice, Frederick L.

2011-01-01

32

Using statistical process control chart techniques to ensure quality of care in pharmacy department of a hospital  

Microsoft Academic Search

To ensure high quality pharmaceutical care in a 1200-bed teaching hospital in southern Taiwan, patient- centered performance indicators, developed based on medication-use indicators, and pharmacy operational indicators were routinely monitored using sequential detection analysis of control charts. A sequential control chart approach was proposed to automatically inspect the outliers at the last time point and email each responsible pharmacist their

T. W. Chien; Agnes L. F. Chan; Henry W. C. Leung

2011-01-01

33

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

ERIC Educational Resources Information Center

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

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

2006-01-01

34

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

ERIC Educational Resources Information Center

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

Williams, Charles A.

2011-01-01

35

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.

36

A New Approach to Ensuring Oral Health Care for People Living With HIV/AIDS: The Dental Case Manager  

PubMed Central

Introduction The American Dental Association has identified several barriers to adequate dental care for vulnerable populations, including appropriate case management. The objective of this study was to examine the perceptions, attitudes, and beliefs of dental patients living with HIV/AIDS on the role and value of the dental case manager (DCM) and the effect of DCM services on their oral or overall health. Methods We used a qualitative descriptive study design and focus groups. Twenty-five people who had received DCM services on Cape Cod, Massachusetts, attended 1 of 5 focus groups in 2009 and 2010. Digital recordings of the groups were transcribed verbatim. Textual data were categorized using directed qualitative content analysis techniques. We identified major themes and representative quotes. Results The following themes emerged from discussions on the DCM’s role: being available, knowledgeable about clients and insurance, and empathetic; increasing access; and providing comfort. Most participants credited their oral and overall health improvements to the DCM. All participants believed that the DCM was a valuable addition to the clinic and noted that other at-risk populations, including the elderly and developmentally disabled, likely would benefit from working with a DCM. Conclusion The addition of a DCM facilitated access to dental care among this sample of people living with HIV/AIDS, providing them with an advocate and resulting in self-reported improvements to oral and overall health. PMID:23098645

Cashman, Suzanne B.; McDonald, Anne; Graves, John R.

2012-01-01

37

[Significance of treatment and adequate care in dementia--including point of medical comments in health care insurance system for elderly people by doctors].  

PubMed

Dementia treatment is one of the most important in home medical care. Donepezil hydrochloride, a dementia treatment drug available in Japan, is a symptomatic therapy but alleviates memory, willingness and feeling disorders and significantly improves QOL. Family doctors will be required to diagnose Alzheimer disease (AD) but it is very difficult for general physician to diagnose AD. This is the reason that the authors devised the simple criteria for diagnosing AD. Meanwhile, recent data from a multi-center study of donepezil hydrochloride for mild cognitive impairment (MCI) conducted in the US suggest that donepezil hydrochloride is also as useful for MCI as for AD. This is considered to suggest the significance to start treatment for AD at the early stage. Care for demented patients is not only the improvement of the apparent dementia. Recent scientific study data may be directly connected to treatment. These days, not a few elderly patients with dementia attend "Day-care Service" and the data indicate that rehabilitations they have under "Day-care Service" are important and useful. It is considered that non-pharmacological treatment may also play an important role and necessary to accumulate evidences in the future. PMID:14708294

Urakami, Katsuya

2003-12-01

38

[Significance of treatment and adequate care in dementia--including point of medical comments in health care insurance system for elderly people by doctors].  

PubMed

Dementia treatment is one of the most important in home medical care. Donepezil hydrochloride, a dementia treatment drug available in Japan, is a symptomatic therapy but alleviates memory, willingness and feeling disorders and significantly improves QOL. Family doctors will be required to diagnose Alzheimer disease (AD) but it is very difficult for general physician to diagnose AD. This is the reason that the authors devised the simple criteria for diagnosing AD. Meanwhile, recent data from a multi-center study of donepezil hydrochloride for mild cognitive impairment (MCI) conducted in the US suggest that donepezil hydrochloride is also as useful for MCI as for AD. This is considered to suggest the significance to start treatment for AD at the early stage. Care for demented patients is not only the improvement of the apparent dementia. Recent scientific study data may be directly connected to treatment. These days, not a few elderly patients with dementia attend "Day care Service" and the data indicate that rehabilitations they have under "Day-care Service" are important and useful. It is considered that non pharmacological treatment may also play an important role and necessary to accumulate evidences in the future. PMID:15311761

Urakami, Katsuya

2003-12-01

39

Occupational health care in small and medium sized enterprises--How many doctors do we need and how do we ensure good care?  

PubMed

The translation of the framework directive 89/391/EEC (Council Directive 89/391/EEC) into national law aims at supplying occupational protection and health care to all employees of large, small, and medium-sized enterprises (SMEs) likewise, depending on assessed exposure. Prior incomplete protection of the German workforce with bias against the SMEs requires an assessment of quantitative and qualitative adequacy of present occupational health care practice and also of future needs. Therefore, the Federal Institute for Occupational Safety and Health of Germany initiated a study to evaluate the present state of occupational health care in 4 regions with different geographic and economic structure. Based on these data the future demand for adequately trained occupational physicians will be estimated by employing a statistical method that allows for including a large number of modifying variables (economic development, demographic change, etc.). Expected result of the applied technique are the estimated minimal and maximal number of occupational physicians that have to be trained to meet future demand. In the same study models of best practice will be identified and evaluated for general application. The project started in October 1997 and will be finished by January 2000. PMID:10657929

Froneberg, B; Wienhold, L; Glomm, D

1999-01-01

40

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

PubMed Central

Background Buruli ulcer is an infectious disease involving the skin, caused by Mycobacterium ulcerans. Its exact transmission mechanism remains unknown. Several arguments indicate a possible role for insects in its transmission. A previous case-control study in the Nyong valley region in central Cameroon showed an unexpected association between bed net use and protection against Buruli ulcer. We investigated whether this association persisted in a newly discovered endemic Buruli ulcer focus in Bankim, northwestern Cameroon. Methodology/Principal Findings We conducted a case-control study on 77 Buruli ulcer cases and 153 age-, gender- and village-matched controls. Participants were interviewed about their activities and habits. Multivariate conditional logistic regression analysis identified systematic use of a bed net (Odds-Ratio (OR)?=?0.4, 95% Confidence Interval [95%CI]?=?[0.2–0.9], p-value (p)?=?0.04), cleansing wounds with soap (OR [95%CI]?=?0.1 [0.03–0.3], p<0.0001) and growing cassava (OR [95%CI]?=?0.3 [0.2–0.7], p?=?0.005) as independent protective factors. Independent risk factors were bathing in the Mbam River (OR [95%CI]?=?6.9 [1.4–35], p?=?0.02) and reporting scratch lesions after insect bites (OR [95%CI]?=?2.7 [1.4–5.4], p?=?0.004). The proportion of cases that could be prevented by systematic bed net use was 32%, and by adequate wound care was 34%. Conclusions/Significance Our study confirms that two previously identified factors, adequate wound care and bed net use, significantly decreased the risk of Buruli ulcer. These associations withstand generalization to different geographic, climatic and epidemiologic settings. Involvement of insects in the household environment, and the relationship between wound hygiene and M. ulcerans infection should now be investigated. PMID:22087346

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

2011-01-01

41

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

42

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

PubMed

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

Premji, Shahirose S

2005-01-01

43

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.

44

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

45

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

46

76 FR 2290 - TRICARE; Reimbursement for Travel for Specialty Care Under Exceptional Circumstances  

Federal Register 2010, 2011, 2012, 2013, 2014

...of specialty providers for which these reasonable travel expenses shall be allowed. For members, and families, enrolled in TPR the Director shall ensure that adequate coordination of care and travel benefits is provided to [[Page 2291

2011-01-13

47

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

48

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

PubMed

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

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

2012-02-01

49

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

PubMed Central

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

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

2011-01-01

50

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 Central

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

51

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

E-print Network

and species), provide a citation, catalog number and/or clone number, supplementary information or reference live vertebrates, include a statement of compliance with ethical regulations and identify the committee

Cai, Long

52

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

Code of Federal Regulations, 2012 CFR

...experience to work in the specific regional geographic environment(s) that the vessel operates in (e.g., bottom type, water turbidity, water depth, sea state and temperature extremes). (13) Resource provider has the logistical and...

2012-07-01

53

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

Code of Federal Regulations, 2011 CFR

...experience to work in the specific regional geographic environment(s) that the vessel operates in (e.g., bottom type, water turbidity, water depth, sea state and temperature extremes). (13) Resource provider has the logistical and...

2011-07-01

54

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

Code of Federal Regulations, 2010 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 equipment, and...

2010-07-01

55

Critical Care of the Newborn Calf Max Irsik DVM MAB  

E-print Network

Critical Care of the Newborn Calf Max Irsik DVM MAB Beef Cattle Extension Veterinarian University a essential control point for ensuring calf health and ranch income. With most calf loss occurring in the first few days' postpartum, adequate resuscitation of the newborn is critical to decreasing calf losses

Watson, Craig A.

56

Ensuring Academic Standards in US Higher Education  

ERIC Educational Resources Information Center

The most recent research on college-student learning in the US by respected scholars such as Richard Arum, Josipa Roksa, and Ernest Pascarella suggests that the nation's means of ensuring academic standards in US colleges and universities are not working effectively. Like US K-12 education and health care, the US higher education system is…

Dill, David D.

2014-01-01

57

Treatment of depression in a low-income primary care setting with co-located mental health care  

PubMed Central

Objective To characterize depression treatment-as-usual in a large primary care practice in the U.S. with co-located mental health care, and to examine predictors of receiving any treatment and receiving adequate treatment. Methods Primary care patients were systematically approached in waiting rooms. Those with a minimum level of depression symptoms (n = 91) were asked to participate in a study in which they completed assessments of mental health service use, depression symptoms, and related problems. Results In this setting with co-located mental health care, most patients with elevated depressive symptoms were receiving some type of mental health care, indicating they had been identified as depressed. However, only half were receiving “minimally adequate care.” Minority patients were less likely to receive any care. Patients who were more depressed, demonstrated poorer problem-solving ability, and had poorer physical health were more likely to receive any treatment and to receive minimally adequate treatment for depression. Conclusion Even in the context of co-located mental health care, there is still room for improving treatment of depressed patients. For some depressed patients, an important first step will be to ensure they are receiving minimally adequate care. However, others may need more intensive care, including combined treatments. PMID:19630457

Uebelacker, Lisa A.; Smith, Marcia; Lewis, Angelique W.; Sasaki, Ryan; Miller, Ivan W.

2010-01-01

58

Costs of Emergency Care  

MedlinePLUS

Costs of Emergency Care Fact Sheet Main Points Emergency care represents less than 2 percent of the ... must be adequately funded. Q. What are the costs of emergency care? The cost of providing emergency ...

59

Palliative Care  

MedlinePLUS

... patient will cope adequately with the rigors of therapy and maintain a satisfying level of physical and psychosocial functioning. For the dying patient, optimal palliative care addresses the traditional concerns of the hospice movement. Comfort for the ...

60

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

61

Tools for Ensuring Program Integrity.  

ERIC Educational Resources Information Center

This training document for financial assistance professionals discusses ensuring program integrity in student financial aid and describes some tools for ensuring internal and external program integrity. The training focuses on these tools and resources: (1) the Federal Student Aid (FSA) Schools Portal; (2) the Information for Financial Aid…

Office of Student Financial Assistance (ED), Washington, DC.

62

2013, . 28, . 1?? IS LANGRANGIAN FORMALISM ADEQUATELY  

E-print Network

2013, . 28, . 1­?? 000.000 IS LANGRANGIAN FORMALISM ADEQUATELY DESCRIBING ENERGY CONSERVATION? V. Kreinovich, O. Kosheleva In most physical theories, total energy is conserved. For example, when the kinetic energy of a particle decreases, the potential energy increases accord- ingly. For some physical

Kreinovich, Vladik

63

The Challenge for Child Care.  

ERIC Educational Resources Information Center

For many years there has been concern over the growing need for adequate and available child care in the United States. Given this concern, the question arises as to what is meant by "adequate child care." It is not enough that child care be available; it must also be adequate with respect to fulfilling the developmental needs of the children it…

Masters, Billie Nave

64

Genetic Modification of Preimplantation Embryos: Toward Adequate Human Research Policies  

PubMed Central

Citing advances in transgenic animal research and setbacks in human trials of somatic cell genetic interventions, some scientists and others want to begin planning for research involving the genetic modification of human embryos. Because this form of genetic modification could affect later-born children and their offspring, the protection of human subjects should be a priority in decisions about whether to proceed with such research. Yet because of gaps in existing federal policies, embryo modification proposals might not receive adequate scientific and ethical scrutiny. This article describes current policy shortcomings and recommends policy actions designed to ensure that the investigational genetic modification of embryos meets accepted standards for research on human subjects. PMID:15016248

Dresser, Rebecca

2004-01-01

65

Ensure a positive candidate experience  

Microsoft Academic Search

Many companies are failing to ensure a positive candidate experience during the recruitment process. This means potentially losing out on highly skilled people to competitors, as well as negatively affecting the employer brand.

Patrice Barbedette

2005-01-01

66

Status of pediatric eye care in India  

PubMed Central

Purpose: To document the status of pediatric eye care in India. Materials and Methods: A list of institutions providing eye care was compiled from various sources, including government officials, professional bodies of ophthalmologists, and national and international non-governmental organizations (NGO) working in the field of eye care in India. A questionnaire on eye care services was sent to all known eye care institutions in the country. Workshops and regional meetings were organized to maximize response. Validity of data was ensured by observational visits to 10% of the institutions who responded. Results: Out of 1204 institutions contacted, 668 (55.5%) responded to the questionnaire. Of these, 192 (28.7%) reported that they provided pediatric eye care services. A higher proportion (48.3%) of NGO hospitals reported separate pediatric ophthalmology units compared to other providers (P< 0.001). Eighty per cent of advanced care eye hospitals had dedicated outpatient, and 40% had dedicated inpatient facilities for children (P< 0.001). The advanced eye care hospitals attended to a larger number of pediatric clients (P < 0.001), and performed more pediatric eye surgeries compared to secondary and tertiary care hospitals (P < 0.001). Eighty- three per cent of advanced care centers and 72.4% of NGO hospitals had an anesthesiologist for pediatric eye service. Refractive error was the commonest reason for seeking service. The commonest surgical procedure was pediatric cataract surgery followed by squint surgery. Conclusion: Pediatric eye care services are not adequate in India. PMID:18974519

John, N; Gupta, S K; Vashist, P; Rao, G V

2008-01-01

67

Will residential aged care facilities meet long-term demand?  

Microsoft Academic Search

Purpose – This paper aims to provide an invaluable insight into long-term forecasting of demand for aged care facilities. This will ensure the provision of adequate supply by government bodies, stakeholders and developers in order to meet the anticipated level of demand, without creating an over-supply or an under-supply scenario. Design\\/methodology\\/approach – Using an innovative approach, different data sources were

Monika Csesko; Richard Reed

2009-01-01

68

Is Bohmian Mechanics an empirically adequate theory?  

E-print Network

Bohmian mechanics (BM) draws a picture of nature, which is completely different from that drawn by standard quantum mechanics (SQM): Particles are at any time at a definite position, and the universe evolves deterministically. Astonishingly, according to a proof by Bohm the empirical predictions of these two very different theories coincide. From the very beginning, BM has faced all kinds of criticism, most of which are either technical or philosophical. There is, however, a criticism first raised by Correggi and Morchio (2002) and recently strengthened by Kiukas and Werner (2010), which holds that, in spite of Bohm's proof, the predictions of BM do not agree with those of SQM in the case of local position measurements on entangled particles in a stationary state. Hence, given that SQM has been proven to be tremendously successful in the past, BM could most likely not be considered an empirically adequate theory. My aim is to resolve the conflict by showing that 1) it relies on hidden differences in the conceptual thinking, and that 2) the predictions of both theories approximately coincide if the process of measurement is adequately accounted for. My analysis makes no use of any sort of wavefunction collapse, refuting a widespread belief that an "effective collapse" is needed to reconcile BM with the predictions of SQM.

Kim Joris Boström

2015-03-01

69

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

70

[Adequate and inadequate trials in "clinical" pharmacology].  

PubMed

Our definition, based on 14 years of practical experience, is as follows: In clinical pharmacology, a procedure is adequate if it can be used in normal subjects in a non-invasive way and if it generates relevant information concerning pharmacotherapy in patients. Six examples are discussed in detail; the variable body weight may cause wide variations, for example, in absorption characteristics; unhomogeneous groups of subjects are likely to lead to poorly reproducible results. Body position and food intake (individual eating habits) may disguise drug effects by creating additional "noise". By titrating the heart rate during work load on the ergometer in order to achieve and maintain a target rate, individual differences in physical fitness and skill can be eliminated. Orthostatic regulation of cardiovascular variables may be impaired without concomitant psychic lability. The latter indicates predisposition to placebo responses, e.g. in studies using the standardized tourniquet pain model and mild analgesics. In normal subjects computer analysis of cerebral biosignals in combination with psychometric and behavioural tests usually gives more reliable information as compared to the patient pretreated with different drugs. PMID:7321659

Badian, M; Dagrosa, E; Rupp, W; Sittig, W

1981-01-01

71

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...

72

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

73

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

Microsoft Academic Search

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

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

1996-01-01

74

10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.  

Code of Federal Regulations, 2014 CFR

...2014-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate...

2014-01-01

75

10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.  

Code of Federal Regulations, 2012 CFR

...2012-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate...

2012-01-01

76

13 CFR 108.200 - Adequate capital for NMVC Companies.  

Code of Federal Regulations, 2010 CFR

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

2010-01-01

77

Long-term care coverage: the need is now.  

PubMed

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

Constable, J F; Wong, S A

1987-11-01

78

Improving access to health care in Latino communities.  

PubMed Central

Public debate about health care reform often focuses on the need for health insurance coverage, but in Latino communities many other barriers also inhibit access to medical care. In addition, basic public health services often go underfunded or ignored. Thus, health care reform efforts, nationally and in each State, must embrace a broader view of the issues if the needs of Latino communities are to be served. This report reviews and summarizes information about the mounting problems Latino communities face in gaining access to medical care. Access to appropriate medical care is reduced by numerous financial, structural, and institutional barriers. Financial barriers include the lack of health insurance coverage and low family incomes common in Latino communities. More than 7 million Latinos (39 percent) go without health insurance coverage. Latinos without health insurance receive about half as much medical care as those who are insured. Structurally, the delivery system organization rarely reflects the cultural or social concerns of the communities where they are located. Therefore, providers and patients fail to communicate their concerns adequately. These communication problems are exacerbated by the extreme shortage of Latino health care professionals and other resources available. Institutional barriers often reflect the failure to consider what it means to provide good service as well as high-quality medical care. Reducing these barriers to medical care requires modifying governmental and institutional policies, expanding the supply of competent providers, restructuring delivery system incentives to ensure primary care and public health services, and enhancing service and satisfaction with care. PMID:8416110

Valdez, R B; Giachello, A; Rodriguez-Trias, H; Gomez, P; de la Rocha, C

1993-01-01

79

On Adequate Comparisons of Antenna Phase Center Variations  

NASA Astrophysics Data System (ADS)

One important part for ensuring the high quality of the International GNSS Service's (IGS) products is the collection and publication of receiver - and satellite antenna phase center variations (PCV). The PCV are crucial for global and regional networks, since they introduce a global scale factor of up to 16ppb or changes in the height component with an amount of up to 10cm, respectively. Furthermore, antenna phase center variations are also important for precise orbit determination, navigation and positioning of mobile platforms, like e.g. the GOCE and GRACE gravity missions, or for the accurate Precise Point Positioning (PPP) processing. Using the EUREF Permanent Network (EPN), Baire et al. (2012) showed that individual PCV values have a significant impact on the geodetic positioning. The statements are further supported by studies of Steigenberger et al. (2013) where the impact of PCV for local-ties are analysed. Currently, there are five calibration institutions including the Institut für Erdmessung (IfE) contributing to the IGS PCV file. Different approaches like field calibrations and anechoic chamber measurements are in use. Additionally, the computation and parameterization of the PCV are completely different within the methods. Therefore, every new approach has to pass a benchmark test in order to ensure that variations of PCV values of an identical antenna obtained from different methods are as consistent as possible. Since the number of approaches to obtain these PCV values rises with the number of calibration institutions, there is the necessity for an adequate comparison concept, taking into account not only the numerical values but also stochastic information and computational issues of the determined PCVs. This is of special importance, since the majority of calibrated receiver antennas published by the IGS origin from absolute field calibrations based on the Hannover Concept, Wübbena et al. (2000). In this contribution, a concept for the adequate comparison as well as combination of PCV values will be presented. Since PCV corrections have to be applied in PPP Processing, the effect on the coordinate estimates have to be studied in detail to verify the consistent PCV modeling during the PPP processing and to quantify the impact on the coordinate domain also. Furthermore, due to the high correlation between station height, troposphere and receiver clock estimates, the impact on all estimated parameters has to be quantified. Since PPP is also frequently used for precise frequency comparison, the effect of PCV is of special interest in this field, too. References Baire Q, Pottiaux E, Bryninx C, Defraigne P, Aerts W, Legrand J, Bergeot N, Chevalier J (2012) Impact of different individual GNSS receiver antenna calibration models on geodetic positioning. EGU General Assembly 2012, #EGU2012-4963-1. Steigenberger P, Hugentobler U, Schmid R, Hessels U, Klügel T, Seitz M (2013) GPS-Specific Local Effects at the Geodetic Observatory Wettzell. In Reference Frames for Applications in Geosciences, IAG Symposia, 138: 125-130. Springer. Wübbena G, Schmitz M, Menge F, Böder V, Seeber G (2000). Automated Absolute Field Calibration of GPS Antennas in Real-Time. Proc. ION GPS 2000, pp 2512-2522.

Schoen, S.; Kersten, T.

2013-12-01

80

Barriers to nutritional care for the undernourished hospitalised older people†  

PubMed Central

Aims and objectives To identify what nurses experience as barriers to ensuring adequate nutritional care for the undernourished hospitalized elderly. Background Undernutrition occurs frequently among the hospitalised elderly and can result in a variety of negative consequences if not treated. Nevertheless, undernutrition is often unrecognised and undertreated. Nurses have a great responsibility for nutritional care, as this is part of the patient's basic needs. Exploring nurses' experiences of preventing and treating undernourishment among older patients in hospitals is therefore highly relevant. Design A focus group study was employed based on a hermeneutic phenomenological methodological approach. Methods Four focus group interviews with totally 16 nurses working in one large university hospital in Norway were conducted in spring 2012. The nurses were recruited from seven somatic wards, all with a high proportion of older (?70 years) inpatients. The data were analysed in the three interpretative contexts: self-understanding, a critical common-sense understanding and a theoretical understanding. Results We identified five themes that reflect barriers the nurses experience in relation to ensuring adequate nutritional care for the undernourished elderly: loneliness in nutritional care, a need for competence in nutritional care, low flexibility in food service practices, system failure in nutritional care and nutritional care is being ignored. Conclusions The results imply that nutritional care at the university hospital has its limits within the hospital structure and organisation, but also regarding the nurses' competence. Moreover, the barriers revealed that the undernourished elderly are not identified and treated properly as stipulated in the recommendations in the national guidelines on the prevention and treatment of undernutrition. Relevance to clinical practice The barriers revealed in this study are valuable when considering improvements to nutritional care practices on hospital wards to enable undernourished older inpatients to be identified and treated properly. PMID:24646060

Eide, Helene Dahl; Halvorsen, Kristin; Almendingen, Kari

2015-01-01

81

Ensuring the Power of Caring for One Child  

ERIC Educational Resources Information Center

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

Silva, Peggy

2006-01-01

82

HSQC-ADEQUATE: an investigation of data requirements.  

PubMed

Utilizing (13)C-(13)C connectivity networks for the assembly of carbon skeletons from HSQC-ADEQUATE spectra was recently reported. HSQC-ADEQUATE data retain the resonance multiplicity information of the multiplicity-edited GHSQC spectrum and afford a significant improvement in the signal-to-noise (s/n) ratio relative to the 1,1-ADEQUATE data used in the calculation of the HSQC-ADEQUATE spectrum by unsymmetrical indirect covariance (UIC) processing methods. The initial investigation into the computation of HSQC-ADEQUATE correlation plots utilized overnight acquisition of the 1,1-ADEQUATE data used for the calculation. In this communication, we report the results of an investigation of the reduction in acquisition time for the 1,1-ADEQUATE data to take advantage of the s/n gain during the UIC processing to afford the final HSQC-ADEQUATE correlation plot. Data acquisition times for the 1,1-ADEQUATE spectrum can be reduced to as little as a few hours, while retaining excellent s/n ratios and all responses contained in spectra computed from overnight data acquisitions. Concatenation of multiplicity-edited GHSQC and 1,1-ADEQUATE data also allows the interrogation of submilligram samples with 1,1-ADEQUATE data when using spectrometers equipped with 1.7-mm Micro CryoProbes ™. PMID:21452353

Martin, Gary E; Hilton, Bruce D; Willcott, M Robert; Blinov, Kirill A

2011-06-01

83

Is the quality of vision with contact lenses adequate? Not only adequate but often superior.  

PubMed

Two factors govern the quality of vision with contact lenses (CLs): the fit and movement of the lens and the adequacy of its optics. Studies have not demonstrated any inherent inadequacies in material or design parameters that might account for visual difficulties in lens wearers. To the contrary, thickness, water content, and fit can be varied within clinically acceptable ranges without compromising vision. A poorly fitted lens, however, can cause excessive corneal edema and consequent visual problems. Poor vision may also result from uncorrected refractive error, the development of an unstable optical surface, or the use of a lens material that is inherently inadequate for a given patient. Such causes of visual dysfunction can usually be avoided through better fitting, better lens care, more careful refraction, or better patient-lens matching. Specialized lens designs can sometimes be used to correct vision problems. Certain types of rigid front-surface aspheric lenses, for example, provide astigmats with even better visual correction than spherical rigid lenses or spectacles, but the improvement is small and highly patient dependent. Similarly, although soft toric lenses can provide good vision, it is often technically difficult to orient and stabilize the correcting cylinder. PMID:2189673

Carney, L G

1990-01-01

84

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

85

"Something Adequate"? In Memoriam Seamus Heaney, Sister Quinlan, Nirbhaya  

ERIC Educational Resources Information Center

Seamus Heaney talked of poetry's responsibility to represent the "bloody miracle", the "terrible beauty" of atrocity; to create "something adequate". This article asks, what is adequate to the burning and eating of a nun and the murderous gang rape and evisceration of a medical student? It considers Njabulo…

Parker, Jan

2014-01-01

86

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.

87

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

SciTech Connect

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

Not Available

1980-07-28

88

HMBC-1,1-ADEQUATE via generalized indirect covariance: a high sensitivity alternative to n,1-ADEQUATE.  

PubMed

1,1-ADEQUATE and the related long-range 1,n- and n,1-ADEQUATE variants were developed to provide an unequivocal means of establishing (2)J(CH) and the equivalent of (n)J(CH) correlations where n = 3,4. Whereas the 1,1- and 1,n-ADEQUATE experiments have two simultaneous evolution periods that refocus the chemical shift and afford net single quantum evolution for the carbon spins, the n,1-variant has a single evolution period that leaves the carbon spin to be observed at the double quantum frequency. The n,1-ADEQUATE experiment begins with an HMBC-type (n)J(CH) magnetization transfer, which leads to inherently lower sensitivity than the 1,1- and 1,n-ADEQUATE experiments that begin with a (1)J(CH) transfer. These attributes, in tandem, serve to render the n,1-ADEQUATE experiment less generally applicable and more difficult to interpret than the 1,n-ADEQUATE experiment, which can in principle afford the same structural information. Unsymmetrical and generalized indirect covariance processing methods can complement and enhance the structural information encoded in combinations of experiments e.g. HSQC-1,1- or -1,n-ADEQUATE. Another benefit is that covariance processing methods offer the possibility of mathematically combining a higher sensitivity 2D NMR spectrum with for example 1,1- or 1,n-ADEQUATE to improve access to the information content of lower sensitivity congeners. The covariance spectrum also provides a significant enhancement in the F(1) digital resolution. The combination of HMBC and 1,1-ADEQUATE spectra is shown here using strychnine as a model compound to derive structural information inherent to an n,1-ADEQUATE spectrum with higher sensitivity and in a more convenient to interpret single quantum presentation. PMID:22930548

Martin, Gary E; Williamson, R Thomas; Blinov, Kirill A; Anklin, Clemens G; Bermel, Wolfgang

2012-10-01

89

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– ...

90

Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program.  

PubMed

Stroke is a neurological emergency. The early administration of specific treatment improves the prognosis of the patients. Emergency care systems with early warning for the hospital regarding patients who are candidates for this treatment (stroke code) increases the number of patients treated. Currently, reperfusion via thrombolysis for ischemic stroke and attention in stroke units are the bases of treatment. Healthcare professionals and health provision authorities need to work together to organize systems that ensure continuous quality care for the patients during the whole process of their disease. To implement this, there needs to be an appropriate analysis of the requirements and resources with the objective of their adjustment for efficient use. It is necessary to provide adequate information and continuous training for all professionals who are involved in stroke care, including primary care physicians, extrahospital emergency teams and all physicians involved in the care of stroke patients within the hospital. The neurologist has the function of coordinating the protocols of intrahospital care. These organizational plans should also take into account the process beyond the acute phase, to ensure the appropriate application of measures of secondary prevention, rehabilitation, and chronic care of the patients that remain in a dependent state. We describe here the stroke care program in the Community of Madrid (Spain). PMID:19342844

Alonso de Leciñana-Cases, María; Gil-Núñez, Antonio; Díez-Tejedor, Exuperio

2009-01-01

91

Paying pharmacists for patient care  

PubMed Central

Background: Expansion of scope of practice and diminishing revenues from dispensing are requiring pharmacists to increasingly adopt clinical care services into their practices. Pharmacists must be able to receive payment in order for provision of clinical care to be sustainable. The objective of this study is to update a previous systematic review by identifying remunerated pharmacist clinical care programs worldwide and reporting on uptake and patient care outcomes observed as a result. Methods: Literature searches were performed in several databases, including MEDLINE, Embase and International Pharmaceutical Abstracts, for papers referencing remuneration, pharmacy and cognitive services. Searches of the grey literature and Internet were also conducted. Papers and programs were identified up to December 2012 and were included if they were not reported in our previous review. One author performed data abstraction, which was independently reviewed by a second author. All results are presented descriptively. Results: Sixty new remunerated programs were identified across Canada, the United States, Europe, Australia and New Zealand, ranging in complexity from emergency contraception counseling to minor ailments schemes and comprehensive medication management. In North America, the average fee provided for a medication review is $68.86 (all figures are given in Canadian dollars), with $23.37 offered for a follow-up visit and $15.16 for prescription adaptations. Time-dependent fees were reimbursed at $93.60 per hour on average. Few programs evaluated uptake and outcomes of these services but, when available, indicated slow uptake but improved chronic disease markers and cost savings. Discussion: Remuneration for pharmacists’ clinical care services is highly variable, with few programs reporting program outcomes. Programs and pharmacists are encouraged to examine the time required to perform these activities and the outcomes achieved to ensure that fees are adequate to sustain these patient care activities. PMID:25360148

Grindrod, Kelly A.; Chatterley, Trish; Tsuyuki, Ross T.

2014-01-01

92

34 CFR 200.14 - Components of Adequate Yearly Progress.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

93

Reforming health care in the Republic of Kazakstan.  

PubMed

Kazakstan, as in other former communist countries, is currently replacing the soviet system of health care financing for a model based on medical insurance. The main initial purpose has been to generate additional revenue for a sector suffering considerably from reductions in state funding induced by economic transition. Two key issues need to be addressed if the new system is to produce genuine reform. First, the rural areas have suffered disproportionately from the changes. There is an urgent need to adapt the existing system so that adequate funding goes to redress this imbalance. Second, although the fund has concentrated on raising revenue, it will only induce real reform if it begins to exercise its role as an independent purchaser of health care. There is a need for the future roles of both health ministry and insurance fund to be clearly defined to ensure that wide access to medical care is preserved. PMID:10175305

Ensor, T; Rittmann, J

1997-01-01

94

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

95

Ensuring the profitability of acquired physician practices.  

PubMed

Healthcare organizations are aggressively acquiring physician group practices to create primary care networks and broaden their managed care market penetration. However, few are realizing a positive return on investment after acquisition. The odds that acquired practices will be profitable can be improved if healthcare organizations plan carefully by establishing separate acquiring entities, setting clear goals for the practices, forming skilled management teams with strong physician leadership to manage the acquired practices, and carefully structuring their physician incentive compensation plans. PMID:10163897

Ortiz, J P

1997-01-01

96

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

97

Creative payment strategy helps ensure a future for teaching hospitals.  

PubMed

The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received. PMID:10187630

Vancil, D R; Shroyer, A L

1998-11-01

98

Impact of adequate empirical combination therapy on mortality from bacteremic Pseudomonas aeruginosa pneumonia  

PubMed Central

Background Pseudomonas aeruginosa has gained an increasing amount of attention in the treatment of patients with pneumonia. However, the benefit of empirical combination therapy for pneumonia remains unclear. We evaluated the effects of adequate empirical combination therapy and multidrug-resistance in bacteremic Pseudomonas pneumonia on the mortality. Methods A retrospective cohort study was performed at the 2,700-bed tertiary care university hospital. We reviewed the medical records of patients with bacteremic pneumonia between January 1997 and February 2011. Patients who received either inappropriate or appropriate empirical therapy were compared by using marginal structural model. Furthermore, we investigated the direct impact of combination therapy on clinical outcomes in patients with monomicrobial bacteremic pneumonia. Results Among 100 consecutive patients with bacteremic Pseudomonas pneumonia, 65 patients were classified in the adequate empirical therapy group, 32 of whom received monotherapy and 33 combination therapy. In the marginal structural model, only inadequate therapy was significantly associated with 28-day mortality (p?=?0.02), and multidrug-resistance was not a significant risk factor. To examine further the direct impact of combination therapy, we performed a subgroup analysis of the 65 patients who received adequate therapy. Multivariate logistic regression analysis identified absence of septic shock at the time of bacteremia (OR, 0.07; 95% CI, 0.01-0.49; p?=?0.008), and adequate combination therapy (OR, 0.05; 95% CI, 0.01-0.34; p?=?0.002) as variables independently associated with decreased all-cause 28-day mortality. Conclusions Our study suggests that adequate empirical combination therapy can decrease mortality in patients with bacteremic Pseudomonas pneumonia. PMID:23157735

2012-01-01

99

Exchange of experience on primary health care.  

PubMed

Objectives of the interregional Conference on Primary Health Care, organized by the World Health Organization (WHO) Regional Office for Southeast Asis together with the government of the Democratic People's Republic of Korea, were as follows: to exchange country experiences in the organization and implementation of primary health care; to assess primary health care development vis-a-vis national socioeconomic development and national health systems; to define alternative approaches to the development of the health infrastructure for inntegrated implementation of the 8 essential elements of primary health care; and to define the coordinating role of governments and international organizations in supporting and mobilizing resources in support of primary health care to to formulate recommendations for the organization and furthr development of primary care. The conference was attended by 35 participants from 18 countries in all 6 WHO regions and by representatives of 5 UN agencies. Conference recommendations include: a program of public information and health education should be launched to create and strengthen the desired awareness and commitment among the people and their representatives; the national health policy on primary health care should be broadly disseminated among all professional groups and functionaries involved in community development activities both in the health sector and outside it; concerted action by all health related development sectors should be initiated and strengthened to support the health sector in acheiving the goal of health for all; appropriate mechanisms relevant to the local situation should be evolved to give suitable training, orientation, and motivation to the community and opinion leaders in order to ensure their total involvement in the implementation and management of their own health care; governments should ensure the allocation of adequate funds for the smooth implementation of the program and that preferential allocation of resources be made for activities in the underserved areas; more rapid measures should be taken to extend primary health care services to all segments of the community that are still not covered; and the shortage of personnel available for providing primary care should be made up by reorienting existing personnel, accelerating the pace of basic training for primary health workers, and possibly also by inducting the health manpower available under traditional systems of medicine. PMID:6506669

1984-01-01

100

Understanding Your Adequate Yearly Progress (AYP), 2011-2012  

ERIC Educational Resources Information Center

The "No Child Left Behind Act (NCLB) of 2001" requires all schools, districts/local education agencies (LEAs) and states to show that students are making Adequate Yearly Progress (AYP). NCLB requires states to establish targets in the following ways: (1) Annual Proficiency Target; (2) Attendance/Graduation Rates; and (3) Participation Rates.…

Missouri Department of Elementary and Secondary Education, 2011

2011-01-01

101

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

102

Adequate Schools and Inadequate Education: An Anthropological Perspective.  

ERIC Educational Resources Information Center

To illustrate his claim that schools generally do a remarkably good job of schooling while the society makes inadequate use of other means to educate young people, the author presents a case history of a young American (identified pseudonymously as "Brad") whose schooling was adequate but whose education was not. Brad, jobless and homeless,…

Wolcott, Harry F.

103

Do Beginning Teachers Receive Adequate Support from Their Headteachers?  

ERIC Educational Resources Information Center

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

Menon, Maria Eliophotou

2012-01-01

104

Child welfare research: How adequate are the data?  

Microsoft Academic Search

This paper provides an overview of recent efforts to improve data collection on the child welfare population, with particular emphasis on measuring outcomes for children at risk of abuse or neglect and at risk of placement, as well as children in foster care, kinship care, and adoption. Although a great deal of progress has been made in improving the data

Jane Waldfogel

2000-01-01

105

Health care for older persons in Switzerland: a country profile.  

PubMed

Switzerland has the second-most-expensive healthcare system worldwide, with 11.5% of gross domestic product spent on health care in 2003. Switzerland has a healthcare system with universal insurance coverage and a social insurance system, ensuring an adequate financial situation for 96% of the 1.1 million older inhabitants. Key concerns related to the care of older persons are topics such as increasing healthcare costs, growing public awareness of patient autonomy, and challenges related to assisted suicide. In 2004, the Swiss Academy of Medical Sciences issued guidelines for the care of disabled older persons. Since 2000, geriatrics has been a board-certified discipline with a 3-year training program in addition to 5 years of training in internal or family medicine. There are approximately 125 certified geriatricians in Switzerland, working primarily in geriatric centers in urban areas. Switzerland has an excellent research environment, ranking second of all countries worldwide in life sciences research-but only 13th in aging research. This is in part due to a lack of specific training programs promoting research on aging and inadequate funding. In addition, there is a shortage of academic geriatricians in Switzerland, in part due to the fact that two of five Swiss universities had no academic geriatric departments in 2005. With more-adequate financial resources for academic geriatrics, Switzerland would have the opportunity to contribute more to aging research internationally and to improved care for older patients. PMID:16776797

Schoenenberger, Andreas W; Stuck, Andreas E

2006-06-01

106

Do national drug control laws ensure the availability of opioids for medical and scientific purposes?  

PubMed Central

Abstract Objective To determine whether national drug control laws ensure that opioid drugs are available for medical and scientific purposes, as intended by the 1972 Protocol amendment to the 1961 Single Convention on Narcotic Drugs. Methods The authors examined whether the text of a convenience sample of drug laws from 15 countries: (i) acknowledged that opioid drugs are indispensable for the relief of pain and suffering; (ii) recognized that government was responsible for ensuring the adequate provision of such drugs for medical and scientific purposes; (iii) designated an administrative body for implementing international drug control conventions; and (iv) acknowledged a government’s intention to implement international conventions, including the Single Convention. Findings Most national laws were found not to contain measures that ensured adequate provision of opioid drugs for medical and scientific purposes. Moreover, the model legislation provided by the United Nations Office on Drugs and Crime did not establish an obligation on national governments to ensure the availability of these drugs for medical use. Conclusion To achieve consistency with the Single Convention, as well as with associated resolutions and recommendations of international bodies, national drug control laws and model policies should be updated to include measures that ensure drug availability to balance the restrictions imposed by the existing drug control measures needed to prevent the diversion and nonmedical use of such drugs. PMID:24623904

Brown, Marty Skemp; Maurer, Martha A

2014-01-01

107

Ensuring Racial, Cultural Harmony in the School.  

ERIC Educational Resources Information Center

Principals must ensure that school climate promotes acceptance of all races and cultures and discourages racial slurs, jokes, and other acts of bias and discrimination. An Ontario (Canada) school district has developed a comprehensive race relations policy governing six areas: incidents of expressed bias and discrimination, student assessment and…

Leake, Donald

1993-01-01

108

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

109

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...

110

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.

111

Ensuring system security through formal software evaluation  

SciTech Connect

With the increasing use of computer systems and networks to process safeguards information in nuclear facilities, the issue of system and data integrity is receiving worldwide attention. Among the many considerations are validation that the software performs as intended and that the information is adequately protected. Such validations are often requested of the Safeguards Systems Group of the Los Alamos National Laboratory. This paper describes our methodology for performing these software evaluations.

Howell, J A; Fuyat, C [Los Alamos National Lab., NM (United States)] [Los Alamos National Lab., NM (United States); Elvy, M [Marble Associates, Boston, MA (United States)] [Marble Associates, Boston, MA (United States)

1992-01-01

112

Carrier screening in preconception consultation in primary care.  

PubMed

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

Metcalfe, Sylvia A

2012-07-01

113

Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology  

NASA Technical Reports Server (NTRS)

Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapid Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, testing planned in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing. 1

Chullen, Cinda; Conger, Bruce

2012-01-01

114

Will the new Australian health privacy law provide adequate protection?  

PubMed

Amendments to the original Privacy Act (1988) come at a key point in time, as a national medical record system looms on the Australian horizon. Changes to The Privacy Act have the potential to define a level of information privacy prior to the implementation of such a system. We have therefore collected expert opinions on the ability of the Health Privacy Guidelines (enacted in December 2001 under The Privacy Act and hereafter more specifically known as Health Privacy Legislation) to ensure the privacy and security of patient information. We conclude that the legislation is flawed in its capacity to withstand an increasingly corporatised health sector. Deficiencies in consent requirements, together with feeble enforcement capabilities, mean The Legislation cannot effectively ensure that personally identifiable information will not end up in corporate third party hands. To significantly bolster the new legislation, we argue that it should be supplemented with explicit health data legislation and privacy auditing. PMID:12136555

Bomba, David; Hallit, George

2002-01-01

115

Quality of Informal Care Is Multidimensional  

PubMed Central

Purpose To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are satisfied on a routine basis. Potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are conceptually distinct dimensions of quality of care. We investigated the extent to which these three dimensions also are empirically distinguishable. Design 237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of depressed affect, life events, cognitive status, and perceived pre-illness relationship quality. Results Confirmatory factor analyses indicated that PHB, adequate care, and EC are empirically distinct factors. Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing further evidence for the distinction between the measures of quality of care used in this study. Conclusions Assessing quality of informal care is a complex endeavor. ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care. PMID:19469607

Christie, Juliette; Smith, G. Rush; Williamson, Gail M.; Lance, Charles. E.; Shovali, Tamar E.; Silva, Luciana

2010-01-01

116

Ensuring Fiscal Sustainability in G-7 Countries  

Microsoft Academic Search

Rising longevity, falling fertility rates, and the retirement of the baby boom generation will substantially raise age-related government spending in most advanced and many emerging market countries. This paper assesses the evolution of fiscal sustainability for each of the G-7 countries using two standard primary gap indicators. The estimated fiscal adjustment required to ensure long-run fiscal sustainability is substantial for

Daniel Leigh; David Hauner; Michael Skaarup

2007-01-01

117

Supporting Temporal Information in Medical Care Planning  

E-print Network

Supporting Temporal Information in Medical Care Planning Kirsty Bradbrook & Graham Winstanley Computational Intelligence Group, University of Brighton Brighton, UK Abstract The problems associated realised that support tools are invaluable in ensuring quality and consistency of care in a domain

Winstanley, Graham

118

Quantifying dose to the reconstructed breast: Can we adequately treat?  

SciTech Connect

To evaluate how immediate reconstruction (IR) impacts postmastectomy radiotherapy (PMRT) dose distributions to the reconstructed breast (RB), internal mammary nodes (IMN), heart, and lungs using quantifiable dosimetric end points. 3D conformal plans were developed for 20 IR patients, 10 autologous reconstruction (AR), and 10 expander-implant (EI) reconstruction. For each reconstruction type, 5 right- and 5 left-sided reconstructions were selected. Two plans were created for each patient, 1 with RB coverage alone and 1 with RB + IMN coverage. Left-sided EI plans without IMN coverage had higher heart Dmean than left-sided AR plans (2.97 and 0.84 Gy, p = 0.03). Otherwise, results did not vary by reconstruction type and all remaining metrics were evaluated using a combined AR and EI dataset. RB coverage was adequate regardless of laterality or IMN coverage (Dmean 50.61 Gy, D95 45.76 Gy). When included, IMN Dmean and D95 were 49.57 and 40.96 Gy, respectively. Mean heart doses increased with left-sided treatment plans and IMN inclusion. Right-sided treatment plans and IMN inclusion increased mean lung V{sub 20}. Using standard field arrangements and 3D planning, we observed excellent coverage of the RB and IMN, regardless of laterality or reconstruction type. Our results demonstrate that adequate doses can be delivered to the RB with or without IMN coverage.

Chung, Eugene; Marsh, Robin B.; Griffith, Kent A.; Moran, Jean M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Pierce, Lori J., E-mail: ljpierce@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

2013-04-01

119

Drinking Water in Schools and Child Care Facilities  

MedlinePLUS

... Drinking Water in 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 ...

120

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

Microsoft Academic Search

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

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

2006-01-01

121

Control Measures: Engineering: Ensure Ventilation is  

E-print Network

with human skin can cause severe damage to living tissue. Damage occurs within seconds with only a br on skin immediate medical attention is required. Any covering or clothing that may restrict circulation should be removed carefully, taking caution not to peel off skin. Any material which has frozen

Jia, Songtao

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

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

124

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

125

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

126

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

127

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

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

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

130

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

131

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 ...

132

Phase-adequate engagement at the post-school transition.  

PubMed

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

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

2012-11-01

133

Literacy in the World of the Aged Care Worker.  

ERIC Educational Resources Information Center

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

Wyse, Linda; Casarotto, Nadia

134

Anxiety in primary care  

Microsoft Academic Search

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

Kristen Hope Demertzis; Michelle G. Craske

2006-01-01

135

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

PubMed Central

Objectives. We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services. Methods. Patients were recruited from the Continuous Improvement for Veterans in Care–Mood Disorders study. We used multivariable logistic regression analyses to assess whether predisposing (demographic characteristics), enabling (e.g., homelessness), or need (bipolar symptoms, substance abuse) factors were associated with difficulties in obtaining care, difficulties in locating specialty providers, and forgoing care because of cost. Results. Patients reported greater difficulty in accessing general medical services than in accessing psychiatric care. Individuals experiencing bipolar symptoms more frequently avoided psychiatric care because of cost (odds ratio [OR] = 2.43) and perceived greater difficulties in accessing medical specialists (OR = 2.06). Homeless individuals were more likely to report hospitalization barriers, whereas older and minority patients generally encountered fewer problems accessing treatment. Conclusions. Need and enabling factors were most influential in predicting self-reported difficulties in accessing care, subsequently interfering with treatment dynamics and jeopardizing clinical outcomes. Efforts in the Department of Veterans Affairs to expand mental health care access should be coupled with efforts to ensure adequate access to general medical services among patients with chronic mental illnesses. PMID:19150912

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

2009-01-01

136

[Hospice Palliative Care is a Universal Value and the Essence of Nursing].  

PubMed

This article uses four examples to illustrate the recent rise of hospice palliative care as a universal value. These examples include the story of Dame Cecily Saunders, the pioneer of the palliative care movement in the U.K.; the national healthcare plan currently promoted by United States' President Obama; a survey on the topic of quality of death in 40 countries conducted by the Lien Foundation (Singapore); and the story of the Hospice Movement in Taiwan. This article further describes how hospice palliative care has changed the healthcare culture and presents the World Health Organization's definition of palliative care and the implications of this definition. Additionally, this article identifies the common palliative-care mistakes that have been made by the general public and by healthcare workers. Healthcare professionals must acquire essential relevant knowledge and skills in order to ensure that hospice palliative care addresses the needs of terminally ill patients adequately. Finally, the author describes a novel approach to instilling proper palliative-care concepts and practices that is entitled Life, Peace, Care, and Honor (LPCH or the "3344" concept). PMID:25854942

Chao, Co-Shi Chantal

2015-04-01

137

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

PubMed Central

Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP) health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI). Large proportion of informal sector labor in India's workforce prevents major upscaling of social health insurance (SHI). Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS), with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete. PMID:23112438

Prinja, Shankar; Kaur, Manmeet; Kumar, Rajesh

2012-01-01

138

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

PubMed Central

Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery. PMID:22013991

2011-01-01

139

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

140

Ensuring Social Sustainability: Can Bhutan's Education System Ensure Intergenerational Transmission of Values?  

E-print Network

, in the master servant relationship, the master is obliged to ensure the welfare of his servant. The servant is in turn expected to serve his master with dedication. Such pairing of relationships ensure stability and predictability in the social context... .7 Similarly, the pressure arising from work and the distractions in the urban areas also weaken the bond between the parent and the child. Young children are often left with their nannies when they are young and in front of the television sets at a...

Wangyal, Tashi

2001-01-01

141

Maintaining Adequate Carbon Dioxide Washout for an Advanced Extravehicular Mobility Unit  

NASA Technical Reports Server (NTRS)

Over the past several years, NASA has realized tremendous progress in technology development that is aimed at the production of an Advanced Extravehicular Mobility Unit (AEMU). Of the many functions provided by the spacesuit and portable life support subsystem within the AEMU, delivering breathing gas to the astronaut along with removing the carbon dioxide (CO2) remains one of the most important environmental functions that the AEMU can control. Carbon dioxide washout is the capability of the ventilation flow in the spacesuit helmet to provide low concentrations of CO2 to the crew member to meet breathing requirements. CO2 washout performance is a critical parameter needed to ensure proper and sufficient designs in a spacesuit and in vehicle applications such as sleep stations and hygiene compartments. Human testing to fully evaluate and validate CO2 washout performance is necessary but also expensive due to the levied safety requirements. Moreover, correlation of math models becomes challenging because of human variability and movement. To supplement human CO2 washout testing, a breathing capability will be integrated into a suited manikin test apparatus to provide a safe, lower cost, stable, easily modeled alternative to human testing. Additionally, this configuration provides NASA Johnson Space Center (JSC) the capability to evaluate CO2 washout under off-nominal conditions that would otherwise be unsafe for human testing or difficult due to fatigue of a test subject. Testing has been under way in-house at JSC and analysis has been initiated to evaluate whether the technology provides sufficient performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an extravehicular activity. This paper will review recent CO2 washout testing and analysis activities, testing planned in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing.

Chullen, Cinda; Navarro, Moses; Conger, Bruce; Korona, Adam; McMillin, Summer; Norcross, Jason; Swickrath, Mike

2013-01-01

142

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

143

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

144

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

145

Dose Limits for Man do not Adequately Protect the Ecosystem  

SciTech Connect

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

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

2004-08-01

146

System and Patient Barriers to Appropriate HIV Care for Disadvantaged Populations: The HIV Medical Care Provider Perspective  

Microsoft Academic Search

Little is known about the perception of system and patient barriers to adequate HIV care by an essential resource in the provision of HIV care, HIV medical care providers. To evaluate such perceptions, be- tween November 2000 and June 2001 a survey was mailed to 526 HIV medical care providers who cared for HIV-infected individuals in Atlanta, Baltimore, Los Angeles,

Eduardo E. Valverde; Drenna Waldrop-Valverde; Pamela Anderson-Mahoney; Anita M. Loughlin; Carlos Del Rio; Lisa Metsch; Lytt I. Gardner

2006-01-01

147

Are minidisc recorders adequate for the study of respiratory sounds?  

PubMed

Digital audio tape (DAT) recorders have become the de facto gold standard recording devices for lung sounds. Sound recorded on DAT is compact-disk (CD) quality with adequate sensitivity from below 20 Hz to above 20 KHz. However, DAT recorders have drawbacks. Although small, they are relatively heavy, the recording mechanism is complex and delicate, and finding one desired track out of many is inconvenient. A more recent development in portable recording devices is the minidisc (MD) recorder. These recorders are widely available, inexpensive, small and light, rugged, mechanically simple, and record digital data in tracks that may be named and accessed directly. Minidiscs hold as much recorded sound as a compact disk but in about 1/5 of the recordable area. The data compression is achieved by use of a technique known as adaptive transform acoustic coding for minidisc (ATRAC). This coding technique makes decisions about what components of the sound would not be heard by a human listener and discards the digital information that represents these sounds. Most of this compression takes place on sounds above 5.5 KHz. As the intended use of these recorders is the storage and reproduction of music, it is unknown whether ATRAC will discard or distort significant portions of typical lung sound signals. We determined the suitability of MD recorders for respiratory sound research by comparing a variety of normal and pathologic lung sounds that were digitized directly into a computer and also after recording by a DAT recorder and 2 different MD recorders (Sharp and Sony). We found that the frequency spectra and waveforms of respiratory sounds were not distorted in any important way by recording on the two MD recorders tested. PMID:12053867

Kraman, Steve S; Wodicka, George R; Kiyokawa, Hiroshi; Pasterkamp, Hans

2002-01-01

148

Are Vancomycin Trough Concentrations Adequate for Optimal Dosing?  

PubMed Central

The current vancomycin therapeutic guidelines recommend the use of only trough concentrations to manage the dosing of adults with Staphylococcus aureus infections. Both vancomycin efficacy and toxicity are likely to be related to the area under the plasma concentration-time curve (AUC). We assembled richly sampled vancomycin pharmacokinetic data from three studies comprising 47 adults with various levels of renal function. With Pmetrics, the nonparametric population modeling package for R, we compared AUCs estimated from models derived from trough-only and peak-trough depleted versions of the full data set and characterized the relationship between the vancomycin trough concentration and AUC. The trough-only and peak-trough depleted data sets underestimated the true AUCs compared to the full model by a mean (95% confidence interval) of 23% (11 to 33%; P = 0.0001) and 14% (7 to 19%; P < 0.0001), respectively. In contrast, using the full model as a Bayesian prior with trough-only data allowed 97% (93 to 102%; P = 0.23) accurate AUC estimation. On the basis of 5,000 profiles simulated from the full model, among adults with normal renal function and a therapeutic AUC of ?400 mg · h/liter for an organism for which the vancomycin MIC is 1 mg/liter, approximately 60% are expected to have a trough concentration below the suggested minimum target of 15 mg/liter for serious infections, which could result in needlessly increased doses and a risk of toxicity. Our data indicate that adjustment of vancomycin doses on the basis of trough concentrations without a Bayesian tool results in poor achievement of maximally safe and effective drug exposures in plasma and that many adults can have an adequate vancomycin AUC with a trough concentration of <15 mg/liter. PMID:24165176

Youn, Gilmer; Jones, Brenda; Jelliffe, Roger W.; Drusano, George L.; Rodvold, Keith A.; Lodise, Thomas P.

2014-01-01

149

Are vancomycin trough concentrations adequate for optimal dosing?  

PubMed

The current vancomycin therapeutic guidelines recommend the use of only trough concentrations to manage the dosing of adults with Staphylococcus aureus infections. Both vancomycin efficacy and toxicity are likely to be related to the area under the plasma concentration-time curve (AUC). We assembled richly sampled vancomycin pharmacokinetic data from three studies comprising 47 adults with various levels of renal function. With Pmetrics, the nonparametric population modeling package for R, we compared AUCs estimated from models derived from trough-only and peak-trough depleted versions of the full data set and characterized the relationship between the vancomycin trough concentration and AUC. The trough-only and peak-trough depleted data sets underestimated the true AUCs compared to the full model by a mean (95% confidence interval) of 23% (11 to 33%; P = 0.0001) and 14% (7 to 19%; P < 0.0001), respectively. In contrast, using the full model as a Bayesian prior with trough-only data allowed 97% (93 to 102%; P = 0.23) accurate AUC estimation. On the basis of 5,000 profiles simulated from the full model, among adults with normal renal function and a therapeutic AUC of ?400 mg · h/liter for an organism for which the vancomycin MIC is 1 mg/liter, approximately 60% are expected to have a trough concentration below the suggested minimum target of 15 mg/liter for serious infections, which could result in needlessly increased doses and a risk of toxicity. Our data indicate that adjustment of vancomycin doses on the basis of trough concentrations without a Bayesian tool results in poor achievement of maximally safe and effective drug exposures in plasma and that many adults can have an adequate vancomycin AUC with a trough concentration of <15 mg/liter. PMID:24165176

Neely, Michael N; Youn, Gilmer; Jones, Brenda; Jelliffe, Roger W; Drusano, George L; Rodvold, Keith A; Lodise, Thomas P

2014-01-01

150

Twenty-Four-Hour Urine Osmolality as a Physiological Index of Adequate Water Intake  

PubMed Central

While associations exist between water, hydration, and disease risk, research quantifying the dose-response effect of water on health is limited. Thus, the water intake necessary to maintain optimal hydration from a physiological and health standpoint remains unclear. The aim of this analysis was to derive a 24?h urine osmolality (UOsm) threshold that would provide an index of “optimal hydration,” sufficient to compensate water losses and also be biologically significant relative to the risk of disease. Ninety-five adults (31.5 ± 4.3 years, 23.2 ± 2.7?kg·m?2) collected 24?h urine, provided morning blood samples, and completed food and fluid intake diaries over 3 consecutive weekdays. A UOsm threshold was derived using 3 approaches, taking into account European dietary reference values for water; total fluid intake, and urine volumes associated with reduced risk for lithiasis and chronic kidney disease and plasma vasopressin concentration. The aggregate of these approaches suggest that a 24?h urine osmolality ?500?mOsm·kg?1 may be a simple indicator of optimal hydration, representing a total daily fluid intake adequate to compensate for daily losses, ensure urinary output sufficient to reduce the risk of urolithiasis and renal function decline, and avoid elevated plasma vasopressin concentrations mediating the increased antidiuretic effort. PMID:25866433

Perrier, Erica T.; Buendia-Jimenez, Inmaculada; Vecchio, Mariacristina; Armstrong, Lawrence E.; Tack, Ivan; Klein, Alexis

2015-01-01

151

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

152

Care coordination impacts on access to care for children with special health care needs enrolled in Medicaid and CHIP.  

PubMed

Children with special health care needs (CSHCN) often require services from multiple health care providers. This study's objective is to evaluate whether CSHCN, enrolled in Medicaid or the Children's Health Insurance Program (CHIP) and receiving care coordination services, experience improved access to mental and specialty health care services. Using data from the 2009-2010 National Survey of Children with Special Health Care Needs, two separate outcomes are used to evaluate children's access to care: receipt of needed mental and specialty care and timely access to services. Using propensity score matching, CSHCN propensity for receiving care coordination services is derived and an assessment is made of care coordination's impact on the receipt of health care and whether care is delayed. Results demonstrate that care coordination is positively associated with whether a child receives the mental and specialty care that they need, regardless of whether or not that coordination is perceived to be adequate by parents. However, receiving care coordination services that parents perceive to be adequate has a larger impact on the timeliness in which care is received. This study indicates that care coordination is associated with an increased ability for CSHCN to access needed mental and specialty care. States should consider offering care coordination services that support provider communication and fulfill families' coordination needs to the CSHCN enrolled in their Medicaid and CHIP programs. PMID:23793536

Miller, Kipyn

2014-05-01

153

The Influence of Cognitive Impairment, Special Care Unit Placement, and Nursing Facility Characteristics on Resident Quality of Life  

PubMed Central

Objectives We examined the (a) influence of nursing facility characteristics on resident quality of life and (b) the impact of cognitive impairment and residence on a dementia special care unit(SCU) on QOL after controlling for resident and facility characteristics. Method Multilevel models (resident and facility) were estimated for residents with and without cognitive impairment on conventional units and dementia SCU. Data came from the 2007 Minnesota Nursing Home Resident Quality of Life and Consumer Satisfaction Survey (N = 13,983). Results Level of resident CI was negatively related to QOL, although residing on a dementia SCU was positively related to QOL. Certified Nursing Assistant and activity personnel hours per resident day had a positive relationship with resident QOL. Discussion Our results highlight the need to ensure adequate levels of paraprofessional direct care staff and the availability of dementia-focused (SCU)s despite current constraints on long-term care funding. PMID:23511654

Abrahamson, Kathleen; Lewis, Teresa; Perkins, Anthony; Clark, Daniel; Nazir, Arif; Arling, Greg

2014-01-01

154

Provider's Constraints and Difficulties in Primary Health Care System  

PubMed Central

Background: The contractualization of human resource in recent years has resulted into various human resource management issues. Objective: To explore the administrative and management issues of contractual model of human resource under primary health care system in Delhi. Materials and Methods: Comparative study was conducted on randomly selected sample of 333, comprised of Medical Officers, ANMs, Pharmacist and Laboratory Assistants and Technicians, both regular and contractual cadre. The data was collected using the semi-structured interview schedule and thematic content analysis was done. Results: The five major themes emerged in the analysis; these are (i) physical infrastructure, (ii) organization's working environment, (iii) privileges of staff, (iv) discontentment, (v) human resource development. Comparative analysis of themes between regular and contractual staff revealed significant differences in factors which are embedded into the organization's culture. Element of discontentment is high amongst contractual staff particularly for discrimination in job, undermining of authority, patient care relationship and privileges provided to regular staff. This reflects the area of dissatisfaction which varies between regular and contractual staff in the organization. Conclusion: If primary health care system fails to address genuine constraints of human resources of both regular and contractual cadre and perception of discrimination persists, it is bound to result into poor motivation for good performance in the system of health care. So, adopting good practices in human resource management keeping regular and contractual employees grievances at forefront are urgently needed to ensure the availability of adequately trained and motivated personnel's in health facilities. PMID:25161964

Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Anu

2014-01-01

155

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

156

Ensuring effective medication reconciliation in home healthcare.  

PubMed

A patient was readmitted two days after discharge with severe hypoglycemia. The treating team discharged the patient on a new insulin regimen without realizing that the patient also had insulin 70/30 at home. The patient continued to take her previous regimen as well as the new one, and was found unresponsive by her husband. The patient was in the ICU with the incident likely resulting in permanent neurological deficits. ()A patient was admitted to a hospital from a home health agency. The list of medications provided by the agency did not completely match the list provided by the patient's family physician (i.e., the antihypertensive agent metoprolol tartrate [Lopressor] was not listed by the agency as one of the medications that the patient was currently taking). Therefore, metoprolol tartrate was not initially ordered. The patient developed atrial fibrillation shortly after hospital admission and required a transfer to the ICU [intensive care unit]. A diltiazem (Cardizem) infusion was started and the patient's family physician became aware that the patient had not been receiving their antihypertensive medication and initiated an order for the metoprolol tartrate (). PMID:25268524

Fuji, Kevin T; Abbott, Amy A

2014-10-01

157

Perceptions about prenatal care: views of urban vulnerable groups  

PubMed Central

Background In the United States, infant mortality rates remain more than twice as high for African Americans as compared to other racial groups. Lack of adherence to prenatal care schedules in vulnerable, hard to reach, urban, poor women is associated with high infant mortality, particularly for women who abuse substances, are homeless, or live in communities having high poverty and high infant mortality. This issue is of concern to the women, their partners, and members of their communities. Because they are not part of the system, these womens' views are often not included in other studies. Methods This qualitative study used focus groups with four distinct categories of people, to collect observations about prenatal care from various perspectives. The 169 subjects included homeless women; women with current or history of substance abuse; significant others of homeless women; and residents of a community with high infant mortality and poverty indices, and low incidence of adequate prenatal care. A process of coding and recoding using Ethnograph and counting ensured reliability and validity of the process of theme identification. Results Barriers and motivators to prenatal care were identified in focus groups. Pervasive issues identified were drug lifestyle, negative attitudes of health care providers and staff, and non-inclusion of male partners in the prenatal experience. Conclusions Designing prenatal care relevant to vulnerable women in urban communities takes creativity, thoughtfulness, and sensitivity. System changes recommended include increased attention to substance abuse treatment/prenatal care interaction, focus on provider/staff attitudes, and commitment to inclusion of male partners. PMID:12421466

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

2002-01-01

158

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 ...

159

Daily Care  

MedlinePLUS

... Finding Care Community Resource Finder Choosing Care Providers Changing Care Providers Glossary Coordinating Care Working with Care ... Association ® . All rights reserved. Our vision is a world without Alzheimer's Formed in 1980, the Alzheimer's Association ...

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

12 CFR 702.303 - Prompt corrective action for “adequately capitalized” new credit unions.  

Code of Federal Regulations, 2010 CFR

...Prompt Corrective Action for New Credit Unions § 702...adequately capitalized” new credit unions. Beginning...adequately capitalized” new credit union must increase...approved initial or revised business plan in accordance with §...

2010-01-01

162

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

163

Health Care for Older Persons in Singapore  

Microsoft Academic Search

Health care policy in Singapore is similar to that in the United States and the United Kingdom, where a residualist strategy is used to pass health care costs to individuals and their families, the rationale being that this enables the state to concentrate on devolution of care to the community and ensure efficient and affordable service to all Singaporeans. The

Peggy Teo

2004-01-01

164

Parent Handbook for Family Child Care Homes.  

ERIC Educational Resources Information Center

Published by Nebraska's Department of Health and Human Services, this guide provides information that will help parents and providers ensure that their child receives the best possible care from a licensed child care home provider. The guide also serves as a basis for discussion between parents and their child care providers to make a child's…

Nebraska State Dept. of Health and Human Services, Lincoln.

165

HYPERBOLIC SEMI-ADEQUATE LINKS DAVID FUTER, EFSTRATIA KALFAGIANNI, AND JESSICA S. PURCELL  

E-print Network

HYPERBOLIC SEMI-ADEQUATE LINKS DAVID FUTER, EFSTRATIA KALFAGIANNI, AND JESSICA S. PURCELL Abstract. We provide a diagrammatic criterion for semi-adequate links to be hyper- bolic. We also give a conjectural description of the satellite structures of semi-adequate links. One application of our result

Kalfagianni, Efstratia

166

It's quite common to take a multi-vitamin each day to ensure good health and promote long-term well being. Just like vitamin supplements can help  

E-print Network

and ensure long-term growth. You may wish to assess your risk tolerance with the help of a financial advisorIt's quite common to take a multi-vitamin each day to ensure good health and promote long-term well the mortgage, and have already put the kids through school. However, health care expenses can be higher

Northern British Columbia, University of

167

Treatment of Depression in a Low-Income Primary Care Setting With Colocated Mental Health Care  

Microsoft Academic Search

In order to characterize depression treatment-as-usual in a large primary care practice in the United States with colocated mental health care, and to examine predictors of receiving any treatment and receiving adequate treatment, primary care patients were systematically approached in waiting rooms. Those with a minimum level of depression symptoms (n = 91) were asked to participate in a study

Lisa A. Uebelacker; Marcia Smith; Angelique W. Lewis; Ryan Sasaki; Ivan W. Miller

2009-01-01

168

45 CFR 1306.35 - Family child care program option.  

Code of Federal Regulations, 2014 CFR

...Ensure the availability of family child care homes capable of serving children and... (4) Policy Council role. The Policy Council...disapprove the addition of family child care as...made plans to notify parents in the event of any...

2014-10-01

169

45 CFR 1306.35 - Family child care program option.  

Code of Federal Regulations, 2012 CFR

...Ensure the availability of family child care homes capable of serving children and... (4) Policy Council role. The Policy Council...disapprove the addition of family child care as...made plans to notify parents in the event of any...

2012-10-01

170

45 CFR 1306.35 - Family child care program option.  

Code of Federal Regulations, 2013 CFR

...Ensure the availability of family child care homes capable of serving children and... (4) Policy Council role. The Policy Council...disapprove the addition of family child care as...made plans to notify parents in the event of any...

2013-10-01

171

45 CFR 1306.35 - Family child care program option.  

Code of Federal Regulations, 2011 CFR

...Ensure the availability of family child care homes capable of serving children and... (4) Policy Council role. The Policy Council...disapprove the addition of family child care as...made plans to notify parents in the event of any...

2011-10-01

172

Oral care.  

PubMed

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

Hitz Lindenmüller, Irène; Lambrecht, J Thomas

2011-01-01

173

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 ...

174

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 ...

175

Ensuring required reliability for nuclear reactor protection systems  

Microsoft Academic Search

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

A. I. Pereguda; A. A. Petrenko

1989-01-01

176

PeerCare: Challenging the monitoring approach to care for the elderly  

E-print Network

PeerCare: Challenging the monitoring approach to care for the elderly Yann Riche and Wendy Mackay of life while ensuring safety and healthcare [8]. HCI research in this domain has focused either they manage and successfully overcome health, social and care challenges in their everyday life. One group

177

Competence assurance - who cares?  

PubMed

The provision of clinical care in the United Kingdom now requires the acquisition of a licence to practise from the regulatory authority. A review process-revalidation has been put in place to ensure that standards of care are maintained by the medical workforce, and that all doctors remain up-to-date and fit for purpose so that this licence can be retained. This article outlines how this new statutory requirement pertains to paediatric surgery and highlights those areas where adjudication of competence remains imprecise and where progress in this process of revalidation needs to be made. PMID:24528958

Youngson, George G

2014-02-01

178

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

179

Transition to intensive care nursing: a state-wide, workplace centred program-12 years on.  

PubMed

In November 1999, the Queensland Health (QH) Transition to Practice Nurse Education Program - Intensive Care (TPNEP-IC) was initiated in QH Intensive Care Units (ICUs) across Queensland. This 12-month, state-wide, workplace based education program has set minimum standards for intensive care nursing education and therefore minimum standards for intensive care nursing practice in QH. In the 12 years of operation, 824 nurses have completed TPNEP-IC, 761 achieving academic credit status and 453 utilising this academic credit status to undertake postgraduate study in critical/intensive care nursing at three Queensland universities. These outcomes were achieved through the appointment of nurse educators within ICUs who, through a united and strong commitment to this state-wide approach formed collaborative professional networks, which resulted in the development, implementation and maintenance of the program. Furthermore, these networks enabled a framework of support for discussion and dissemination of evidence based practice, to endorse quality processes for TPNEP-IC and to nurture leadership potential among educators. Challenges to overcome included obtaining adequate resources to support all aspects of the program, gaining local management and administrative support, and embedding TPNEP-IC within ICU culture. The 12 years of operation of the program have demonstrated its long term sustainability. The program is being launched through a new blended learning approach utilising e-learning strategies. To capitalise on the current success, a strong commitment by all stakeholders will be required to ensure the ongoing sustainability of the program. PMID:21962835

Juers, Alison; Wheeler, Margaret; Pascoe, Helen; Gregory, Nicola; Steers, Cheryl

2012-05-01

180

HSQC-1,1-ADEQUATE and HSQC-1,n-ADEQUATE: enhanced methods for establishing adjacent and long-range 13C-13C connectivity networks.  

PubMed

1H-13C GHSQC and GHMBC spectra are irrefutably among the most valuable 2D NMR experiments for the establishment of unknown chemical structures. However, the indeterminate nature of the length of the long-range coupling(s) observed via the (n)J(CH)-optimized delay of the GHMBC experiment can complicate the interpretation of the data when dealing with novel chemical structures. A priori there is no way to differentiate 2J(CH) from (n)J(CH) correlations, where n ? 3. Access to high-field spectrometers with cryogenic NMR probes brings 1,1- and 1,n-ADEQUATE experiments into range for modest samples. Subjecting ADEQUATE spectra to covariance processing with high sensitivity experiments such as multiplicity-edited GHSQC affords a diagonally symmetric 13C-13C correlation spectrum in which correlation data are observed with the apparent sensitivity of the GHSQC spectrum. HSQC-1,1-ADEQUATE covariance spectra derived by co-processing of GHSQC and 1,1-ADEQUATE spectra allow the carbon skeleton of molecules to be conveniently traced. HSQC-1,n-ADEQUATE spectra provide enhanced access to correlations equivalent to 4J(CH) correlations in a GHMBC spectrum. When these data are used to supplement GHMBC data, a powerfully synergistic set of heteronuclear correlations are available. The methods discussed are illustrated using retrorsine (1) as a model compound. PMID:22054075

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

2011-11-28

181

Conflict between parents over care  

Microsoft Academic Search

Conflict between parents over care of young arises when the young benefit from the effort of both parents, but each parent suffers a reduction in future reproductive success as a consequence of its own effort. Here, we review existing models and argue that they fail to capture many important components of parental con- flict. For example, we lack adequate models

Alasdair I. Houston; Tamás Székely; John M. McNamara

2005-01-01

182

Caring for Children at the Poverty Line.  

ERIC Educational Resources Information Center

Examines the child-care needs and arrangements of working and nonworking-poor and working-class families relative to middle-class families. Suggests that child-care decisions of low-income parents appear to be very similar to those of high-income parents; what differs is access, including convenience, and the ability to afford adequate programs.…

Hofferth, Sandra L.

1995-01-01

183

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.

184

Lactose Intolerance: Information for Health Care Providers  

E-print Network

Lactose Intolerance: Information for Health Care are at or above their adequate intake of calcium.1 And adolescents who may be lactose intolerant are even less of their adult bone mass is established. As a health care provider, you can help your patients get the calcium

Rau, Don C.

185

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

186

GUIDO Music Notation Towards an Adequate Representation of Score Level Music  

E-print Network

more sophisticated musical concepts, such as advanced lyrics or gured bass. The third layer, ExtendedGUIDO Music Notation Towards an Adequate Representation of Score Level Music Holger H. Hoosy Keith A. Hamelz Kai Fladey Jurgen Kiliany Abstract GUIDO Music Notation is a novel approach for adequately

Hoos, Holger H.

187

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

188

Building consensus on key priorities for rural health care in South Africa using the Delphi technique  

PubMed Central

Background South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results Response rates ranged from 83% in the first round (n=44) to 64% in the final round (n=34). The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH), governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential. PMID:23364081

Versteeg, Marije; du Toit, Lilo; Couper, Ian

2013-01-01

189

Quality control in tissue banking--ensuring the safety of allograft tissues.  

PubMed

DESPITE FEDERAL REGULATIONS for tissue-banking practices, inadequate quality control led to the largest allograft tissue recall in history in October 2005. THE RECALL INCLUDED all allograft tissues obtained from 761 donors and distributed by five tissue banks. Many of these tissues already had been implanted and were unrecoverable. THIS ARTICLE DESCRIBES the many tissue-banking industry variables, including donor selection and testing and tissue recovery, processing, and preservation. QUESTIONS THAT HEALTH CARE providers can ask to determine which tissue banks' quality control measures best ensure the safety of the allografts they provide also are included. PMID:17004664

Humphries, Linda K; Mansavage, Vicki L

2006-09-01

190

The role of the advanced practice registered nurse in ensuring evidence-based practice.  

PubMed

The advanced practice registered nurse (APRN) is vital in role-modeling and ensuring evidence-based practice (EBP) engagement and application at the point of care. This article describes the formulation of national competencies for EBP, specific to the APRN level. The application of selected competencies is delineated and the creation of an APRN action plan to identify necessary EBP competencies is discussed. If EBP skills are lacking, the action plan is used for development of skills in the required areas. PMID:22579062

Moseley, Marthe J

2012-06-01

191

34 CFR 300.154 - Methods of ensuring services.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

192

34 CFR 300.154 - Methods of ensuring services.  

Code of Federal Regulations, 2012 CFR

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

2012-07-01

193

34 CFR 300.154 - Methods of ensuring services.  

Code of Federal Regulations, 2014 CFR

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

2014-07-01

194

34 CFR 300.154 - Methods of ensuring services.  

Code of Federal Regulations, 2011 CFR

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

2011-07-01

195

34 CFR 300.154 - Methods of ensuring services.  

Code of Federal Regulations, 2013 CFR

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

2013-07-01

196

Ensuring Food Safety: The Cooperative Retail Food Program  

MedlinePLUS

... Biologics Articulos en Espanol Ensuring Food Safety: The Cooperative Retail Food Program Search the Consumer Updates Section ... and retail food specialists. FDA’s role in this cooperative effort includes developing, interpreting, and promoting the FDA ...

197

Bovine hemoglobin as the sole source of dietary iron does not support adequate iron status in copper-adequate or copper-deficient rats  

Technology Transfer Automated Retrieval System (TEKTRAN)

This experiment was designed to determine whether hemoglobin as the sole source of dietary iron (Fe) could sustain normal Fe status in growing rats. Because adequate copper (Cu) status is required for efficient Fe absorption in the rat, we also determined the effects of Cu deficiency on Fe status of...

198

Managed Care  

MedlinePLUS

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

199

Hospice Care  

MedlinePLUS

... end-of-life care. A team of health care professionals and volunteers provides it. They give medical, psychological, and spiritual support. The goal of the care is to help people who are dying have ...

200

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 ...

201

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 ...

202

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 ...

203

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

NASA Astrophysics Data System (ADS)

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

Klavetter, Eric

2005-09-01

204

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

ERIC Educational Resources Information Center

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

Caesar, Lena G.

2006-01-01

205

Effective Marketing of Quality Child Care.  

ERIC Educational Resources Information Center

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

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

1984-01-01

206

Transforming IT University Health Care System  

E-print Network

-- Improved access to archived cardiology studies provides a competitive advantage for UHCS in the community to help improve healthcare GMAS delivers three important capabilities to ensure UHCS cliniciansTransforming IT University Health Care System improves patient care with enterprise grid storage

207

Group Care Practitioners as Family Workers  

ERIC Educational Resources Information Center

This article sets out a rationale and provides a model for family work by group care practitioners. In doing so it points out that practitioners will need to avoid parent blaming attitudes and become family-centered rather than simply child-focused. Thus the critical issues to be addressed are how to ensure that a group care program is from an…

Ainsworth, Frank

2005-01-01

208

Health Care Reform Act is Constitutional and Necessary  

Microsoft Academic Search

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

Ian C. Bartrum

2011-01-01

209

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

PubMed Central

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

Amar, Praveen Kumar

2010-01-01

210

A corporate treasurer toolkit to ensure fund delivery in disaster zones.  

PubMed

In a disaster situation, the corporate treasury department of an organisation is also responsible for ensuring business continuity. The treasury department's key role would be to ensure that vendors, suppliers and employees are adequately remunerated and that operations do not seize due to a lack of working capital. Treasury practitioners concerned with business continuity have traditionally focused on three mainstay aspects of the initiative: (1) creating virtual or remote treasury offices; (2) training key backup staff on emergency procedures; (3) maintaining power and telecommunication connectivity with their cash concentration bank to guarantee treasury is able to transmit funding instructions to them. This paper aims to take business continuity measures for corporate treasury departments to a higher level of preparedness by asking one critical question: 'What will happen if the cash concentration bank or the entire banking system of a country in which a company has operations collapses?' Rarely have treasury professionals contemplated such a cataclysmic scenario. This paper aims to (1) validate that banking system failures are common, (2) rationalise why treasury practitioners need to devise contingency funding strategies outside of the banking system and (3) offer some viable alternatives to commercial banks. In this regard the author will draw from the experience of international non-governmental organisations that routinely respond to and operate in cataclysmic emergencies. PMID:23315248

Parandeh, Sassan Cyrus

211

Electronic End-of-Life Care Registry: the Utah ePOLST Initiative  

PubMed Central

As a patient’s end-of-life approaches, it is typical for the disease to be the focus of treatment instead of the dying patient. There is limited congruence between the care preferred by patients and the treatment actually delivered to patients during their end-of-life. The Physician Orders for Life-Sustaining Treatment Paradigm has been endorsed or is in development in all but three states and the District of Columbia in an effort to ensure that patients are provided with adequate opportunities to specify their end-of-life care preferences. However, most states are using paper forms to document these preferences which may be inaccessible when needed. We have developed an electronic end-of-life care registry that allows authorized users to store and retrieve information pertaining to patients’ end-of-life care preferences. In this paper, we describe (a) the requirements identified for the registry from the users’ perspective and (b) the design and development of the electronic registry. PMID:24551342

Duncan, Jeffrey; Taillac, Peter; Nangle, Barry; Henry, Maureen; Houston, Janice; Talebreza, Shaida; Finch, Leisa; Brunker, Cherie; Rajeev, Deepthi; Smith, Heidi J.; North, Christie

2013-01-01

212

Charity care in nonprofit urban hospitals: analysis of the role of size and ownership type in Washington State for 2011.  

PubMed

Nonprofit hospitals are expected to serve their communities as charitable organizations in exchange for the tax exemption benefits they receive. With the passage into law of the Affordable Care Act, additional guidelines were generated in 2010 to ensure nonprofit hospitals are compliant. Nonetheless, the debate continues on whether nonprofit hospitals provide adequate charity care to their patient population. In this study, charity care provided by 29 Washington State nonprofit urban hospitals was examined for 2011 using financial data from the Washington State Department of Health. Charity care levels were compared to both income tax savings and gross revenues to generate two financial ratios that were analyzed according to hospital bed size and nonprofit ownership type. For the first ratio, 97% of the hospitals (28 of 29) were providing charity care in greater amounts than the tax savings they accrued. The average ratio value using total charity care and total income tax savings of all the hospitals in the study was 6.10, and the median value was 3.46. The nonparametric Kruskal-Wallis test results by bed size and nonprofit ownership type indicate that ownership type has a significant effect on charity care to gross revenue ratios (p = .020). Our analysis indicates that church-owned hospitals had higher ratios of charity care to gross revenues than did the other two ownership types--government and voluntary--in this sample. Policy implications are offered and further studies are recommended to analyze appropriate levels of charity care in nonprofit hospitals given new requirements for maintaining a hospital's tax-exempt status. PMID:25647964

Coyne, Joseph S; Ogle, Natalie M; McPherson, Sterling; Murphy, Sean; Smith, Gary J; Davidson, Gregg Agustín

2014-01-01

213

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

214

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

215

42 CFR 413.24 - Adequate cost data and cost finding.  

Code of Federal Regulations, 2010 CFR

... 2010-10-01 2010-10-01 false Adequate cost data and cost finding. 413.24 Section 413.24 Public Health...SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL...

2010-10-01

216

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

Code of Federal Regulations, 2010 CFR

... Medicare Payment: Cost Basis § 417.568 Adequate financial records, statistical data, and cost finding. (a...institutions that use a cash basis of accounting, cost data developed on this basis is acceptable....

2010-10-01

217

30 CFR 1227.801 - What if a State does not adequately perform a delegated function?  

Code of Federal Regulations, 2013 CFR

...NATURAL RESOURCES REVENUE DELEGATION TO STATES Performance Review § 1227.801 What if a State does not adequately perform a delegated function? If your performance of the delegated function does not comply with...

2013-07-01

218

30 CFR 1227.801 - What if a State does not adequately perform a delegated function?  

Code of Federal Regulations, 2012 CFR

...NATURAL RESOURCES REVENUE DELEGATION TO STATES Performance Review § 1227.801 What if a State does not adequately perform a delegated function? If your performance of the delegated function does not comply with...

2012-07-01

219

30 CFR 1227.801 - What if a State does not adequately perform a delegated function?  

Code of Federal Regulations, 2011 CFR

...Natural Resources Revenue DELEGATION TO STATES Performance Review § 1227.801 What if a State does not adequately perform a delegated function? If your performance of the delegated function does not comply with...

2011-07-01

220

30 CFR 1227.801 - What if a State does not adequately perform a delegated function?  

Code of Federal Regulations, 2014 CFR

...NATURAL RESOURCES REVENUE DELEGATION TO STATES Performance Review § 1227.801 What if a State does not adequately perform a delegated function? If your performance of the delegated function does not comply with...

2014-07-01

221

30 CFR 227.801 - What if a State does not adequately perform a delegated function?  

Code of Federal Regulations, 2010 CFR

...MINERALS REVENUE MANAGEMENT DELEGATION TO STATES Performance Review § 227.801 What if a State does not adequately perform a delegated function? If your performance of the delegated function does not comply with...

2010-07-01

222

75 FR 5893 - Suspension of Community Eligibility for Failure To Maintain Adequate Floodplain Management...  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency 44 CFR Part 64...adequate floodplain management measures with effective...Federal Emergency Management Agency, Department of Homeland Security. [FR Doc....

2010-02-05

223

34 CFR 200.21 - Adequate yearly progress of a State.  

Code of Federal Regulations, 2010 CFR

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

2010-07-01

224

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

MedlinePLUS

... Sign Out Percentage of Adults with High Blood Pressure Whose Hypertension is Adequately Controlled Heart disease and ... and third leading causes of death. High blood pressure is a major risk factor for cardiovascular disease, ...

225

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

Microsoft Academic Search

BACKGROUND: Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6–8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was

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

2006-01-01

226

PERFORMANCE-BASED MEASUREMENT SYSTEMS - ENSURING DATA DEFENSIBILITY  

EPA Science Inventory

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

227

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

228

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

229

Health Care Quality Improvement Program: a new approach.  

PubMed

The Health Care Financing Administration (HCFA) has embarked on a new program to ensure the quality of care provided to Medicare and Medicaid beneficiaries. The approach, entitled the Health Care Quality Improvement Program (HCQIP), focuses on improving the outcomes of care, measuring improvement, and surveying for patient satisfaction. HCQIP, still in its infancy, is undertaken in collaboration with the providers of care. This article describes HCQIP. PMID:10151886

Gagel, B J

1995-01-01

230

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

PubMed

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

Higgins, W

2000-01-01

231

Intervention fidelity: Ensuring application to practice for youth and families  

PubMed Central

Purpose Limited information on intervention fidelity is available in published studies with youth and families. The components of intervention fidelity, the complexity of measurement in these studies, and strategies for measuring intervention fidelity are described. Conclusions Strategies for ensuring intervention fidelity according to the Treatment Fidelity Workgroup of the Behavior Change Consortium in the areas of study design, provider training, treatment delivery, treatment receipt, and treatment enactment provide guidance for evaluating or developing intervention fidelity plans. Practice Implications Ensuring the quality of intervention fidelity in evidence-based reviews or when developing new interventions is essential for translating findings into practice. PMID:22188270

Faulkner, Melissa Spezia

2014-01-01

232

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

ERIC Educational Resources Information Center

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

Brown, Bettina Lankard

233

Building strategies to ensure language coexistence in presence of bilingualism  

E-print Network

Gaelic, Quechua and other endangered languages, predicts that one of the competing languagesBuilding strategies to ensure language coexistence in presence of bilingualism C. Bernard, S Aubi`ere Cedex - France Abstract For twenty years many authors have attempted to model language compe

Paris-Sud XI, Université de

234

Making the Grade: How Boards Can Ensure Academic Quality  

ERIC Educational Resources Information Center

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

Ewell, Peter

2006-01-01

235

Future Testing Opportunities to Ensure Sustainability of the Biofuels Industry  

Technology Transfer Automated Retrieval System (TEKTRAN)

The Energy Independence and Security Act (EISA) of 2007 increased the intensity of biofuel research and development throughout the U.S. For the Soil and Plant Analysis Community, this will undoubtedly create new opportunities to provide analytical services that will help ensure mandates such as the ...

236

Strategies for Ensuring Gender Equity in the Classroom.  

ERIC Educational Resources Information Center

This report describes a program promoting gender equity in classroom participation to ensure the active engagement of all students. Targeted population consisted of eighth-grade health classes and ninth and tenth grade biology classes. Gender inequities in class participation were documented by behavioral checklists, anecdotal records, and student…

Owens, Jo; Cooney, Tamar

237

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...

Ragsdale, G.

238

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

239

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

240

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

241

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

242

Optimum porous journal bearing ensuring maximum load capacity  

Microsoft Academic Search

The problem of an infinite journal bearing having an isothermal compressible lubricant and a porous bush and ensuring the\\u000a optimum load capacity is solved. The optimum clearance profiles and bush dimensions and position are found for various properties\\u000a of the bush and lubricant supply conditions.

V. I. Grabovskii

2006-01-01

243

Simulated annealing algorithm for scheduling problem in daily nursing cares  

Microsoft Academic Search

In most Japanese hospitals, different nurses handle the pre-assigned nursing cares in different ways, which directly affect the quality of nursing cares. To our knowledge, there has been less attention on ensuring that nurses provide nursing cares in a timely and accurate fashion. Consequently, in this paper, considering the similarities to the traditional job shop scheduling problems, we will model

Mingang Cheng; Hiromi Itoh Ozaku; Noriaki Kuwahara; Kiyoshi Kogure; Jun Ota

2008-01-01

244

Animal and Range Sciences Department Agricultural Animal Care Training Program  

E-print Network

Animal and Range Sciences Department Agricultural Animal Care Training Program Approved by AACUC May 2003 Goals The goals of the Agricultural Animal Care Training Program are to ensure animal well-being, the validity and effectiveness of research and teaching activities, and the health and safety of animal care

Maxwell, Bruce D.

245

Investing in Our Future: A Guide to Child Care Financing.  

ERIC Educational Resources Information Center

This book investigates the innovative ways being used to ensure and finance high quality care for children. Chapter 1, "Introduction," discusses the government's role in helping to structure, build, and finance the system, as well as financing strategies. Chapter 2, "Financing Child Care Supply," addresses center-based child care, supports for…

Stoney, Louise; Groginsky, Scott; Poppe, Julie

246

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

PubMed Central

Introduction Primary care has a central role in integrating care within a health system. However, conceptual ambiguity regarding integrated care hampers a systematic understanding. This paper proposes a conceptual framework that combines the concepts of primary care and integrated care, in order to understand the complexity of integrated care. Methods The search method involved a combination of electronic database searches, hand searches of reference lists (snowball method) and contacting researchers in the field. The process of synthesizing the literature was iterative, to relate the concepts of primary care and integrated care. First, we identified the general principles of primary care and integrated care. Second, we connected the dimensions of integrated care and the principles of primary care. Finally, to improve content validity we held several meetings with researchers in the field to develop and refine our conceptual framework. Results The conceptual framework combines the functions of primary care with the dimensions of integrated care. Person-focused and population-based care serve as guiding principles for achieving integration across the care continuum. Integration plays complementary roles on the micro (clinical integration), meso (professional and organisational integration) and macro (system integration) level. Functional and normative integration ensure connectivity between the levels. Discussion The presented conceptual framework is a first step to achieve a better understanding of the inter-relationships among the dimensions of integrated care from a primary care perspective. PMID:23687482

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

2013-01-01

247

ASID (HICSIG) position statement: infection control guidelines for patients with influenza-like illnesses, including pandemic (H1N1) influenza 2009, in Australian health care facilities.  

PubMed

Standard and Droplet Precautions are considered adequate to control the transmission of influenza in most health care situations. Vaccination of health care staff, carers and vulnerable patients against seasonal and, eventually, pandemic influenza strains is an essential protective strategy. Management principles include: performance of hand hygiene before and after every patient contact or contact with the patient environment, in accord with the national 5 Moments for Hand Hygiene Standard; disinfection of the patient environment; early identification and isolation of patients with suspected or proven influenza; adoption of a greater minimum distance of patient separation (2 metres) than previously recommended; use of a surgical mask and eye protection for personal protection on entry to infectious areas or within 2 metres of an infectious patient; contact tracing for patient and health care staff and restriction of prophylactic antivirals mainly to those at high risk of severe disease; in high aerosol-risk settings, use of particulate mask, eye protection, impervious long-sleeved gown, and gloves donned in that sequence and removed in reverse sequence, avoiding self-contamination; exclusion of symptomatic staff from the workplace until criteria for non-infectious status are met; reserving negative-pressure ventilation rooms (if available) for intensive care patients, especially those receiving non-invasive ventilation; ensuring that infectious postpartum women wear surgical masks when caring for their newborn infants and practise strict hand hygiene; and implementation of special arrangements for potentially infected newborns who require nursery or intensive care. PMID:19835543

Stuart, Rhonda L; Cheng, Allen C; Marshall, Caroline L; Ferguson, John K

2009-10-19

248

Cascading Goals and Objectives to Ensure Accountability and Action  

E-print Network

Bristol-Myers Squibb Worldwide Beauty Care Group has adopted a methodology that is reaping benefits throughout the company. The underlying principle in cascading goals and objectives is that every employee is accountable for achieving any corporate...

Tarifi, M.; Bingham, P. R.

249

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

SciTech Connect

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

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

1980-12-01

250

A method for determining adequate resistance form of complete cast crown preparations.  

PubMed

A diagram with various degrees of occlusal convergence, which takes into consideration the length and diameter of complete crown preparations, was designed as a guide to assist the dentist to obtain adequate resistance form. To test the validity of the diagram, five groups of complete cast crown stainless steel dies were prepared (3.5 mm long, occlusal convergence 10, 13, 16, 19, and 22 degrees). Gold copings were cast for each of the 50 preparations. Displacement force was applied to the casting perpendicularly to a simulated 30-degree cuspal incline until the casting was displaced. Castings were deformed at margins except for the 22-degree group. Castings from this group were displaced without deformation, and it was concluded that there was a lack of adequate resistance form as predicted by the diagram. The hypothesis that the diagram could be used to predict adequate or inadequate resistance form was confirmed by this study. PMID:6384470

Weed, R M; Baez, R J

1984-09-01

251

Impetigo Care  

MedlinePLUS

... Issues > Conditions > Skin > Impetigo Care Health Issues Listen Impetigo Care Article Body Impetigo is a contagious bacterial skin infection that often ... mouth, and ears. More than 90 percent of impetigo cases are caused by staphyloccus, or “staph,” bacteria, ...

252

Foot Care  

MedlinePLUS

... at NIH www.nia.nih.gov/Go4Life • Foot Care Healthy feet are key to being physically active, ... day. Be kind to your feet. Take good care of them: • Wash your feet regularly, especially between ...

253

Palliative Care  

MedlinePLUS

... Making Decisions About End-of-Life Care DNR/DNI/AND End of Life Immediately After Death Months ... Making Decisions About End-of-Life Care DNR/DNI/AND End of Life Immediately After Death Months ...

254

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

Microsoft Academic Search

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

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

2007-01-01

255

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

256

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

257

Incentives in primary care and their impact on potentially avoidable hospital admissions.  

PubMed

Financial incentives in primary care have been introduced with the purpose of improving appropriateness of care and containing demand. We usually observe pay-for-performance programs, but alternatives, such as pay-for-participation in improvement activities and pay-for-compliance with clinical guidelines, have also been implemented. Here, we assess the influence of different programs that ensure extra payments to GPs for containing avoidable hospitalisations. Our dataset covers patients and GPs of the Italian region Emilia-Romagna for the year 2005. By separating pay-for-performance from pay-for-participation and pay-for-compliance programs, we estimate the impact of different financial incentives on the probability of avoidable hospitalisations. As dependent variable, we consider two different sets of conditions for which timely and effective primary care should be able to limit the need for hospital admission. The first is based on 27 medical diagnostic related groups that Emilia-Romagna identifies as at risk of inappropriateness in primary care, while the second refers to the internationally recognised ambulatory care-sensitive conditions. We show that pay-for-performance schemes may have a significant effect over aggregate indicators of appropriateness, while the effectiveness of pay-for-participation schemes is adequately captured only by taking into account subpopulations affected by specific diseases. Moreover, the same scheme produces different effects on the two sets of indicators used, with performance improvements limited to the target explicitly addressed by the Italian policy maker. This evidence is consistent with the idea that a "tunnel vision" effect may occur when public authorities monitor specific sets of objectives as proxies for more general improvements in the quality of health care delivered. PMID:20424882

Fiorentini, Gianluca; Iezzi, Elisa; Lippi Bruni, Matteo; Ugolini, Cristina

2011-08-01

258

Inequalities in public health care delivery in Zambia  

PubMed Central

Background Access to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documents, there is evidence suggesting that those needing health services are not receiving their fair share. This study seeks therefore, to assess if socioeconomic related inequalities/inequities in public health service utilisation in Zambia still persist. Methods The 2010 nationally representative Zambia Living Conditions and Monitoring Survey data are used. Inequality is assessed using concentration curves and concentrations indices while inequity is assessed using a horizontal equity index: an index of inequity across socioeconomic status groups, based on standardizing health service utilisation for health care need. Public health services considered include public health post visits, public clinic visits, public hospital visits and total public facility visits. Results There is evidence of pro-poor inequality in public primary health care utilisation but a pro-rich inequality in hospital visits. The concentration indices for public health post visits and public clinic visits are ?0.28 and ?0.09 respectively while that of public hospitals is 0.06. After controlling for need, the pro-poor distribution is maintained at primary facilities and with a pro-rich distribution at hospitals. The horizontal equity indices for health post and clinic are estimated at ?0.23 and ?0.04 respectively while that of public hospitals is estimated at 0.11. A pro-rich inequity is observed when all the public facilities are combined (horizontal equity index?=?0.01) though statistically insignificant. Conclusion The results of the paper point to areas of focus in ensuring equitable access to health services especially for the poor and needy. This includes strengthening primary facilities that serve the poor and reducing access barriers to ensure that health care utilisation at higher-level facilities is distributed in accordance with need for it. These initiatives may well reduce the observed inequities and accelerate the move towards universal health coverage in Zambia. PMID:24645826

2014-01-01

259

Strategies for ensuring quality data from Indian investigational sites  

PubMed Central

The topic of ensuring quality and compliance is and must be a top priority in the conduct of clinical trials, as warranted by regulatory guidelines as well as the inherent responsibility of the professionals conducting such research. Fast-growing emerging clinical geographies such as India demand special attention due to rapid growth and associated factors that may put study quality at risk. In this paper, we used the basic principle of PDCA (Plan, Do, Check, and Adjust) to structure the processes of a clinical trial from protocol to final analysis in order to highlight the interactive nature of involved people and processes required to ensure quality of data and site functioning. PMID:21731855

Hajos, Antal K.; Kamble, Sujal K.

2011-01-01

260

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

261

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

PubMed

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

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

2013-10-01

262

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, like glaucoma. Most memorable from that first meeting was the laser look Israel Moiseevitch fixed on us

263

GUIDO Music Notation --Towards an Adequate Representation of Score Level Music  

E-print Network

more sophisticated musical concepts, such as advanced lyrics or figured bass. The third layer, ExtendedGUIDO Music Notation -- Towards an Adequate Representation of Score Level Music Holger H. Hoos \\Lambday Keith A. Hamel z Kai Flade y J¨urgen Kilian y Abstract GUIDO Music Notation is a novel approach

Hoos, Holger H.

264

Determining Adequate Yearly Progress in a State Performance or Proficiency Index Model  

ERIC Educational Resources Information Center

The purpose of this paper is to present an overview regarding how several states use a performance or proficiency index in their determination of adequate yearly progress (AYP) under the No Child Left Behind Act of 2001 (NCLB). Typically, indexes are based on one of two weighting schemes: (1) either they weight academic performance levels--also…

Erpenbach, William J.

2009-01-01

265

Prenatal zinc supplementation of zinc-adequate rats adversely affects immunity in offspring  

Technology Transfer Automated Retrieval System (TEKTRAN)

We previously showed that zinc (Zn) supplementation of Zn-adequate dams induced immunosuppressive effects that persist in the offspring after weaning. We investigated whether the immunosuppressive effects were due to in utero exposure and/or mediated via milk using a cross-fostering design. Pregnant...

266

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

ERIC Educational Resources Information Center

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

Hill, Richard

267

The Relationship between Parental Involvement and Adequate Yearly Progress among Urban, Suburban, and Rural Schools  

ERIC Educational Resources Information Center

Using national data from the 2007-08 School and Staffing Survey, we compared the relationships between parental involvement and school outcomes related to adequate yearly progress (AYP) in urban, suburban, and rural schools. Parent-initiated parental involvement demonstrated significantly positive relationships with both making AYP and staying off…

Ma, Xin; Shen, Jianping; Krenn, Huilan Y.

2014-01-01

268

Adequate intake values for dietary fibre based on faecal bulking indexes of 66 foods  

Microsoft Academic Search

Objective: To determine an adequate daily intake value for dietary fibre (AIdf) based on faecal bulking indexes (FBIs) for 66 foods of known total dietary fibre (TDF) content.Design: FBIs of 66 foods were measured and expressed as wheat bran equivalents (WBEfb) per 100 g of food. A daily WBEfb requirement for humans was calculated from faecal bulk generated per gram

J A Monro

2004-01-01

269

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

270

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

271

Getting adequate information across to colorectal cancer screening subjects can be difficult  

Microsoft Academic Search

OBJECTIVES: Participation in screening should be the outcome of an informed decision. We evaluated whether invitees in the first Dutch colorectal cancer (CRC) screening programme were adequately informed after having received a detailed information leaflet. METHODS: A total of 20,623 subjects aged 50-75 years were invited to the fecal occult blood test (FOBT) screening programme. All received a detailed information

AF van Rijn; L. G. M. van Rossum; M. Deutekom; R. J. F. Laheij; P M M Bossuyt; P. Fockens; E. den Dekker; J. B. M. J. Jansen

2008-01-01

272

Human milk feeding supports adequate growth in infants  

Technology Transfer Automated Retrieval System (TEKTRAN)

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 ...

273

Lawyer problem A legal firm has accepted five new cases, each of which can be adequately  

E-print Network

Lawyer problem A legal firm has accepted five new cases, each of which can be adequately handled of the senior partner assigning cases, one per junior lawyer, in such a way as to minimize the total hours expended. Case 1 Case 2 Case 3 Case 4 Case 5 Lawyer 1 145 122 130 95 115 Lawyer 2 80 63 85 48 78 Lawyer 3

Galvin, David

274

ADEQUATE MOODS FOR NON-EU DECISION MAKING IN A SEQUENTIAL FRAMEWORK  

E-print Network

ADEQUATE MOODS FOR NON-EU DECISION MAKING IN A SEQUENTIAL FRAMEWORK A Synthetic Discussion Nathalie for non-EU decision making. KEYWORDS: Non-expected utility, sequential choice, dynamic consistency, money and Decision 52 (2002) 1-28" DOI : 10.1023/A:1015503119317 #12;1. INTRODUCTION The modern theory of utility

Paris-Sud XI, Université de

275

Massively parallel computing systems with real time constraints: the “Algorithm Architecture Adequation” methodology  

Microsoft Academic Search

Massively Parallel Computing Systems (MPCS) provide high performance computing generally used to accelerate numerical computation applications. We present a methodology called “Algorithm Architecture Adequation” used to take advantage of the computation power of these systems in the case of real-time applications. With this methodology, the application algorithm as well as the MPCS are specified with graphs, then the implementation of

Y. Sorel

1994-01-01

276

Adequate Motion Simulation and Collision Detection for Soccer Playing Humanoid Robots  

E-print Network

Adequate Motion Simulation and Collision Detection for Soccer Playing Humanoid Robots Martin Friedmann, Karen Petersen, Oskar von Stryk Simulation, Systems Optimization and Robotics Group Technische.tu-darmstadt.de Abstract-- In this paper a humanoid robot simulator built with the Multi-Robot-Simulation-Framework (Mu

Stryk, Oskar von

277

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

278

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

279

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

Microsoft Academic Search

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

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

1999-01-01

280

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

PubMed Central

Background There is a danger that mass drug administration campaigns may fail to maintain adequate treatment coverage to achieve lymphatic filariasis elimination. Hence, additional measures to suppress transmission might be needed to ensure the success of the Global Program for the Elimination of Lymphatic Filariasis. Discussion Vector control successfully eliminated lymphatic filariasis when implemented alone or with mass drug administration. Challenges to lymphatic filariasis elimination include uncertainty of the exact level and duration of microfilarial suppression required for elimination, the mobility of infected individuals, consistent non-participation of some infected individuals with mass drug administration, the possible development of anti-filarial drug resistance and treatment strategies in areas co-endemic with loasis. Integration of vector control with mass drug administration can address some of these challenges. The potential benefits of vector control would include: (1) the ability to suppress filariasis transmission without the need to identify all individual 'foci of infection'; (2) minimizing the risk of reestablishment of transmission from imported microfilaria positive individuals; and (3) decreasing the risk of dengue or malaria transmission where, respectively, Aedes or Anopheles are lymphatic filariasis vectors. Summary With adequate sustained treatment coverage, mass drug administration should meet the criteria for elimination of lymphatic filariasis. However, it may be difficult to sustain sufficiently high mass drug administration coverage to achieve lymphatic filariasis elimination in some areas, particularly, where Aedes species are the vectors. Since vector control was effective in controlling and even eliminating lymphatic filariasis transmission, integration of vector control with mass drug administration will ensure the sustainability of transmission suppression and thereby better ensure the success of national filariasis elimination programs. Although trials of some vector control interventions are needed, proven vector control strategies are ready for immediate integration with mass drug administration for many important vectors. Vector control is the only presently available additional lymphatic filariasis control measure with the potential for immediate implementation. PMID:16914040

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

2006-01-01

281

Caring for Latino patients.  

PubMed

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

Juckett, Gregory

2013-01-01

282

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

Code of Federal Regulations, 2011 CFR

...Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection...Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection...ensure that Federal funds are not used for abortion services (except in cases of...

2011-01-01

283

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection...Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection...ensure that Federal funds are not used for abortion services (except in cases of rape...

2010-03-29

284

Overview of the Medicare Catastrophic Coverage Act of 1988 and its impact on health-care delivery.  

PubMed

The Medicare Catastrophic Coverage Act of 1988 is described, and its impact on health-care delivery is discussed. The act will expand Medicare coverage of inpatient hospital care and will also provide payment for outpatient prescription drugs and home i.v. therapy. For the prescription drug benefit, deductible and coinsurance payments will be phased in, and Medicare will establish payment limits. A per diem fee schedule will be established to pay for the supplies and services used in home i.v. therapy. Providers of home therapy must have qualifications specified by the act. Pharmacists will have an important role in ensuring that patients understand and comply with their drug therapy once they leave the hospital. As members of the home health-care team, pharmacists will be involved in identifying candidates for home care, instructing patients in the use of sophisticated medical equipment, and monitoring the safety and efficacy of therapy. Medicare beneficiaries will help finance the new coverage by paying a flat premium; in addition, all individuals eligible for Medicare will pay supplemental premiums based on their federal income tax liability. Congress, however, will come under pressure to lower or freeze these premiums. Hospitals and pharmacists should cooperate in urging Congress to provide adequate funding for services specified by the catastrophic coverage act. PMID:2672805

Grealy, M R

1989-07-01

285

Primary care for adolescents with developmental disabilities.  

PubMed

Disability is a natural part of the human experience. To maximize potential, adolescents with disabilities require multidisciplinary transition planning and life-skill training. Health care professionals can reduce barriers to accessing health care. They can encourage self-determination and connect patients to self-advocacy organizations. They can facilitate smooth transitions to adult health care services. Careful descriptions of a patient's baseline traits and function are critical, not only to assist in person centered planning processes, but to ensure that new caregivers and clinicians have the information they need to recognize changes in function or behavior that can signal illness. PMID:25124203

Kripke, Clarissa Calliope

2014-09-01

286

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

Consortium must ensure that each resident or clinical fellow has achieved competence to the level expected knowledge, skills, behaviors, and attitudes required, and provide educational experiences as needed in order for their residents to demonstrate competence in patient care, medical knowledge, practice-based learning

Kornfeld, S. Kerry

287

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

Reporting Animal Mistreatment or Animal Protocol Noncompliance The IACUC is responsible for ensuring that all animals used in research and teaching programs are treated in accordance with the Federal Animal Welfare Act, the PHS "Policy on Humane Care and Use of Laboratory Animals", the NIH, the National

Howitt, Ivan

288

Integrated transitional care: patient, informal caregiver and health care provider perspectives on care transitions for older persons with hip fracture  

PubMed Central

Introduction Complex older adults, such as those with hip fracture, frequently require care from multiple professionals across a variety of settings. Integrated care both between providers and across settings is important to ensure care quality and patient safety. The purpose of this study was to determine the core factors related to poorly integrated care when hip fracture patients transition between care settings. Methods A qualitative, focused ethnographic approach was used to guide data collection and analysis. Patients, their informal caregivers and health care providers were interviewed and observed at each care transition. A total of 45 individual interviews were conducted. Interview transcripts and field notes were coded and analysed to uncover emerging themes in the data. Results Four factors related to poorly integrated transitional care were identified: confusion with communication about care, unclear roles and responsibilities, diluted personal ownership over care, and role strain due to system constraints. Conclusions Our research supports a broader notion of collaborative practice that extends beyond specific care settings and includes an appropriate, informed role for patients and informal caregivers. This research can help guide system-level and setting-specific interventions designed to promote high-quality, patient-centred care during care transitions. PMID:22977426

Toscan, Justine; Mairs, Katie; Hinton, Stephanie; Stolee, Paul

2012-01-01

289

42 CFR 460.106 - Plan of care.  

Code of Federal Regulations, 2010 CFR

...observation, input from participants or caregivers, and communications among members of...as necessary. (e) Participant and caregiver involvement in plan of care. The...collaboration with the participant or caregiver, or both, to ensure that there...

2010-10-01

290

42 CFR 460.106 - Plan of care.  

Code of Federal Regulations, 2011 CFR

...observation, input from participants or caregivers, and communications among members of...as necessary. (e) Participant and caregiver involvement in plan of care. The...collaboration with the participant or caregiver, or both, to ensure that there...

2011-10-01

291

38 CFR 51.120 - Quality of care.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS...associated with a medication error; or (ii) Any...these drugs. (n) Medication Errors. The facility management...ensure that— (1) Medication errors are identified...

2013-07-01

292

38 CFR 51.120 - Quality of care.  

Code of Federal Regulations, 2011 CFR

...CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS...associated with a medication error; or (ii) Any...these drugs. (n) Medication Errors. The facility management...ensure that— (1) Medication errors are identified...

2011-07-01

293

38 CFR 51.120 - Quality of care.  

Code of Federal Regulations, 2014 CFR

...CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS...associated with a medication error; or (ii) Any...these drugs. (n) Medication Errors. The facility management...ensure that— (1) Medication errors are identified...

2014-07-01

294

38 CFR 51.120 - Quality of care.  

Code of Federal Regulations, 2012 CFR

...CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS...associated with a medication error; or (ii) Any...these drugs. (n) Medication Errors. The facility management...ensure that— (1) Medication errors are identified...

2012-07-01

295

Because you careEmergency Care OR/Anesthesia Critical Care Perinatal Care Home Care Introduction  

E-print Network

Because you careEmergency Care · OR/Anesthesia · Critical Care · Perinatal Care · Home Care practitioners to make efficient decisions in time. In intensive care and anesthesia, the demand for computerised of physiological needs during the patient wake-up from anesthesia or drug intoxication. Knowledge-Based Systems

Dojat, Michel

296

Free Handwriting in Home-Care Workers Support System using Personal Digital Assistants  

Microsoft Academic Search

In Japan, infrastructure for home care services is being built for the future aging society. To ensure ideal home care, however, we further need to establish a social system in which home care providers, including physicians, home visiting nurses and homehelpers, coordinate with each other. Given this background, we have proposed a home care workers support system using personal digital

Takuji Suzuki; Masafumi Kondo

1998-01-01

297

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

298

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

299

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

300

Estimation of haemopoietic progenitor cells in peripheral blood by the Advia 120 and BD vantage flow cytometer: a direct comparison for the prediction of adequate collections.  

PubMed

Peripheral blood stem cells are increasingly used to ensure rapid haematological engraftment after myeloablative chemotherapy. After mobilization, progenitor cells in the blood can be enumerated to predict an adequate collection by leukapheresis. The Advia 120 automated counter has an immature cell channel measuring a parameter known as large undifferentiated cells (LUC's), which were quantified to assess their value in refining the timing of apheresis. Data were available from 102 apheresis sessions. Positive correlation was found for peripheral blood CD34+ cells and apheresis counts (r = 0.82, P < 0.0005) but not for total WCC (r = -0.15, P = 0.13) or LUC count (r = 0.12, P = 0.23). Our results indicate that the LUC population in peripheral blood has no relevance to the subsequent CD34 content of the apheresis product and CD34 cell enumeration by flow cytometry is advocated. PMID:16178906

Greenfield, H M; Sweeney, D A; Newton, R K; Leather, A; Murray, J; Angelica, R; Swindell, R; Chang, J

2005-10-01

301

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

302

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

303

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

SciTech Connect

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

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

1995-06-01

304

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

305

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

MedlinePLUS

... health plan, Medicare (disability), Indian Health Service or military health care (TRICARE, VA, or CHAMP-VA). This measure is calculated by the Centers for Disease Control and Prevention, National Center for Health Statistics from ...

306

Oral Care  

Microsoft Academic Search

Adequate dental and oral hygiene may become a challenge for all users and especially for elderly people and young children because of their limited motor skills. The same holds true for patients undergoing\\/recovering from chemo-\\/radiotherapy with accompanying sensitive mucosal conditions. Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath (halitosis), fungal infection and gum diseases.

Irène Hitz Lindenmüller; J. Thomas Lambrecht

2011-01-01

307

Residential Group Care Quarterly. Volume 5, Number 3, Winter 2005  

ERIC Educational Resources Information Center

This issue of "Residential Group Care Quarterly" contains the following articles: (1) "Promising Practices for Adequately Funding and Reimbursing Residential Services" (Lloyd Bullard); (2) "Closing the Gender Gap" (Erin Andersen); (3) "Residential Child Care: Guidelines for Physical Techniques, Crisis Prevention, and Management" (Kurk Lalemand);…

Michael, Jennifer, Ed.

2005-01-01

308

SAN JOSE STATE UNIVERSITY INSTITUTIONAL ANIMAL CARE & USE COMMITTEE  

E-print Network

to animals. On that premise, the PI will be expected to adequately support that the experimental designSAN JOSE STATE UNIVERSITY INSTITUTIONAL ANIMAL CARE & USE COMMITTEE GUIDELINES FOR CONDUCTING A LITERATURE SEARCH FOR ANIMAL CARE AND USE SUBMISSIONS The Federal government requires an Institution's Animal

Su, Xiao

309

Treatment of depression in a low-income primary care setting with colocated mental health care.  

PubMed

In order to characterize depression treatment-as-usual in a large primary care practice in the United States with colocated mental health care, and to examine predictors of receiving any treatment and receiving adequate treatment, primary care patients were systematically approached in waiting rooms. Those with a minimum level of depression symptoms (n = 91) were asked to participate in a study in which they completed assessments of mental health service use, depression symptoms, and related problems. Results suggested that most patients with elevated depressive symptoms were receiving some type of mental health care, indicating they had been identified as depressed. However, only half were receiving "minimally adequate care." Minority patients were less likely to receive any care. Patients who were more depressed, demonstrated poorer problem-solving ability, and had poorer physical health were more likely to receive any treatment and to receive minimally adequate treatment for depression. These results suggest that, even in the context of colocated mental health care, there is still room for improving treatment of depressed patients. PMID:19630457

Uebelacker, Lisa A; Smith, Marcia; Lewis, Angelique W; Sasaki, Ryan; Miller, Ivan W

2009-06-01

310

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

311

Caring Reflexivity  

ERIC Educational Resources Information Center

This article provides a brief summary of the seven articles in this special issue through the lens of the concept of "caring reflexivity". In joining "caring" and "reflexivity", we deepen the conversation about what constitutes reflexivity, encouraging an explicit focus on the relational. Revisiting the first article, we argue that…

Rallis, Sharon F.; Rossman, Gretchen B.

2010-01-01

312

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

313

Managing resources and ensuring accountability: understanding return on investment.  

PubMed

Leaders of colleges of nursing face increasing challenges associated with insufficient resources coupled with growing market demands. Managing financial resources and ensuring accountability are essential leadership skills for deans and academic leaders across the nation. An understanding of "return on investment" or "ROI" analysis as a mechanism to negotiate and validate outcomes with varied stakeholders is critical to building a financial business case. ROI analysis is one component of metrics for knowledge management and must be understood from a business perspective. Providing leadership to a resilient college of nursing requires a willingness to utilize innovative strategies and effective metrics to measure outcomes. By raising the effectiveness of base spending, thereby increasing ROI, an academic leader is better positioned to innovate, which is crucial to the future success of nursing education. PMID:16259102

Green, Alexia; Masten, Yondell; Cherry, Barbara

2005-01-01

314

Ensuring data consistency over CMS distributed computing system  

SciTech Connect

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

Rossman, Paul; /Fermilab

2009-05-01

315

A learning program that ensures prompt and versatile vocal imitation  

PubMed Central

Here we show how a migratory songbird, the chipping sparrow (Spizella passerina), achieves prompt and precise vocal imitation. Juvenile chipping sparrow males develop five to seven potential precursor songs; the normal development of these songs requires intact hearing but not imitation from external models. The potential precursor songs conform with general species-typical song parameters but differ from the song of wild, adult territorial males. As chipping sparrow males return from migration to start their first breeding season, they settle close to an older adult. The young male then stops producing all but one of its precursor songs, retaining the one that most resembles that of its neighbor. This single song then becomes more variable and, in a matter of days, is altered to closely match the neighbor's song. This elegant solution ensures species specificity and promptness of imitation. PMID:18077359

Liu, Wan-chun; Nottebohm, Fernando

2007-01-01

316

A learning program that ensures prompt and versatile vocal imitation.  

PubMed

Here we show how a migratory songbird, the chipping sparrow (Spizella passerina), achieves prompt and precise vocal imitation. Juvenile chipping sparrow males develop five to seven potential precursor songs; the normal development of these songs requires intact hearing but not imitation from external models. The potential precursor songs conform with general species-typical song parameters but differ from the song of wild, adult territorial males. As chipping sparrow males return from migration to start their first breeding season, they settle close to an older adult. The young male then stops producing all but one of its precursor songs, retaining the one that most resembles that of its neighbor. This single song then becomes more variable and, in a matter of days, is altered to closely match the neighbor's song. This elegant solution ensures species specificity and promptness of imitation. PMID:18077359

Liu, Wan-Chun; Nottebohm, Fernando

2007-12-18

317

Ensuring minimal humidity levels in hermetic implant housings.  

PubMed

The electronic circuitry of active implantable devices is commonly protected against the risk of water-induced corrosion by using gas-tight (hermetic) packages, preventing moisture from the host body to reach the electronics. However, when closing the package, one has to ensure that the packaged components do not contain moisture that could rise humidity inside the package to critical levels by outgassing. For our miniature metal/ceramic packages, we found a drying procedure of 120 °C at 180 mbar absolute pressure for one hour, followed by a dry helium purge sufficient to keep the relative humidity below 2.5% over a time span of 300 days at 80 °C, corresponding to over 15 years at 37 °C. The additional integration of a desiccant inside the package permits to keep the relative humidity below 0.1%, the detection limit of the integrated sensor. This sensor was selected based on an evaluation of 17 commercially available humidity sensors. PMID:22254800

Schuettler, Martin; Schatz, Andreas; Ordonez, Juan S; Stieglitz, Thomas

2011-01-01

318

Duplex rolling element bearing mounting for ensuring preload control  

NASA Astrophysics Data System (ADS)

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 there between. Preloading of the bearings is achieved by inserting preload springs between external surfaces of the outer races and respective bearing housing surf aces. A second gap A2 may also be provided between the bearing housing and the external surface of one of the outer races to prevent a change in preload due to thermal gradients.

Daugherty, Thomas L.

1994-05-01

319

Retention in mental health care of Portuguese-speaking patients.  

PubMed

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

2013-02-01

320

Patients' Experiences with Navigation for Cancer Care  

PubMed Central

Objective We examined how navigation, defined as the assessment and alleviation of barriers to adequate health care, influences patients' perspectives on the quality of their cancer care. Methods We conducted post-study patient interviews from a randomized controlled trial (usual care vs. patient navigation services) from cancer diagnosis through treatment completion. Patients were recruited from 11 primary care, hospital and community oncology practices in New York. We interviewed patients about their expectations and experience of patient navigation or, for non-navigated patients, other sources of assistance. Results Thirty-five patients newly diagnosed with breast or colorectal cancer. Valued aspects of navigation included emotional support, assistance with information needs and problem-solving, and logistical coordination of cancer care. Unmet cancer care needs expressed by patients randomized to usual care consisted of lack of assistance or support with childcare, household responsibilities, coordination of care, and emotional support. Conclusion Cancer patients value navigation. Instrumental benefits were the most important expectations for navigation from navigated and non-navigated patients. Navigated patients received emotional support and assistance with information needs, problem-solving, and logistical aspects of cancer care coordination. Practice Implications Navigation services may help improve cancer care outcomes important to patients by addressing fragmented, confusing, uncoordinated, or inefficient care. PMID:20006459

Carroll, Jennifer K.; Humiston, Sharon G.; Meldrum, Sean C.; Salamone, Charcy M.; Jean-Pierre, Pascal; Epstein, Ronald M.; Fiscella, Kevin

2010-01-01

321

The health literacy, self-care, and medication hassles of patients with heart failure and their caregivers  

Microsoft Academic Search

Nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Patients with heart failure are particularly challenged by meeting with multiple healthcare providers, who may emphasize different self-care strategies, which can be difficult for patients to interpret. Understanding how to effectively care for one's

Aleda M Hess

2009-01-01

322

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

323

Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability—An Emerging Framework  

PubMed Central

Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four “pillars” of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two “foundational considerations,” adaptive capacity and policy levers, are also discussed.

Holve, Erin

2013-01-01

324

Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey.  

PubMed

The transition resulting from the break-up of the Soviet Union significantly affected the health care systems and population health status in the newly independent States. The available body of evidence suggests that contraction of public resources resulting from economic slowdown has led to the proliferation of out-of-pocket payments and private spending becoming a major source of finance to health service provision to the population. Emerging financial access barriers impede adequate utilization of health care services. Most transition countries embarked on reforming health systems and health care financing in order to tackle this problem. However, little evidence is available about the impact of these reforms on improved access and health outcomes. This paper aims to contribute to the assessment of the impact of health sector reforms in Georgia. It mainly focuses on changes in the patterns of health services utilization in rural areas of the country as a function of implemented changes in health care financing on a primary health care (PHC) level. Our findings are based on a household survey which was carried out during summer 2002. Conclusions derived from the findings could be of interest to policy makers in transitional countries. The paper argues that health financing reforms on the PHC level initiated by the Government of Georgia, aimed at decreasing financial access barriers for the population in the countryside, have rendered initial positive results and improved access to essential PHC services. However, to sustain and enhance this attainments the government should ensure equity, improve the targeting mechanisms for the poor and mobilize additional public and private funds for financing primary care in the country. PMID:15571898

Gotsadze, George; Zoidze, Akaki; Vasadze, Otar

2005-02-01

325

Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package  

PubMed Central

Background The government of Malawi is committed to the broad rollout of antiretroviral treatment in Malawi in the public health sector; however one of the primary challenges has been the shortage of trained health care workers. The Practical Approach to Lung Health Plus HIV/AIDS in Malawi (PALM PLUS) package is an innovative guideline and training intervention that supports primary care middle-cadre health care workers to provide front-line integrated primary care. The purpose of this paper is to describe the lessons learned in implementing the PALM PLUS package. Methods A clinical tool, based on algorithm- and symptom-based guidelines was adapted to the Malawian context. An accompanying training program based on educational outreach principles was developed and a cascade training approach was used for implementation of the PALM PLUS package in 30 health centres, targeting clinical officers, medical assistants, and nurses. Lessons learned were identified during program implementation through engagement with collaborating partners and program participants and review of program evaluation findings. Results Key lessons learned for successful program implementation of the PALM PLUS package include the importance of building networks for peer-based support, ensuring adequate training capacity, making linkages with continuing professional development accreditation and providing modest in-service training budgets. The main limiting factors to implementation were turnover of staff and desire for financial training allowances. Conclusions The PALM PLUS approach is a potential model for supporting mid-level health care workers to provide front-line integrated primary care in low and middle income countries, and may be useful for future task-shifting initiatives. PMID:25080192

2014-01-01

326

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

PubMed Central

The KCNQ1 ? subunit and the KCNE2 ? subunit form a potassium channel in thyroid epithelial cells. Genetic disruption of KCNQ1-KCNE2 causes hypothyroidism in mice, resulting in cardiac hypertrophy, dwarfism, alopecia, and prenatal mortality. Here, we investigated the mechanistic requirement for KCNQ1-KCNE2 in thyroid hormone biosynthesis, utilizing whole-animal dynamic positron emission tomography. The KCNQ1-specific antagonist (?)-[3R,4S]-chromanol 293B (C293B) significantly impaired thyroid cell I? uptake, which is mediated by the Na+/I? symporter (NIS), in vivo (dSUV/dt: vehicle, 0.028±0.004 min?1; 10 mg/kg C293B, 0.009±0.006 min?1) and in vitro (EC50: 99±10 ?M C293B). Na+-dependent nicotinate uptake by SMCT, however, was unaffected. Kcne2 deletion did not alter the balance of free vs. thyroglobulin-bound I? in the thyroid (distinguished using ClO4?, a competitive inhibitor of NIS), indicating that KCNQ1-KCNE2 is not required for Duox/TPO-mediated I? organification. However, Kcne2 deletion doubled the rate of free I? efflux from the thyroid following ClO4? injection, a NIS-independent process. Thus, KCNQ1-KCNE2 is necessary for adequate thyroid cell I? uptake, the most likely explanation being that it is prerequisite for adequate NIS activity.—Purtell, K., Paroder-Belenitsky, M., Reyna-Neyra, A., Nicola, J. P., Koba, W., Fine, E., Carrasco, N., Abbott, G. W. The KCNQ1-KCNE2 K+ channel is required for adequate thyroid I? uptake. PMID:22549510

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

2012-01-01

327

Optimal detection pinhole for lowering speckle noise while maintaining adequate optical sectioning in confocal reflectance microscopes  

PubMed Central

Abstract. Coherent speckle influences the resulting image when narrow spectral line-width and single spatial mode illumination are used, though these are the same light-source properties that provide the best radiance-to-cost ratio. However, a suitable size of the detection pinhole can be chosen to maintain adequate optical sectioning while making the probability density of the speckle noise more normal and reducing its effect. The result is a qualitatively better image with improved contrast, which is easier to read. With theoretical statistics and experimental results, we show that the detection pinhole size is a fundamental parameter for designing imaging systems for use in turbid media. PMID:23224184

Glazowski, Christopher; Rajadhyaksha, Milind

2012-01-01

328

Failure to receive health care among people with mental illness: theory and implications.  

PubMed

Often individuals with serious mental illness suffer from comorbid physical health problems but fail to receive necessary health care services. This article explores the major factors associated with the failure to receive adequate medical care using 3 theories of health care utilization: Andersen's behavioral model of health services use, the health belief model, and the avoidance and approach framework. Finding these theories inadequate to fully explain the failure to receive adequate care on their own, a new intervention model incorporating an individual and context-specific dimension is proposed as a comprehensive way of conceptualizing how people with mental illness may be effectively engaged with the health care system. PMID:19042304

Hahm, Hyeouk Chris; Speliotis, Ashley E; Bachman, Sara S

2008-01-01

329

Technical Basis for the Determination that Current Characterization Data and Processes are Sufficient to Ensure Safe Storage and to Design Waste Disposal  

SciTech Connect

This document presents the technical basis for closure of Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 93-5 Implementation Plan milestone 5.6.3.13, ''Core sample all tanks by 2002'' (DOE-RL 1996). The milestone was based on the need for characterization data to ensure safe storage of the waste, to operate the tanks safely, and to plan and implement retrieval and processing of the waste. Sufficient tank characterization data have been obtained to ensure that existing controls are adequate for safe storage of the waste in the 177 waste tanks at the Hanford Site. In addition, a process has been developed, executed, and institutionalized to systemically identify information needs, to integrate and prioritize the needs, and to reliably obtain and analyze the associated samples. This document provides a technical case that the remaining 45 incompletely sampled tanks no longer require sampling to support the intent of the Implementation Plan milestone. Sufficient data have been obtained to close the Unreviewed Safety Questions (USQs), and to ensure that existing hazard controls are adequate and appropriately applied. However, in the future, additional characterization of tanks at the site will be required to support identified information needs. Closure of this milestone allows sampling and analytical data to be obtained in a manner that is consistent with the integrated priority process.

SIMPSON, B.C.

1999-08-12

330

Ensuring privacy in the study of pathogen genetics  

PubMed Central

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.

2014-01-01

331

Involving Parents in Their Children's Dental Care.  

ERIC Educational Resources Information Center

Asserts that parent education is vital to good dental hygiene for the whole family. Discusses what Head Start staffers can do to ensure that children's dental needs are being met, particularly in assisting parents with taking responsibility for children's dental hygiene. Covers dental care tips for parents, questions and answers about dental…

Becker, Donna

1998-01-01

332

Residential Care  

MedlinePLUS

... Zip: * *required We will not sell or share your name. Residential Care Tweet Bookmark this page | Email | Print ... and participation in Medicare or Medicaid . Consider placing your name on a waiting list even if you are ...

333

Hospice care  

MedlinePLUS

... social workers, counselors, aides, clergy, and therapists. The team works together to give the patient and family comfort and support. The hospice team is always available. Hospice care treats the mind, ...

334

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 ...

335

Continuing Care  

MedlinePLUS

... Expectancies Popular Drugs May Have Little Benefit in Aggression of Alzheimer’s Aricept Proves Ineffective for the Agitation ... Key for Alzheimer’s Caregivers Treatment Steps May Ease Aggression in Nursing Home Residents Caring for a Loved ...

336

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. ...

337

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

338

Medical Care: "Say Ahh!". Health and the Consumer.  

ERIC Educational Resources Information Center

Secondary level students learn about medical care in this learning activity package, which is one in a series. The developers believe that consumer education in the health field would ensure better patient care and help eliminate incompetent medical practices and practitioners. The learning package includes instructions for the teacher,…

Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.

339

Recommendations for Long Term Care in an Elderly Medicaid Population.  

ERIC Educational Resources Information Center

The State of Virginia has had a statewide nursing home preadmission screening program since 1977 and has made efforts to ensure appropriate placement of individuals in long term care settings. In a major effort to divert certain individuals from institutionalization, a personal care option has been provided. Using data from the Preadmission…

Travis, Shirley S.; McAuley, William J.

340

Child Care and Employed Parents of Children with Emotional or Behavioral Disorders  

ERIC Educational Resources Information Center

Lack of appropriate child care is frequently reported by parents of children with disabilities as a major obstacle to finding and maintaining their employment. Care for children with emotional or behavioral disorders is particularly difficult to locate because child care providers often lack adequate training. Findings are presented from…

Rosenzweig, Julie M.; Brennan, Eileen M.; Huffstutter, Katherine; Bradley, Jennifer R.

2008-01-01

341

Treating depression in primary care: An innovative role for mental health nurses  

Microsoft Academic Search

Late-life depression is common in primary care. However, because of barriers such as stigma and the assumption that depression in older adults is a normal part of aging, it is often underrecognized and undertreated. Further, most primary care providers do not have the time or resources to provide adequate follow-up depression care. By integrating a depression clinical specialist into the

Carol D. Saur; Linda H. Harpole; David C. Steffens; Caryl D. Fulcher; Yvonne Porterfield; Rita Haverkamp; Dena Kivett; Jürgen Unützer

2002-01-01

342

Analysing equity in health care financing: A flow of funds approach  

Microsoft Academic Search

There are concerns that existing methods for analysing equity in Irish health care financing, based on progressivity index measures, are not adequately capturing patterns of inequity that occur in practice. This paper follows a new direction in the literature whereby equity in health care financing and delivery are analysed together. A flow of funds for Irish health care resources is

Samantha Smith; Charles Normand

2009-01-01

343

Failure to Receive Health Care Among People with Mental Illness: Theory and Implications  

Microsoft Academic Search

Often individuals with serious mental illness suffer from comorbid physical health problems but fail to receive necessary health care services. This article explores the major factors associated with the failure to receive adequate medical care using 3 theories of health care utilization: Andersen's behavioral model of health services use, the health belief model, and the avoidance and approach framework. Finding

Hyeouk Chris Hahm; Ashley E. Speliotis; Sara S. Bachman

2008-01-01

344

Robust mitotic entry is ensured by a latching switch.  

PubMed

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

Tuck, Chloe; Zhang, Tongli; Potapova, Tamara; Malumbres, Marcos; Novák, Béla

2013-01-01

345

Robust mitotic entry is ensured by a latching switch  

PubMed Central

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

Tuck, Chloe; Zhang, Tongli; Potapova, Tamara; Malumbres, Marcos; Novák, Béla

2013-01-01

346

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

Microsoft Academic Search

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

Nicki Pesik; Mark Keim; Tomoko Rie Sampson

1999-01-01

347

Occupational health care in small and medium-sized enterprises--introduction of services to craftsmen by using their professional networks.  

PubMed

In order to ensure equality of occupational health care among employees of small and medium-sized enterprises (SMEs) and of larger companies amendments in the regulations of the numerous German accident insurance funds had to be made to provide for full availability of services, as requested by German and European law. According to these amendments, sectors formerly exempted due to small size and due to lack of an adequate number of qualified personnel, had to be covered by occupational health care. In order to reach this target group new strategies of care delivery had to be developed, making use of pre-existing infrastructure and networks. In Germany, district trade association (Kreishandwerkerschaften) have proved to be very effective for introducing occupational safety and health care into SMEs by either hiring external multidisciplinary services or by establishing a common service to be used by all associated crafts establishments. In a study conducted by the Federal Office for Health and Safety at Work in 1996 (Boldt, Gille, & Grahl, 1997), 7 district trade association were looked at in detail for their strategies. The results were discussed and supplemented in a 2-day workshop. PMID:10657928

Froneberg, B; Boldt, U

1999-01-01

348

CARE is an institutional resource for the Cornell research and teaching community. The mission of CARE is to  

E-print Network

of CARE is to facilitate advances in research and teaching while ensuring animal welfare. Mary E. Martin in research, teaching, testing Biomedical, agricultural, behavioral, field studies Animal facilities at 41 and teaching Serve as a resource for investigators consult on animal models, refinements, post-op care, drug

Danforth, Bryan Nicholas

349

Attracting and retaining nurses in HIV care.  

PubMed

Attracting and retaining nurses in HIV care is essential to treatment success, preventing the spread of HIV, slowing its progression, and improving the quality of life of people living with HIV. Despite the wealth of studies examining HIV care, few have focused on the factors that influenced nurses' choices to specialize in HIV care. We examined the factors that attracted and retained eight nurses currently working in HIV care in two large Canadian cities. Participants were primarily women between the ages of 20 and 60 years. Interviews were conducted between November 2010 and September 2011 using interpretive description, a qualitative design. Factors that influenced participants to focus their careers in HIV care included both attracting factors and retaining factors. Although more research is needed, this exploration of attracting and retaining factors may motivate others to specialize in HIV nursing, and thus help to promote adequate support for individuals suffering from the disease. PMID:23499392

Puplampu, Gideon L; Olson, Karin; Ogilvie, Linda; Mayan, Maria

2014-01-01

350

Collaborative Drug Therapy Management: Case Studies of Three Community-Based Models of Care  

PubMed Central

Collaborative drug therapy management agreements are a strategy for expanding the role of pharmacists in team-based care with other providers. However, these agreements have not been widely implemented. This study describes the features of existing provider–pharmacist collaborative drug therapy management practices and identifies the facilitators and barriers to implementing such services in community settings. We conducted in-depth, qualitative interviews in 2012 in a federally qualified health center, an independent pharmacy, and a retail pharmacy chain. Facilitators included 1) ensuring pharmacists were adequately trained; 2) obtaining stakeholder (eg, physician) buy-in; and 3) leveraging academic partners. Barriers included 1) lack of pharmacist compensation; 2) hesitation among providers to trust pharmacists; 3) lack of time and resources; and 4) existing informal collaborations that resulted in reduced interest in formal agreements. The models described in this study could be used to strengthen clinical–community linkages through team-based care, particularly for chronic disease prevention and management. PMID:25811494

Snyder, Margie E.; Earl, Tara R.; Greenberg, Michael; Heisler, Holly; Revels, Michelle; Matson-Koffman, Dyann

2015-01-01

351

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

352

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

353

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

Code of Federal Regulations, 2014 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...

2014-10-01

354

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

355

009 pp: exploring carers' experiences of caring for someone with advanced dementia.  

PubMed

During advanced stages of dementia many people are no longer able to live independently at home. In Australia, home based case management packages were introduced for people with dementia and nursing home level care needs who wanted to remain at home. My PhD study aimed to develop a more in-depth exploration of carers' experiences of caring for someone with advanced dementia within the context of the formal service system. I undertook semi-structured interviews with carers who were eligible for a package (on a waiting list n=11; currently accessing a package n=14; accessed a package prior to their relative moving into a care home n=12; or prior to their relative's death n=1). As a PhD study I did not have a second researcher available to code and analyse data in depth. I was able to discuss themes and issues with my supervisors but this was not adequate for ensuring a rigorous analysis. I relied on participants to check my interpretation of the interview using summary reports. Participants were followed up three months after the interview to check whether their circumstances had changed and to reflect on the interview and report. This process proved to be useful as some participants made small clarifications about my interpretation while most indicated that the report was an accurate summary. For some, the report was enlightening and some commented that they appreciated having the opportunity to comment. The summary reports were used to identify themes which were then illustrated with quotes from transcriptions. This paper provides an approach to analysis that aims to reduce the limitation of having a sole researcher analysing qualitative data. This study was undertaken at The University of Melbourne and the National Ageing Research Institute and was financially supported with an Assessment and Better Care Outcomes Dementia Collaborative Research Centre PhD scholarship. PMID:25869705

Moore, K J; Ozanne, E; Dow, B; Ames, D

2015-01-01

356

Foster Care: State Practices for Assessing Health Needs, Facilitating Service Delivery, and Monitoring Children's Care. Report to the Chairman, Subcommittee on Income Security and Family Support, Committee on Ways and Means, House of Representatives. GAO-09-26  

ERIC Educational Resources Information Center

Providing health care services for foster children, who frequently have significant health care needs, can be challenging. The Administration for Children and Families (ACF) oversees foster care, but state child welfare agencies are responsible for ensuring that these children receive health care services, which are often financed by Medicaid. In…

Brown, Kay; Bascetta, Cynthia A.

2009-01-01

357

Ensuring Credibility of NASA's Earth Science Data (Invited)  

NASA Astrophysics Data System (ADS)

The summary description of the Fall 2013 AGU session on 'Data Curation, Credibility, Preservation Implementation, and Data Rescue to Enable Multi-Source Science' identifies four attributes needed to ensure credibility in Earth science data records. NASA's Earth Science Data Systems Program has been working on all four of these attributes: transparency, completeness, permanence, and ease of access and use, by focusing on them and upon improving our practices of them, over many years. As far as transparency or openness, NASA was in the forefront of free and open sharing of data and associated information for Earth observations. The US data policy requires such openness, but allows for the recoup of the marginal cost of distribution of government data and information - but making the data available with no such charge greatly increases their usage in scientific studies and the resultant analyses hasten our collective understanding of the Earth system. NASA's currently available Earth observations comprise primarily those obtained from satellite-borne instruments, suborbital campaigns, and field investigations. These data are complex and must be accompanied by rich metadata and documentation to be understandable. To enable completeness, NASA utilizes standards for data format, metadata content, and required documentation for any data that are ingested into our distributed Earth Observing System Data and Information System, or EOSDIS. NASA is moving to a new metadata paradigm, primarily to enable a fuller description of data quality and fit-for-purpose attributes. This paradigm offers structured approaches for storing quality measures in metadata that include elements such as Positional Accuracy, Lineage and Cloud Cover. NASA exercises validation processes for the Earth Science Data Systems Program to ensure users of EOSDIS have a predictable level of confidence in data as well as assessing the data viability for usage and application. The Earth Science Data Systems Program has been improving its data management practices for over twenty years to assure permanence of data utility through reliable preservation of bits, readability, understandability, usability and reproducibility of results. While NASA has focused on the Earth System Science research community as the primary data user community, broad interest in the data due to climate change and how it is affecting people everywhere (e.g. sea level rise) by environmental managers, public policymakers and citizen scientists has led the Program to respond with new tools and ways to improve ease of access and use of the data. NASA's standard Earth observation data will soon be buttressed with the long tail of federally-funded research data created or analyzed by grantees, in response to John Holdren's OSTP Memorandum to federal departments and agencies entitled 'Increasing Access to the Results of Federally-Funded Scientific Research'. We fully expect that NASA's Earth Science Data Systems Program will be able to work with our grantees to comply early, and flexibly improve the openness of this source of scientific data to a best practice for NASA and the grantees

Maiden, M. E.; Ramapriyan, H. K.; Mitchell, A. E.; Berrick, S. W.; Walter, J.; Murphy, K. J.

2013-12-01

358

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

359

Working together to ensure safety at hydro projects  

SciTech Connect

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

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

1993-05-01

360

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

361

Types of Care  

MedlinePLUS

... of Care Child Care Centers Family Child Care In-home Caregivers Care Provided by Relatives, Friends and Neighbors Choosing Child Care If You Can't Find Care Evaluating Providers Child Care Aware of America Child Care Aware Parent Network Provider Appreciation Day ...

362

Adequate connexin-mediated coupling is required for proper insulin production  

PubMed Central

To assess whether connexin (Cx) expression contributes to insulin secretion, we have investigated normal and tumoral insulin-producing cells for connexins, gap junctions, and coupling. We have found that the glucose-sensitive cells of pancreatic islets and of a rat insulinoma are functionally coupled by gap junctions made of Cx43. In contrast, cells of several lines secreting insulin abnormally do not express Cx43, gap junctions, and coupling. After correction of these defects by stable transfection of Cx43 cDNA, cells expressing modest levels of Cx43 and coupling, as observed in native beta-cells, showed an expression of the insulin gene and an insulin content that were markedly elevated, compared with those observed in both wild-type (uncoupled) cells and in transfected cells overexpressing Cx43. These findings indicate that adequate levels of Cx-mediated coupling are required for proper insulin production and storage. PMID:8522612

1995-01-01

363

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

364

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

PubMed

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

Greindl, M G; Preat, S

1976-09-01

365

Submicroscopic infections among children with adequate clinical and parasitological response (ACPR).  

PubMed

The aim of the study was to re-assess the treatment outcomes of Gabonese children, treated with sulfadoxine-pyrimethamine (SP) and artesunate-mefloquine (AM) and categorized by microscopy as adequate clinical and parasitological response (ACPR), using polymerase chain reaction (PCR). Dried blood spots were collected at day 0 and day 28 and stevor gene amplification was performed to detect Plasmodium falciparum infections. Plasmodial DNA was found in 27.5% (n=19/69) of the isolates collected at day 28; this proportion was 34.3% (n=12/35) in the SP group and 20.6% (n=7/34) in the AM group. This study underlines the need of an accurate and more appropriate technique such as PCR to evaluate antimalarial drug efficacy during clinical trials. PMID:24561075

Mawili-Mboumba, D P; Bouyou-Akotet, M K; Kombila, M

2014-06-01

366

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

367

New markets for ambulatory care: wellness center + physicians' office building + urgent care/diagnostic center.  

PubMed

As the shift to ambulatory care increases, many established acute care facilities are searching for ways to serve their communities more effectively, to maintain their position in the market--and to ensure continuing, healthy revenue streams. This article explores some of the issues faced by such an institution in a rapidly growing market in the Southeast. For this article, we refer to it as Metropolitan Hospital. PMID:10387442

Burns, G B

1999-01-01

368

Creating a Culture of Consumer Engagement in Maternity Care  

PubMed Central

In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses opportunities to establish a culture of consumer engagement in maternity care. The author demonstrates how improving health literacy, ensuring multi-stakeholder participation in the development of clinical guidelines, and supporting comparative effectiveness research of woman- and family-centered care practices may improve maternity care. PMID:21358836

Romano, Amy M.

2010-01-01

369

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...  

Code of Federal Regulations, 2011 CFR

...programmatic responsibilities for ensuring that scholarship recipients become successful teachers...QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.52 What are a grantee's...programmatic responsibilities for ensuring that scholarship recipients become successful...

2011-07-01

370

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...  

Code of Federal Regulations, 2014 CFR

...programmatic responsibilities for ensuring that scholarship recipients become successful teachers...QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.52 What are a grantee's...programmatic responsibilities for ensuring that scholarship recipients become successful...

2014-07-01

371

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...  

Code of Federal Regulations, 2013 CFR

...programmatic responsibilities for ensuring that scholarship recipients become successful teachers...QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.52 What are a grantee's...programmatic responsibilities for ensuring that scholarship recipients become successful...

2013-07-01

372

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...  

Code of Federal Regulations, 2012 CFR

...programmatic responsibilities for ensuring that scholarship recipients become successful teachers...QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.52 What are a grantee's...programmatic responsibilities for ensuring that scholarship recipients become successful...

2012-07-01

373

34 CFR 611.52 - What are a grantee's programmatic responsibilities for ensuring that scholarship recipients...  

Code of Federal Regulations, 2010 CFR

...programmatic responsibilities for ensuring that scholarship recipients become successful teachers...QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.52 What are a grantee's...programmatic responsibilities for ensuring that scholarship recipients become successful...

2010-07-01

374

42 CFR 401.713 - Ensuring the privacy and security of data.  

Code of Federal Regulations, 2012 CFR

... Ensuring the privacy and security of data. 401.713 Section 401.713 Public...REQUIREMENTS Availability of Medicare Data for Performance Measurement § 401.713 Ensuring the privacy and security of data. (a) A qualified entity must...

2012-10-01

375

42 CFR 401.713 - Ensuring the privacy and security of data.  

Code of Federal Regulations, 2013 CFR

... Ensuring the privacy and security of data. 401.713 Section 401.713 Public...REQUIREMENTS Availability of Medicare Data for Performance Measurement § 401.713 Ensuring the privacy and security of data. (a) A qualified entity must...

2013-10-01

376

42 CFR 401.713 - Ensuring the privacy and security of data.  

Code of Federal Regulations, 2014 CFR

... Ensuring the privacy and security of data. 401.713 Section 401.713 Public...REQUIREMENTS Availability of Medicare Data for Performance Measurement § 401.713 Ensuring the privacy and security of data. (a) A qualified entity must...

2014-10-01

377

Models for Designing Long-Term Care Service Plans and Care Programs for Older People  

PubMed Central

The establishment of a system for providing appropriate long-term care services for older people is a national issue in Japan, and it will likely become a worldwide issue in the years to come. Under Japanese Long-term Care Insurance System, long-term care is provided based on long-term care programs, which were designed by care providers on the basis of long-term care service plans, which were designed by care managers. However, defined methodology for designing long-term care service plans and care programs has not been established yet. In this paper, we propose models for designing long-term care service plans and care programs for older people, both by incorporating the technical issues from previous studies and by redesigning the total methodology according to these studies. Our implementation model consists of “Function,” “Knowledge Structure,” and “Action Flow.” In addition, we developed the concrete knowledgebases based on the Knowledge Structure by visualizing, summarizing, and structuring the inherent knowledge of healthcare/welfare professionals. As the results of the workshop and retrospective verification, the adequacy of the models was suggested, while some further issues were pointed. Our models, knowledgebases, and application make it possible to ensure the quality of long-term care for older people. PMID:23589773

Tsuru, Satoko; Iizuka, Yoshinori

2013-01-01

378

Towards community-based integrated care: trends and issues in Japan's long-term care policy  

PubMed Central

Introduction In 2000, Japan implemented a mandatory long-term care insurance system. With the rapid growth of the system, problems became apparent. Several critical alterations were made to long-term care insurance system, particularly with respect to integrated care. Methods This paper elucidates the policy trends that led to the reforms of the long-term care insurance system, which included new concepts of ‘integrated care’ and ‘community-based care’, an agenda of cost containment and service streamlining, and coordination with medical care. Results Community-based integrated care, as envisaged in the long-term care policy, includes not only the integration of medical care into service provision but also the inclusion of the informal mutual aid, oversight of for-profit providers by an administration that ensures users are not exploited and coordination between systems that cover different geographical areas. Conclusions Japan's experience in community-based care integration suggests that this project requires multi-faceted care integration in local communities. In the future, it will be necessary to conduct empirical assessments of the effectiveness of these measures. PMID:24605073

Morikawa, Mie

2014-01-01

379

Screening for depression in the primary care population.  

PubMed

Despite strong efforts, the diagnosis and treatment of depression bring many challenges in the primary care setting. Screening for depression has been shown to be effective only if reliable systems of care are in place to ensure appropriate treatment by clinicians and adherence by patients. New evidence-based models of care for depression exist, but spread has been slow because of inadequate funding structures and conflicts within current clinical culture. The Affordable Care Act introduces potential opportunities to reorganize funding structures, conceivably leading to increased adoption of these collaborative care models. Suicide screening remains controversial. PMID:25725567

Deneke, D Edward; Schultz, Heather E; Fluent, Thomas E

2015-03-01

380

Screening for depression in the primary care population.  

PubMed

Despite strong efforts, the diagnosis and treatment of depression bring many challenges in the primary care setting. Screening for depression has been shown to be effective only if reliable systems of care are in place to ensure appropriate treatment by clinicians and adherence by patients. New evidence-based models of care for depression exist, but spread has been slow because of inadequate funding structures and conflicts within current clinical culture. The Affordable Care Act introduces potential opportunities to reorganize funding structures, conceivably leading to increased adoption of these collaborative care models. Suicide screening remains controversial. PMID:24830614

Deneke, D Edward; Schultz, Heather; Fluent, Thomas E

2014-06-01

381

Respiratory Home Health Care  

MedlinePLUS

Respiratory Home Health Care Respiratory care at home can contribute to improved quality of life and significant cost savings. Your respiratory care ... your family and home situation to help your health care provider plan for your care after you are ...

382

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 ...

383

Home Health Care  

MedlinePLUS

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

384

The role of adequate reference materials in density measurements in hemodialysis  

NASA Astrophysics Data System (ADS)

In hemodialysis, oscillation-type density meters are used to measure the density of the acid component of the dialysate solutions used in the treatment of kidney patients. An incorrect density determination of this solution used in hemodialysis treatments can cause several and adverse events to patients. Therefore, despite the Fresenius Medical Care (FME) tight control of the density meters calibration results, this study shows the benefits of mimic the matrix usually measured to produce suitable reference materials for the density meter calibrations.

Furtado, A.; Moutinho, J.; Moura, S.; Oliveira, F.; Filipe, E.

2015-02-01

385

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

386

Stepped care treatment for depression and anxiety in primary care. a randomized controlled trial  

Microsoft Academic Search

Background  Depressive and anxiety disorders are common in general practice but not always treated adequately. Introducing stepped care\\u000a might improve this. In this randomized trial we examined the effectiveness of such a stepped care model.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The study population consisted of primary care attendees aged 18-65 years with minor or major DSM-IV depressive and\\/or anxiety\\u000a disorders, recruited through screening. We randomized 120

Wike Seekles; Annemieke van Straten; Aartjan Beekman; Harm van Marwijk; Pim Cuijpers

2011-01-01

387

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

388

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. PMID:25530770

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

2014-01-01

389

Maximizing Health Care Enrollment through Seamless Coverage for Families in Transition  

E-print Network

policymakers on how best to ensure seamless health coverage under the Affordable Care Act for individuals of coverage. Background Under the recently enacted federal health law, the Affordable Care Act, Americans of recommendations will follow in a policy brief to be released in the summer. Introduction The Affordable Care Act

Kammen, Daniel M.

390

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

391

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

392

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

393

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

394

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 ...

395

Ensuring Credit to Data Creators: A Case Study for Geodesy  

NASA Astrophysics Data System (ADS)

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

Boler, F. M.; Gorman, A.

2011-12-01

396

The high cost of a nutritionally adequate diet in four Yukon communities.  

PubMed

The cost of purchasing a nutritionally adequate diet in four Yukon communities was examined, based on the 46 food items and quantities of the federal government's Northern Food Basket. In Old Crow, unit purchase prices were on average 250% of those in Edmonton, while in three southern Yukon communities, unit purchase prices were about 125% of those in Edmonton. In quantities needed to meet weekly nutrient needs of a family of four, the cost in Old Crow was 320% of that in Edmonton, while in three southern Yukon communities, it was 140%. It appears that due to financial necessity, Yukon aboriginal people need continuing access to traditional food resources (wild game animals, birds, fish and berries). Since the Northern Food Basket does not include any traditional foods, it alone is of limited acceptability to these people. The high cost of marketed food and the role of traditional foods in contemporary diets should be considered in giving dietary advice and in determining food allowances in social assistance programs. PMID:7804933

Wein, E E

1994-01-01

397

The placental pursuit for an adequate oxidant balance between the mother and the fetus  

PubMed Central

The placenta is the exchange organ that regulates metabolic processes between the mother and her developing fetus. The adequate function of this organ is clearly vital for a physiologic gestational process and a healthy baby as final outcome. The umbilico-placental vasculature has the capacity to respond to variations in the materno-fetal milieu. Depending on the intensity and the extensity of the insult, these responses may be immediate-, mediate-, and long-lasting, deriving in potential morphostructural and functional changes later in life. These adjustments usually compensate the initial insults, but occasionally may switch to long-lasting remodeling and dysfunctional processes, arising maladaptation. One of the most challenging conditions in modern perinatology is hypoxia and oxidative stress during development, both disorders occurring in high-altitude and in low-altitude placental insufficiency. Hypoxia and oxidative stress may induce endothelial dysfunction and thus, reduction in the perfusion of the placenta and restriction in the fetal growth and development. This Review will focus on placental responses to hypoxic conditions, usually related with high-altitude and placental insufficiency, deriving in oxidative stress and vascular disorders, altering fetal and maternal health. Although day-to-day clinical practice, basic and clinical research are clearly providing evidence of the severe impact of oxygen deficiency and oxidative stress establishment during pregnancy, further research on umbilical and placental vascular function under these conditions is badly needed to clarify the myriad of questions still unsettled. PMID:25009498

Herrera, Emilio A.; Krause, Bernardo; Ebensperger, German; Reyes, Roberto V.; Casanello, Paola; Parra-Cordero, Mauro; Llanos, Anibal J.

2014-01-01

398

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

399

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

400

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

401

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

PubMed Central

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

2015-01-01

402

Extracorporeal Shockwave Lithotripsy Monotherapy is not Adequate for Management of Staghorn Renal Calculi.  

PubMed

Between 1990 and 1999 a total of 186 patients with staghorn renal stones were treated in our unit. Of them, 76 patients were managed by extra-corporeal shockwave lithotripsy (ESWL) alone using a third generation Siemen's Lithostar Plus lithotriptor. Sixty-one of these patients who completed a follow-up of 41 months formed the subjects of this study. ESWL was done after routine stenting of the affected side in all cases except one. The mean number of ESWL sessions was 5.2, delivering an average 15,940 shocks per patient. The average hospital stay was 21.68 days and the duration of the treatment was 1-41 months (mean 6.75 months). Significant complications occurred in 35 patients (57.4%) eight of whom sustained multiple significant complications. A total of 162 auxiliary procedures were used in conjunction with ESWL and in the management of complications. The stone free rate at three months was 18%, but rose by the end of the treatment period (41 months) to 63.9%. Our study indicates that ESWL monotherapy is associated with high morbidity rates, high rates of unplanned invasive procedures as well as prolonged treatment periods and hospitalization. Thus, ESWL monotherapy is not adequate for the management of staghorn calculi. PMID:17657121

Koko, Abdelmoniem K; Onuora, Vincent C; Al Turki, Mohammed A; Mesbed, Ahmed H; Al Jawini, Nasser A

2003-01-01

403

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

Code of Federal Regulations, 2010 CFR

...determine whether my system's watershed control requirements are adequate...Additional Watershed Control Requirements for Unfiltered Systems § 141.522 How...determine whether my system's watershed control requirements are...

2010-07-01

404

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

405

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

406

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

407

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

408

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

409

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

410

Coordinated and adequately funded state streams for rehabilitation of newly injured persons with tbi.  

PubMed

Traumatic brain injury (TBI) rates are highest among families with the lowest income levels. A paucity of appropriate funding streams for low-income, recently injured TBI patients is reported to cause delays in provision of early postacute rehabilitation or to cause patients to be discharged without receiving rehabilitation. There are also reports of patients remaining in hospitals with minimal care or being returned home, both because of a lack of a discharge site. The purposes of this exploratory study were to: (1) identify model aspects of existing publicly supported and administered programs for postacute individuals with TBI; (2) present results of a survey measuring to what extent state Medicaid programs fund postacute rehabilitation services for recently injured patients with TBI; (3) present results of interviews with trauma center social workers affiliated with the National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems projects to determine whether and how delays in receiving Medicaid coverage occur; and (4) make recommendations for improved systems of care for postacute individuals with TBI. PMID:11277849

Reynolds, W E; Page, S J; Johnston, M V

2001-02-01

411

The outcomes of health care process in Iran's rural society  

PubMed Central

Background: Health care systems in rural areas face numerous challenges in meeting the community's needs and adequate attention has not been paid to this problem. The aim of this study was to describe the outcomes of health care process in rural society. Materials and Methods: Twenty-six participants including twenty-one rural health care providers and five clients were selected according to purposive sampling. The data were collected via semi-structured individual interviews and a mini focus group. Data were analyzed by using qualitative content analysis based on methods described by Granheme and Landman. Results: Data analysis eventually led to formation of one category of inefficiency in health care process in rural society including subcategories such as arbitrary self-therapy, slow care process, dissatisfaction with the care process, superficial caring, job stress and burn out of caregivers, and ineffective caring relationship. Conclusion: Outcomes in health care in rural society of Iran represents inefficiency of the current health care process. These outcomes are related to the cultural and social context of rural communities and the structure of the health system. These outcomes in health care in the rural society of Iran represent impairment of the current health care process. The necessity of modifying the existing care trend with new models designed to improve the health care process is felt. PMID:24403941

Eskandari, Manije; Abbaszadeh, Abbas; Borhani, Fariba

2013-01-01

412

A six-year descriptive analysis of hospitalisations for ambulatory care sensitive conditions among people born in refugee-source countries  

Microsoft Academic Search

BACKGROUND: Hospitalisation for ambulatory care sensitive conditions (ACSHs) has become a recognised tool to measure access to primary care. Timely and effective outpatient care is highly relevant to refugee populations given the past exposure to torture and trauma, and poor access to adequate health care in their countries of origin and during flight. Little is known about ACSHs among resettled

Ignacio Correa-Velez; Zahid Ansari; Vijaya Sundararajan; Kaye Brown; Sandra M Gifford

2007-01-01

413

Adult Day Care  

MedlinePLUS

... that are offered may include the following: Counseling Education Evening care Exercise Health screening Meals Medical care Physical therapy Recreation Respite care Socialization Supervision Transportation Medication ...

414

Reflections on curative health care in Nicaragua.  

PubMed

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

1989-05-01

415

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

416

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 ...

417

Spiritual growth through care of the dying.  

PubMed

One of the most difficult issues with which clergy must deal is that of theodicy, the reconciliation of a good God with evil in this world. The case of L.R. is that of a good thirty-nine-year-old man dying of cancer. This paper examines the role of the clergy in working with the dying patient, traditional responses to the questions of theodicy, and a proposal for an adequate contemporary solution to the issue of theodicy. One key factor in caring for the dying is the mutual spiritual growth of the dying patient and the clergy care giver. PMID:24306825

Friedman, B W

1983-12-01

418

[Postacute care].  

PubMed

The aging of the population and changes in family and social structures have led to increasing care needs for elderly persons following an acute disease or accident, with consequent concerns regarding costs and sustainability within the public health system. The main objective of postacute care (PAC) is to restore the functional capabilities of the patient after an acute event and contribute to determine the patient's outcome and future healthcare requirements. With this background, we carried out a systematic review of the published literature from 1990 to 2011 focused on the following aspects of PAC: a) objectives; b) estimations of the need and the indicators for access to it, and c) transfer strategies from acute care to PAC. The results of this review indicate that PAC is an efficient approach to improve patients' quality of life and to sustain the public healthcare system. The choice of candidates for PAC should be based on both health and social indicators, and the overall process viewed in a cross-sectional manner in order to avoid increases in total cost. PMID:23896450

Admetlla Falgueras, Margarita; Fusté Sugrañes, Josep

2014-07-01

419

[Computers in intensive care units (author's transl)].  

PubMed

The increasing amount of physiological data which is required to be stored and displayed has created a need for computers in Intensive Care Units. Small computerised units are now available with three main advantages: 1. A memory allowing the display of parameters value and trend curves. 2. A "decision table" allowing more sophisticated diagnosis. 3. The use of new programmes without having to change the unit. These systems are reliable, providing the quality of the input signal is adequate. PMID:533005

Frank, R; Fontaine, G; Grosgogeat, Y

1979-01-01

420

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

421

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

422

Household-level technologies to improve the availability and preparation of adequate and safe complementary foods.  

PubMed

Plant-based complementary foods are the main source of nutrients for many young children in developing countries. They may, however, present problems in providing nutritionally adequate and safe diets for older infants and young children. The high starch content leads to low-nutrient diets that are bulky and dense, with high levels of antinutritive factors such as phytates, tannins, lectins, and enzyme inhibitors. Phytates impair mineral bioavailability, lectins interfere with intestinal structure, and enzyme inhibitors inhibit digestive enzymes. In addition, there is often microbial contamination, which leads to diarrhea, growth-faltering, and impaired development, and the presence of chemical contaminants may lead to neurological disease and goiter. The fact that some fruits containing carotenoids are only available seasonally contributes to the vulnerability of children receiving predominantly plant-based diets. Traditional household food technologies have been used for centuries to improve the quality and safety of complementary foods. These include dehulling, peeling, soaking, germination, fermentation, and drying. While modern communities tend to reject these technologies in favor of more convenient fast-food preparations, there is now a resurgence of interest in older technologies as a possible means of improving the quality and safety of complementary foods when the basic diet cannot be changed for economic reasons. This paper describes the biology, safety, practicability, and acceptability of these traditional processes at the household or community level, as well as the gaps in research, so that more effective policies and programs can be implemented to improve the quality and safety of complementary foods. PMID:12664529

Mensah, Patience; Tomkins, Andrew

2003-03-01

423

A Better Diet Quality is Attributable to Adequate Energy Intake in Hemodialysis Patients  

PubMed Central

Poor diet quality is one of strong predictors of subsequent increased mortality in hemodialysis patients. To determine diet quality and to define major problems contributing to poor diet quality in hemodialysis patients, a cross-sectional study was conducted between June 2009 and October 2010. Sixty-three hemodialysis patients (31 men, 32 women; aged 55.3 ± 11.9 years) in stable condition were recruited from the Artificial Kidney Center in Kyung Hee University, Seoul, Korea. Three-day diet records were obtained for dietary assessment. Mean adequacy ratio (MAR) is the average of the ratio of intakes to Dietary Reference Intakes (DRI) for 12 nutrients. Index of nutritional quality (INQ) was determined as the nutritional density per 1,000 kcal of calories. Overall diet quality was evaluated using the Diet Quality Index-International (DQI-I). Statistics were used to determine diet quality, comparing dietary intake to DRI. Dietary calories (21.9 ± 6.7 kcal/kg/day) and protein (0.9 ± 0.3 g/kg/day) were found insufficient in the participants. The overall intake of 12 nutrients appeared to be also inadequate (0.66 ± 0.15), but INQs of overall nutrients, except for folate (0.6) and calcium (0.8), were found relatively adequate (INQ ? 1). As a result of diet quality assessment using DQI-I, dietary imbalance and inadequacy were found to be the most problematic in hemodialysis patients. This study suggests that the main reason for insufficient intake of essential nutrients is insufficient calorie intake. Hemodialysis patients should be encouraged to use various food sources to meet their energy requirements as well as satisfy overall balance and nutrient adequacy. PMID:25713792

Kim, Hyerang

2015-01-01

424

Are Community-Level Financial Data Adequate to Assess Population Health Investments?  

PubMed Central

The variation in health outcomes among communities results largely from different levels of financial and nonfinancial policy investments over time; these natural experiments should offer investment and policy guidance for a business model on population health. However, little such guidance exists. We examined the availability of data in a sample of Wisconsin counties for expenditures in selected categories of health care, public health, human services, income support, job development, and education. We found, as predicted by the National Committee on Vital and Health Statistics in 2002, that availability is often limited by the challenges of difficulty in locating useable data, a lack of resources among public agencies to upgrade information technology systems for making data more usable and accessible to the public, and a lack of enterprise-wide coordination and geographic detail in data collection efforts. These challenges must be overcome to provide policy-relevant information for optimal population health resource allocation. PMID:22877572

Casper, Tim

2012-01-01

425

[Ischaemic stroke secondary to viper envenomation in Morocco in the absence of adequate antivenom].  

PubMed

An ischaemic stroke is a rare complication of viper envenomation that is due to multifactorial pathophysiological mechanisms. The authors describe the case of a 55-year-old patient bitten by the viper Cerastes cerastes. The patient was admitted to the intensive care unit with multiple organ failure, disseminated intravascular coagulopathy, rhabdomyolysis, anuria and elevated troponin level. The persistent disturbance of consciousness has motivated a brain scan which has revealed a bifocal ischemic stroke. The complex venom of the species C. cerastes may induce hypotension, tissue necrosis, acute renal failure, bleeding disorders or DIC. With the cessation of a non-indicated heparintherapy and haemodialysis, the patient recovered in a few weeks despite the initial infusion of an unsuitable antivenom due to the late identification of the reptile. The preventive treatment of the complications of this envenomation is based on the infusion of the polyvalent antivenom Favirept(®). PMID:22154446

Chani, M; Abouzahir, A; Haimeur, C; Kamili, N Drissi; Mion, G

2012-01-01

426

Wealth and antenatal care use: implications for maternal health care utilisation in Ghana.  

PubMed

The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths. Prior to the introduction of the policy, studies found wealth to have a positive and significant influence on the use of Antenatal care. It is thus expected that with the policy, wealth should not influence the use of maternal health care significantly. Using secondary data from the 2008 Ghana Demographic and Health survey, the results have revealed that wealth still has a significant influence on adequate use of Antenatal care. Education, age, number of living children, transportation and health insurance are other factors that were found to influence the use of Antenatal care in Ghana. There also exist considerable variations in the use of Antenatal care in the geographical regions and between the rural and urban dwellers. It is recommended that to improve the use of Antenatal care and hence maternal health care utilization, some means of support is provided especially to women within the lowest wealth quintiles, like the provision and availability of recommended medication at the health center; secondly, women should be encouraged to pursue education to at least the secondary level since this improves their use of maternal health services. Policy should also target mothers who have had the experience of child birth on the need to use adequate Antenatal care for each pregnancy, since these mothers tend to use less antenatal care for subsequent pregnancies. The regional disparities found may be due to inaccessibility and unavailability of health facilities and services in the rural areas and in some of the regions. The government and other service providers (NGOs, religious institutions and private providers) may endeavor to improve on the distribution of health facilities, human resources, good roads and necessary infrastructure among other things in order to facilitate easy access to health care providers especially for the rural dwellers. PMID:22866869

Arthur, Eric

2012-01-01

427

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

428

Long-Term Care Policy and Financing as a Public or Private Matter in the United States  

Microsoft Academic Search

Effective approaches to assure adequate resources, infrastructure, and broad societal support to address chronic care needs are volatile and potentially unpopular issues that can result in many losers (those getting far less than they want) and few winners (those who gain access to scarce societal resources for care). In the United States, debates on long-term care involve a complex set

Donna L. Yee

2002-01-01

429

Caring for the Caregiver  

MedlinePLUS

... Advisory Boards and Groups Español Caring for the Caregiver Caring for the Caregiver is for friends and family members giving care ... Love Is Being Treated for Cancer. Being a caregiver to someone you care about may mean helping ...

430

Continuum of Care  

MedlinePLUS

... Opinion Rehabilitation Options Home Care Options Advanced Care Planning Palliative Care Hospice Care Brain Tumor Treatments Treatment Side Effects & their Management Support and Resources Caregiving Information About Us Letter ...

431

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. ...

432

Women Veterans Health Care  

MedlinePLUS

... Women Veterans Health Care Women Veterans Health Care Womens Health Women Veterans Health Care Home Program Overview About ... Priorities FAQs Women Veterans Call Center Providers WVPMs Women's Health Services Eligibility and Enrollment About VA Health Care ...

433

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 ...

434

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 ...

435

Ensuring Vitamin D Supplementation in Nursing Home Patients—A Quality Improvement Project  

Microsoft Academic Search

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

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

2012-01-01

436

ADEQUACY OF TREATMENT RECEIVED BY PRIMARY CARE PATIENTS WITH ANXIETY DISORDERS  

PubMed Central

Background We examined the adequacy of pharmacotherapy and psychotherapy received by primary care patients with anxiety disorders over up to 5 years of follow-up. Method Five hundred thirty-four primary care patients at 15 US sites, who screened positive for anxiety symptoms, were assessed for anxiety disorders. Those meeting anxiety disorder criteria were offered participation and interviewed again at six and 12 months postintake, and yearly thereafter for up to 5 years. We utilized existing definitions of appropriate pharmacotherapy and created definitions of potentially adequate psychotherapy/cognitive-behavioral therapy (CBT). Results At intake, of 534 primary care participants with anxiety disorders, 19% reported receiving appropriate pharmacotherapy and 14% potentially adequate CBT. Overall, 28% of participants reported receiving potentially adequate anxiety treatment, whether pharmacotherapy, psychotherapy, or both. Over up to five years of follow-up, appropriate pharmacotherapy was received by 60% and potentially adequate CBT by 36% of the sample. Examined together, 69% of participants received any potentially adequate treatment during the follow-up period. Over the course of follow-up, primary care patients with MDD, panic disorder with agoraphobia, and with medicaid/medicare were more likely to receive appropriate anxiety treatment. Ethnic minority members were less likely to receive potentially adequate care. Conclusions Potentially adequate anxiety treatment was rarely received by primary care patients with anxiety disorders at intake. Encouragingly, rates improved over the course of the study. However, potentially adequate CBT remained much less utilized than pharmacotherapy and racial-ethnic minority members were less likely to received care, suggesting much room for improved dissemination of quality treatment. PMID:24190762

Weisberg, Risa B.; Beard, Courtney; Moitra, Ethan; Dyck, Ingrid; Keller, Martin B.

2014-01-01

437

COLOSTOMY CARE  

PubMed Central

Psychic preparation of the patient for the necessity of colostomy is a long first step toward his adjustment to living with an artificial anus. Proper surgical placement of the outlet will ease care of the bowel. Control of fecal consistency and peristaltic rate should ideally produce constipation responsive only to habit or enemata. The object of the enema is to produce an evacuation thorough enough to prevent soiling for a day or two. The object of dietary variations is to produce a manageable volume and consistency of fecal stream. The technique of enemas and choice of diet can be individualized when the underlying principles are understood. PMID:13230924

Lee Marsh, Robert

1955-01-01

438

Surviving sepsis in the critical care environment.  

PubMed

The management of sepsis and septic shock in the intensive care environment is a complex task requiring the cooperation of a multidisciplinary team. The Surviving Sepsis Campaign provides systematic guidelines for the recognition, early intervention, and supportive management of sepsis. Critical care nurses are instrumental in ensuring that these guidelines and other sources of evidence-based practice are used for patients with severe sepsis or septic shock. This article discusses the pathophysiologic processes in severe sepsis and septic shock and discusses the appropriate interventions as recommended by the Surviving Sepsis Campaign. Recommended early treatments are reviewed along with interventions related to hemodynamics, perfusion, and supportive care in the critical care environment. PMID:25741954

Benedict, Lara

2015-01-01

439

Creating a financially sound primary care network.  

PubMed

Primary care networks can play a pivotal role in the delivery of healthcare services and are much sought after by integrated delivery systems that are attempting to attract managed care contracts. However, not all primary care networks are attractive prospects for affiliation; some lack the ingredients for financial success that integrated delivery systems require. A primary care network can ensure its financial soundness and thereby become an attractive candidate for affiliation by meeting the requirements of effective networks. These requirements include reaching consensus on the role the network will play in the delivery system, consolidating network practice sites, paying justifiable practice acquisition prices, using nonphysician practitioners appropriately, assuming risk, offering physicians participation packages, providing incentive compensation plans, implementing integrated information technology, securing multiple payer contracts, and implementing quality assurance standards. PMID:10167300

Holm, C E

1997-05-01

440

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

441

Transforming emergency care for older adults  

PubMed Central

Already crowded and stressful, US emergency departments are facing the challenge of serving an aging population that requires complex and lengthy evaluations. Creative solutions are necessary to improve the value and ensure the quality of emergency care delivered to older adults while more fully addressing their complex underlying physical, social, cognitive, and situational needs. Developing models of geriatric emergency care, including some that are already in use at dedicated geriatric emergency departments, incorporate a variety of physical, procedural, and staffing changes. Among the options for “geriatricizing” emergency care are approaches that may eliminate the need for an emergency department visit, such as telemedicine; for initial hospitalization, such as patient observation units; and for rehospitalization, such as comprehensive discharge planning. By transforming its current safety-net role to becoming a partner in care coordination, emergency departments have the opportunity to better integrate into the broader health care system, improve patient health outcomes, contribute to optimizing the health care system, and reduce overall costs of care—keys to improving emergency care for patients of all ages. PMID:24301394

Hwang, Ula; Shah, Manish N.; Han, Jin H.; Carpenter, Christopher R.; Siu, Albert L.; Adams, James G.

2014-01-01

442

Strategic service quality management for health care.  

PubMed

Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215

Anderson, E A; Zwelling, L A

1996-01-01

443

HSQC-1,n-ADEQUATE: a new approach to long-range 13C-13C correlation by covariance processing.  

PubMed

Long-range, two-dimensional heteronuclear shift correlation NMR methods play a pivotal role in the assembly of novel molecular structures. The well-established GHMBC method is a high-sensitivity mainstay technique, affording connectivity information via (n)J(CH) coupling pathways. Unfortunately, there is no simple way of determining the value of n and hence no way of differentiating two-bond from three- and occasionally four-bond correlations. Three-bond correlations, however, generally predominate. Recent work has shown that the unsymmetrical indirect covariance or generalized indirect covariance processing of multiplicity edited GHSQC and 1,1-ADEQUATE spectra provides high-sensitivity access to a (13)C-(13) C connectivity map in the form of an HSQC-1,1-ADEQUATE spectrum. Covariance processing of these data allows the 1,1-ADEQUATE connectivity information to be exploited with the inherent sensitivity of the GHSQC spectrum rather than the intrinsically lower sensitivity of the 1,1-ADEQUATE spectrum itself. Data acquisition times and/or sample size can be substantially reduced when covariance processing is to be employed. In an extension of that work, 1,n-ADEQUATE spectra can likewise be subjected to covariance processing to afford high-sensitivity access to the equivalent of (4)J(CH) GHMBC connectivity information. The method is illustrated using strychnine as a model compound. PMID:21915897

Martin, Gary E; Hilton, Bruce D; Willcott, M Robert; Blinov, Kirill A

2011-10-01

444

Managed long-term care: care integration through care coordination.  

PubMed

The New York State managed long-term care demonstration program combines traditional home, community, and institutional long-term care services with other benefits integral to maximizing overall well-being for a frail elderly population. A distinguishing feature of the model is the responsibility to coordinate both covered and noncovered services. This article, a case study of VNS CHOICE, a managed long-term care plan that serves 2,500 New York City residents, describes the program's operating structure, service delivery model, and care management strategies. By providing a capitated Medicaid long-term care benefit, VNS CHOICE can utilize a broad array of services, offer significant flexibility to care management staff, and support member and family involvement in care planning. Its broad care coordination responsibility allows it to achieve integrated care without integrated financing. PMID:12613469

Fisher, Holly Michaels; Raphael, Terrie G

2003-02-01

445

41 CFR 51-7.3 - Ensuring environmental documents are actually considered in agency determinations.  

Code of Federal Regulations, 2010 CFR

...Contracts and Property Management 1 2010-07-01... true Ensuring environmental documents are actually...Contracts and Property Management Other Provisions...7-PROCEDURES FOR ENVIRONMENTAL ANALYSIS §...

2010-07-01

446

77 FR 46069 - Proposed Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity...  

Federal Register 2010, 2011, 2012, 2013, 2014

...BUREAU OF CONSUMER FINANCIAL PROTECTION Proposed Guidelines for Ensuring...Information Disseminated by the Bureau of Consumer Financial Protection AGENCY: Bureau of Consumer Financial Protection. ACTION: Notice of...

2012-08-02

447

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

Code of Federal Regulations, 2014 CFR

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

2014-10-01

448

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

Code of Federal Regulations, 2013 CFR

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

2013-10-01

449

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

Code of Federal Regulations, 2011 CFR

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

2011-10-01

450

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

Code of Federal Regulations, 2012 CFR

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

2012-10-01

451

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

Code of Federal Regulations, 2010 CFR

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

2010-10-01

452

Secondary Care Clinic for Chronic Disease: Protocol  

PubMed Central

Background The complexity of chronic disease management activities and the associated financial burden have prompted the development of organizational models, based on the integration of care and services, which rely on primary care services. However, since the institutions providing these services are continually undergoing reorganization, the Centre hospitalier affilié universitaire de Québec wanted to innovate by adapting the Chronic Care Model to create a clinic for the integrated follow-up of chronic disease that relies on hospital-based specialty care. Objective The aim of the study is to follow the project in order to contribute to knowledge about the way in which professional and management practices are organized to ensure better care coordination and the successful integration of the various follow-ups implemented. Methods The research strategy adopted is based on the longitudinal comparative case study with embedded units of analysis. The case study uses a mixed research method. Results We are currently in the analysis phase of the project. The results will be available in 2015. Conclusions The project’s originality lies in its consideration of the macro, meso, and micro contexts structuring the creation of the clinic in order to ensure the integration process is successful and to allow a theoretical generalization of the reorganization of practices to be developed. PMID:25689840

St-Pierre, Michèle; Juneau, Lucille; Legault-Mercier, Samuel; Bernardino, Elizabeth

2015-01-01

453

Is the Health Level 7/LOINC document ontology adequate for representing nursing documents?  

PubMed

The use of nursing documents from different electronic health record (EHR) systems is challenging due to inconsistency in document naming across systems and institutions. Mapping each local document name to standard document ontology may enable health care professionals to navigate and retrieve documents efficiently for multiple purposes such as quality assurance, outcomes research or public health reporting. The purpose of this study was to evaluate the sufficiency of the Health Level 7 (HL7)/Logical Observation Identifiers, Names, and Codes (LOINC) document ontology for representing nursing document names. We collected 94 nursing document types from the Eclipsys Clinical Information System (CIS) and the Columbia Medical Entities Dictionary (MED) and mapped them to the components of the HL7/LOINC document ontology. Seventy-five (79.8%) nursing document names were completely represented and 19 (20.2%) document names were partially represented. In order for the HL7/LOINC document ontology to be of more use in implementing EHRs that support nursing documentation, Subject Matter Domain and Type of Service axes require extension and clarification. PMID:17102314

Hyun, Sookyung; Ventura, Rosemary; Johnson, Stephen B; Bakken, Suzanne

2006-01-01

454

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

455

Health Care and Dependent Care Flexible  

E-print Network

the end of the current calendar year. Benefit elections are generally effective the first of the monthHealth 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

456

Next steps for federal child care policy.  

PubMed

In Mark Greenberg's view, a national child care strategy should pursue four goals. Every parent who needs child care to get or keep work should be able to afford care without having to leave children in unhealthy or dangerous environments; all families should be able to place their children in settings that foster education and healthy development; parental choice should be respected; and a set of good choices should be available. Attaining these goals, says Greenberg, requires revamping both federal child care subsidy programs and federal tax policy related to child care. Today subsidies are principally provided through a block grant structure in which states must restrict eligibility, access, or the extent of assistance because both federal and state funds are limited. Tax policy principally involves a modest nonrefundable credit that provides little or no assistance to poor and low-income families. Greenberg would replace the block grant with a federal guarantee of assistance for all families with incomes under 200 percent of poverty that need child care to enter or sustain employment. States would administer the federal assistance program under a federal-state matching formula with the federal government paying most of the cost. States would develop and implement plans to improve the quality of child care, coordinate child care with other early education programs, and ensure that child care payment rates are sufficient to allow families to obtain care that fosters healthy child development. Greenberg would also make the federal dependent care tax credit refundable, with the credit set at 50 percent of covered child care costs for the lowest-income families and gradually phasing down to 20 percent as family income increases. The combined subsidy and tax changes would lead to a better-coordinated system of child care subsidies that would assure substantial financial help to families below 200 percent of poverty, while tax-based help would ensure continued, albeit significantly reduced, assistance for families with higher incomes. Greenberg indicates that the tax credit expansions are estimated to cost about $5 billion a year, and the subsidy and quality expansions would cost about $18 billion a year. PMID:17902261

Greenberg, Mark

2007-01-01

457

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

458

Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care  

PubMed Central

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed. PMID:17356977

Berenson, Robert A.; Schoenbaum, Stephen C.; Gardner, Laurence B.

2007-01-01

459

A Guide to Enteral Drug Administration in Palliative Care  

Microsoft Academic Search

Enteral feeding is indicated in patients unable to ingest sufficient nutrients but whose gastrointestinal function is adequate for digestion and absorption. Indications in palliative care include patients with radical esophageal surgery, upper gastrointestinal tract obstruction, anorexia, and dysphagia. As the oral route is the preferred method of palliative drug delivery, the enteral feeding tube can become an important tool for

Peter J Gilbar; Dip Hosp Clin Pharm Pract

1999-01-01

460

Quality Control Issues in Point of Care Testing  

Microsoft Academic Search

Summary • Quality Control (QC) in Point of Care Testing (PoCT) is often thought of as a complex issue; however intelligent system analysis can simplify matters and greatly increase the chances of a well controlled system. What we want to achieve is a QC program which adequately controls the PoCT system, but does not excessively contribute to the operating costs

Cameron L Martin

461

Future Pursuits: Building Early Care and Education Careers.  

ERIC Educational Resources Information Center

Summarizes the findings of "Making a Career of It: The State of the States Report on Career Development in Early Care and Education," which concludes that few states set adequate standards for early childhood practitioner training and that practitioners have few incentives to invest in training. Includes the report's recommendations for improving…

Morgan, Gwen; And Others

1994-01-01

462

HIV\\/AIDS related stigma: Delivering appropriate nursing care  

Microsoft Academic Search

Persons with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) often experience disease related stigma and nurses are likely to encounter them in a wide variety of health care settings. It may be difficult for nurses to adequately assume patient advocacy roles if they have personal angst or are apprehensive. The purpose of this literature review was to (a)

Ronald Vance; Sharon Denham

2008-01-01

463

45 CFR 1306.35 - Family child care program option.  

Code of Federal Regulations, 2010 CFR

... OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT...THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES...be adequate to allow children to be supervised and...socio-emotional, and physical development, including both gross and fine motor. Family child care settings must...

2010-10-01

464

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

Code of Federal Regulations, 2010 CFR

...2010-04-01 false How does Job Corps ensure that contract...Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE...Provisions § 670.993 How does Job Corps ensure that contract...

2010-04-01

465

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.

466

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

467

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

468

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

469

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

470

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

471

The Inextricable Nature of Mental and Physical Health: Implications for Integrative Care  

Microsoft Academic Search

There is growing evidence that physical health problems are caused and exacerbated by psychological factors. Research indicates that psychological distress leads to physical disease through impairment of the neuroendocrine system and its interface with the body’s immune response. However, the current health care delivery system splinters care into “psychiatric” and “physical” health silos. New approaches are needed to assure adequate

Sandra J. Weiss; Judith Haber; June Andrews Horowitz; Gail W. Stuart; Barbara Wolfe

2009-01-01

472

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

473

A Program to Improve Access to Health Care Among Mexican Immigrants in Rural Colorado  

ERIC Educational Resources Information Center

Migration to the United States from Mexico is increasing every year. Mexican immigrants tend to be poor, uninsured, monolingual Spanish speakers without adequate access to appropriate medical care. As a further barrier, many are also undocumented. This article describes a program developed to improve access to health care among Mexican immigrants…

Diaz-Perez, Maria de Jesus; Farley, Tillman; Cabanis, Clara Martin

2004-01-01

474

From private profits to public goods? A human rights assessment of health care reform plans  

Microsoft Academic Search

Although the crisis of health care in the United States is widely acknowledged - marked by poor health outcomes, high costs, unequal access, and widening health inequities - its structural underpinnings have not been adequately addressed, and reformers have settled on promoting piecemeal measures to avoid disruption. The human right to health care offers an analytical and advocacy framework for

Anja Rudiger

475

Table 10A Percent of Women Delivering Live Infants and Having Adequate Prenatal Care by Woman's Age, Race and Residence Louisiana, 2003  

Microsoft Academic Search

83.99 0.00 100.00 66.67 51.85 57.78 64.52 60.81 77.20 89.66 93.95 90.40 84.62 0.00 0.00 WHITE 89.51 0.00 0.00 80.00 64.29 69.23 71.79 70.24 82.95 94.85 95.15 91.35 84.62 0.00 0.00 BLACK 66.26 0.00 100.00 57.14 38.46 42.11 52.17 48.44 65.60 69.14 86.84 84.21 0.00 0.00 0.00 OTHER 83.33 0.00 0.00 0.00 0.00 0.00 0.00 0.00 66.67 80.00 87.50 100.00

476

The Standard One Gram Dose of Vancomycin is not Adequate Prophylaxis for MRSA  

PubMed Central

Introduction The indications for vancomycin prophylaxis to prevent Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infections are increasing. The recommended dose of vancomycin has traditionally been 1 gram intravenous. However, the increasing prevalence of obesity in our population coupled with increasing resistance of MRSA to vancomycin has resulted in recent recommendations for weight-based dosing of vancomycin at 15mg/kg. We hypothesize that the standard one gram dose of vancomycin is inadequate to meet the recently recommended dosage of 15mg/kg. Methods We performed a retrospective chart review on 216 patients who were screened positive for MRSA prior to undergoing elective total joint or spine surgeries between January 2009 to January 2012. All patients were given 1 gram of vancomycin within an hour prior to surgical incision as prophylaxis. Using the revised dosing protocol of 15mg/kg of body weight for vancomycin, proper dosage was calculated for each patient. These values were then compared to the 1 gram dose given to the patients at time of surgery. Patients were assessed as either underdosed (a calculated weight-based dose >1 gram) or overdosed (a calculated weight-based dose <1 gram). Additionally, we used actual case times and pharmacokinetic equations to determine the vancomycin (VAN) levels at the end of the procedures. Results Out of 216 patients who tested positive for MRSA, 149 patients (69%) were determined to be underdosed and 22 patients (10%) patients were determined to be overdosed. The predicted VAN level at the end of procedure was <15 mg/L in 60% of patients with 1 gram dose compared to 12% (p=0.0005) with weight base dose. Six patients developed post-operative MRSA surgical site infections (SSI). Of these six patients; four had strains of MRSA with vancomycin minimum inhibitory concentration of >1.0mg/L. Based on 1g dosing, 5/6 patients with MRSA positive SSIs had wound closure levels of <15 mg/L and all six were <20 mg/L. Conclusion In settings such as hospitals, where the risk for resistant bacteria, especially MRSA, is high, it is becoming increasingly important to accurately dose patients who require vancomycin. In order to avoid incorrect dosing of vancomycin health care providers must use weight-based dosing. PMID:25328469

Catanzano, Anthony; Phillips, Michael; Dubrovskaya, Yanina; Hutzler, Lorraine; Bosco, Joseph

2014-01-01

477

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

478

Selecting effective incentive structures in health care: A decision framework to support health care purchasers in finding the right incentives to drive performance  

Microsoft Academic Search

BACKGROUND: The Ontario health care system is devolving planning and funding authority to community based organizations and moving from steering through rules and regulations to steering on performance. As part of this transformation, the Ontario Ministry of Health and Long-Term Care (MOHLTC) are interested in using incentives as a strategy to ensure alignment – that is, health service providers' goals

Thomas Custers; Jeremiah Hurley; Niek S Klazinga; Adalsteinn D Brown

2008-01-01

479

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

480

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

481

[Practical guideline for nutritional care in geriatric institutions].  

PubMed

Malnutrition is widespread in geriatric patients, but often unrecognized and untreated. The main barriers against implementation of adequate nutritional care are seen in low nutritional awareness, lack of knowledge, interest and responsibilities but also in established procedures and lack of standard protocols for nutritional screening and therapy. It is, thus, the aim of the present publication to provide a comprehensive, practice oriented guideline for quality assurance of nutritional care of elderly people in geriatric institutions. The guideline includes routine assessment of individual nutritional status as well as the planning and implementation of appropriate interventions and measurement of results. The guideline is aimed at the prevention and adequate treatment of weight loss and malnutrition and is composed of the following sections: 1) screening, 2) assessment, 3) definition of aims, 4) intervention, 5) monitoring with adaptation of aims and interventions, 6) planning of nutritional care after discharge. Appropriate interventions aim, on the one hand, at the elimination of underlying causes of malnutrition and, on the other hand, at adequate and sufficient dietary intake to meet the requirements. Dietetic, nursing and medical actions should be implemented in a coordinated manner in order to use all options to achieve the best nutritional care for each patient. As a prerequisite for high quality individual nutritional care, several basic conditions have to be established, e.g. appropriate supply of food and beverages to meet patient needs, well-organized caring processes during meals, willingness of all involved persons for interdisciplinary teamwork, and well-regulated responsibilities. This general guideline has to be adapted to the local conditions of each institution and consistently put into practice. For implementation of the guideline, a nutrition team with members of all relevant professions should be organized with regular meetings. In the long run, increasing nutritional awareness and established routines for adequate nutritional screening and therapy will enable high quality nutritional care of geriatric patients with manageable charges. PMID:18398632

Volkert, D

2009-04-01

482

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

483

Update with 2009-10 Data and Five-Year Trends: How Many Schools Have Not Made Adequate Yearly Progress?  

ERIC Educational Resources Information Center

Recently, much attention has focused on the number of schools in the nation failing to make adequate yearly progress (AYP) in raising student achievement under the No Child Left Behind Act (NCLB). The Obama Administration has projected a dramatic increase in this number as 2014--the year when 100% of students are expected to score proficient on…

Usher, Alexandra

2011-01-01

484

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