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Sample records for national guard hospital

  1. Successful Army National Guard units: A guard perspective

    SciTech Connect

    Wolfe, A.K.; Saulsbury, J.W.; Schexanayder, S.M.

    1991-10-01

    This project sought to identify factors contributing to a healthy Army National Guard (ARNG) unit. Its results were intended to contribute to a computerized forecasting model under development at Oak Ridge National Laboratory. The model, the ARNG Regional Recruiting Potential Model (RRPM), forecasts locations of successful new or modified Guard units. The study was expected to enhance the understanding of what constituents a healthy Guard unit. A Delphi approach was used to define criteria for healthy Guard units and to elicit rankings of those criteria. Two sets of telephone interviews were conducted with a sample of 102 individuals-two battalion-level administrative officers, or their equivalents, in each state in Washington, DC. During these telephone calls, the phrase ``unit supportability`` was used to express the notion of a healthy unit. The first set of interviews obtained background information and respondents` ideas of the criteria that lead to unit supportability and to a lack of supportability. The data were analyzed to develop a list of ten criteria for unit supportability. In the second interview, the same respondents were asked to rank those criteria in order of importance.

  2. Successful Army National Guard units: A guard perspective

    SciTech Connect

    Wolfe, A.K.; Saulsbury, J.W. ); Schexanayder, S.M. )

    1991-10-01

    This project sought to identify factors contributing to a healthy Army National Guard (ARNG) unit. Its results were intended to contribute to a computerized forecasting model under development at Oak Ridge National Laboratory. The model, the ARNG Regional Recruiting Potential Model (RRPM), forecasts locations of successful new or modified Guard units. The study was expected to enhance the understanding of what constituents a healthy Guard unit. A Delphi approach was used to define criteria for healthy Guard units and to elicit rankings of those criteria. Two sets of telephone interviews were conducted with a sample of 102 individuals-two battalion-level administrative officers, or their equivalents, in each state in Washington, DC. During these telephone calls, the phrase unit supportability'' was used to express the notion of a healthy unit. The first set of interviews obtained background information and respondents' ideas of the criteria that lead to unit supportability and to a lack of supportability. The data were analyzed to develop a list of ten criteria for unit supportability. In the second interview, the same respondents were asked to rank those criteria in order of importance.

  3. Suicide in the Army National Guard: An Empirical Inquiry

    ERIC Educational Resources Information Center

    Griffith, James

    2012-01-01

    Since 2004, suicides in the U.S. military have risen, most notably in the Army National Guard (ARNG). Data used in this study were obtained for suicides occurring from 2007 to 2010 and for a random sample of nonsuicides from the general ARNG population. Of the military-related variables considered, a few showed relationships to suicide. Rather,

  4. Experimenting with the National Guard: Field Artillery Gunnery.

    ERIC Educational Resources Information Center

    Day, Michael A.; Walker, Martin H.

    1993-01-01

    Describes a college physics class that uses National Guard artillery practice as a practical source for the studying of projectile motion. Provides a firing table for the shell used and the physics involved when using variables such as drag, weight, and elevation. (MVL)

  5. Suicide in the Army National Guard: An Empirical Inquiry

    ERIC Educational Resources Information Center

    Griffith, James

    2012-01-01

    Since 2004, suicides in the U.S. military have risen, most notably in the Army National Guard (ARNG). Data used in this study were obtained for suicides occurring from 2007 to 2010 and for a random sample of nonsuicides from the general ARNG population. Of the military-related variables considered, a few showed relationships to suicide. Rather,…

  6. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  7. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  8. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  9. Geothermal Retrofit of Illinois National Guard's State headquarters Building

    SciTech Connect

    Lee, Mark

    2015-04-27

    The goal of this project was to assess the feasibility of utilizing mine water as a heat sink for a geothermal heat pump system to heat and cool the 74,000 sq. ft. Illinois National Guard State Headquarters’ building in Springfield Illinois. If successful, this type of system would be less expensive to install than a traditional closed loop geothermal (ground source) heat pump system by significantly reducing the size of the well field, thus shortening or eliminate the payback period compared to a conventional system. In the end, a conventional ground loop was used for the project.

  10. The Mobilization and Return of Undergraduate Students Serving in the National Guard and Reserves

    ERIC Educational Resources Information Center

    Bauman, Mark

    2009-01-01

    Some reserve and National Guard personnel are enrolled in college. Much like those who choose not to attend college, reservists and Guard members who are students are challenged by issues of separation from family and employment. However, members of the reserves and National Guard who are college students must also separate from their educational…

  11. Preliminary assessment report for National Guard Training Center, Georgia Army National Guard, Fort Stewart, Georgia. Installation restoration program

    SciTech Connect

    Not Available

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Georgia Army National Guard (GAARNG) facility near Hinesville, Georgia, known as the National Guard Training Center (NGTC). Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a priority basis for completing corrective actions (where necessary) in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining previous site activities, types and quantities of hazardous substances utilized, and potential pathways by which contamination could affect public health and the environment. The scope of this assessment is limited to the facilities and past activities contained within the NGTC. Preliminary assessment site score sheet information is also provided for the NGTC. However, this assessment report is intended to be read in conjunction with a previous IRP assessment of Fort Stewart completed in 1992 (USATHAMA 1992) and to provide comprehensive information on the NGTC area for incorporation with information contained in that previous assessment for the entirety of Fort Stewart.

  12. 32 CFR 536.98 - Claims payable under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable under the National Guard Claims Act. 536.98 Section 536.98 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY... Act § 536.98 Claims payable under the National Guard Claims Act. The provisions of § 536.75 apply...

  13. 32 CFR 536.99 - Claims not payable under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims not payable under the National Guard Claims Act. 536.99 Section 536.99 National Defense Department of Defense (Continued) DEPARTMENT OF THE... Claims Act § 536.99 Claims not payable under the National Guard Claims Act. The provisions of §...

  14. 5 CFR 831.306 - Service as a National Guard technician before January 1, 1969.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Service as a National Guard technician before January 1, 1969. 831.306 Section 831.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Credit for Service § 831.306 Service as a National Guard technician before January...

  15. Response capabilities of the National Guard: a focus on domestic disaster medical response.

    PubMed

    Bochicchio, Daniel

    2010-01-01

    The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal. PMID:20349703

  16. National Guard service members returning home after deployment: the case for increased community support.

    PubMed

    Blow, Adrian; MacInnes, Maryhelen D; Hamel, Jessica; Ames, Barbara; Onaga, Esther; Holtrop, Kendal; Gorman, Lisa; Smith, Sheila

    2012-09-01

    National Guard service members and their families face unique circumstances that distinguish them from other branches of the military. In this article, we highlight unique National Guard needs and argue that more can be done by policy makers to help this population. We present the findings from a representative survey of Michigan citizens showing that public support exists for increased assistance for these service members. Using the multiple streams framework, we propose that policy makers currently have the opportunity to facilitate increased support for National Guard members and families. Specifically we suggest policy implications that feature the important role of state and local resources. PMID:21547542

  17. The National Demonstration Hospitals Program.

    PubMed

    Alexander, A

    2000-01-01

    Fifty-five public hospitals in all Australian States and Territories participated in the first two phases of National Demonstration Hospitals Program (NDHP). The program was established in 1994 as part of a commitment by the then Department of Health and Family Services to reduce waiting times and improve health outcomes for patients. The program uses a collaborative approach to assist public hospitals to improve service delivery and patient care outcomes. Key results from Phases 1 and 2 of the NDHP have confirmed that identification of industry best practice, collaboration, knowledge sharing and innovation are key elements required to achieve positive health care reforms. PMID:11256268

  18. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Army and Air Force National Guard personnel. 728.25 Section 728.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Reserve Components, Reserve Officers' Training...

  19. 75 FR 58277 - National Employer Support of the Guard and Reserve Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... From the Federal Register Online via the Government Publishing Office ] Part VI The President Proclamation 8564--National Employer Support of the Guard and Reserve Week, 2010 Proclamation 8565--National Farm Safety and Health Week, 2010 Proclamation 8566--National Hispanic-Serving Institutions Week, 2010 #0; #0; #0; Presidential Documents #0; #0;...

  20. Task force St. Bernard: operational issues and medical management of a National Guard disaster response operation.

    PubMed

    Bonnett, Carl J; Schock, Tony R; McVaney, Kevin E; Colwell, Christopher B; Depass, Christopher

    2007-01-01

    After Hurricane Katrina struck the Gulf Coast of the United States on 29 August 2005, it became obvious that the country was facing an enormous national emergency. With local resources overwhelmed, governors across the US responded by deploying thousands of National Guard soldiers and airmen. The National Guard has responded to domestic disasters due to natural hazards since its inception, but an event with the magnitude of Hurricane Katrina was unprecedented. The deployment of >900 Army National Guard soldiers to St. Bernard Parish, Louisiana in the aftermath of the Hurricane was studied to present some of the operational issues involved with providing medical support for this type of operation. In doing so, the authors attempt to address some of the larger issues of how the National Guard can be incorporated into domestic disaster response efforts. A number of unforeseen issues with regards to medical operations, medical supply, communication, preventive medicine, legal issues, and interactions with civilians were encountered and are reviewed. A better understanding of the National Guard and how it can be utilized more effectively in future disaster response operations can be developed. PMID:18087915

  1. Learning Without Boundaries: A NASA - National Guard Bureau Distance Learning Partnership

    NASA Technical Reports Server (NTRS)

    Anderson, Susan H.; Chilelli, Christopher J.; Picard, Stephan

    2003-01-01

    With a variety of high-quality live interactive educational programs originating at the Johnson Space Center in Houston, Texas and other space and research centers, the US space agency NASA (National Aeronautics and Space Administration) has a proud track record of connecting with students throughout the world and stimulating their creativity and collaborative skills by teaching them underlying scientific and technological underpinnings of space exploration. However, NASA desires to expand its outreach capability for this type of interactive instruction. In early 2002, NASA and the National Guard Bureau -- using the Guard's nationwide system of state-ofthe-art classrooms and high bandwidth network -- began a collaboration to extend the reach of NASA content and educational programs to more of America's young people. Already, hundreds of elementary, middle, and high school students have visited Guard e-Learning facilities and participated in interactive NASA learning events. Topics have included experimental flight, satellite imagery-interpretation, and Mars exploration. Through this partnership, NASA and the National Guard are enabling local school systems throughout the United States (and, increasingly, the world) to use the excitement of space flight to encourage their students to become passionate about the possibility of one day serving as scientists, mathematicians, technologists, and engineers. At the 54th International Astronautical Conference MAJ Stephan Picard, the guiding visionary behind the Guard's partnership with NASA, and Chris Chilelli, an educator and senior instructional designer at NASA, will share with attendees background on NASA's educational products and the National Guard's distributed learning network; will discuss the unique opportunity this partnership already has provided students and teachers throughout the United States; will offer insights into the formation by government entities of e-Learning partnerships with one another; and will suggest a possible future for the NASA - National Guard Bureau partnership, one potentially to include live multi-party interaction of hundreds of students in several countries with astronauts, scientists, engineers and designers. To inspire the next generation of explorers as only NASA can!

  2. 78 FR 59153 - National Employer Support of the Guard and Reserve Week, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... thirty- eighth. (Presidential Sig.) [FR Doc. 2013-23542 Filed 9-24-13; 11:15 am] Billing code 3295-F3 ... September 25, 2013 Part IV The President Proclamation 9022--National Employer Support of the Guard and...;Title 3-- #0;The President ] Proclamation 9022 of September 20, 2013 National Employer Support of...

  3. Life goes on: the experiences of wives of multiply-deployed National Guard soldiers.

    PubMed

    Patzel, Brenda; McBride, Maryellen; Bunting, Judith; Anno, Tony

    2013-05-01

    Whether a service member is active duty or part of the National Guard, deployment of these service members is a major issue for most families. There is limited knowledge of the experience of multiple deployments on the family. The purpose of this study was to describe experiences of wives of National Guard soldiers that were deployed more than once. Nine wives were interviewed. An analysis of the interviews revealed four themes: (1) "Life Goes On" (i.e., despite the repeated deployments, life continues at home); (2) the "Guard is a Different Animal" (i.e., life as a National Guard spouse is different from that of an active duty spouse); (3) "It's a Mind-Set" (i.e., how wives cope their husband's deployment); and (4) "Going Back Again" (i.e., wives' experiences of multiple deployments). Exploring how multiple deployments affects wives of National Guard soldiers is helpful in understanding their experiences and the adjustments that must be made in family life. Knowledge of the experiences of these wives may help in formulating more effective interventions with families who have experienced multiple deployments. PMID:23663024

  4. 70 FR 31525 - Notice of Intent to Repatriate a Cultural Item: National Guard Bureau, Texas Army National Guard...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2005-06-01

    .... SUMMARY: Pursuant to the Native American Graves Protection and Repatriation Act (NAGPRA), the National... the TXMF as part of the National Park Service's administrative responsibilities under NAGPRA. The TXMF... Service is not responsible for the TXMF's determinations. Information about NAGPRA is available online...

  5. 75 FR 78978 - Record of Decision for the 158th Fighter Wing's Proposed Realignment of National Guard Avenue and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ...On November 18, 2010, the United States Air Force signed the ROD for the 158th Fighter Wing's Proposed Realignment of National Guard Avenue and New Main Gate Construction, Vermont Air National Guard, Burlington International Airport, South Burlington, Vermont. The ROD states the Air Force decision to implement the preferred alternative (Alternative 1---Realignment of a portion of National......

  6. Children of National Guard Troops Deployed in the Global War on Terrorism

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; Houston, J. Brian; Sherman, Michelle D.; Melson, Ashley G.

    2011-01-01

    This study examined deployment effects in children and spouses of National Guard troops using a longitudinal design to assess 18 children (ages 6 to 17 years) and 13 nondeployed spouses before, during, and after deployment. Both self- and parent reports revealed that children of deployed service personnel experienced emotional and behavioral…

  7. National Guard Youth ChalleNGe Program. What Works Clearinghouse Intervention Report

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2010

    2010-01-01

    The "National Guard Youth ChalleNGe Program" is a residential education and training program designed for youth ages 16 to 18 who have dropped out of or been expelled from high school. During the 22-week residential period, participants are offered GED preparation classes and other program services intended to promote positive youth development,…

  8. Staying on Course: Three-Year Results of the National Guard Youth ChalleNGe Evaluation

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Muller-Ravett, Sara; Broadus, Joseph

    2011-01-01

    High school dropouts face an uphill battle in a labor market that increasingly rewards skills and postsecondary credentials: they are more likely than their peers to need public assistance, be arrested or incarcerated, and less likely to marry. This report presents results from a rigorous evaluation of the National Guard Youth ChalleNGe Program,…

  9. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  10. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  11. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  12. Making the Transition: Interim Results of the National Guard Youth ChalleNGe Evaluation

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Dillon, Colleen

    2010-01-01

    Young people who drop out of high school face long odds of success in a labor market that increasingly values education and skills. This report presents interim results from a rigorous, ongoing evaluation of the National Guard Youth ChalleNGe Program, which aims to "reclaim the lives of at-risk youth" who have dropped out of high school. ChalleNGe…

  13. Making the Transition: Interim Results of the National Guard Youth ChalleNGe Evaluation. [Executive Summary

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Dillon, Colleen

    2010-01-01

    Young people who drop out of high school face long odds of success in a labor market that increasingly values education and skills. This report presents interim results from a rigorous, ongoing evaluation of the National Guard Youth ChalleNGe Program, which aims to "reclaim the lives of at-risk youth" who have dropped out of high school. ChalleNGe…

  14. 77 FR 58295 - National Employer Support of the Guard and Reserve Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Sig.) [FR Doc. 2012-23295 Filed 9-18-12; 11:15 am] Billing code 3295-F2-P ... Documents#0;#0; ] Proclamation 8864 of September 14, 2012 National Employer Support of the Guard and Reserve... employers, and reaffirm our commitment to giving our troops, our military families, and our veterans...

  15. 77 FR 25952 - Oregon Army National Guard, Camp Rilea, Clatsop County, OR; Danger Zone

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ... Department of the Army, Corps of Engineers 33 CFR Part 334 Oregon Army National Guard, Camp Rilea, Clatsop... danger zone in the waters adjacent to Camp Rilea located in Clatsop County, Oregon. The regulation would... adjacent to Camp Rilea during use of weapons training ranges, thereby ensuring that no threat is posed...

  16. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  17. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  18. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  19. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  20. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  1. 3 CFR 8415 - Proclamation 8415 of September 14, 2009. National Employer Support of the Guard and Reserve Week...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Proclamation 8415 of September 14, 2009. National Employer Support of the Guard and Reserve Week, 2009 8415 Proclamation 8415 Presidential Documents Proclamations Proclamation 8415 of September 14, 2009 Proc. 8415 National Employer Support of the Guard and Reserve Week, 2009By the President of...

  2. 3 CFR 9022 - Proclamation 9022 of September 20, 2013. National Employer Support of the Guard and Reserve Week...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Proclamation 9022 of September 20, 2013. National Employer Support of the Guard and Reserve Week, 2013 9022 Proclamation 9022 Presidential Documents Proclamations Proclamation 9022 of September 20, 2013 Proc. 9022 National Employer Support of the Guard and Reserve Week, 2013By the President of...

  3. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  4. Preliminary assessment report for National Guard Facility, Installation 25255, Rehoboth, Massachusetts. Installation Restoration Program

    SciTech Connect

    Haffenden, R.; Flaim, S.; Krokosz, M.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Massachusetts Army National Guard (MAARNG) property known as the Rehoboth National Guard Facility (RNGF) in Rehoboth, Massachusetts. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for ftirther action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the RNGF property, phase I of the Department of Defense Installation Restoration Program (IRP). The scope of this assessment is limited to the facilities under the control of the MAARNG and the past activities contained within that area.

  5. Army National Guard (ARNG) Objective Supply Capability Adaptive Redesign (OSCAR) end-user manual

    SciTech Connect

    Pelath, R.P.; Rasch, K.A.

    1997-12-01

    The Objective Supply Capability Adaptive Redesign (OSCAR) project is designed to identify and develop programs which automate requirements not included in standard army systems. This includes providing automated interfaces between standard army systems at the National Guard Bureau (NGB) level and at the state/territory level. As part of the OSCAR project, custom software has been installed at NGB to streamline management of major end items. This software allows item managers to provide automated disposition on excess equipment to states operating the Standard Army Retail Supply System Objective (SARSS-O). It also accelerates movement of excess assets to improve the readiness of the Army National Guard (ARNG)--while reducing excess on hand. The purpose of the End-User Manual is to provide direction and guidance to the customer for implementing the ARNG Excess Management Program.

  6. 32 CFR 161.11 - Benefits for National Guard and Reserve Members of the Uniformed Services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CHC DC C MWR E Member (Self) No No Yes Yes Yes. Table 4 to Part 161—Benefits for National Guard and Reserve Members on Active Duty for Periods Greater Than 30 Days CHC DC C MWR E Member (Self) No Yes Yes... age of 23, is enrolled in a full-time course of study at an institution of higher learning approved...

  7. Predictors of postdeployment alcohol use disorders in National Guard soldiers deployed to Operation Iraqi Freedom.

    PubMed

    Kehle, Shannon M; Ferrier-Auerbach, Amanda G; Meis, Laura A; Arbisi, Paul A; Erbes, Christopher R; Polusny, Melissa A

    2012-03-01

    Alcohol use in the military is a significant problem. The goal of this study was to examine the associations between personality, posttraumatic stress disorder (PTSD) symptoms, and postdeployment alcohol use disorders (AUDs) among a group of Operation Iraqi Freedom (OIF) deployed National Guard soldiers, with a focus on differentiating predeployment and postdeployment onset AUDs. Participants were 348 National Guard soldiers deployed to Iraq from March 2006 to July 2007 drawn from the Readiness and Resilience in National Guard Soldiers (RINGS) study. Participants completed self-report measures one month before deployment and 3 to 6 months postdeployment; current and lifetime history of AUDs were assessed 6 to 12 months postdeployment, using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (4th ed. text rev.; DSM-IV; American Psychiatric Association, 2000). Overall, 13% of the panel was diagnosed with a current AUD. Of those who met criteria for a current AUD, 38% had an AUD that developed following return from deployment (new onset AUD). The development of new onset AUDs was uniquely predicted by higher levels of PTSD symptom severity, higher levels of avoidance-specific PTSD symptoms, and lower levels of positive emotionality. AUDs with onset prior to deployment were predicted by higher levels of negative emotionality and disconstraint. Results of this study suggest that combat deployed soldiers with current AUDs are a heterogeneous group and point to the influence of combat-related PTSD symptoms in the development of AUDs following deployment. PMID:21823766

  8. Assessment of a Post-deployment Yellow Ribbon Reintegration Program for National Guard Members and Supporters

    PubMed Central

    Scherrer, Jeffrey F.; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi Kato

    2014-01-01

    The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP’s delivery of information and assistance during the post-deployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and help provision, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed education needs being met (76.8% and 78.2% respectively) and were least likely to endorse legal needs being met (63.5% and 60% respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health; while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2-4 months after a deployment. PMID:25373071

  9. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were with treatment can elucidate the problems that exist and so enable them to be solved. PMID:7819893

  10. Preliminary assessment report for Kent National Guard Facility (Installation 53065), 24410 Military Road, Kent, Washington

    SciTech Connect

    Ketels, P.; Aggarwal, P.; Rose, C.M.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Washington Army National Guard property in Kent, Washington. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment.

  11. Predictors of alcohol use prior to deployment in National Guard Soldiers.

    PubMed

    Ferrier-Auerbach, Amanda G; Kehle, Shannon M; Erbes, Christopher R; Arbisi, Paul A; Thuras, Paul; Polusny, Melissa A

    2009-08-01

    Frequent and heavy alcohol use is associated with negative mental and physical health consequences. Previous research has suggested that alcohol misuse is associated with demographic, personality, and mental health variables. This study examined the relative contribution of these factors in predicting drinking among National Guard soldiers prior to deployment to a combat zone. Members of a National Guard Brigade Combat Team (N=515) completed questionnaires assessing drinking behaviors in the past year (frequency, quantity, binge, and total drinking), as well as demographic, personality, and mental health variables. As a group, demographic and personality variables significantly predicted all drinking outcomes. Negative emotionality and disconstraint were independent predictors of all drinking variables. Younger age predicted higher quantity of drinking, while being unmarried predicted greater total drinking and higher frequency of binge drinking. Once the influence of personality variables were accounted for, mental health was not associated with any drinking variable. The results of this study illustrate the role of factors associated with problematic drinking in a sample of high-risk individuals. PMID:19375239

  12. A Comparative Case Study of Risk, Resiliency, and Coping Among Injured National Guard.

    PubMed

    Gorman, Lisa A; Huebner, Angela J; Hirschfeld, Mara K; Sankar, Sudha; Blow, Adrian J; Guty, Danielle; Kees, Michelle; Ketner, Joel S

    2016-05-01

    An injury during deployment disrupts family and life functioning. The purpose of the present study was to provide an in-depth examination of three injured National Guard soldiers showing how differential experiences of navigating multiple systems to obtain treatment for injury resulted in different adjustment trajectories for these soldiers and their families. A comparative case study examined three families where a soldier's injury was a central theme of family adjustment. Qualitative data were drawn from interviews conducted conjointly with both the soldier and spouse to provide an in-depth perspective of adjustment, meaning, and resource utilization patterns. In addition, survey data were collected at three time points in the deployment cycle (predeployment, 90 days post, and 1 year). These data were integrated into the case analysis, including mental health, marital relationship, treatment history, and characteristics of resilience. Study findings suggest that a delay in diagnosis, wait time for treatment, and the lack of comprehensive formal and financial support for a soldier following nonhostile injury lead to a pileup of stressors that are detrimental to the soldier's physical and mental health, financial stability, and family well-being. Further study is needed to understand how these system level issues impede resilience among National Guard families. PMID:27168555

  13. Risk factors for post-deployment posttraumatic stress disorder in national guard/reserve service members.

    PubMed

    Tracie Shea, M; Reddy, Madhavi K; Tyrka, Audrey R; Sevin, Elizabeth

    2013-12-30

    Identification of factors that increase risk for PTSD in military personnel following deployments is critical to early intervention and prevention. The study tested hypothesized main and moderating risk factors for PTSD in National Guard/Reserve members deployed to Iraq or Afghanistan. Members of the National Guard/Reserves (n=238) completed diagnostic interviews and measures of risk factors at a post-deployment assessment conducted an average of four and a half months following return from deployment. Hierarchical multivariate logistic regression analyses were used to test hypotheses. Higher levels of combat exposure, life and family concerns during deployment, and post-deployment social support independently predicted PTSD. Life/family concerns during deployment and perceived adequacy of training and preparation were significant moderators of the association between combat exposure and PTSD. Among those with higher levels of both combat exposure and life and family stress, 27% had PTSD in contrast to 3% of those with high exposure but lower levels of such stress during deployment. In addition to combat exposure, life and family stress during deployment is a particularly important predictor of PTSD. The findings highlight the importance of identifying and addressing such stress. PMID:24054062

  14. Superfund record of decision (EPA Region 1): Otis Air National Guard (USAF), Operable Unit 3, Falmouth, MA, September 30, 1998

    SciTech Connect

    1999-03-01

    The Massachusetts Military Reservation (MMR) on Cape Cod, Massachusetts, lies within the boundaries of the towns of Falmouth, Mashpee, Sandwich, and Bourne. The Area of Contamination (AOC) known as Chemical Spill 3 United States Coast Guard (CS-3 (USCG)) is located on Lee Road, in the south central portion of the MMR. The Air Force Center for Environmental Excellence (AFCEE) Installation Restoration Program Office at Otis Air National Guard (ANG) Base, Massachusetts.

  15. Civilian Stressors Associated with Alcohol Use Disorders in the National Guard

    PubMed Central

    Cerdá, Magdalena; Richards, Catherine; Cohen, Greg H.; Calabrese, Joseph R.; Liberzon, Israel; Tamburrino, Marijo; Galea, Sandro; Koenen, Karestan C.

    2014-01-01

    Background Alcohol use disorders are a serious public health concern among soldiers. Although deployment-related exposures have been linked with alcohol use disorders in soldiers, less is understood about the link between modifiable, civilian stressors and post-deployment alcohol use disorders. Purpose To (1) compare the influence of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorders among Army National Guardsmen primarily deployed to Afghanistan and Iraq; and (2) evaluate whether civilian stressors influence a different set of alcohol use disorder phenotypes than deployment-related traumatic events and stressors. Methods A cohort of Ohio National Guard soldiers was recruited in 2008–2009 and interviewed three times over 3 years. The analytic sample included Ohio National Guard soldiers who had been deployed by 2008–2009, had participated in at least one follow-up wave, had reported consuming at least one alcoholic drink in their lifetime, and had non-missing data on alcohol use disorders (n=1,095). Analyses were conducted in 2013. Results In a model including measures of civilian stressors and deployment-related traumatic events, only civilian stressors (OR=2.07, 95% CI=1.46, 2.94) were associated with subsequent alcohol use disorder. The effects of civilian stressors were only present among people with no history of alcohol use disorder. Conclusions Independent of deployment-related exposures, post-deployment civilian stressors are associated with the onset of alcohol use disorder among reserve-component soldiers. Concerted investment to address daily civilian difficulties associated with reintegration into civilian life may be needed to prevent new cases of alcohol use disorders among returning military personnel. PMID:25089013

  16. Coast Guard

    SciTech Connect

    Not Available

    1991-09-01

    The 11-million gallon Exxon Valdez oil spill highlighted deficiencies in the nation's ability to contain and recover spilled oil. The Oil Pollution Act of 1990 represents a major effort by Congress to address these deficiencies and to clarify the roles and responsibilities of the private sector and the federal government in preventing, preparing for, and responding to oil spills. This report examines the Coast Guard's efforts to avoid unnecessary and wasteful duplication by coordinating with the private sector and others, including federal and state agencies, its plans to buy oil spill response equipment and the new responsibilities the act places on the private sector and the Coast Guard and if these responsibilities call for a shift in emphasis in Coast Guard oil spill response activities.

  17. Posttraumatic Stress Symptoms among National Guard Soldiers Deployed to Iraq: Associations with Parenting Behaviors and Couple Adjustment

    ERIC Educational Resources Information Center

    Gewirtz, Abigail H.; Polusny, Melissa A.; DeGarmo, David S.; Khaylis, Anna; Erbes, Christopher R.

    2010-01-01

    Objective: In this article, we report findings from a 1-year longitudinal study examining the impact of change in posttraumatic stress disorder (PTSD) symptoms following combat deployment on National Guard soldiers' perceived parenting and couple adjustment 1 year following return from Iraq. Method: Participants were 468 Army National Guard…

  18. Posttraumatic stress, family adjustment, and treatment preferences among National Guard soldiers deployed to OEF/OIF.

    PubMed

    Khaylis, Anna; Polusny, Melissa A; Erbes, Christopher R; Gewirtz, Abigail; Rath, Michael

    2011-02-01

    We used an anonymous self-reported questionnaire to assess posttraumatic stress disorder symptoms, relationship concerns, and treatment preferences including interest in family-focused interventions among 100 National Guard Soldiers who were recently redeployed from Iraq or Afghanistan. We found that the majority of married or partnered soldiers were concerned about getting along with their partners, while the majority of parents were concerned about their child-rearing practices. Posttraumatic stress disorder symptoms were significantly associated with the degree of relationship concerns. Soldiers showed a striking preference for family-based interventions over individual treatment, highlighting the importance of developing family-based interventions tailored to address post-deployment mental health and co-occurring family problems. PMID:21366071

  19. Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war.

    PubMed

    Erbes, Christopher R; Meis, Laura A; Polusny, Melissa A; Compton, Jill S

    2011-08-01

    Relationship adjustment and posttraumatic stress disorder (PTSD) symptoms were assessed across two time points in a sample of 313 married or partnered National Guard soldiers recently returned from combat duty in Iraq. Structural equation modeling using a four-factor model for PTSD found the latent variable dysphoria (reflecting generalized distress including aspects of emotional numbing and arousal) had the strongest independent contribution to predicting relationship adjustment at Time 1 and indirectly predicted poorer relationship adjustment at Time 2. Exploratory analysis of gender differences (n = 33 women; n = 280 men) suggested a different pattern of relations between PTSD factors and relationship adjustment among female soldiers at Time 1, with a trend toward trauma specific avoidance being more highly related to relationship adjustment. Clinical and research implications are discussed. PMID:21639633

  20. Early mental health treatment-seeking among U.S. National Guard soldiers deployed to Iraq.

    PubMed

    Kehle, Shannon M; Polusny, Melissa A; Murdoch, Maureen; Erbes, Christopher R; Arbisi, Paul A; Thuras, Paul; Meis, Laura A

    2010-02-01

    The authors examined rates of and factors associated with postdeployment treatment-seeking in a panel of 424 National Guard soldiers who spent 16 months in Iraq. Soldiers completed a self-report, mailed survey 3- to 6-months after returning home. Approximately one third of respondents reported postdeployment mental health treatment. Those who screened positive for mental health problems were more likely to indicate that they had received treatment compared to those who screened negative, but over one half of those who screened positive were not engaged with mental health treatment. Variables related to reported treatment receipt included positive attitudes about mental health therapies, having been injured in-theater, illness-based need, and having received mental health treatment while in-theater. Implications and future research directions are discussed. PMID:20104591

  1. Children of National Guard troops: a pilot study of deployment, patriotism, and media coverage.

    PubMed

    Pfefferbaum, Betty; Jeon-Slaughter, Haekyung; Jacobs, Anne K; Houston, J Brian

    2013-01-01

    This exploratory pilot study examined the psychosocial effects of the war in Iraq, patriotism, and attention to war-related media coverage in the children of National Guard troops across phases of parental deployment--pre deployment, during deployment, and post deployment. Participants included 11 children, ages 8 to 18 years. Data collected in each deployment phase included demographics, the Behavior Assessment System for Children, (Second Edition, BASC-2), patriotism (national identity, uncritical patriotism, and constructive patriotism), and attention to war-related media coverage. School problems and emotional symptoms were significantly higher during deployment than post deployment. National identity and constructive patriotism increased and uncritical patriotism decreased post deployment from levels during deployment. Uncritical patriotism correlated positively with emotional symptoms and correlated negatively with personal adjustment. Constructive patriotism correlated positively with emotional symptoms and with internalizing problems. Greater attention to war-related media coverage correlated with uncritical patriotism, and attention to internet coverage correlated with constructive patriotism. Attention to media coverage was linked to greater emotional and behavioral problems and was negatively correlated with personal adjustment. The results of this pilot study identified relationships of both patriotism and attention to media coverage with children's emotional and behavioral status and personal adjustment suggesting areas for future investigation. PMID:24558700

  2. Anger Problems and Posttraumatic Stress Disorder in Male and Female National Guard and Reserve Service Members

    PubMed Central

    Worthen, Miranda; Rathod, Sujit D.; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer

    2014-01-01

    Anger is a common problem among veterans and has been associated with posttraumatic stress disorder (PTSD). This study aimed to improve understanding of how anger and PTSD co-occur by examining gender differences and differences by whether the triggering traumatic event is deployment-related vs. civilian-related in current service members. A representative cohort of Reserve and National Guard service personnel (n = 1,293) were interviewed to assess for deployment- or civilian-related traumas, PTSD, and anger. The prevalence of self-reported anger problems was estimated among male (n = 1,036) and female (n = 257) service members. Log Poisson regression models with robust standard errors were used to estimate the associations of problems with anger with PTSD and PTSD symptom severity for men and women. Self-reported anger problems were common among male (53.0%) and female (51.3%) service members. Adjusted prevalence ratios (PR) showed associations between anger and PTSD connected to both civilian- and deployment-related traumas (PR were 1.77 (95% CI 1.52 – 2.05) and 1.85 (95% CI 1.62 – 2.12), respectively). PTSD symptom severity was also associated with anger. This study was cross-sectional and so a causal relationship between PTSD and anger cannot be established. Problems with anger are common among male and female current Guard and Reserve members. These findings suggest that anger treatment should be made available to current service members and that clinicians should assess anger problems irrespective of gender. Future research should examine the effectiveness of anger treatment protocols by gender. PMID:24755257

  3. Preliminary assessment report for Redmond Army National Guard Facility, Installation 53120, Redmond, Washington. Installation Restoration Program

    SciTech Connect

    Ketels, P.; Aggarwal, P.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Washington Army National Guard (WAARNG) property in Redmond, Washington. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Redmond ARNG property, Phase I of the Department of Defense Installation Restoration Program. The environmentally significant operations (ESOs) associated with the property are (1) supply/storage of hazardous materials, (2) weapons cleaning, (3) the underground storage tanks (USTs), and (4) the use of herbicides. These ESOs are no longer active because of the closure of OMS 10 activities in 1988.

  4. Occupational Analysis of Air Force Reserve and Air National Guard Nurses. Final Report for Period January 1974-July 1975.

    ERIC Educational Resources Information Center

    Bergmann, Joseph A.; Smith, Michael C.

    An occupational survey comparing active duty and Reserve Forces nurses was conducted to support a Nursing Resources Study Group gathering information on current and future nurse requirements. Job inventory booklets were sent to chief nurses at Reserve and Air National Guard locations which were administered during unit training meetings. Returned…

  5. 20 CFR 1002.306 - Is a National Guard civilian technician considered a State or Federal employee for purposes of...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Is a National Guard civilian technician considered a State or Federal employee for purposes of USERRA? 1002.306 Section 1002.306 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND TRAINING SERVICE, DEPARTMENT OF LABOR REGULATIONS UNDER THE UNIFORMED...

  6. Lifelong Education Needs for Providing Pastoral Care for Post-Traumatic Stress in South Dakota National Guard Soldiers

    ERIC Educational Resources Information Center

    Meirose, William J.

    2010-01-01

    Throughout many communities in South Dakota the members of the South Dakota National Guard have been activated to serve in many different parts of the world since 2001. Approximately 20% of these individuals returned to their homes with some degree of PTSD (Hoge, et al., 2004). Pastoral Care has changed since September 11, 2001. The purpose of…

  7. Staying on Course: Three-Year Results of the National Guard Youth ChalleNGe Evaluation. Executive Summary

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Muller-Ravett, Sara; Broadus, Joseph

    2011-01-01

    High school dropouts face an uphill battle in a labor market that increasingly rewards skills and postsecondary credentials: they are more likely than their peers to need public assistance, be arrested or incarcerated, and less likely to marry. This executive summary summarizes results from a rigorous evaluation of the National Guard Youth…

  8. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc.... (b) The regulation. (1) During specific, infrequent periods when Military exercises will be...

  9. Reengaging High School Dropouts: Early Results of the National Guard Youth ChalleNGe Program Evaluation. Full Report

    ERIC Educational Resources Information Center

    Bloom, Dan; Gardenhire-Crooks, Alissa; Mandsager, Conrad

    2009-01-01

    High school dropouts face daunting odds of success in a labor market that increasingly rewards education and skills. This report presents very early results from a rigorous, independent evaluation of the National Guard Youth ChalleNGe Program, an intensive residential program that aims to "reclaim the lives" of young people ages 16 to 18 who have…

  10. The Predictive Validity of the PTSD Checklist in a Nonclinical Sample of Combat-Exposed National Guard Troops

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Kaler, Matthew E.; Kehle-Forbes, Shannon M.; Erbes, Christopher R.; Polusny, Melissa A.; Thuras, Paul

    2012-01-01

    After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the "Diagnostic and Statistical…

  11. Army National Guard. Officer Candidate Training Should Be Consolidated at One Site. Report to the Secretary of Defense.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. National Security and International Affairs Div.

    The operations of the 50 Army National Guard (ARNG) schools were reviewed to determine if the ARNG could meet its officer needs more effectively and economically. The study examined the following: (1) the numbers of officers being produced by the various ARNG commissioning sources, particularly the state officer candidate schools (OCS); (2) the

  12. The Predictive Validity of the PTSD Checklist in a Nonclinical Sample of Combat-Exposed National Guard Troops

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Kaler, Matthew E.; Kehle-Forbes, Shannon M.; Erbes, Christopher R.; Polusny, Melissa A.; Thuras, Paul

    2012-01-01

    After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the "Diagnostic and Statistical

  13. Psychiatric distress among spouses of National Guard soldiers prior to combat deployment.

    PubMed

    Erbes, Christopher R; Meis, Laura A; Polusny, Melissa A; Arbisi, Paul A

    2012-09-01

    Background The mental health functioning of military spouses and intimate partners prior to the combat deployments of their loved ones is poorly studied. Aims Whereas service members and veterans often receive healthcare directly from the military or the Department of Veterans Affairs, family members may be more likely to present in family care settings. An understanding of mental health problems commonly occurring in this population is therefore important. Method National Guard soldiers and their spouses or cohabitating partners (n = 223 couples) were surveyed about mental health symptoms, social functioning and mental health service utilisation one to two months prior to a combat deployment to Afghanistan. Results Screening rates for partner post-traumatic stress disorder, depression, alcohol problems and social impairment were 2.4, 15.3, 3.7 and 10.7%, respectively, and were significantly higher for partners than soldiers with regards to depression and social impairment. The majority of partners screening positive for psychiatric distress did not report utilising mental health services or military support services (i.e. family readiness groups). Clinical implications are discussed. PMID:23997822

  14. Mental health diagnosis and occupational functioning in National Guard/Reserve veterans returning from Iraq.

    PubMed

    Erbes, Christopher R; Kaler, Matthew E; Schult, Tamara; Polusny, Melissa A; Arbisi, Paul A

    2011-01-01

    Occupational functioning represents both an important outcome for military service members returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom and a predictor for long-term mental health functioning. We investigated the role of mental health diagnoses, determined by structured clinical interviews, on occupational functioning in a group of 262 National Guard/Reserve service members within 1 year of returning from a 16-month OIF combat deployment. We assessed occupational functioning at the time of diagnostic interviews and 1 year later. We hypothesized that service members with diagnoses of posttraumatic stress disorder (PTSD), depression, and/or alcohol abuse or dependence would exhibit lower rates of employment at both time points and lower rates of reported work and/or school role functioning. Service members with a diagnosis of PTSD (5%, n = 13), subthreshold PTSD (6%, n = 15), a major depressive disorder (11%, n = 29), or alcohol abuse or dependence (11%, n = 28) did not differ on employment status from service members without a diagnosis at either time point. However, those with a diagnosis of PTSD, depression, and/or alcohol abuse or dependence reported lower levels of work role functioning. In addition, service members with a diagnosis of PTSD reported greater rates of deterioration in work role functioning over time. PMID:22234661

  15. Relationship adjustment, PTSD symptoms, and treatment utilization among coupled National Guard soldiers deployed to Iraq.

    PubMed

    Meis, Laura A; Barry, Robin A; Kehle, Shannon M; Erbes, Christopher R; Polusny, Melissa A

    2010-10-01

    Although combat-related posttraumatic stress disorder (PTSD) is associated with considerable impairment in relationship adjustment, research has yet to investigate how PTSD symptoms and relationship distress uniquely and jointly predict utilization of a range of mental health services. The present study sought to examine these issues utilizing a longitudinal sample of National Guard soldiers surveyed 2-3 months following return from deployment to Iraq and again 12 months later (N = 223). Results indicated that PTSD symptom severity, but not relationship adjustment, uniquely predicted greater odds of utilizing individual-oriented mental health services. A significant interaction was found indicating associations between PTSD symptoms and the odds of using services were increased when soldiers reported greater relationship adjustment. For utilization of family-oriented care, greater relationship distress was significantly correlated with greater odds of using services, but associations with PTSD symptoms were nonsignificant. The association between relationship distress and utilization of family-oriented services did not vary significantly with severity of PTSD symptoms. Results suggest supportive intimate relationships facilitate mental health treatment utilization for soldiers with PTSD symptoms. PMID:20954766

  16. Psychiatric distress among spouses of National Guard soldiers prior to combat deployment

    PubMed Central

    2012-01-01

    Background The mental health functioning of military spouses and intimate partners prior to the combat deployments of their loved ones is poorly studied. Aims Whereas service members and veterans often receive healthcare directly from the military or the Department of Veterans Affairs, family members may be more likely to present in family care settings. An understanding of mental health problems commonly occurring in this population is therefore important. Method National Guard soldiers and their spouses or cohabitating partners (n = 223 couples) were surveyed about mental health symptoms, social functioning and mental health service utilisation one to two months prior to a combat deployment to Afghanistan. Results Screening rates for partner post-traumatic stress disorder, depression, alcohol problems and social impairment were 2.4, 15.3, 3.7 and 10.7%, respectively, and were significantly higher for partners than soldiers with regards to depression and social impairment. The majority of partners screening positive for psychiatric distress did not report utilising mental health services or military support services (i.e. family readiness groups). Clinical implications are discussed. PMID:23997822

  17. Civilian Unemployment and Mental Health: The Moderating Impact of Alcohol Misuse in Returning National Guard.

    PubMed

    Kintzle, Sara; Oh, Hyunsung; Wilcox, Sherrie; Hassan, Anthony; Ell, Kathy; Castro, Carl

    2015-09-01

    Postdeployment civilian unemployment has become a common problem and source of additional stress for National Guard (NG) personnel. This study evaluated 126 California NG members, exploring the relationship between immediate postdeployment employment status and self-reported mental health symptoms, including evidence of alcohol misuse. Participants were recruited from a NG unit within the first 3 months after returning home in August 2011. Over one-third of participants reported being unemployed beyond the part-time NG commitment. Mental health symptoms were greater in those participants without civilian employment. Additionally, those participants with comorbid alcohol misuse with either depression or post-traumatic stress disorder were significantly more likely to lack civilian employment. Interaction testing revealed a significant interaction between employment status and alcohol misuse for both depression and post-traumatic stress disorder. Alcohol use was concluded to moderate the relationship between civilian unemployment and mental health symptoms. Results suggest that the part-time employment provided through NG service may serve as a protective factor in the development of negative psychological outcomes, except for cases where alcohol misuse is present. PMID:26327551

  18. Unit Support Protects Against Sexual Harassment and Assault among National Guard Soldiers

    PubMed Central

    Walsh, Kate; Galea, Sandro; Cerda, Magdalena; Richards, Catherine; Liberzon, Israel; Tamburrino, Marijo B.; Calabrese, Joseph; Koenen, Karestan C.

    2014-01-01

    Objective Despite concerns about increased sexual harassment and assault following 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members’ relationships within their unit, protects against sexual harassment and assault during deployment. Methods Participants were 1674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008-2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. Results Approximately 13.2% (n=198) of men and 43.5% (n=74) of women reported sexual harassment, and 1.1% (n=17) of men and 18.8% (n=32) of women reported sexual assault during their most recent deployment. Higher unit support was associated with decreased odds of sexual harassment and assault. Conclusions A substantial proportion of men and women reported sexual harassment/assault. Higher unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has potential to reduce sexual harassment and assault. PMID:25442705

  19. Posttraumatic stress disorder, depression, and HIV risk behavior among Ohio Army National Guard Soldiers.

    PubMed

    Marshall, Brandon D L; Prescott, Marta R; Liberzon, Israel; Tamburrino, Marijo B; Calabrese, Joseph R; Galea, Sandro

    2013-02-01

    We examined the relationship between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and human immunodeficiency virus (HIV) risk behavior among the Ohio Army National Guard (OHARNG). We analyzed data collected from a sample of OHARNG enlisted between June 2008 and February 2009. Participants completed interviews assessing HIV risk activities defined by the Behavioral Risk Factor Surveillance System, and were screened for PTSD and MDD based on DSM-IV criteria according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994). Logistic regression was used to examine the independent and combined effects of PTSD and MDD on past-year HIV risk behavior. Of 2,259 participants, 142 (6.3%) reported at least 1 past-year HIV risk behavior. In adjusted models, relative to soldiers with neither disorder, screening positive for MDD only was associated with HIV risk behavior (adjusted odds ratio [AOR] = 2.33, 95% CI = [1.15, 4.71]), whereas PTSD was not significant (AOR = 1.60, 95% CI = [0.80, 3.20]). Participants with both PTSD and depression were most likely to report HIV risk behavior (AOR = 2.75, 95% CI = [1.06, 7.11]). Soldiers with PTSD and MDD may be at greater risk for HIV infection due to increased engagement in HIV risk behavior. Integrated interventions to address mental health problems and reduce HIV risk behavior are in need of development and evaluation. PMID:23417876

  20. Hazardous drinking and family functioning in National Guard veterans and spouses postdeployment.

    PubMed

    Blow, Adrian J; Gorman, Lisa; Ganoczy, Dara; Kees, Michelle; Kashy, Deborah A; Valenstein, Marcia; Marcus, Sheila M; Fitzgerald, Hiram E; Chermack, Stephen

    2013-04-01

    The current study examined rates of alcohol misuse among National Guard (NG) service members and their spouses/partners, concordance of drinking behaviors among couples, and the effects of alcohol misuse, depression, and posttraumatic stress disorder (PTSD) on three measures of family functioning. This study is important because it addresses the topics of heavy drinking and family functioning in an at-risk population-NG service members returning from a combat zone deployment. We surveyed NG service members (1,143) and their partners (674) 45-90 days after returning from a military deployment. Service member rates of hazardous drinking were 29.2% and spouses/partners 10.7%. Of the 661 linked couples, 26.2% were discrepant where only one member met the criteria for hazardous drinking and 5.4% were congruent for alcohol misuse where both members met hazardous drinking criteria. Service members belonging to either congruent or discrepant drinking groups were more distressed in their marriages/relationships than those in the nonhazardous group. In dyadic analyses, an unexpected partner effect was found for parenting outcomes; that is, when service members drink more, their spouses/partners are less stressed when it comes to parenting. Importantly, both service member and spouse/partner depression was significantly associated with negative family outcomes. Results from this study suggest that when working with these families, it is important to understand the drinking status of both soldier and spouse and to treat depression in addition to alcohol misuse. PMID:23544925

  1. Installation Restoration Program. Remedial Investigation Report. Minnesota Air National Guard Base, Duluth International Airport, Duluth, Minnesota. Volume 1. Final report

    SciTech Connect

    Not Available

    1990-01-01

    This report describes the remedial actions performed on sites confirmed to contain hazardous waste contamination which endangers the human health. The actions performed are described and the potential for future problems. The study was conducted under the Air National Guard's Installation Restoration Program. Partial contents of Volume I include: description of Installation Restoration Program; physiography, climate and drainage; demography and land use; geology and topography; hydrology; water quality; history; drainage; ground water; sampling; surface water; soils; chemical contamination; migration; and sedimentation.

  2. A specific labor market comparison of male and female willingness to travel: The case of the Army National Guard

    SciTech Connect

    Daniell, A. ); Bell, S.E. ); Vogt, D.P. )

    1991-01-01

    This paper reports on an examination of gender differences in commuting behavior within the Army National Guard. This labor market provides a more level playing field than most for a direct comparison between male and female willingness to travel. In contrast to other studies, we find that women as a group are willing to travel greater distances, in this particular labor market. 9 refs., 1 fig., 10 tabs.

  3. Longitudinal predictors of desire to re-enlist in the military among male and female national guard soldiers.

    PubMed

    Lancaster, Steven L; Erbes, Christopher R; Kumpula, Mandy J; Ferrier-Auerbach, Amanda; Arbisi, Paul A; Polusny, Melissa A

    2013-03-01

    Given the cost and burden associated with training and recruitment of military members, identifying predictors of military retention remains an important goal. The aim of the current study was to examine predictors of male and female service members' likelihood of remaining in the National Guard following combat deployment in support of Operation Iraqi Freedom. Using a prospective, longitudinal design, this study assessed a wide range of predictors including mental health functioning, personality variables, deployment stressors, and various domains of quality of life. Results indicated perceived unit support was the strongest predictor of intention to re-enlist for both male and female participants. However, significant gender differences emerged as predeployment depression and a trend toward perceived life threat during deployment were predictors of men's intention to re-enlist, whereas the predeployment personality dimension of introversion (low positive emotionality) and postdeployment life stressors were predictors of women's intention to re-enlist. Surprisingly, no postdeployment mental health variables predicted National Guard soldiers' intention to re-enlist. Findings from this study suggest factors associated with National Guard service members' retention or attrition from the military may be amenable to intervention. PMID:23707112

  4. A longitudinal study of pain and pain catastrophizing in a cohort of National Guard troops at risk for PTSD.

    PubMed

    Ciccone, Donald S; Kline, Anna

    2012-10-01

    A recent cross-sectional study of National Guard troops found that pain and pain catastrophizing were prevalent and highly correlated with posttraumatic stress disorder (PTSD). At issue in the present study was whether pain and catastrophizing before military deployment could account for individual differences in PTSD symptoms after deployment. An anonymous survey was administered to a population sample of New Jersey National Guard troops before they were sent overseas and again when they returned home (1 year later). The survey included a validated PTSD screening questionnaire, numerical ratings of pain intensity, and a measure of pain catastrophizing. A cohort of 922 National Guard members completed the survey before and after deployment. An uncontrolled analysis indicated that pain and catastrophizing before deployment were significantly but modestly associated with PTSD symptoms after deployment (accounting for 4.5% and 1.3% of the variance, respectively). A hierarchical regression model that controlled for sex, preexisting PTSD symptoms, and recent combat found that pain but not pain catastrophizing explained variance in postdeployment PTSD. The size of the effect, however, was negligible (0.8%, p<.01). Consistent with previous research, a cross-sectional analysis revealed that postdeployment pain and catastrophizing successfully accounted for unique variance in postdeployment PTSD. The failure of longitudinal predictors in the present study, therefore, cannot be attributed to insensitive screening instruments. These findings offer little or no support for the hypothesis that predeployment pain and catastrophizing can account for individual differences in PTSD after exposure to combat trauma. PMID:22862893

  5. Risk and resilience factors associated with posttraumatic stress in ethno-racially diverse National Guard members in Hawai׳i.

    PubMed

    Whealin, Julia M; Nelson, Dawna; Stotzer, Rebecca; Guerrero, Anthony; Carpenter, Megan; Pietrzak, Robert H

    2015-06-30

    This study examinedrisk and resilience factors associated with posttraumatic stress symptomatology (PTSS) in an ethno-racially diverse sample of Hawai׳i National Guard members comprised of Native Hawaiians, Filipino Americans, Japanese Americans, and European Americans. In the full sample, identifying as Japanese American and higher scores on measures of perceived social support and psychological resilience were negatively associated with PTSS, while Army Guard (vs. Air Guard) status and stronger family norms against disclosing mental health problems were positively associated with PTSS. Exploratory analyses of ethno-racial subgroups identified different patterns of within and between-group correlates of PTSS. For example, when controlling for other factors, higher psychological resilience scores were negatively associated with PTSS only among Native Hawaiian and European Americans. Overall, results of this study suggest that some risk and resilience factors associated with posttraumatic stress disorder (PTSD) may extend to military populations with high numbers of Filipino American, Japanese American, and Native Hawaiian Veterans. Results further suggest differences in risk and resilience factors unique to specific ethno-racial subgroups. PMID:25863819

  6. Bumper guard

    SciTech Connect

    Heyman, N.R.

    1987-02-10

    A bumper guard is described for protecting a selected portion of an automobile body comprising guard means for covering the selected portion of the automobile body and shaped complementary to the automobile body. A bracket means is attached to the automobile frame for holding the guard means in position on the selected portion of the automobile body. The guard means comprises a V-shaped angle iron adapted to fit over the selected portion of the automobile body. The guard means further comprises a padding secured to the angle iron for interposition between the angle iron and automobile body to thereby protectively separate the angle iron from the automobile body.

  7. Posttraumatic Stress Symptoms Among National Guard Soldiers Deployed to Iraq: Associations with Parenting Behaviors and Couple Adjustment

    PubMed Central

    Gewirtz, Abigail H.; Polusny, Melissa A.; DeGarmo, David S.; Khaylis, Anna; Erbes, Christopher R.

    2011-01-01

    Objective This article reports findings from a one-year longitudinal study examining the impact of change in PTSD symptoms following combat deployment on National Guard soldiers’ perceived parenting, and couple adjustment one year following return from Iraq. Method Participants were 468 Army National Guard fathers from a Brigade Combat Team (mean age 36 years; median deployment length 16 months; 89% European American, 5% African American, 6% Hispanic American). Participants completed an in-theater survey one month before returning home from OIF deployment (Time 1), and again, one year post-deployment (Time 2). The PTSD Checklist-Military Version (PCL-M; Weathers, Litz, Herman, Huska, & Keane, 1993) was gathered at both times, and two items assessing social support were gathered at baseline only. At Time 2, participants also completed self-report measures of parenting (Alabama Parenting Questionnaire—Short Form; Elgar, Waschbusch, Dadds, & Sigvaldason, 2007), couple adjustment (Dyadic Adjustment Scale-7; Sharpley & Rogers, 1984; Spanier, 1976), parent-child relationship quality (4 items from the Social Adjustment Scale-Self Report; Weissman & Bothwell, 1976), alcohol use (Alcohol Use Disorders Identification Test; Babor, Higgins-Biddle, Saunders, & Monteiro, 2001), and items assessing injuries sustained while deployed. Results Structural equation modeling analyses showed that increases in PTSD symptoms were associated with poorer couple adjustment and greater perceived parenting challenges at Time 2 (both at p<.001). Furthermore, PTSD symptoms predicted parenting challenges independent of their impact on couple adjustment. Conclusions Findings highlight the importance of investigating and intervening to support parenting and couple adjustment among combat-affected National Guard families. PMID:20873896

  8. Peers and peer-based interventions in supporting reintegration and mental health among National Guard soldiers: a qualitative study.

    PubMed

    Pfeiffer, Paul N; Blow, Adrian J; Miller, Erin; Forman, Jane; Dalack, Gregory W; Valenstein, Marcia

    2012-12-01

    National Guard soldiers experience high levels of mental health symptoms following deployment to Iraq and Afghanistan, yet many do not seek treatment. We interviewed 30 National Guard soldiers with prior deployments to Iraq or Afghanistan to assess mental health treatment barriers and the role of peers in treatment engagement. Interview transcripts were analyzed by a multidisciplinary research team using techniques drawn from grounded theory. The following themes were identified: (1) personal acceptance of having a mental health problem rather than treatment access is the major barrier to treatment entry; (2) tightly connected, supportive peer networks can decrease stigma related to mental health problems and encourage treatment; however, soldiers in impoverished or conflicted peer networks are less likely to receive these benefits; and (3) soldiers are generally positive about the idea of peer-based programs to improve treatment engagement, although they note the importance of leadership support, peer assignment, and unit specialty in implementing these programs. We conclude that some, but not all, naturally occurring peer networks serve to overcome stigma and encourage mental health treatment seeking by soldiers. Formal peer-based programs may assist soldiers not sufficiently benefitting from natural peer networks, although there are barriers to implementation. PMID:23397691

  9. Mortality of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Standley, W.G.; Berry, W.H.; O`Farrell, T.P.; Kato, T.T.

    1992-09-01

    Sources and rates of mortality of a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. National Guard-authorized activities, including military training, caused the death of three of the 94 (3%) kit foxes radiocollared, and do not appear to jeopardize the continued existence of the population. Predation by larger carnivores, primarily coyotes (Canis latrans), caused the death of 75% of the 32 radiocollared kit foxes recovered dead for which a cause of death could be determined; vehicle impacts, disease (rabies), poisoning, and shooting were each responsible for the deaths of 6.3%. Adult annual mortality rate was 0.47 and the juvenile mortality rate was 0.80, and both rates are similar to rates reported for kit foxes in other locations. There was no significant difference between male and female mortality rates in either age class. The proportions of dead kit foxes recovered in different habitat types were similar to the availability of the habitat types within the distribution of kit fox on the installation.

  10. Preliminary assessment report for Virginia Army National Guard Army Aviation Support Facility, Richmond International Airport, Installation 51230, Sandston, Virginia

    SciTech Connect

    Dennis, C.B.

    1993-09-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Virginia Army National Guard (VaARNG) property in Sandston, Virginia. The Army Aviation Support Facility (AASF) is contiguous with the Richmond International Airport. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The PA is designed to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. The AASF, originally constructed as an active Air Force interceptor base, provides maintenance support for VaARNG aircraft. Hazardous materials used and stored at the facility include JP-4 jet fuel, diesel fuel, gasoline, liquid propane gas, heating oil, and motor oil.

  11. Preliminary assessment report for Fort William Henry Harrison, Montana Army National Guard, Helena, Montana. Installation Restoration Program

    SciTech Connect

    DuWaldt, J.; Meyer, T.

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at a Montana Army National Guard (MTARNG) property near Helena, Montana. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Fort William Henry Harrison property, requirements of the Department of Defense Installation Restoration Program.

  12. Optimization of a guard ring structure in Geiger-mode avalanche photodiodes fabricated at National NanoFab Center

    NASA Astrophysics Data System (ADS)

    Lim, K. T.; Kim, H.; Cho, M.; Kim, Y.; Kim, C.; Kim, M.; Lee, D.; Kang, D.; Yoo, H.; Park, K.; Sul, W. S.; Cho, G.

    2016-01-01

    A typical Geiger-mode avalanche photodiode (G-APD) contains a guard ring that protects the structure from having an edge breakdown due to the lowering of electric fields at junction curvatures. In this contribution, G-APDs with a virtual guard ring (vGR) merged with n-type diffused guard ring (nGR) in various sizes were studied to find the optimal design for G-APDs fabricated at National NanoFab Center (NNFC) . The sensors were fabricated via a customized CMOS process with a micro-cell size of 65× 65 μm2 on a 200 mm p-type epitaxial layer wafer. I-V characteristic curves for proposed structures were measured on a wafer-level with an auto probing system and plotted together to compare their performance. A vGR width of 1.5 μm and a nGR width of 1.5 μm with an overlapping between vGR and nGR of 1.5 μm showed the lowest leakage current before the breakdown voltage while suppressing the edge breakdown. Furthermore, the current level of the lowest-leakage-current structure was as low as that of only vGR with a width of 2.0 μm, indicating that the structure is also area efficient. Based on these results, the design with vGR, nGR, and OL with width of 1.5 μm is determined to be the optimal structure for G-APDs fabricated at NNFC.

  13. Bird guard

    SciTech Connect

    Fairchild, Dana M.

    2010-03-02

    The bird guard provides a device to protect electrical insulators comprising a central shaft; a clamp attached to an end of the shaft to secure the device to a transmission tower; a top and bottom cover to shield transmission tower insulators; and bearings to allow the guard to rotate in order to frighten birds away from the insulators.

  14. Financial Analysis of National University Hospitals in Korea

    PubMed Central

    Lee, Munjae

    2015-01-01

    Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

  15. Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD: a longitudinal study.

    PubMed

    Kline, Anna; Weiner, Marc D; Ciccone, Donald S; Interian, Alejandro; St Hill, Lauren; Losonczy, Miklos

    2014-03-01

    Studies show high rates of co-morbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) but there is no consensus on the causal direction of the relationship. Some theories suggest AUD develops as a coping mechanism to manage PTSD symptoms and others that AUD is a vulnerability factor for PTSD. A third hypothesis posits independent developmental pathways stemming from a shared etiology, such as the trauma exposure itself. We examined these hypotheses using longitudinal data on 922 National Guard soldiers, representing a subsample (56%) of a larger pre- and post-deployment cross-sectional study of New Jersey National Guard soldiers deployed to Iraq. Measures included the PTSD Checklist (PCL), DSM-IV-based measures of alcohol use/misuse from the National Household Survey of Drug Use and Health and other concurrent mental health, military and demographic measures. Results showed no effect of pre-deployment alcohol status on subsequent positive screens for new onset PTSD. However, in multivariate models, baseline PTSD symptoms significantly increased the risk of screening positive for new onset alcohol dependence (AD), which rose 5% with each unit increase in PCL score (AOR = 1.05; 95% CI = 1.02-1.07). Results also supported the shared etiology hypothesis, with the risk of a positive screen for AD increasing by 9% for every unit increase in combat exposure after controlling for baseline PTSD status (AOR = 1.09; 95% CI = 1.03-1.15) and, in a subsample with PCL scores <34, by 17% for each unit increase in exposure (AOR = 1.17; 95% CI = 1.05-1.31). These findings have implications for prevention, treatment and compensation policies governing co-morbidity in military veterans. PMID:24332924

  16. Coast Guard

    SciTech Connect

    Meed, R.M.

    1991-10-01

    This paper testifies that water pollution by oil remains significant, and noncompliance with federal regulations to prevent oil pollution continues to be great in the four ports GAO visited. Additionally, the impact of the Coast Guard's efforts to reduce oil spill in unknown because the agency does not compile and analyze inspection and spill data needed to make this determination. Further, the Coast Guard has not been inspecting portions of pipes that transport oil between docks and storage tanks. Coast Guard officials now acknowledge this responsibility.

  17. Population trends of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Berry, W.H.; Standley, W.G.

    1992-10-01

    Population trends of a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, from November 1989 through August 1991. Six semiannual livetrapping sessions and eight scent-station survey sessions were conducted. Livetrapping results and radiotelemetry data were used to calculate minimum population size, density, and distribution. A total of 175 individual foxes were trapped 463 times. The number of individuals trapped and minimum population size calculations showed a decline over time. The highest minimum population (109) was observed in winter 1988. Summer 1991 had the lowest minimum population size (45). No evidence was found to indicate that the apparent population decline was a result of military-authorized activities.

  18. Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives.

    PubMed

    Boscarino, J A; Steiber, S R

    1995-01-01

    Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 and January 1993. The survey was part of an ongoing annual survey of hospitals and included questions about AIDS, health education, marketing, patient satisfaction, and hospital planning. Altogether, 12.4 percent of executives indicated their hospital had a reputation for treating AIDS patients. Among hospitals without an AIDS reputation, 34.1 percent believed developing one would be harmful to the hospital's image, in contrast to none in hospitals that had such a reputation (chi 2 = 11.676, df = 1, P = .0006). Although 16.6 percent did not know if large-scale HIV testing should be implemented, a near majority (47.7 percent) expressed some support. In addition, 15 percent reported that HIV-positive physicians on the hospital's medical staff should not be allowed to practice medicine, but 32.1 percent indicated that they should. Also, 33.1 percent thought the hospital should be more involved in AIDS education. Finally, certain hospital characteristics,such as location and for-profit status, were not associated with support for hospital-based AIDS interventions. Contrary to what was hypothesized,however, hospitals in AIDS epicenters were less supportive of the CDC recommendations for some reason (X2 = 7.735, df = 1, P = .005).Support for AIDS education and voluntary testing is significant among hospital marketing and public relations executives. Over the past decade, community marketing and public relations have become an integral part of the hospital's business activities.However, financial pressures now are forcing hospitals to restrict these efforts. Findings reported in this paper suggest that future health care reform may assist public health aims by redirecting these endeavors towards the fight against AIDS and other preventable diseases, not eliminating them. Additional research is needed to determine why executives in AIDS epicenters are less supportive of large-scale hospital HIV testing and counseling in comparison with those outside these areas. PMID:7638335

  19. The second national hospital costing study: background, results and implications.

    PubMed

    Oates, B; Murray, J; Hindle, D

    1998-01-01

    The costing of hospital outputs, and especially of acute admitted patients categorised by DRG, has been the focus of considerable attention in the last decade. Many individual hospitals now routinely estimate the costs of their main products, several State and Territory health authorities undertake periodic multi-site studies, and there have been a few one-off national studies. This paper summarises the methods and results of the most recent national study, which measured costs at a sample of public and private hospitals around Australia for the 1996-97 financial year. We briefly describe the main results and note some implications. PMID:10185689

  20. Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives.

    PubMed Central

    Boscarino, J A; Steiber, S R

    1995-01-01

    Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 and January 1993. The survey was part of an ongoing annual survey of hospitals and included questions about AIDS, health education, marketing, patient satisfaction, and hospital planning. Altogether, 12.4 percent of executives indicated their hospital had a reputation for treating AIDS patients. Among hospitals without an AIDS reputation, 34.1 percent believed developing one would be harmful to the hospital's image, in contrast to none in hospitals that had such a reputation (chi 2 = 11.676, df = 1, P = .0006). Although 16.6 percent did not know if large-scale HIV testing should be implemented, a near majority (47.7 percent) expressed some support. In addition, 15 percent reported that HIV-positive physicians on the hospital's medical staff should not be allowed to practice medicine, but 32.1 percent indicated that they should.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7638335

  1. Knowledge, Attitude, Practice, and Perceived Barriers of Colorectal Cancer Screening among Family Physicians in National Guard Health Affairs, Riyadh

    PubMed Central

    2014-01-01

    Objectives. The objective of this study is to explore the current knowledge, attitude, and practice of family physicians working in family medicine clinics in National Guard Health Affairs (NGHA), Riyadh, toward colorectal cancer (CRC) screening and to identify the barriers of the screening. Methods. Data were collected using a validated self-administered questionnaire adopted from the National Cancer Institute in USA, customized by adding and eliminating questions to be in line with the institution (NGHA) characteristics. Results. Of the 130 physicians, 56.2% of the physicians were not practicing CRC screening although 94.6% considered CRC screening effective. Board certified physicians had higher knowledge score and were practicing CRC screening more when compared to other physicians. Physicians who reported practicing CRC screening scored more on the knowledge score than those not practicing. Male physicians scored better on attitude score than female physicians. The study found that barriers were cited in higher rates among physicians not practicing CRC screening compared with practicing physicians. Lack of patients' awareness was the most cited barrier. Conclusion. Large percentage of family physicians in this study do not practice CRC screening, despite the knowledge level and the positive attitude. PMID:25328703

  2. Coast Guard

    SciTech Connect

    Not Available

    1990-02-01

    GAO found the situation in the Philadelphia and New York ports similar to that in Prince William Sound-neither industry nor the Coast Guard are prepared to respond to major oil spills. This report discusses how this unpreparedness is due to a lack of specificity in the industry and Coast Guard's plan on how to deal with spills of various sizes and Coast Guard authority to require ship owners and operators to have contingency plans or to require changes in existing plans. On the basic of recent experiences, GAO believes that prevention of oil spills rather than responding to them should be the main priority. Experiences in Price William Sound and in Philadelphia, however, show that much needs to be done to improve prevention measures like monitoring and guiding ship movements and using harbor pilots or vessel escorts.

  3. Installation Restoration Program. Site investigation report for 166th Tactical Airlift Group, Delaware Air National Guard, Greater Wilmington Airport, New Castle, Delaware. Final report

    SciTech Connect

    Not Available

    1990-05-01

    An investigation of sites determined to possibly contain hazardous waste in quantities that might endanger public health is presented. The study outlines the procedure used in the investigation and the results obtained. The data are used to determine if there is a risk to public health and the appropriate means of cleanup. The study was conducted under the Air National Guard's Installation Restoration Program.

  4. 20 CFR 1002.57 - Is all service as a member of the National Guard considered “service in the uniformed services?”

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Is all service as a member of the National Guard considered âservice in the uniformed services?â 1002.57 Section 1002.57 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND TRAINING SERVICE, DEPARTMENT OF LABOR REGULATIONS UNDER THE UNIFORMED SERVICES...

  5. The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard Soldiers Screening Positive for Posttraumatic Stress Disorder and Mild Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Polusny, Melissa A.; Erbes, Christopher R.; Thuras, Paul; Reddy, Madhavi K.

    2011-01-01

    The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the…

  6. WWC Quick Review of the Report "Reengaging High School Dropouts: Early Results of the National Guard Youth ChalleNGe Program Evaluation"

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2009

    2009-01-01

    The study examined whether participating in the "National Guard Youth ChalleNGe Program", a quasi-military residential/mentoring program for dropouts, improved the educational and other outcomes of at-risk youth. The study analyzed data on about 1,000 16- to 18-year-old high school dropouts enrolled in 10 ChalleNGe programs throughout the…

  7. The combined use of Skype and the STORZ CMAC video laryngoscope in field intubation training with the Nebraska National Air Guard.

    PubMed

    Boedeker, Ben H; Bernhagen, Mary; Miller, David J; Miljkovic, Nikola; Kuper, Gail M; Murray, W Bosseau

    2011-01-01

    This study examined the feasibility of using Skype technology in basic manikin intubation instruction of Nebraska National Air Guard personnel at a Casualty Training Exercise. Results show that the Skype monitor provided clear sound and visualization of the airway view to the trainees and the combination of VoIP technology and videolaryngoscopy for intubation training was highly valued by study participants. PMID:21335766

  8. The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard Soldiers Screening Positive for Posttraumatic Stress Disorder and Mild Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Polusny, Melissa A.; Erbes, Christopher R.; Thuras, Paul; Reddy, Madhavi K.

    2011-01-01

    The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the

  9. Critical Needs and Level of Support for the Military Spouse: A Comparative Study of the National Guard and Active Army during the Iraq War

    ERIC Educational Resources Information Center

    Vasilas, Cynthia Nikki

    2009-01-01

    National Guard units have been asked to serve in ways never before experienced since the beginning of the Iraq War and throughout the continued war on terror. Multiple deployments, frequent long-term separations from families, communities, and jobs may have far reaching implications. Family Readiness Groups and a climate of support shown by…

  10. Sound Guard

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Lubrication technology originally developed for a series of NASA satellites has produced a commercial product for protecting the sound fidelity of phonograph records. Called Sound Guard, the preservative is a spray-on fluid that deposits a microscopically thin protective coating which reduces friction and prevents the hard diamond stylus from wearing away the softer vinyl material of the disc. It is marketed by the Consumer Products Division of Ball Corporation, Muncie, Indiana. The lubricant technology on which Sound Guard is based originated with NASA's Orbiting Solar Observatory (OSO), an Earth-orbiting satellite designed and built by Ball Brothers Research Corporation, Boulder, Colorado, also a division of Ball Corporation. Ball Brothers engineers found a problem early in the OSO program: known lubricants were unsuitable for use on satellite moving parts that would be exposed to the vacuum of space for several months. So the company conducted research on the properties of materials needed for long life in space and developed new lubricants. They worked successfully on seven OSO flights and attracted considerable attention among other aerospace contractors. Ball Brothers now supplies its "Vac Kote" lubricants and coatings to both aerospace and non-aerospace industries and the company has produced several hundred variations of the original technology. Ball Corporation expanded its product line to include consumer products, of which Sound Guard is one of the most recent. In addition to protecting record grooves, Sound Guard's anti-static quality also retards particle accumulation on the stylus. During comparison study by a leading U.S. electronic laboratory, a record not treated by Sound Guard had to be cleaned after 50 plays and the stylus had collected a considerable number of small vinyl particles. The Sound Guard-treated disc was still clean after 100 plays, as was its stylus.

  11. Installation-Restoration Program. Phase 2. Confirmation/quantification. Stage 1. Problem confirmation study: Otis Air National Guard Base, Massachusetts, Air National Guard Support Center, Andrews Air Force Base, Maryland. Final technical report, November 1983-July 1985

    SciTech Connect

    Kraybill, R.L.; Smart, G.R.; Bopp, F.

    1985-09-04

    A Problem Confirmation Study was performed at seven sites on Otis Air National Guard Base: the Current and Former Training Areas, the Base Landfill, the Nondestructive Inspection Laboratory, the Fuel Test Dump Site, the Railyard Fuel Pumping Station, and the Petrol Fuel Storage Area. The field investigation was conducted in two stages, in November 1983 through January 1984, and in October through December 1984. Resampling was performed at selected locations in April and July 1985. A total of 11 monitor wells were installed and sampled and test-pit investigations were conducted at six sites. In addition, the contents of a sump tank, and two header pipes for fuel-transmission lines were sampled. Analytes included TOC, TOX, cyanide, phenols, Safe Drinking Water metals, pesticides and herbicides, and in the second round, priority-pollutant volatile organic compounds and a GC fingerprint scan for fuel products. On the basis of the field-work findings, it is concluded that, to date, water-quality impacts on ground water from past activities have been minimal.

  12. Seoul National University Bundang Hospital's Electronic System for Total Care

    PubMed Central

    Yoo, Sooyoung; Lee, Kee Hyuck; Lee, Hak Jong; Ha, Kyooseob; Lim, Cheong; Chin, Ho Jun; Yun, Jonghoar; Cho, Eun-Young; Chung, Eunja; Baek, Rong-Min; Chung, Chin Youb; Wee, Won Ryang; Lee, Chul Hee; Lee, Hai-Seok; Byeon, Nam-Soo

    2012-01-01

    Objectives Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). Methods SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. Results The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. Conclusions Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value. PMID:22844650

  13. ICEPOD - Developing Ice Imaging Capabilities for the New York Air National Guard's LC-130 Aircraft

    NASA Astrophysics Data System (ADS)

    Detemple, J.; Frearson, N.; Zappa, C. J.; Turrin, M.; Bell, R. E.

    2010-12-01

    The ICEPOD program is a 5-year development effort to develop a polar instrumentation suite for the New York Air National Guard’s (NYANG) LC-130’s supported by the NSF American Reinvestment and Recovery Act (ARRA) Major Research Instrumentation program. The fundamental goal of the ICEPOD program is to develop an instrumentation package that can capture the dynamics of the changing polar regions, focusing on ice and ocean targets. The vision is for this instrumentation to be operated both on routine flights of the NYANG in the polar regions, such as missions between McMurdo and South Pole Station and on targeted science missions, such as mapping the sea ice and outlet glaciers surrounding Ross Island or the draining systems from large subglacial lakes in East Antarctica. We are in the process of finalizing the science requirements for the system. To provide support to the ICEPOD development, we are defining the goals for imaging the surface of the ice sheet with a scanning laser system and stereo-photogrammetry, the temperature of the ice surface using an IR camera and the internal structure of the ice sheet using a depth-sounding radar and an accumulation radar. The instrumentation will be positioned using an IMU and differential GPS. We also are working toward two operational modes - low-altitude flight operations to optimize the surface imaging systems, specifically the scanning laser, and a high-altitude flight operation to facilitate wide use of the instrumentation suite during a routine NYANG support mission flight envelope. The ICEPOD program is seeking input on the science goals of the instrumentation suite to ensure the system meets the community’s need for observations. The ultimate goal of the ICEPOD program is to provide the community with a facility for dedicated and routine measurements over the polar regions using the suite of instruments. The final ICEPOD system will also be capable of supporting instrumentation developed by other groups. The backbone ICEPOD system will provide power, positioning and data acquisition. The IcePod program provides an excellent opportunity to promote STEM education initiatives. An education team is being assembled to develop activities focused on polar concepts, ice data, technology and science careers exploration. Partnerships for educational outreach are available.

  14. The predictive validity of the PTSD Checklist in a nonclinical sample of combat-exposed National Guard troops.

    PubMed

    Arbisi, Paul A; Kaler, Matthew E; Kehle-Forbes, Shannon M; Erbes, Christopher R; Polusny, Melissa A; Thuras, Paul

    2012-12-01

    After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). There were 6.5% of the soldiers who met diagnostic criteria for posttraumatic stress disorder (PTSD) based on structured interview. The predictive validity of the PCL was examined and contrasted with the predictive validity of the BDI-II in identifying soldiers meeting CAPS diagnosis for PTSD. The best identified PCL cut scores produced between 65% and 76% false positive errors when used as the sole source for identification of enduring PTSD. Comparison of prediction between the PCL and the BDI-II in identifying PTSD suggested that both instruments may be operating through tapping generalized distress rather than specific aspects of the disorder. PMID:22545697

  15. Blood characteristics of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Standley, W.G.; McCue, P.M.

    1992-09-01

    Hematology, serum chemistry, and prevalence of antibodies against selected, pathogens in a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, in 1989 and 1990. Samples from 18 (10 female, 8 male) adult kit foxes were used to establish normal hematology and serum chemistry values for this population. Average values were all within the normal ranges reported for kit foxes in other locations. Three hematology parameters had significant differences between male and female values; males had higher total white blood cell and neutrophil counts, and lower lymphocyte counts. There were no significant differences between serum chemistry values from male and female foxes. Prevalence of antibodies was determined from serum samples from 47 (26 female, 21 male) adult kit foxes and eight (4 female, 4 male) juveniles. Antibodies were detected against five of the eight pathogens tested: canine parvovirus, Toxoplasma gondii Leptospira interrogans, canine distemper virus, and canine hepatitis virus. Antibodies were not detected against Brucella, canis, Coccidioides immitis, or Yersinia pestis.

  16. Fleas of the San Joaquin kit fox (Vulpes velox macrotis) on Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Spencer, K.A.; Egoscue, H.J.

    1992-09-01

    A total of 3,241 fleas, representing seven species, were identified from 398 samples collected from San Joaquin kit foxes (Vulpes velox macrotis), California ground squirrels (Spermophilus beecheyi), and deer mice (Peromyscus maniculatus) at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. Of 3,109 fleas collected from kit foxes 95.7% were Echidnophaga gallinacea, 4.0% Pulex irritans, 0.2% Hoplopsyllus anomolus, and 0.1% Odontopsyllus dentatus. One male Ctenocephalides fells was also collected from a kit fox. The 118 fleas collected from California ground squirrels consisted of Hoplopsyllus anomolus (55.9%), Echidnophaga gallinacea (37.3%), and Oropsylla montanus (6.8%). The 14 fleas collected from deer mice were Aetheca wagneri. Based on the distribution and abundance of flea species collected, and the vector efficiency of these fleas, it appears that kit foxes could play a role in the transfer of natural vectors of sylvatic plague between rodent populations, if the bacterium responsible for plague (Yersinia pestis) were present at Camp Roberts. Little information regarding kit fox food habits was evidenced by the distribution and abundance of small mammal flea species collected from kit foxes.

  17. Reproduction of the San Joaquin kit fox (Vulpes velox macrotis) on Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Spencer, K A; Berry, W H; Standley, W G; O`Farrell, T P

    1992-09-01

    The reproduction of a San Joaquin kit fox population (Vulpes velox macrotis) was investigated at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. Of 38 vixens radiocollared prior to parturition, 12 (32%) were successful in raising pups from conception to the point where pups were observed above ground. No yearling vixens were known tb be reproductively active. The mean litter size during 1989 - 1991 was 3.0 (n = 21, SE = 0.28) and ranged from one to six pups. Both the proportion of vixens successfully raising pups and the mean litter size observed at Camp Roberts during this study were lower than those reported at other locations. Sex ratios of kit fox pups were male biased two of the three years, but did not differ statistically from 1:1 throughout the study. Whelping was estimated to occur between February 15 and March 5. Results of this study support previous reports that kit foxes are primarily monogamous, although one case of polygamy may have occurred. Both the proportion of dispersing radiocollared juveniles (26%) and the mean dispersal distance (5.9 km) of juveniles at Camp Roberts appeared low compared to other locations.

  18. Perception of change and burden in children of national guard troops deployed as part of the global war on terror.

    PubMed

    Pfefferbaum, Betty; Houston, J Brian; Allen, Sandra F

    2012-01-01

    Changes in relationships, roles, and dynamics associated with deployment of troops to the Global War on Terror can create challenges for their families as non-deployed spouses and their children take on new responsibilities. Children, aged 6 to 18 years, of deployed National Guard troops were assessed to determine the children's perceptions about how their father's deployment would or did change them and their family, the burden the children experienced in relation to helping their mothers, and child- and parent-reported emotional and behavioral symptoms in the children. Endorsement of personal change was associated with psychological health. During deployment, recognizing personal change was associated with less perceived burden while perceived change in the family was associated with more perceived burden. In general, increased perception of burden was associated with increased psychological symptoms and problems. The children of deployed service personnel may experience burdens and challenges in relation to the changes associated with the circumstances of deployment. Helping children prepare for and manage changes in relationships, roles, rules, and routines may lessen adverse reactions to changes in the environment. PMID:23894799

  19. Preliminary assessment report for Wayland Army National Guard Armory (former Boston Defense Area Nike Battery 73), Installation 23295, Wayland, Massachusetts. Installation Restoration Program

    SciTech Connect

    Haffenden, R.; Flaim, S.; Krokosz, M.

    1993-08-01

    This report presents the results of preliminary assessment (PA) conducted by Argonne National Laboratory at the Massachusetts Army National Guard property near Wayland, Massachusetts. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in respond to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining sites activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Wayland Army National Guard Army property, Phase I of the Department of Defense Installation Restoration Program.

  20. Guard Darks

    NASA Astrophysics Data System (ADS)

    Long, Knox

    2011-10-01

    The goal of the Guard Dark program is to collect WFC3/IR dark current data prior to each visit in two of the Multi-Cycle Treasury {MCT} programs in Cycle 19. By scheduling a dark current observation between the last pre-MCT observation and the first MCT visit, we will be able to measure any residual persistent signal resulting from the former which may affect the latter.

  1. Coast Guard

    SciTech Connect

    Not Available

    1991-06-01

    This paper reports that about 16,000 oil spills involving the release of more than 46 million gallons of oil took place in U.S. navigable waters in 1988; spills at water-front facilities, where vessels load and unload oil, accounted for about half of the oil spilled. While the Coast Guard acknowledges its responsibility for regulating and inspecting waterfront facilities, it efforts in this area have fallen short because it has not been inspecting portions of intrafacility pipes that transport oil between docks and storage tanks. Water pollution and noncompliance with federal oil pollution prevention regulations continue to be high at waterfront facilities. Yet the Coast Guard cannot determine how effective its inspection program has been in reducing the risk of oil spills because information on program results, such as the types, severity, and frequency of deficiencies found by inspectors, is not compiled an linked with information on the causes of oil spills found by investigators. Until the Coast Guard collects this type of information, it will not be in a position to establish measurable goals.

  2. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  3. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  4. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  5. Predictors of Army National Guard and Reserve members' use of Veteran Health Administration health care after demobilizing from OEF/OIF deployment.

    PubMed

    Harris, Alex H S; Chen, Cheng; Mohr, Beth A; Adams, Rachel Sayko; Williams, Thomas V; Larson, Mary Jo

    2014-10-01

    This study described rates and predictors of Army National Guard and Army Reserve members' enrollment in and utilization of Veteran Health Administration (VHA) services in the 365 days following demobilization from an index deployment. We also explored regional and VHA facility variation in serving eligible members in their catchment areas. The sample included 125,434 Army National Guard and 48,423 Army Reserve members who demobilized after a deployment ending between FY 2008 and FY 2011. Demographic, geographic, deployment, and Military Health System eligibility were derived from Defense Enrollment Eligibility Reporting System and "Contingency Tracking System" data. The VHA National Patient Care Databases were used to ascertain VHA utilization and status (e.g., enrollee, TRICARE). Logistic regression models were used to evaluate predictors of VHA utilization as an enrollee in the year following demobilization. Of the study members demobilizing during the observation period, 56.9% of Army National Guard members and 45.7% of Army Reserve members utilized VHA as an enrollee within 12 months. Demographic, regional, health coverage, and deployment-related factors were associated with VHA enrollment and utilization, and significant variation by VHA facility was found. These findings can be useful in the design of specific outreach efforts to improve linkage from the Military Health System to the VHA. PMID:25269126

  6. Does cynicism play a role in failure to obtain needed care? Mental health service utilization among returning U.S. National Guard soldiers.

    PubMed

    Arbisi, Paul A; Rusch, Laura; Polusny, Melissa A; Thuras, Paul; Erbes, Christopher R

    2013-09-01

    In the present study, the authors examined cynicism, a trait associated with mistrust and a misanthropic world view, as an impediment to seeking needed mental health services among a group of National Guard Soldiers with diagnoses of anxiety, depression, or substance abuse or dependence after a combat deployment. On their return from deployment, 40 National Guard soldiers were assessed for self-stigma, current distress, attitudes toward mental health care, and psychiatric diagnoses. Eight and a half months later, mental health service utilization was evaluated. Cynicism assessed prior to deployment was associated with lower odds of utilizing mental health services independent of self-stigma and negative attitudes toward mental health care. Further, neither self-stigma nor attitudes toward mental health care predicted engaging in needed mental health care when cynicism was included in the model. PMID:23544401

  7. Installation-Restoration Program. Phase 1. Records search for the 176th Tactical Airlift Group, Kulis Air National Guard Base, Anchorage, Alaska

    SciTech Connect

    Not Available

    1986-04-01

    The Hazardous Materials Technical Center (HMTC) was retained in October 1985 to conduct the Installation Restoration Program (IRP) Phase I Records Search of the 176th Tactical Airlift Group (TAG), Kulis Air National Guard Base (ANGB). The Records Search included a detailed review of pertinent installation records and an onsite-base visit conducted by HMTC on October 31, 1985. Activities during the onsite-base visit included interviews with ten Base employees, and a search of Base records.

  8. Effects of Repeated Deployment to Iraq and Afghanistan on the Health of New Jersey Army National Guard Troops: Implications for Military Readiness

    PubMed Central

    Falca-Dodson, Maria; Sussner, Bradley; Ciccone, Donald S.; Chandler, Helena; Callahan, Lanora; Losonczy, Miklos

    2010-01-01

    Objectives. We assessed the effects of prior military service in Iraq or Afghanistan on the health of New Jersey Army National Guard members preparing for deployment to Iraq. Methods. We analyzed anonymous, self-administered predeployment surveys from 2543 National Guard members deployed to Iraq in 2008. We used bivariate and multivariate analyses to measure the effects of prior service in Afghanistan (Operation Enduring Freedom [OEF]) or Iraq (Operation Iraqi Freedom [OIF]) on mental and physical health. Results. Nearly 25% of respondents reported at least 1 previous OEF or OIF deployment. Previously deployed soldiers were more than 3 times as likely as soldiers with no previous deployments to screen positive for posttraumatic stress disorder (adjusted odds ratio [AOR] = 3.69; 95% confidence interval [CI] = 2.59, 5.24) and major depression (AOR = 3.07; 95% CI = 1.81, 5.19), more than twice as likely to report chronic pain (AOR = 2.20; 95% CI = 1.78, 2.72) and more than 90% more likely to score below the general population norm on physical functioning (AOR = 1.94; 95% CI = 1.51, 2.48). Conclusions. Repeated OEF and OIF deployments may adversely affect the military readiness of New Jersey National Guard combat soldiers. PMID:20019304

  9. Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers.

    PubMed

    Rudenstine, Sasha; Cohen, Greg; Prescott, Marta; Sampson, Laura; Liberzon, Israel; Tamburrino, Marijo; Calabrese, Joseph; Galea, Sandro

    2015-09-01

    This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers. PMID:26327549

  10. Cost of Hospitalization and Length of Stay in People with Down Syndrome: Evidence from a National Hospital Discharge Claims Database

    ERIC Educational Resources Information Center

    Hung, Wen-Jiu; Lin, Lan-Ping; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to describe the hospitalization profiles which include medical expenses and length of stays, and to determine their possible influencing factors of hospital admission on persons with Down syndrome in Taiwan. We employed a population-based, retrospective analyses used national health insurance hospital discharge data of the…

  11. Cost of Hospitalization and Length of Stay in People with Down Syndrome: Evidence from a National Hospital Discharge Claims Database

    ERIC Educational Resources Information Center

    Hung, Wen-Jiu; Lin, Lan-Ping; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to describe the hospitalization profiles which include medical expenses and length of stays, and to determine their possible influencing factors of hospital admission on persons with Down syndrome in Taiwan. We employed a population-based, retrospective analyses used national health insurance hospital discharge data of the

  12. 75 FR 22829 - National Environmental Policy Act; Final Environmental Impact Statement on U.S. Coast Guard...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... our public dockets in the January 17, 2008, issue of the Federal Register (73 FR 3316). Background and.... The Coast Guard published a notice of intent to prepare an EIS in the Federal ] Register (71 FR 14233... period was initiated through publication of a Notice of Availability in the Federal Register (73 FR...

  13. IcePod - A versatile Science Platform for the New York Air National Guard's LC-130 Aircraft

    NASA Astrophysics Data System (ADS)

    Frearson, N.; Bell, R. E.; Zappa, C. J.

    2011-12-01

    The ICEPOD program is a five-year effort to develop an ice imaging system mounted on New York Air National Guard (NYANG) LC-130 aircraft to map the surface and sub-surface topography of ice sheets, ice streams and outlet glaciers for the NSF Major Research Instrumentation program. The project is funded by the American Recovery and Reinvestment Act. The fundamental goal of the ICEPOD program is to develop an instrumentation package that can capture the dynamics of the changing polar regions, focusing on ice and ocean systems. The vision is that this instrumentation will be operated both on routine flights of the NYANG in the polar regions, such as on missions between McMurdo and South Pole Station, and on targeted science missions, from mapping sea ice and outlet glaciers such as those surrounding Ross Island or Greenland to quantifying the drainage systems from large subglacial lakes in East Antarctica. It is a key aspect of the design that at the conclusion of this program, the Pod, Deployment Arm and Data Acquisition and Management system will become available for use by the science community at large to install their own instruments onto. The science requirements for the primary instruments in the Icepod program have been defined and can be viewed on-line at www.ldeo.columbia.edu/icepod. As a consequence, the instrumentation will consist of a scanning laser for precise measurements of the ice surface, stereo-photogrammetry from both visible and infrared imaging cameras to document the ice surface and temperature, a VHF coherent, pulsed radar to recover ice thickness and constrain the distribution of water at the ice sheet bed and an L-band radar to measure surface accumulation or sea-ice thickness. All instrument data sets will be time-tagged and geo-referenced by recording precision GPS satellite data integrated with inertial measurement technology integrated into the pod. There will also be two operational modes - a low altitude flight mode that will optimize the imaging systems and a high altitude flight mode that will facilitate wider use of the instrumentation suite on routine NYANG support missions. Proposals for new observations are welcome. The sensor system will become a research facility operated for the science community, and data will be maintained at and provided through a polar data center.

  14. Baseline water-quality characteristics of the Alaska Army National Guard Stewart River Training Area near Nome, Alaska

    USGS Publications Warehouse

    Eash, Josh D.

    2005-01-01

    The Alaska Army National Guard Stewart River Training Area is approximately 23 miles north of Nome on the Seward Peninsula in northwest Alaska. The Stewart River Training Area encompasses much of the Stewart River Basin and a small part of the Snake River Basin. Hydrologic, water-quality, and physical-habitat data were collected at seven surface-water sites within the Stewart River Training Area during the summer runoff months (late-May to early-September) in 2004. Two of the sampling sites selected for this study were on the main stem Stewart River, one at the upstream boundary and one at the downstream boundary of the training area. Continuous hydrologic, precipitation, and water temperature data were collected at these two sites throughout the summer of 2004. Three pond sites, along the upper, middle, and lower reaches of the Stewart River within the training area, were each sampled twice during the summer of 2004 for analysis of water-quality constituents. Two tributaries to the Snake River Basin, Goldbottom Creek and North Fork Snake River, within the Stewart River Training Area boundary, also were sampled twice during the summer of 2004. Water-quality data collected from the Stewart River at the upstream and downstream study sites indicate similar constituent concentrations. Concentrations of most water-quality constituents collected during the summer of 2004 did not exceed standards for drinking water or recreational contact. Analysis of trace-element concentrations in bed sediment samples indicate the threshold effect concentration (below which no adverse effects on organisms is expected) was exceeded for arsenic, chromium, and nickel concentrations at all sample sites within the Stewart River Training Area and cadmium, copper, zinc, and lead concentrations were found to exceed the threshold effect concentration in varying degrees at the sample sites. The probable effect concentration (above which toxic effects on organisms is likely) was exceeded by arsenic concentrations at all sites except the lower pond site. Chromium and nickel concentrations exceeded the probable effect concentration at the upstream Stewart River site and at the North Fork Snake River site.

  15. Hospital library service and the changes in national standards.

    PubMed Central

    Glitz, B; Flack, V; Lovas, I M; Newell, P

    1998-01-01

    Two important sets of standards affecting hospital libraries were significantly revised in 1994, those of the Medical Library Association (MLA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). As part of its continuing efforts to monitor library services within its region, the University of California, Los Angeles Biomedical Library, Regional Medical Library for the Pacific Southwest Region of the National Network of Libraries of Medicine (NN/LM) conducted a survey in late 1994, in part to determine the effects of these revised standards on regional hospital libraries. Data from the survey were also used to provide a view of hospital libraries in the Pacific Southwest region, and to make comparisons with similar data collected in 1989. Results showed that while libraries remained stable in overall number, size, and staffing, services, especially those associated with end-user searching and interlibrary loan, increased enormously. With respect to the MLA standards, results show a high compliance level. Interesting differences were seen between the perceptions of library staff concerning their rate of compliance with the JCAHO standards and their actual compliance as measured by the MLA criteria. While some libraries appear to measure up better than their own perceptions would indicate, others may be fully aware of their actual compliance level. PMID:9549016

  16. New Integrated Information System for Pusan National University Hospital

    PubMed Central

    Kim, Hyung Hoi; Cho, Kyung-Won; Kim, Hye Sook; Kim, Ju-Sim; Kim, Jung Hyun; Han, Sang Pil; Park, Chun Bok; Kim, Seok

    2011-01-01

    Objectives This study presents the information system for Pusan National University Hospital (PNUH), evaluates its performance qualitatively, and conducts economic analysis. Methods Information system for PNUH was designed by component-based development and developed by internet technologies. Order Communication System, Electronic Medical Record, and Clinical Decision Support System were newly developed. The performance of the hospital information system was qualitatively evaluated based on the performance reference model in order to identify problem areas for the old system. The Information Economics approach was used to analyze the economic feasibility of hospital information system in order to account for the intangible benefits. Results Average performance scores were 3.16 for input layer, 3.35 for process layer, and 3.57 for business layer. In addition, the cumulative benefit to cost ratio was 0.50 in 2011, 1.73 in 2012, 1.76 in 2013, 1.71 in 2014, and 1.71 in 2015. The B/C ratios steadily increase as value items are added. Conclusions While overall performance scores were reasonably high, doctors were less satisfied with the system, perhaps due to the weak clinical function in the systems. The information economics analysis demonstrated the economic profitability of the information systems if all intangible benefits were included. The second qualitative evaluation survey and economic analysis were proposed to evaluate the changes in performance of the new system. PMID:21818459

  17. The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury.

    PubMed

    Arbisi, Paul A; Polusny, Melissa A; Erbes, Christopher R; Thuras, Paul; Reddy, Madhavi K

    2011-03-01

    The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance. PMID:21381845

  18. Reported barriers to mental health care in three samples of U.S. Army National Guard soldiers at three time points.

    PubMed

    Valenstein, Marcia; Gorman, Lisa; Blow, Adrian J; Ganoczy, Dara; Walters, Heather; Kees, Michelle; Pfeiffer, Paul N; Kim, H Myra; Lagrou, Robert; Wadsworth, Shelley MacDermid; Rauch, Sheila A M; Dalack, Gregory W

    2014-08-01

    The military community and its partners have made vigorous efforts to address treatment barriers and increase appropriate mental health services use among returning National Guard soldiers. We assessed whether there were differences in reports of treatment barriers in 3 categories (stigma, logistics, or negative beliefs about treatment) in sequential cross-sectional samples of U.S. soldiers from a Midwestern Army National Guard Organization who were returning from overseas deployments. Data were collected during 3 time periods: September 2007-August 2008 (n = 333), March 2009-March 2010 (n = 884), and August 2011-August 2012 (n = 737). In analyses using discretized time periods and in trend analyses, the percentages of soldiers endorsing negative beliefs about treatment declined significantly across the 3 sequential samples (19.1%, 13.9%, and 11.1%). The percentages endorsing stigma barriers (37.8%, 35.2%, 31.8%) decreased significantly only in trend analyses. Within the stigma category, endorsement of individual barriers regarding negative reactions to a soldier seeking treatment declined, but barriers related to concerns about career advancement did not. Negative treatment beliefs were associated with reduced services use (OR = 0.57; 95% CI [0.33, 0.97]). PMID:25158634

  19. Superfund record of decision (EPA Region 1): Otis Air National Guard, (AOC CS-1 (USCG)), Falmouth, MA, September 29, 1995

    SciTech Connect

    1996-03-01

    The Massachusetts Military Reservation (MMR) on Cape Cod, Massachusetts, lies within the boundaries of the towns of Falmouth, Mashpee, Sandwich, and Bourne. The U.S. Coast Guard (USCG) Transmitter Station, designed Area of Contamination (AOC) CS-1 (USCG) is located adjacent to the eastern boundary of the MMR. The NGB, acting as executive agent of the USCG, and USEPA, with concurrence of the Commonwealth of Massachusetts, have determined that No Action is necessary to address the contamination at AOC CS-1 (USCG). However, groundwater monitoring will be performed at well WW-7 for a period of five years to provide information over time on the levels of volatile organic compounds (VOCs) detected in this well, and on the sporadic detection of inorganics in groundwater at this AOC.

  20. Final report on testing of ACONF technology for the US Coast Guard National Distress Systems : a study for the DOE Energy Storage Systems Program.

    SciTech Connect

    Storey, Leanne M.; Byrd, Thomas M., Jr.; Murray, Aaron T.; Ginn, Jerry W.; Symons, Philip C.; Corey, Garth P.

    2005-08-01

    This report documents the results of a six month test program of an Alternative Configuration (ACONF) power management system design for a typical United States Coast Guard (USCG) National Distress System (NDS) site. The USCG/USDOE funded work was performed at Sandia National Laboratories to evaluate the effect of a Sandia developed battery management technology known as ACONF on the performance of energy storage systems at NDS sites. This report demonstrates the savings of propane gas, and the improvement of battery performance when utilizing the new ACONF designs. The fuel savings and battery performance improvements resulting from ACONF use would be applicable to all current NDS sites in the field. The inherent savings realized when using the ACONF battery management design was found to be significant when compared to battery replacement and propane refueling at the remote NDS sites.

  1. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  2. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  3. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  4. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  5. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  6. Coast Guard

    SciTech Connect

    Not Available

    1991-08-01

    In the wake of the Exxon Valdez oil spill in Alaska's Prince William Sound, Congress passed the Oil Pollution Act of 1990, thereby activating the Oil Spill Liability Trust Fund. This fund had been set up four years earlier with the proviso that no money could be spent until the enactment of comprehensive oil spill legislation. Passage of the Oil Pollution Act, which significantly expanded the nation's oil spill prevention and response activities, meant that funds became available to federal agencies for the cost of oil spill prevention and response activities. This report provides information on the fund's receipts and disbursements as of March 31, 1991, and the status of activities under way to fully implement the provisions of the Act concerning the fund, including the development of regulations.

  7. Predeployment gender differences in stressors and mental health among U.S. National Guard troops poised for Operation Iraqi Freedom deployment.

    PubMed

    Carter-Visscher, Robin; Polusny, Melissa A; Murdoch, Maureen; Thuras, Paul; Erbes, Christopher R; Kehle, Shannon M

    2010-02-01

    Increased exposure of women soldiers to combat in current conflicts heightens interest in the question of whether risk and resilience factors differ for female and male military personnel prior to deployment. The authors examined this question in a panel of 522 National Guard soldiers (462 men and 60 women) poised for deployment to Iraq. Soldiers completed a battery of self-report measures, including the PTSD Checklist, Beck Depression Inventory-II, and scales from the Deployment Risk and Resilience Inventory. Modest differences were observed between women and men on predeployment risk factors and some risk-related correlations with PTSD and depression measures; however, gender did not moderate the associations between hypothesized risk/resilience factors and baseline mental health. Implications for interventions and future research are discussed. PMID:20135681

  8. Installation restoration program. Site investigation report, Volume 1. 182 Airlift Wing, Illinois Air National Guard, Greater Peoria Regional Airport, Peoria, Illinois. Final report

    SciTech Connect

    1996-06-01

    Site Investigation Report, Illinois Air National Guard, 182nd Airlift Wing, Greater Peoria Regional Airport, Peoria, Illinois, Volume I - Text. This is the first volume of a two volume Site Investigation Report. Three sites (Site 1 - Septic System Filter Beds, Site 2 - Grassy Area Along Facility Boundary East of the Aircraft Apron, and Site 3 - Grass Area West of Aircraft Apron and East of Fuel Truck Parking) were investigated under the Installation Restoration Program. Soil and groundwater samples were collected and analyzed. A Remedial Investigation was recommended for the soils at Site 1. No further action was recommended for Site 2 and the soils at Site 3. A groundwater investigation was recommended to identify the source of low concentrations of VOCs in the groundwater.

  9. Installation restoration program. Site investigation report, Volume 2. 182 Airlift Wing, Illinois Air National Guard, Greater Peoria Regional Airport, Peoria, Illinois. Final report

    SciTech Connect

    1996-06-01

    Site Investigation Report, Illinois Air National Guard, 182nd Airlift Wing, Greater Peoria Regional Airport, Peoria, Illinois, Volume II - Appendices A-K. This is the second volume of a two volume Site Investigation Report. Three sites (Site 1 - Septic System Filter Beds Site 2 Grassy Area Facility Boundary East of the Aircraft Apron, and Site 3 - Grass Area West of Aircraft Apron and East of Fuel Truck Parking) were investigated under the Installation Restoration Program. Soil and groundwater samples were collected and analyzed. A Remedial Investigation was recommended for the soils at Site 1. No further action was recommended for Site 2 and the soils at Site 3. A groundwater investigation was recommended to identify the source of low concentrations of VOCs in the groundwater.

  10. Installation-Restoration Program; preliminary assessment for the 165th Tactical Airlift Group and Savannah Permanent Field Training Site, Georgia Air National Guard, Savannah International Airport, Savannah, Georgia

    SciTech Connect

    Not Available

    1987-12-01

    The Hazardous Materials Technical Center (HMTC) was retained in May 1987 to conduct the Installation-Restoration Program (IRP) Preliminary Assessment of the 165th Tactical Airlift Group (TAG) and the Savannah Permanent Field Training Site (PTFS) of the Georgia Air National Guard (ANG), Savannah International Airport, Savannah, Georgia (hereinafter referred to as the Base). The Preliminary Assessment included: an onsite Base visit, including interviews with 26 past and present base employees and conducted by HMTC personnel during 18-21 May 1987; the acquisition and analysis of pertinent information and records on the use of hazardous material and generation and disposal of hazardous waste at the Base; the acquisition and analysis of available geologic, hydrologic, meteorologic, and environmental data from pertinent Federal and State agencies; and the identification of sites on the Base which may be potentially contaminated with hazardous material/hazardous waste (HM/HW).

  11. Hospital characteristics affecting potentially avoidable emergency admissions: national ecological study.

    PubMed

    O'Cathain, A; Knowles, E; Maheswaran, R; Turner, J; Hirst, E; Goodacre, S; Pearson, T; Nicholl, J

    2013-11-01

    Some emergency admissions can be avoided if acute exacerbations of health problems are managed by emergency and urgent care services without resorting to admission to a hospital bed. In England, these services include hospitals, emergency ambulance, and a range of primary and community services. The aim was to identify whether characteristics of hospitals affect potentially avoidable emergency admission rates. An age-sex adjusted rate of admission for 14 conditions rich in avoidable emergency admissions was calculated for 129 hospitals in England for 2008-2011. Twenty-two per cent (3,273,395/14,998,773) of emergency admissions were classed as potentially avoidable, with threefold variation between hospitals. Explanatory factors of this variation included those which hospital managers could not control (demand for hospital emergency departments) and those which they could control (supply in terms of numbers of acute beds in the hospital, and management of non-emergency and emergency patients within the hospital). Avoidable admission rates were higher for hospitals with higher emergency department attendance rates, higher numbers of acute beds per 1000 catchment population and higher conversion rates from emergency department attendance to admission. Hospital managers may be able to reduce avoidable emergency admissions by reducing supply of acute beds and conversion rates from emergency department attendance. PMID:25595008

  12. Performance Analysis of Hospital Information System of the National Health Insurance Corporation Ilsan Hospital

    PubMed Central

    Han, Jung Mi; Boo, Eun Hee; Kim, Jung A; Yoon, Soo Jin; Kim, Seong Woo

    2012-01-01

    Objectives This study evaluated the qualitative and quantitative performances of the newly developed information system which was implemented on November 4, 2011 at the National Health Insurance Corporation Ilsan Hospital. Methods Registration waiting time and changes in the satisfaction scores for the key performance indicators (KPI) before and after the introduction of the system were compared; and the economic effects of the system were analyzed by using the information economics approach. Results After the introduction of the system, the waiting time for registration was reduced by 20%, and the waiting time at the internal medicine department was reduced by 15%. The benefit-to-cost ratio was increased to 1.34 when all intangible benefits were included in the economic analysis. Conclusions The economic impact and target satisfaction rates increased due to the introduction of the new system. The results were proven by the quantitative and qualitative analyses carried out in this study. This study was conducted only seven months after the introduction of the system. As such, a follow-up study should be carried out in the future when the system stabilizes. PMID:23115744

  13. 3 CFR 8864 - Proclamation 8864 of September 14, 2012. National Employer Support of the Guard and Reserve Week...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and care they need during deployment. At a time when our Nation has asked so much of our troops and... Administration remains committed to honoring that trust. As part of First Lady Michelle Obama and Dr. Jill Biden..., BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by...

  14. 3 CFR 8715 - Proclamation 8715 of September 16, 2011. National Employer Support of the Guard and Reserve Week...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and Reserve members would not be possible without the unwavering support and care provided by their... our sacred duty to honor and care for our service members when they come home. The support of... together to serve and protect our Nation. NOW, THEREFORE, I, BARACK OBAMA, President of the United...

  15. Guard For Fuse Caps

    NASA Technical Reports Server (NTRS)

    Atwell, D. C.

    1985-01-01

    L-shaped guard attached to fuse holder. Guard prevents casual tampering with fuses in electrical junction box or fuse block. Protects fuses from being damaged by handling or by rope or string used to secure them. With fuse-cap guard, only responsible people have access to fuses.

  16. Hospital-Sponsored Child Care: A 1988 National Survey.

    ERIC Educational Resources Information Center

    American Coll. of Healthcare Executives, Chicago, IL.

    A representative sample of 965 U.S. hospitals was surveyed for the purpose of obtaining information about: (1) current and projected involvement in provision of child care services to employees and their communities; and (2) hospitals' views of the costs and benefits of offering child care services, and of appropriate governmental policies.…

  17. [Establishment of national naval hospitals in the XVIII century].

    PubMed

    Kostiukov, A V

    2011-11-01

    The first naval hospitals were established in St. Petersburg, Revel and Kronstadt, Kazan, Revel, Astrakhan and Archangel. The question when the first hospitals were opened is still controversial because of the lack of many documents of those years. Researchers disagree, probably because of the fact that they take into account different timeframes for the project of a hospital corps. Regardless of whether you will find unequivocal, direct evidence for their discoveries in a given year, the value of the old hospital as medical institutions will not change. Much more important is the fact of their education because of intense activity of the domestic fleet. In the creation of naval hospitals as in anything else to take care of the state of preservation, strengthening and restoring the health of personnel, of which largely depended on the readiness of the fleet. PMID:22329177

  18. Site investigation report for IRP site numbers 1, 2, 3, 4 and 5, West Virginia Air National Guard, 130th Airlift Group, Yeager Field, Charleston, West Virginia. Final report

    SciTech Connect

    1996-04-01

    Site Investigation Report for IRP Sites Nos. 1, 2, 3, 4, and 5 West Virginia Air National Guard, 130th Airlift Group, Yeager Field, Charleston, West Virginia. No further action was recommended for all 5 sites, and was agreed to by the WVDEP.

  19. Installation restoration program. Site investigation report: Site 7, pol area, 171st Air Refueling Wing, Pittsburgh International Airport, Pennsylvania Air National Guard, Coraopolis, Pennsylvania. Final report, 1994-1996

    SciTech Connect

    1996-09-01

    This Site Investigation (SI) Report documents activities performed at the 171st Air Refueling Wing, Pennsylvania Air National Guard, Corapolis, Pennsylvania, under the U.S. Department of Defense Installation Restoration Program. One IRP site, Site 7, was addressed. No further action was recommended based on the results of an environmental investigation.

  20. Case eleven. Children's hospitals' response to national coalitions: the creation of their own cooperative.

    PubMed

    Considine, W H

    1990-01-01

    Over the past several years, national coalitions and multi-hospital systems have been expanding and increasing in popularity. These organizations have offered the member hospitals services and resources to enhance the competitive position of the member hospitals. As these coalitions have grown, they have approached children's hospitals but, in most cases, to be an affiliate of one of the general acute care hospitals. The services of these coalitions are designed to enhance the general acute care centers and have not been refined to address the needs of children's specialty centers. As children's hospitals around the country assessed how they should work with these national coalitions, they were faced with several challenges. These coalitions did pose a potential competitive threat to the children's hospitals. But, at the same time, the coalitions did not offer services to the children's hospitals that would justify membership and the large outlay in dues. Faced with this dilemma, a group of children's hospitals came together to develop a formal national coalition for children's hospitals. This case provides an excellent example of and the opportunity to explore the implementation of a collaborative strategy designed to create competitive advantage for each of the collaborators. PMID:10117091

  1. Efficacy of a post-secondary environmental science education program on the attitude toward science of a group of Mississippi National Guard Youth ChalleNGe Program students

    NASA Astrophysics Data System (ADS)

    Smith, William Bradford, Jr.

    The National Guard Youth ChalleNGe Program (ChalleNGe) is a 17 month quasi-military training program authorized by Congress in the 1993 Defense Authorization Bill designed to improve life skills, education levels, and employment potential of 16--18 year old youth who drop out of high school. ChalleNGe is currently operational in 27 states/territories with the focus of this study on the Mississippi National Guard Program operated at Camp Shelby, Mississippi. During the five month residential portion of the program students are guided through an eight step process designed to meet the goals of improving life skills, education levels, and employment potential while ultimately leading to completion of high school equivalency credentials followed by a 12 month mentoring phase to encourage and track progress toward goals. The purpose of this study was to investigate the attitude toward science of a group of students enrolled in the ChalleNGe Program at Camp Shelby (ChalleNGe). The GED test is administered approximately two months into the residential phase of the program. While the program boasts an overall GED pass rate of nearly 80%, approximately 30--35% of students successfully complete the initial offering of the GED. As high school graduates, these students are offered college courses through William Carey College in Hattiesburg, Mississippi. Twenty four students elected to take the Introduction to Environmental Science course and formed the experimental group while 24 other students who passed the GED comprised the control group. Each group was administered the Scientific Attitude Inventory II, a 40 statement instrument with Likert Scale responses, as a pretest. Paired samples t-tests indicated no significant difference in attitude toward science between the experimental and control groups on the pretest. Following the two week Introduction to Environmental Science course for the experimental group, both groups were post tested. As predicted, the attitude toward science of the experimental group was significantly higher than that of the control group. Further investigation into correlation between the length of time students were away from the traditional school prior to starting ChalleNGe, the number of science classes previously taken, and reading scores on the Test of Adult Basic Education revealed no significant relationship. Responses provided by students to each of these three factors was significantly different between the experimental and control groups. In summary, attitude toward science can be positively impacted by short term interventions such as the environmental science course described herein. While the positive impact on attitude toward science caused by this course was the desired outcome of this project, appropriate emphasis should be placed on prevention of dropouts and the accompanying social issues.

  2. National perspective on in-hospital emergency units in Iraq

    PubMed Central

    Lafta, Riyadh K.; Al-Nuaimi, Maha A.

    2013-01-01

    Background: Hospitals play a crucial role in providing communities with essential medical care during times of disasters. The emergency department is the most vital component of hospitals' inpatient business. In Iraq, at present, there are many casualties that cause a burden of work and the need for structural assessment, equipment updating and evaluation of process. Objective: To examine the current pragmatic functioning of the existing set-up of services of in-hospital emergency departments within some general hospitals in Baghdad and Mosul in order to establish a mechanism for future evaluation for the health services in our community. Methods: A cross-sectional study was employed to evaluate the structure, process and function of six major hospitals with emergency units: four major hospitals in Baghdad and two in Mosul. Results: The six surveyed emergency units are distinct units within general hospitals that serve (collectively) one quarter of the total population. More than one third of these units feature observation unit beds, laboratory services, imaging facilities, pharmacies with safe storage, and ambulatory entrance. Operation room was found only in one hospital's reception and waiting area. Consultation/track area, cubicles for infection control, and discrete tutorial rooms were not available. Patient assessment was performed (although without adequate privacy). The emergency specialist, family medicine specialist and interested general practitioner exist in one-third of the surveyed units. Psychiatrist, physiotherapists, occupational therapists, and social work links are not available. The shortage in medication, urgent vaccines and vital facilities is an obvious problem. Conclusions: Our emergency unit's level and standards of care are underdeveloped. The inconsistent process and inappropriate environments need to be reconstructed. The lack of drugs, commodities, communication infrastructure, audit and training all require effective build up. PMID:25003053

  3. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  4. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  5. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  6. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  7. Exe-Guard Project

    SciTech Connect

    Smith, Rhett; Marshall, Tim; Chavez, Adrian; Bratus, Sergey

    2015-12-26

    The exe-Guard Project is an alliance between Dominion Virginia Power (DVP), Sandia National Laboratories (SNL), Dartmouth University, and Schweitzer Engineering Laboratories (SEL). SEL is primary recipient on this project. The exe-Guard project was selected for award under DE-FOA-0000359 with CFDA number 81.122 to address Topic Area of Interest 4: Hardened platforms and Systems. The exe-Guard project developed an antivirus solution for control system embedded devices to prevent the execution of unauthorized code and maintain settings and configuration integrity. This project created a white list antivirus solution for control systems capable of running on embedded Linux® operating systems. White list antivirus methods allow only credible programs to run through the use of digital signatures and hash functions. Once a system’s secure state is baselined, white list antivirus software denies deviations from that state because of the installation of malicious code as this changes hash results. Black list antivirus software has been effective in traditional IT environments but has negative implications for control systems. Black list antivirus uses pattern matching and behavioral analysis to identify system threats while relying on regular updates to the signature file and recurrent system scanning. Black list antivirus is vulnerable to zero day exploits which have not yet been incorporated into a signature file update. System scans hamper the performance of high availability applications, as revealed in NIST special publication 1058 which summarizes the impact of blacklist antivirus on control systems: Manual or “on-demand” scanning has a major effect on control processes in that they take CPU time needed by the control process (Sometimes close to 100% of CPU time). Minimizing the antivirus software throttle setting will reduce but not eliminate this effect. Signature updates can also take up to 100% of CPU time, but for a much shorter period than a typical manual scanning process. Control systems are vulnerable to performance losses if off-the-shelf blacklist antivirus solutions aren’t implemented with care. This investment in configuration in addition to constant decommissioning to perform manual signature file updates is unprecedented and impractical. Additionally, control systems are often disconnected or islanded from the network making the delivery of signature updates difficult. Exe-Guard project developed a white list antivirus solution that mitigated the above drawbacks and allows control systems to cost-effectively apply malware protection while maintaining high reliability. The application of security patches can also be minimized since white listing maintains constant defense against unauthorized code execution. Security patches can instead be applied in less frequent intervals where system decommissioning can be scheduled and planned for. Since control systems are less dynamic than IT environments, the feasibility of maintaining a secure baselined state is more practical. Because upgrades are performed in infrequent, calculated intervals, it allows a new security baseline to be established before the system is returned to service. Exe-Guard built on the efforts of SNL under the Code Seal project. SNL demonstrated prototype Trust Anchors on the project which are independent monitoring and control devices that can be integrated into untrustworthy components. The exe-Guard team started with the lessons learned under this project then designed commercial solution for white list malware protection. Malware is a real threat, even on islanded or un-networked installations, since operators can unintentionally install infected files, plug in infected mass storage devices, or infect a piece of equipment on the islanded local area network that can then spread to other connected equipment. Protection at the device level is one of the last layers of defense in a security-in-depth defense model before an asset becomes compromised. This project provided non-destructive intrusion, isolation and automated response solution, achieving a goal of the Department of Energy (DOE) Roadmap to Secure Control Systems. It also addressed CIP-007-R4 which requires asset owners to employ malicious software prevention tools on assets within the electronic security perimeter. In addition, the CIP-007-R3 requirement for security patch management is minimized because white listing narrows the impact of vulnerabilities and patch releases. The exe-Guard Project completed all tasks identified in the statement of project objective and identified additional tasks within scope that were performed and completed within the original budget. The cost share was met and all deliverables were successfully completed and submitted on time. Most importantly the technology developed and commercialized under this project has been adopted by the Energy sector and thousands of devices with exe-Guard technology integrated in them have now been deployed and are protecting our power systems today

  8. Evaluation of off-service rotations at National Guard Health Affairs: Results from a perception survey of off-service residents

    PubMed Central

    Alquraini, Mustafa M.; Baig, Lubna; Magzoub, Mohi; Omair, Amir

    2013-01-01

    Context: “Off-service” clinical rotations are part of the necessary requirements for many residency training programs. Because these rotations are off-service, little attention is given to their structure and quality of training. This often leads to suboptimal educational experience for the residents on these rotations. Aims: The aim of this study was to assess medical residents’ perceptions, opinions, and levels of satisfaction with their “off-service” rotations at a major residency training site in Saudi Arabia. It was also to evaluate the reliability and validity of a questionnaire used for quality assurance in these rotations. Improved reliability and validity of this questionnaire may help to improve the educational experience of residents in their “off-service” rotations. Materials and Methods: A close-ended questionnaire was developed, Pilot tested and distributed to 110 off-service residents in training programs of different specializations at King Fahad Naitonal Guard Hospital and King Abdulziz Medical City, Riyadh, Saudi Arabia, between September 2011 and December 2011. Results: A total of 80 out of 110 residents completed and returned the questionnaire. Only 33% of these residents had a clear set of goals and educational learning objectives before the beginning of their off-service rotations to direct their training. Surgical specializations had low satisfaction mean scores of 57.2 (11.9) compared to emergency medicine, which had 70.7 (16.2), P value (0.03). The reliability of the questionnaire was Cronbach's alpha 0.57. The factor analysis yielded a 4-factor solution (educational environment, educational balance, educational goals and objectives, and learning ability); thus, accounting for 51% variance in the data. Conclusion: Our data suggest that there were significant weaknesses in the curriculum for off-service clinical rotations in KAMC and that residents were not completely satisfied with their training. PMID:23983565

  9. Maternal Clinical Diagnoses and Hospital Variation in the Risk of Cesarean Delivery: Analyses of a National US Hospital Discharge Database

    PubMed Central

    Kozhimannil, Katy B.; Arcaya, Mariana C.; Subramanian, S. V.

    2014-01-01

    Background Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. Methods and Findings Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project—a 20% sample of US hospitals—we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. Conclusions Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight the need for more comprehensive or linked data including parity and gestational age as well as examination of other factors—such as hospital policies, practices, and culture—in determining cesarean section use. Please see later in the article for the Editors' Summary PMID:25333943

  10. The Coast Guard Comes to Class.

    ERIC Educational Resources Information Center

    Fawcett, Paul

    2002-01-01

    Focuses on Sea Partners, by the United States Coast Guard, that enables students to understand how pollution affects the marine environment. Correlates the activities with the National Science Education Standards. (DDR)

  11. Pre-deployment daytime and nighttime sleep complaints as predictors of post-deployment PTSD and depression in National Guard troops.

    PubMed

    Koffel, Erin; Polusny, Melissa A; Arbisi, Paul A; Erbes, Christopher R

    2013-06-01

    There is growing evidence that disturbed sleep is a risk factor for the development of a number of psychiatric diagnoses including depression, PTSD and substance use. The goal of this study was to use a subset of participants from a larger prospective longitudinal study to examine whether preexisting daytime and nighttime sleep disturbances predict depression, PTSD and substance use in US National Guard Soldiers deployed to Iraq. Data on daytime and nighttime sleep complaints, baseline symptoms and personality variables were gathered prior to deployment to Iraq. Measures of psychopathology were collected at three time points post-deployment over the course of two years using both questionnaires and interviews. Multiple regressions were used to predict diagnoses and symptoms of depression, PTSD and substance use. Pre-deployment daytime and nighttime sleep complaints contributed significantly to the prediction of PTSD and depression up to two years after deployment, but not substance use. This study suggests that daytime and nighttime sleep complaints are a risk factor for internalizing disorders including PTSD and depression. PMID:23939336

  12. Installation-Restoration Program. Preliminary assessment for the 153rd Tactical Airlift Group, Wyoming Air National Guard, Cheyenne Municipal Airport, Cheyenne, Wyoming

    SciTech Connect

    Not Available

    1988-03-01

    The Hazardous Materials Technical Center (HMTC) was retained in September 1987 to conduct the Installation-Restoration Program (IRP) Preliminary Assessment of the 153rd Tactical Airlift Group (TAG), Wyoming Air National Guard, Cheyenne Municipal Airport, Cheyenne, Wyoming. The Preliminary Assessment included: an onsite visit, including interviews with 15 present and past Base personnel and 2 airport personnel conducted by HMTC personnel during 13-16 October 1987; the acquisition and analysis of pertinent information and records on hazardous materials use, and hazardous-waste generation and disposal at the Base; the acquisition and analysis of available geological, hydrological, meteorological development, and environmental data from pertinent Federal, State, and local agencies; and the identification of sites on the Base that may be potentially contaminated with hazardous materials/hazardous wastes (HM/HW). Past Base operations involved the use and disposal of materials and wastes that subsequently were categorized as hazardous. The major operations of the 153rd TAG that have used and disposed of these materials and wastes are flightline, NDI, avionics, AGE, airframe, electrical, engine and propulsion, nose dock and fuel cell, phase dock, pneudraulics, POL and refueling, repair and reclamation, photography lab, clinic, and vehicle maintenance. Waste oils, recovered fuels, spent cleaners, strippers, photographic chemicals, acids, and solvents were generated by these activities.

  13. Impact of Deployment-Related Sexual Stressors on Psychiatric Symptoms After Accounting for Predeployment Stressors: Findings From a U.S. National Guard Cohort.

    PubMed

    McCallum, Ethan B; Murdoch, Maureen; Erbes, Christopher R; Arbisi, Paul; Polusny, Melissa A

    2015-08-01

    This study used a longitudinal research design to examine the impact of predeployment stressors and deployment-related sexual stressors on self-reported psychiatric symptoms of U.S. National Guard soldiers returning from deployments to Iraq or Afghanistan. Prior to deployment, participants completed measures of depression and posttraumatic stress symptoms, along with an inventory of predeployment stressor experiences. At 3-months postdeployment, participants (468 men, 60 women) again completed self-report measures of psychiatric symptoms, along with an inventory of sexual stressors experienced during deployment. We compared a cross-sectional model of sexual stressors' impact on psychiatric symptoms, in which only postdeployment reports were considered, to a longitudinal model in which we adjusted for participants' predeployment stressors and psychiatric symptoms. No participants reported sexual assault during deployment, though sexual harassment was common. The cross-sectional model suggested that deployment-related sexual stressors were significantly associated with postdeployment depression (R(2) = .11) and posttraumatic stress symptoms (R(2) = .10). Once predeployment factors were taken into consideration, however, sexual stressors were no longer significant. The results did not support the notion of lasting negative impact for low-level sexual stressors (e.g., sexual harassment) during deployment after predeployment stressors are accounted for. Future studies of sexual stressors should consider longitudinal designs. PMID:26184776

  14. Promoting Reintegration of National Guard Veterans and Their Partners Using a Self-Directed Program of Integrative Therapies: A Pilot Study

    PubMed Central

    Collinge, William; Kahn, Janet; Soltysik, Robert

    2013-01-01

    This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan. Data are reported on 43 dyads. Intervention was an integrated multimedia package of guided meditative, contemplative, and relaxation exercises (CD) and instruction in simple massage techniques (DVD) to promote stress reduction and interpersonal connectedness. A repeated measures design with standardized instruments was used to establish stability of baseline levels of relevant mental health domains (day 1, day 30), followed by the intervention and assessments 4 and 8 weeks later. Significant improvements in standardized measures for post-traumatic stress disorder, depression, and self-compassion were seen in both veterans and partners; and in stress for partners. Weekly online reporting tracked utilization of guided exercises and massage. Veterans reported significant reductions in ratings of physical pain, physical tension, irritability, anxiety/worry, and depression after massage, and longitudinal analysis suggested declining baseline levels of tension and irritability. Qualitative data from focus groups and implications for continued development and a phase II trial are discussed. PMID:23397692

  15. Effects of military-authorized activities on the San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Berry, W.H.; Standley, W.G.; O`Farrell, T.P.; Kato, T.T.

    1992-10-01

    The effects of military-authorized activities on San Joaquin kit fox (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site from 1988 to 1991. Military-authorized activities included military training exercises, facilities maintenance, new construction, controlled burning, livestock grazing, and public-access hunting. Positive effects of the military included habitat preservation, preactivity surveys, and natural resources management practices designed to conserve kit foxes and their habitat. Perceived negative effects such as entrapment in dens, shootings during military exercises, and accidental poisoning were not observed. Foxes were observed in areas being used simultaneously by military units. Authorized activities were known to have caused the deaths of three of 52 radiocollared foxes recovered dead: one became entangled in concertina wire, one was believed shot by a hunter, and one was struck by a vehicle. Entanglement in communication wire may have contributed to the death of another radiocollared fox that was killed by a predator. Approximately 10% of kit fox dens encountered showed evidence of vehicle traffic, but denning sites did not appear to be a limiting factor for kit foxes.

  16. Suicide and war: the mediating effects of negative mood, posttraumatic stress disorder symptoms, and social support among army National Guard soldiers.

    PubMed

    Griffith, James

    2012-08-01

    The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard soldiers (N=4,546). Results from structural equation modeling suggested that war experiences may precipitate a sequence of psychological consequences leading to suicidality. However, suicidality may be an enduring behavioral health condition. War experiences showed no direct effects on postdeployment suicidality, rather its effect was indirect through PTSD symptoms and negative mood. War experiences were, however, predictive of PTSD symptoms, as would be expected. PSTD symptoms showed no direct effect on postdeployment suicidality, but showed indirect effects through negative mood. Results also suggested that suicidality is relatively persistent, at least during deployment and postdeployment. The percentage of those at risk for suicide was low both during and after deployment, with little association between suicidality and time since returning from deployment. Additionally, few soldiers were initially nonsuicidal and then reported such symptoms at postdeployment. Implications of relationships of both negative mood and combat trauma to suicidality are discussed, as well as possible mediating effects of both personal dispositions and social support on relationships of war experiences to PTSD, negative mood, and suicidality. PMID:22924892

  17. Superfund Record of Decision (EPA Region 1): Otis Air National Guard/Camp Edwards, MA. (First remedial action), May 1992. Interim report

    SciTech Connect

    Not Available

    1992-05-20

    The 22,000-acre Otis National Guard/Camp Edwards site is a former military vehicle maintenance facility on Cape Cod, Massachusetts, within the Massachusetts Military Reservation (MMR). The Area of Contamination Chemical Spill Area Number 4 (AOC CS-4) plume extends 11,000 feet and is located 1.1 miles from the southern boundary of MMR. Wastes and equipment handled at AOC CS-4 included oils, solvents, antifreeze, battery electrolytes, paint, and waste fuels. Additionally, the northern portion of AOC CS-4 was used as a storage yard for wastes generated by shops and laboratories operating at MMR. Liquid wastes were stored in containers or underground storage tanks (USTs) in an unbermed area or deposited in USTs designated for motor gasoline. The ROD addresses OU2, the interim action for MMR AOC CS-4 ground water to prevent further down gradient migration of the contaminants. The primary contaminants of concern affecting the ground water are VOCs, including PCE and TCE.

  18. 45 CFR 60.17 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Information which hospitals must request from the National Practitioner Data Bank. 60.17 Section 60.17 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK Disclosure of Information by the National Practitioner Data Bank § 60.17...

  19. 45 CFR 60.17 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Information which hospitals must request from the National Practitioner Data Bank. 60.17 Section 60.17 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK Disclosure of Information by the National Practitioner Data Bank § 60.17...

  20. Distinct enough? A national examination of Catholic hospital affiliation and patient perceptions of care

    PubMed Central

    Kutney-Lee, Ann; Melendez-Torres, G.J.; McHugh, Matthew D.; Wall, Barbra Mann

    2014-01-01

    Background Catholic hospitals play a critical role in the provision of health care in the United States; yet, empirical evidence of patient outcomes in these institutions is practically absent in the literature. Purpose The purpose of this study was to determine whether patient perceptions of care are more favorable in Catholic hospitals as compared with non-Catholic hospitals in a national sample of hospitals. Methodology This cross-sectional secondary analysis used linked data from the 2008 American Hospital Association Annual Survey, the 2008 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, the 2008 Medicare Case Mix Index file, and the 2010 Religious Congregations and Membership Study. The study included over 3,400 hospitals nationwide, including 494 Catholic hospitals. Propensity score matching and ordinary least-squares regression models were used to examine the relationship between Catholic affiliation and various HCAHPS measures. Findings Our findings revealed that patients treated in Catholic hospitals appear to rate their hospital experience similar to patients treated in non-Catholic hospitals. Catholic hospitals maintain a very slight advantage above their non-Catholic peers on five HCAHPS measures related to nurse communication, receipt of discharge information, quietness of the room at night, overall rating, and recommendation of the hospital; yet, these differences were minimal. Practice Implications If the survival of Catholic health care services is contingent upon how its provision of care is distinct, administrators of Catholic hospitals must show differences more clearly. Given the great importance of Catholic hospitals to the health of millions of patients in the United States, this study provides Catholic hospitals with a set of targeted areas on which to focus improvement efforts, especially in light of current pay-for-performance initiatives. PMID:23493045

  1. Followership characteristics among infection preventionists in U.S. hospitals: Results of a national survey.

    PubMed

    Greene, M Todd; Saint, Sanjay

    2016-03-01

    Infection prevention practices vary across U.S. hospitals. Although the importance of leadership in infection prevention has been described, little is known about how followership influences such efforts. Our national survey found that hospitals with truly exemplary followers in infection control roles may be more likely to use recommended prevention practices. PMID:26698669

  2. Guarded Motion for Mobile Robots

    Energy Science and Technology Software Center (ESTSC)

    2005-03-30

    The Idaho National Laboratory (INL) has created codes that ensure that a robot will come to a stop at a precise, specified distance from any obstacle regardless of the robot's initial speed, its physical characteristics, and the responsiveness of the low-level motor control schema. This Guarded Motion for Mobile Robots system iteratively adjusts the robot's action in response to information about the robot's environment.

  3. 46 CFR 14.103 - Addresses of Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Addresses of Coast Guard. 14.103 Section 14.103 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN SHIPMENT AND DISCHARGE OF MERCHANT MARINERS General § 14.103 Addresses of Coast Guard. (a) U.S. postal mail: U.S. Coast Guard National Maritime Center (NMC-42),...

  4. National Survey of Children's Hospitals on Legacy-Making Activities

    PubMed Central

    Dietrich, Mary S.; Friedman, Debra L.; Gordon, Jessie E.; Gilmer, Mary J.

    2012-01-01

    Abstract Objective Many hospitals offer legacy-building activities for children with serious illnesses or their family members, yet legacy-making has received little empirical attention. This descriptive cross-sectional study examined healthcare provider perceptions of legacy-making activities (e.g., memory books) currently offered by hospitals to pediatric patients and their families. Methods Healthcare providers in seventy-seven (100%) teaching children's hospitals across the United States completed an electronic survey. Results Nearly all providers surveyed reported offering legacy-making activities to ill children and their families, with patients and families usually completing the activity together. Most activities were offered before a patient died and when cure is no longer being sought. Perceived outcomes included benefit to bereaved families and a tangible memento of their deceased child. Conclusion Legacy-making may enhance life and decrease suffering for dying children and their families. Healthcare professionals can facilitate opportunities for children and their families to build legacies. Additional research is needed to examine activities across different age groups and conditions, the best time to offer such activities, and associations with positive and negative outcomes for ill children, their family members, and the bereaved. PMID:22577785

  5. Assessment of soil and water contaminants from selected locations in and near the Idaho Army National Guard Orchard Training Area, Ada County, Idaho, 2001-2003

    USGS Publications Warehouse

    Parliman, D.J.

    2004-01-01

    In 2001, the National Guard Bureau and the U.S. Geological Survey began a project to compile hydrogeologic data and determine presence or absence of soil, surface-water, and ground-water contamination at the Idaho Army National Guard Orchard Training Area in southwestern Idaho. Between June 2002 and April 2003, a total of 114 soil, surface-water, ground-water, precipitation, or dust samples were collected from 68 sample sites (65 different locations) in the Orchard Training Area (OTA) or along the vehicle corridor to the OTA. Soil and water samples were analyzed for concentrations of selected total trace metals, major ions, nutrients, explosive compounds, semivolatile organics, and petroleum hydrocarbons. Water samples also were analyzed for concentrations of selected dissolved trace metals and major ions. Distinguishing naturally occurring large concentrations of trace metals, major ions, and nutrients from contamination related to land and water uses at the OTA was difficult. There were no historical analyses for this area to compare with modern data, and although samples were collected from 65 locations in and near the OTA, sampled areas represented only a small part of the complex OTA land-use areas and soil types. For naturally occurring compounds, several assumptions were made?anomalously large concentrations, when tied to known land uses, may indicate presence of contamination; naturally occurring concentrations cannot be separated from contamination concentrations in mid- and lower ranges of data; and smallest concentrations may represent the lowest naturally occurring range of concentrations and (or) the absence of contaminants related to land and water uses. Presence of explosive, semivolatile organic (SVOC), and petroleum hydrocarbon compounds in samples indicates contamination from land and water uses. In areas along the vehicle corridor and major access roads within the OTA, most trace metal, major ion, and nutrient concentrations in soil samples were not in the upper 10th percentile of data, but concentrations of 25 metals, ions, or nutrients were in the upper 10th percentile in a puddle sample near the heavy equipment maneuvering area, MPRC-H. The largest concentrations of tin, ammonia, and nitrite plus nitrate (as nitrogen) in water from the OTA were detected in a sample from this puddle. Petroleum hydrocarbons were the most common contaminant, detected in all soil and surface-water samples. An SVOC, bis (2-ethylhexyl) phthalate, a plasticizer, was detected at a site along the vehicle corridor. In Maneuver Areas within the OTA, many soil samples contained at least one trace metal, major ion, or nutrient in the upper 10th percentile of data, and the largest concentrations of cobalt, iron, mercury, titanium, sodium, ammonia, or total phosphorus were detected in 6 of 13 soil samples outside the Tadpole Lake area. The largest concentrations of aluminum, arsenic, beryllium, nickel, selenium, silver, strontium, thallium, vanadium, chloride, potassium, sulfate, and nitrite plus nitrate were detected in soil samples from the Tadpole Lake area. Water from Tadpole Lake contained the largest total concentrations of 19 trace metals, 4 major ions, and 1 nutrient. Petroleum hydrocarbons were detected in 5 soil samples and water from Tadpole Lake. SVOCs related to combustion of fuel or plasticizers were detected in 1 soil sample. Explosive compounds were detected in 1 precipitation sample.In the Impact Area within the OTA, most soil samples contained at least one trace metal, major ion, or nutrient in the upper 10th percentile of data, and the largest concentrations of barium, chromium, copper, manganese, lead, or orthophosphate were detected in 6 of the 18 soil samples. Petroleum hydrocarbons were detected in 4 soil samples, SVOCs in 6 samples, and explosive compounds in 4 samples. In the mobilization and training equipment site (MATES) compound adjacent to the OTA, all soil and water samples contained at lea

  6. Organizational and market factors associated with leadership development programs in hospitals: a national study.

    PubMed

    Kim, Tae Hyun; Thompson, Jon M

    2012-01-01

    Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed. PMID:22530292

  7. Incidence of never events among weekend admissions versus weekday admissions to US hospitals: national analysis

    PubMed Central

    Attenello, Frank J; Cen, Steven Y; Ng, Alvin; Kim-Tenser, May; Sanossian, Nerses; Amar, Arun P; Mack, William J

    2015-01-01

    Objective To evaluate the association between weekend admission to hospital and 11 hospital acquired conditions recently considered by the Centers for Medicare and Medicaid as never events for which resulting healthcare costs are not reimbursed. Design National analysis. Setting US Nationwide Inpatient Sample discharge database. Participants 351 million patients discharged from US hospitals, 2002-10. Main outcome measures Univariate rates and multivariable likelihood of hospital acquired conditions among patients admitted on weekdays versus weekends, as well as the impacts of these events on prolonged length of stay and total inpatient charges. Results From 2002 to 2010, 351?170?803 patients were admitted to hospital, with 19% admitted on a weekend. Hospital acquired conditions occurred at an overall frequency of 4.1% (5.7% among weekend admissions versus 3.7% among weekday admissions). Adjusting for patient and hospital cofactors the probability of having one or more hospital acquired conditions was more than 20% higher in weekend admissions compared with weekday admissions (odds ratio 1.25, 95% confidence interval 1.24 to 1.26, P<0.01). Hospital acquired conditions have a negative impact on both hospital charges and length of stay. At least one hospital acquired condition was associated with an 83% (1.83, 1.77 to 1.90, P<0.01) likelihood of increased charges and 38% likelihood of prolonged length of stay (1.38, 1.36 to 1.41, P<0.01). Conclusion Weekend admission to hospital is associated with an increased likelihood of hospital acquired condition, cost, and length of stay. Future protocols and staffing regulations must be tailored to the requirements of this high risk subgroup. PMID:25876878

  8. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Information which hospitals must request from the National Practitioner Data Bank. 60.12 Section 60.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS Disclosure...

  9. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Information which hospitals must request from the National Practitioner Data Bank. 60.12 Section 60.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS Disclosure...

  10. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Information which hospitals must request from the National Practitioner Data Bank. 60.12 Section 60.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS Disclosure...

  11. The Nanaimo and Charles Camsell Indian Hospitals: First Nations' narratives of health care, 1945 to 1965.

    PubMed

    Drees, Laurie Meijer

    2010-01-01

    First Nations' perspectives on health and health care as delivered by doctors, nurses, and Canada's former Indian hospital system form a significant part of Canada's medical history, as well as a part of First Nations people's personal histories. Oral histories collected in Alberta and British Columbia suggest that First Nations people who experienced the Nanaimo and Charles Camsell Indian hospitals between 1945 and 1965 perceive the value of their experiences to be reflected in their survivance, a concept recalled through narratives emphasizing both humour and pain, as well as past and present personal resilience. PMID:21114087

  12. National Lupus Hospitalization Trends Reveal Rising Rates of Herpes Zoster and Declines in Pneumocystis Pneumonia

    PubMed Central

    Murray, Sara G.; Schmajuk, Gabriela; Trupin, Laura; Gensler, Lianne; Katz, Patricia P.; Yelin, Edward H.; Gansky, Stuart A.; Yazdany, Jinoos

    2016-01-01

    Objective Infection is a leading cause of morbidity and mortality in systemic lupus erythematosus (SLE). Therapeutic practices have evolved over the past 15 years, but effects on infectious complications of SLE are unknown. We evaluated trends in hospitalizations for severe and opportunistic infections in a population-based SLE study. Methods Data derive from the 2000 to 2011 United States National Inpatient Sample, including individuals who met a validated administrative definition of SLE. Primary outcomes were diagnoses of bacteremia, pneumonia, opportunistic fungal infection, herpes zoster, cytomegalovirus, or pneumocystis pneumonia (PCP). We used Poisson regression to determine whether infection rates were changing in SLE hospitalizations and used predictive marginals to generate annual adjusted rates of specific infections. Results We identified 361,337 SLE hospitalizations from 2000 to 2011 meeting study inclusion criteria. Compared to non-SLE hospitalizations, SLE patients were younger (51 vs. 62 years), predominantly female (89% vs. 54%), and more likely to be racial/ethnic minorities. SLE diagnosis was significantly associated with all measured severe and opportunistic infections. From 2000 to 2011, adjusted SLE hospitalization rates for herpes zoster increased more than non-SLE rates: 54 to 79 per 10,000 SLE hospitalizations compared with 24 to 29 per 10,000 non-SLE hospitalizations. Conversely, SLE hospitalizations for PCP disproportionately decreased: 5.1 to 2.5 per 10,000 SLE hospitalizations compared with 0.9 to 1.3 per 10,000 non-SLE hospitalizations. Conclusions Among patients with SLE, herpes zoster hospitalizations are rising while PCP hospitalizations are declining. These trends likely reflect evolving SLE treatment strategies. Further research is needed to identify patients at greatest risk for infectious complications. PMID:26731012

  13. Human mate guarding.

    PubMed

    Buss, David M

    2002-12-01

    Long-term committed mating is a fundamental strategy in the human repertoire. Successful enactment of this strategy requires solving two related adaptive problems--fending off potential mate poachers and preventing a mates from defecting. Mate guarding adaptations evolved to solve these persistent problems. Those who failed in mate guarding risked suffering substantial reproductive costs ranging from genetic cuckoldry to reputational damage to the entire loss of a mate. Because the precise nature of the adaptive problems confronted differed historically for the sexes, men and women evolved corresponding differences in the underlying psychology of mate guarding. Men's mate guarding, relative to that of women's, is strongly triggered as a consequence of being mated to young and physically attractive women, being confronted by interested rivals who have superior economic resources or prospects, and having a mate who displays signs of sexual involvement with a rival. Women's mate guarding, relative to that of men's, is triggered as a consequence of being mated to men high in income and status striving, rivals who are more physically attractive, and having a partner who shows signs of emotional involvement with another woman. Behavioral output of mate guarding adaptations range from vigilance to violence. PMID:12496732

  14. A national system for monitoring the performance of hospitals in Ethiopia

    PubMed Central

    McNatt, Zahirah; Linnander, Erika; Endeshaw, Abraham; Tatek, Dawit; Conteh, David

    2015-01-01

    Abstract Many countries struggle to develop and implement strategies to monitor hospitals nationally. The challenge is particularly acute in low-income countries where resources for measurement and reporting are scarce. We examined the experience of developing and implementing a national system for monitoring the performance of 130 government hospitals in Ethiopia. Using participatory observation, we found that the monitoring system resulted in more consistent hospital reporting of performance data to regional health bureaus and the federal government, increased transparency about hospital performance and the development of multiple quality-improvement projects. The development and implementation of the system, which required technical and political investment and support, would not have been possible without strong hospital-level management capacity. Thorough assessment of the health sector’s readiness to change and desire to prioritize hospital quality can be helpful in the early stages of design and implementation. This assessment may include interviews with key informants, collection of data about health facilities and human resources and discussion with academic partners. Aligning partners and donors with the government’s vision for quality improvement can enhance acceptability and political support. Such alignment can enable resources to be focused strategically towards one national effort – rather than be diluted across dozens of potentially competing projects. Initial stages benefit from having modest goals and the flexibility for continuous modification and improvement, through active engagement with all stakeholders. PMID:26600614

  15. The Impact of National Cultural Differences on Nurses' Acceptance of Hospital Information Systems.

    PubMed

    Lin, Hsien-Cheng

    2015-06-01

    This study aims to explore the influence of national cultural differences on nurses' perceptions of their acceptance of hospital information systems. This study uses the perspective of Technology Acceptance Model; national cultural differences in terms of masculinity/femininity, individualism/collectivism, power distance, and uncertainty avoidance are incorporated into the Technology Acceptance Model as moderators, whereas time orientation is a control variable on hospital information system acceptance. A quantitative research design was used in this study; 261 participants, US and Taiwan RNs, all had hospital information system experience. Data were collected from November 2013 to February 2014 and analyzed using a t test to compare the coefficients for each moderator. The results show that individualism/collectivism, power distance, and uncertainty avoidance all exhibit significant difference on hospital information system acceptance; however, both masculinity/femininity and time orientation factors did not show significance. This study verifies that national cultural differences have significant influence on nurses' behavioral intention to use hospital information systems. Therefore, hospital information system providers should emphasize the way in which to integrate different technological functions to meet the needs of nurses from various cultural backgrounds. PMID:25899441

  16. Surface-water quantity and quality, aquatic biology, stream geomorphology, and groundwater-flow simulation for National Guard Training Center at Fort Indiantown Gap, Pennsylvania, 2002-05

    USGS Publications Warehouse

    Langland, Michael J.; Cinotto, Peter J.; Chichester, Douglas C.; Bilger, Michael D.; Brightbill, Robin A.

    2010-01-01

    Base-line and long-term monitoring of water resources of the National Guard Training Center at Fort Indiantown Gap in south-central Pennsylvania began in 2002. Results of continuous monitoring of streamflow and turbidity and monthly and stormflow water-quality samples from two continuous-record long-term stream sites, periodic collection of water-quality samples from five miscellaneous stream sites, and annual collection of biological data from 2002 to 2005 at 27 sites are discussed. In addition, results from a stream-geomorphic analysis and classification and a regional groundwater-flow model are included. Streamflow at the facility was above normal for the 2003 through 2005 water years and extremely high-flow events occurred in 2003 and in 2004. Water-quality samples were analyzed for nutrients, sediments, metals, major ions, pesticides, volatile and semi-volatile organic compounds, and explosives. Results indicated no exceedances for any constituent (except iron) above the primary and secondary drinking-water standards or health-advisory levels set by the U.S. Environmental Protection Agency. Iron concentrations were naturally elevated in the groundwater within the watershed because of bedrock lithology. The majority of the constituents were at or below the method detection limit. Sediment loads were dominated by precipitation due to the remnants of Hurricane Ivan in September 2004. More than 60 percent of the sediment load measured during the entire study was transported past the streamgage in just 2 days during that event. Habitat and aquatic-invertebrate data were collected in the summers of 2002-05, and fish data were collected in 2004. Although 2002 was a drought year, 2003-05 were above-normal flow years. Results indicated a wide diversity in invertebrates, good numbers of taxa (distinct organisms), and on the basis of a combination of metrics, the majority of the 27 sites indicated no or slight impairment. Fish-metric data from 25 sites indicated results similar to the invertebrate data. Stream classification based on evolution of the stream channels indicates about 94 percent of the channels were considered to be in equilibrium (type B or C channels), neither aggrading nor eroding. A regional, uncalibrated groundwater-flow model indicated the surface-water and groundwater-flow divides coincided. Because of folding of rock layers, groundwater was under confined conditions and nearly all the water leaves the facility via the streams.

  17. Body weight, weight perceptions and food intake patterns. A cross-sectional study among male recruits in the Norwegian National Guard

    PubMed Central

    2011-01-01

    Background Young men tend to have a low intake of vegetables and fruit. Unfortunately, this group is difficult to reach with health information. Furthermore, knowledge about weight perceptions and the relationship to food behaviour among young men is scant. The purpose of this study was to explore the relationship between BMI, health and weight perceptions and food intake patterns among young men in the military. Methods Data were collected with a 4-day food diary among 578 male recruits (age 18-26, mean 19.7) in the Norwegian National Guard (response rate 78%), in addition to a questionnaire, including questions about health and weight perceptions, and food frequency when still living at home. Weight and height were objectively measured. Food patterns were explored with principal component analysis, based on the diary data. A multivariate linear regression analysis determined the association between BMI and food patterns, and attitudes to health and slenderness, adjusting for smoking, physical activity and phase of data collection. Results Twenty eight percent of the recruits were overweight/obese (BMI > 25 kg/m2). Two-thirds meant that it is important for them to be slender, and these recruits reported more of both light (p = 0.025) and hard (p = 0.016) physical activity than the others. It was a positive association between the recruits' food frequency at home, and the amount of intake in the military camp for several food items. A principal component analysis identified three distinct food patterns, loading on 1) plant foods, 2) fast food/soft drinks, 3) milk/cereals. Those who stated that it is important for them to be slender, or to have good health, did not have significantly different food intake patterns than the others. BMI was inversely related to scores on the plant food pattern, and positive attitudes to slenderness. Conclusion The majority of the recruits find it important to be slender. This orientation had a bearing on their physical activity pattern, but less on the food intake pattern. The data also indicate that subjects with high intakes of plant foods were less likely to have a high BMI than others. It is important to raise awareness of healthy eating in young men. PMID:21595899

  18. Trends in Inpatient Hospital Deaths: National Hospital Discharge Survey, 2000-2010

    MedlinePlus

    ... once in NHDS. Because of the complex multistage design of NHDS, the survey data must be inflated, or weighted, in order to produce national estimates. Estimates of inpatient care presented in this report exclude newborns. More details about the design of NHDS have been published elsewhere ( 8 ). A ...

  19. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing--2001.

    PubMed

    Pedersen, C A; Schneider, P J; Santell, J P

    2001-12-01

    Results of the 2001 ASHP national survey of pharmacy practice in hospital settings that pertain to prescribing and transcribing are presented. A stratified random sample of pharmacy directors at 1091 general and children's medical-surgical hospitals in the United States was surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. The response rate was 49.0%. During 2001, nearly all hospitals are estimated to have pharmacy and therapeutics (P&T) committees that meet an average of seven times per year. It is estimated that more than 90% of P&T committees are responsible for formulary development and management, drug policy development, adverse-drug-reaction review, and medication-use evaluation. More than 90% of hospitals use clinical and therapeutic, cost, and pharmacoeconomic information in the formulary management process, while nearly two thirds consider quality-of-life issues. Nearly 70% use clinical practice guidelines in the formulary management process, and 78% have a medication-use evaluation program designed to improve prescribing. Pharmacists in more than 75% of hospitals provide consultations on drug information, dosage adjustments for patients with renal impairment, antimicrobials, and pharmacokinetics. Further, a majority of hospitals ensure accurate transcription of medication orders by clarifying illegible orders before transcription or entry into medication administration records (MARs), using standardized prescriber order forms, requiring prescribers to countersign all oral orders, and reconciling MARs and pharmacy patient profiles at least daily. In 2001, large hospitals are most likely to use prescriber order-entry systems to improve patient safety and are least likely to require the reentry of medication orders into the pharmacy computer system. The 2001 ASHP survey results suggest that pharmacists in hospital settings have positioned themselves well to improve the prescribing and transcribing components of the medication-use process. PMID:11763804

  20. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  1. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  2. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  3. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  4. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  5. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  6. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  7. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  8. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  9. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  10. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    PubMed Central

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics. Results The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. Conclusion The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria. PMID:24159497

  11. Use of a national collaborative to improve hospital quality in a low-income setting

    PubMed Central

    Linnander, Erika; McNatt, Zahirah; Sipsma, Heather; Tatek, Dawit; Abebe, Yigeremu; Endeshaw, Abraham; Bradley, Elizabeth H.

    2016-01-01

    Background Quality improvement collaboratives are a widely used mechanism to improve hospital performance in high-income settings, but we lack evidence about their effectiveness in low-income settings. Methods We conducted cross-sectional and longitudinal analysis of data from the Ethiopian Hospital Alliance for Quality, a national collaborative sponsored by Ethiopia's Federal Ministry of Health. We identified hospital strategies associated with more positive patient satisfaction using linear regression and assessed changes in patient experience over a 3-year period (2012–2014) using matched t-tests. Results A total of 68 hospitals (response rate 68/120, 56.7%) were included in cross-sectional analysis. Four practices were significantly associated with more positive patient satisfaction (p<0.05): posting a record of cleaning activity in toilets and in patient wards, distributing leaflets in the local language with each prescription, and sharing ideas about patient experience across the hospital. Among hospitals that had complete data for longitudinal analysis (44/68, 65%), we found a 10% improvement in a 10-point measure of patient satisfaction (7.7 vs 8.4, p<0.01) from the start to the end of the study period. Conclusions Quality improvement collaboratives can be useful at scale in low-income settings in sub-Saharan Africa, particularly for hospitals that adopt strategies associated with patient satisfaction. PMID:26796023

  12. Transforming safety and effectiveness in pediatric hospital care locally and nationally.

    PubMed

    Mandel, Keith E; Muething, Stephen E; Schoettker, Pamela J; Kotagal, Uma R

    2009-08-01

    Achieving dramatic, sustainable improvements in the safety and effectiveness of care for children requires a transformational approach to how hospitals individually focus on improvement and learn from each other to achieve national goals. The authors describe a theoretic framework for transformation that includes setting system-level priorities, aligning measures with each priority, identifying breakthrough targets, testing interventions to get results, and spreading successful interventions throughout the organization. Essential key drivers of transformation include leadership, building will, transparency, a business case for quality, patient and family engagement, improvement infrastructure, improvement capability, and reliability and standardization. Improving national system-level measures requires each hospital to pursue its own transformation journey while collaborating with hospitals and other organizations. PMID:19660634

  13. GUARD RING SEMICONDUCTOR JUNCTION

    DOEpatents

    Goulding, F.S.; Hansen, W.L.

    1963-12-01

    A semiconductor diode having a very low noise characteristic when used under reverse bias is described. Surface leakage currents, which in conventional diodes greatly contribute to noise, are prevented from mixing with the desired signal currents. A p-n junction is formed with a thin layer of heavily doped semiconductor material disposed on a lightly doped, physically thick base material. An annular groove cuts through the thin layer and into the base for a short distance, dividing the thin layer into a peripheral guard ring that encircles the central region. Noise signal currents are shunted through the guard ring, leaving the central region free from such currents. (AEC)

  14. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Other national accreditation programs for hospitals and other providers and suppliers. 488.6 Section 488.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES...

  15. Hydrogeologic framework and water quality of the Vermont Army National Guard Ethan Allen Firing Range, northern Vermont, October 2002 through December 2003

    USGS Publications Warehouse

    Clark, Stewart F.; Chalmers, Ann; Mack, Thomas J.; Denner, Jon C.

    2005-01-01

    The Ethan Allen Firing Range of the Vermont Army National Guard is a weapons-testing and training facility in a mountainous region of Vermont that has been in operation for about 80 years. The hydrologic framework and water quality of the facility were assessed between October 2002 and December 2003. As part of the study, streamflow was continuously measured in the Lee River and 24 observation wells were installed at 19 locations in the stratified drift and bedrock aquifers to examine the hydrogeology. Chemical analyses of surface water, ground water, streambed sediment, and fish tissue were collected to assess major ions, trace elements, nutrients, and volatile and semivolatile compounds. Sampling included 5 surface-water sites sampled during moderate and low-flow conditions; streambed-sediment samples collected at the 5 surface-water sites; fish-tissue samples collected at 3 of the 5 surface-water sites; macroinvertebrates collected at 4 of the 5 surface-water sites; and ground-water samples collected from 10 observation wells, and samples collected at all surface- and ground-water sites. The hydrogeologic framework at the Ethan Allen Firing Range is dominated by the upland mountain and valley setting of the site. Bedrock wells yield low to moderate amounts of water (0 to 23 liters per minute). In the narrow river valleys, layered stratified-drift deposits of sand and gravel of up to 18 meters thick fill the Lee River and Mill Brook Valleys. In these deposits, the water table is generally within 3 meters below the land surface and overall ground-water flow is from east to west. Streamflow in the Lee River averaged 0.72 cubic meters per second (25.4 cubic feet per second) between December 2002 and December 2003. Streams are highly responsive to precipitation events in this mountainous environment and a comparison with other nearby watersheds shows that Lee River maintains relatively high streamflow during dry periods. Concentrations of trace elements and nutrients in surface-water samples are well below freshwater-quality guidelines for the protection of aquatic life. Brook-trout samples collected in 1992 and 2003 show trace-metal concentrations have decreased over the past 11 years. concentrations in water samples are well below levels that restrict swimming at all five stream sites at moderate and low-flow conditions and in all observation wells. Comparisons among surface-water, streambed-sediment, and biological samples collected in 2003 to earlier studies at the Ethan Allen Firing Range indicate water-quality conditions are similar or have improved over the past 15 years. Ground water in the stratified-drift aquifers at the facility is well buffered with relatively high alkalinities and pH greater than 6. Concentrations of arsenic, cadmium, chromium, lead, nickel, uranium, and zinc were below detection levels in ground-water samples. Barium, cobalt, copper, iron, manganese, molybdenum, and strontium were the only trace elements detected in ground-water samples. Cobalt and iron were detected at low levels in two wells near Mill Brook, and copper was detected at the detection limit in one of these wells. These same two wells had concentrations of barium and manganese 2 to 10 times greater than other ground-water samples. Concentrations of nutrients are at or below detection levels in most ground-water samples. Volatile organic compounds and semivolatile organic compounds were not detected in any water samples from the Ethan Allen Firing Range.

  16. Coast Guard Firefighting Module

    NASA Technical Reports Server (NTRS)

    1977-01-01

    NASA and the U.S. Coast Guard are jointly developing a lightweight, helicopter-transportable, completely self-contained firefighting module for combating shipboard and dockside fires. The project draws upon NASA technology in high-capacity rocket engine pumps, lightweight materials and compact packaging.

  17. National Hospital Management Portal (NHMP): a framework for e-health implementation.

    PubMed

    Adetiba, E; Eleanya, M; Fatumo, S A; Matthews, V O

    2009-01-01

    Health information represents the main basis for health decision-making process and there have been some efforts to increase access to health information in developing countries. However, most of these efforts are based on the internet which has minimal penetration especially in the rural and sub-urban part of developing countries. In this work, a platform for medical record acquisition via the ubiquitous 2.5G/3G wireless communications technologies is presented. The National Hospital Management Portal (NHMP) platform has a central database at each specific country's national hospital which could be updated/accessed from hosts at health centres, clinics, medical laboratories, teaching hospitals, private hospitals and specialist hospitals across the country. With this, doctors can have access to patients' medical records more easily, get immediate access to test results from laboratories, deliver prescription directly to pharmacists. If a particular treatment can be provided to a patient more effectively in another country, NHMP makes it simpler to organise and carry out such treatment abroad. PMID:20643641

  18. A comparison of hospital administrative costs in eight nations: US costs exceed all others by far.

    PubMed

    Himmelstein, David U; Jun, Miraya; Busse, Reinhard; Chevreul, Karine; Geissler, Alexander; Jeurissen, Patrick; Thomson, Sarah; Vinet, Marie-Amelie; Woolhandler, Steffie

    2014-09-01

    A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital administrative costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that administrative costs accounted for 25.3 percent of total US hospital expenditures--a percentage that is increasing. Next highest were the Netherlands (19.8 percent) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest administrative costs. Costs were intermediate in France and Germany (which bill per patient but pay separately for capital projects) and in Wales. Reducing US per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011. This study suggests that the reduction of US administrative costs would best be accomplished through the use of a simpler and less market-oriented payment scheme. PMID:25201663

  19. [Problems in career planning for novice medical technologists in Japanese national hospitals].

    PubMed

    Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

    2012-12-01

    Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs. PMID:23427696

  20. An international survey of physicians regarding clinical trials: a comparison between Kyoto University Hospital and Seoul National University Hospital

    PubMed Central

    2013-01-01

    Background International clinical trials are now rapidly expanding into Asia. However, the proportion of global trials is higher in South Korea compared to Japan despite implementation of similar governmental support in both countries. The difference in clinical trial environment might influence the respective physicians’ attitudes and experience towards clinical trials. Therefore, we designed a questionnaire to explore how physicians conceive the issues surrounding clinical trials in both countries. Methods A questionnaire survey was conducted at Kyoto University Hospital (KUHP) and Seoul National University Hospital (SNUH) in 2008. The questionnaire consisted of 15 questions and 2 open-ended questions on broad key issues relating to clinical trials. Results The number of responders was 301 at KUHP and 398 at SNUH. Doctors with trial experience were 196 at KUHP and 150 at SNUH. Among them, 12% (24/196) at KUHP and 41% (61/150) at SUNH had global trial experience. Most respondents at both institutions viewed clinical trials favorably and thought that conducting clinical trials contributed to medical advances, which would ultimately lead to new and better treatments. The main reason raised as a hindrance to conducting clinical trials was the lack of personnel support and time. Doctors at both university hospitals thought that more clinical research coordinators were required to conduct clinical trials more efficiently. KUHP doctors were driven mainly by pure academic interest or for their desire to find new treatments, while obtaining credits for board certification and co-authorship on manuscripts also served as motivation factors for doctors at SNUH. Conclusions Our results revealed that there might be two different approaches to increase clinical trial activity. One is a social level approach to establish clinical trial infrastructure providing sufficient clinical research professionals. The other is an individual level approach that would provide incentives to encourage doctors to participate in and conduct clinical trials. PMID:24156760

  1. Factors influencing the provision of clinical pharmacy services in United Kingdom National Health Service hospitals.

    PubMed

    Cotter, S M; Barber, N D; McKee, M; Chalmers, C P

    1996-01-01

    There is much variation in the provision of clinical pharmacy services in U.K. National Health Service hospitals. Some services are provided in groups and there are differences in the extent to which barriers exist to the provision of services. Factors that linked services included efficient use of resources; barriers involved a requirement for pharmacists to participate in multidisciplinary teams. The strong resemblances between service uptake by hospital pharmacies and the technology diffusion model provides insight into the future development of services in this era of evidence-based care. PMID:8840667

  2. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  3. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  4. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  5. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  6. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  7. The Place of the Hospital Library Consortium in the National Biomedical Communications Network *

    PubMed Central

    Fink, Wendy Ratcliff; Bloomquist, Harold; Allen, Richard G.

    1974-01-01

    The National Library of Medicine has issued a policy statement outlining expectations of more self-sufficiency at the Basic Unit level than was required during earlier programs under the Medical Library Assistance Act. A consortium of hospital libraries is presented as one viable alternative for meeting NLM's expectations that hospital libraries serve the primary and most immediate information needs of their own constituencies. The Biomedical Communications Network is reviewed so that hospital administrators and librarians will have a more thorough understanding of the system which they should now enter as contributors rather than as recipients only. A Network configuration illustrating the interaction of Basic Units functioning in consortia relationships is presented, and general areas for sharing are discussed. PMID:4466503

  8. Laser beam guard clamps

    DOEpatents

    Dickson, Richard K.

    2010-09-07

    A quick insert and release laser beam guard panel clamping apparatus having a base plate mountable on an optical table, a first jaw affixed to the base plate, and a spring-loaded second jaw slidably carried by the base plate to exert a clamping force. The first and second jaws each having a face acutely angled relative to the other face to form a V-shaped, open channel mouth, which enables wedge-action jaw separation by and subsequent clamping of a laser beam guard panel inserted through the open channel mouth. Preferably, the clamping apparatus also includes a support structure having an open slot aperture which is positioned over and parallel with the open channel mouth.

  9. A national survey of inpatient medication systems in English NHS hospitals

    PubMed Central

    2014-01-01

    Background Systems and processes for prescribing, supplying and administering inpatient medications can have substantial impact on medication administration errors (MAEs). However, little is known about the medication systems and processes currently used within the English National Health Service (NHS). This presents a challenge for developing NHS-wide interventions to increase medication safety. We therefore conducted a cross-sectional postal census of medication systems and processes in English NHS hospitals to address this knowledge gap. Methods The chief pharmacist at each of all 165 acute NHS trusts was invited to complete a questionnaire for medical and surgical wards in their main hospital (July 2011). We report here the findings relating to medication systems and processes, based on 18 closed questions plus one open question about local medication safety initiatives. Non-respondents were posted another questionnaire (August 2011), and then emailed (October 2011). Results One hundred (61% of NHS trusts) questionnaires were returned. Most hospitals used paper-based prescribing on the majority of medical and surgical inpatient wards (87% of hospitals), patient bedside medication lockers (92%), patients’ own drugs (89%) and ‘one-stop dispensing’ medication labelled with administration instructions for use at discharge as well as during the inpatient stay (85%). Less prevalent were the use of ward pharmacy technicians (62% of hospitals) or pharmacists (58%) to order medications on the majority of wards. Only 65% of hospitals used drug trolleys; 50% used patient-specific inpatient supplies on the majority of wards. Only one hospital had a pharmacy open 24 hours, but all had access to an on-call pharmacist. None reported use of unit-dose dispensing; 7% used an electronic drug cabinet in some ward areas. Overall, 85% of hospitals had a double-checking policy for intravenous medication and 58% for other specified drugs. “Do not disturb” tabards/overalls were routinely used during nurses’ drug rounds on at least one ward in 59% of hospitals. Conclusions Inter- and intra-hospital variations in medication systems and processes exist, even within the English NHS; future research should focus on investigating their potential effects on nurses’ workflow and MAEs, and developing NHS-wide interventions to reduce MAEs. PMID:24572075

  10. Improved table-saw guard

    NASA Technical Reports Server (NTRS)

    Dunn, B. R.; Zebus, P. P.

    1980-01-01

    Guard makes lighter contact on materials being sawed. Cuts are better controlled, and damages to fragile foam-type materials are reduced. Overhead support makes it possible to perform slot and step cuts, and thick materials are pushed under guard with less force. Guard is transparent plastic enclosure held by side-attached overhead support arm.

  11. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  12. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  13. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  14. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  15. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  16. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  17. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  18. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  19. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  20. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  1. Great hospitals of Asia: the Department of Neurosurgery at Seoul National University College of Medicine.

    PubMed

    Kim, Dong Gyu; Park, Chul-Kee; Paek, Sun Ha; Kim, Jeong Eun; Kim, Chi Heon; Phi, Ji Hoon

    2011-01-01

    Established in 1957, the Department of Neurosurgery at Seoul National University College of Medicine is the one of the oldest neurosurgical departments in Korea. The seven past Chairmen (Bo Sung Sim, Kil Soo Choi, Dae Hee Han, Byung-Kyu Cho, Hyun Jib Kim, Hee-Won Jung, and Dong Gyu Kim) have devoted themselves to the development of the department. The current chair, Chun Kee Chung, assumed the position in July 2010. The current department comprises several clinical programs that encompass the entire spectrum of neurosurgical disorders, with 29 specialized faculty members and care teams in three hospitals: Seoul National University Hospital (SNUH), Boramae Medical Center (BMC), and Seoul National University Bundang Hospital (SNUBH). The remarkable growth of the department during the last half century made it possible to perform 5,666 operations (3,299 at SNUH, 411 at BMC and 1,860 at SNUBH) during 2009. A total of 1,201 articles authored by faculty members were published in scientific journals between 1958 and 2009, approximately 32% of which were published in international journals. The department is regarded as the "Mecca" of neurosurgery in Korea because of its outstanding achievement and the many distinguished alumni with leadership roles in the academic field. This article traces the clinical, academic, and scientific development of the department, its present activities, and its future direction. PMID:21600472

  2. Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

    PubMed Central

    Martínez, Cristina; Fu, Marcela; Martínez-Sánchez, Jose M; Ballbè, Montse; Puig, Montse; García, Montse; Carabasa, Esther; Saltó, Esteve; Fernández, Esteve

    2009-01-01

    Background Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smoke-free Hospitals before and after a comprehensive national smoking ban. Methods We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two cross-sectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results The mean of the implementation score of tobacco control policies was 52.4 (95% CI: 45.4–59.5) in 2005 and 71.6 (95% CI: 67.0–76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35–39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network. PMID:19473549

  3. Length of hospital stay after craniotomy for tumor: a National Surgical Quality Improvement Program analysis.

    PubMed

    Dasenbrock, Hormuzdiyar H; Liu, Kevin X; Devine, Christopher A; Chavakula, Vamsidhar; Smith, Timothy R; Gormley, William B; Dunn, Ian F

    2015-12-01

    OBJECT Although the length of hospital stay is often used as a measure of quality of care, data evaluating the predictors of extended hospital stay after craniotomy for tumor are limited. The goals of this study were to use multivariate regression to examine which preoperative characteristics and postoperative complications predict a prolonged hospital stay and to assess the impact of length of stay on unplanned hospital readmission. METHODS Data were extracted from the National Surgical Quality Improvement Program (NSQIP) database from 2007 to 2013. Patients who underwent craniotomy for resection of a brain tumor were included. Stratification was based on length of hospital stay, which was dichotomized by the upper quartile of the interquartile range (IQR) for the entire population. Covariates included patient age, sex, race, tumor histology, comorbidities, American Society of Anesthesiologists (ASA) class, functional status, preoperative laboratory values, preoperative neurological deficits, operative time, and postoperative complications. Multivariate logistic regression with forward prediction was used to evaluate independent predictors of extended hospitalization. Thereafter, hierarchical multivariate logistic regression assessed the impact of length of stay on unplanned readmission. RESULTS The study included 11,510 patients. The median hospital stay was 4 days (IQR 3-8 days), and 27.7% (n = 3185) had a hospital stay of at least 8 days. Independent predictors of extended hospital stay included age greater than 70 years (OR 1.53, 95% CI 1.28%-1.83%, p < 0.001); African American (OR 1.75, 95% CI 1.44%-2.14%, p < 0.001) and Hispanic (OR 1.68, 95% CI 1.36%-2.08%) race or ethnicity; ASA class 3 (OR 1.52, 95% CI 1.34%-1.73%) or 4-5 (OR 2.18, 95% CI 1.82%-2.62%) designation; partially (OR 1.94, 95% CI 1.61%-2.35%) or totally dependent (OR 3.30, 95% CI 1.95%-5.55%) functional status; insulin-dependent diabetes mellitus (OR 1.46, 95% CI 1.16%-1.84%); hematological comorbidities (OR 1.68, 95% CI 1.25%-2.24%); and preoperative hypoalbuminemia (OR 1.78, 95% CI 1.51%-2.09%, all p ≤ 0.009). Several postoperative complications were additional independent predictors of prolonged hospitalization including pulmonary emboli (OR 13.75, 95% CI 4.73%-39.99%), pneumonia (OR 5.40, 95% CI 2.89%-10.07%), and urinary tract infections (OR 11.87, 95% CI 7.09%-19.87%, all p < 0.001). The C-statistic of the model based on preoperative characteristics was 0.79, which increased to 0.83 after the addition of postoperative complications. A length of stay after craniotomy for tumor score was created based on preoperative factors significant in regression models, with a moderate correlation with length of stay (p = 0.43, p < 0.001). Extended hospital stay was not associated with differential odds of an unplanned hospital readmission (OR 0.97, 95% CI 0.89%-1.06%, p = 0.55). CONCLUSIONS In this NSQIP analysis that evaluated patients who underwent craniotomy for tumor, much of the variance in hospital stay was attributable to baseline patient characteristics, suggesting length of stay may be an imperfect proxy for quality. Additionally, longer hospitalizations were not found to be associated with differential rates of unplanned readmission. PMID:26621410

  4. A national, cross-sectional survey of children's hospital-based safety resource centres

    PubMed Central

    Kendi, Sadiqa; Zonfrillo, Mark R; Seaver Hill, Karen; Arbogast, Kristy B; Gittelman, Michael A

    2014-01-01

    Objective To describe the location, staffing, clientele, safety product disbursement patterns, education provided and sustainability of safety resource centres (SRCs) in US children's hospitals. Methods A cross-sectional survey was distributed to children's hospital-based SRC directors. Survey categories included: funding sources, customer base, items sold, items given free of charge, education provided and directors’ needs. Results 32/38 (84.2%) SRC sites (affiliated with 30 hospitals) completed the survey. SRCs were in many hospital locations including lobby (28.1%), family resource centres (12.5%), gift shop/retail space (18.8%), mobile units (18.8%) and patient clinics (12.5%). 19% of respondents reported that their SRC was financially self-sustainable. Sales to patients predominated (mean of 44%); however, hospital employees made up a mean of 20% (range 0–60%) of sales. 78.1% of SRCs had products for children with special healthcare needs. Documentation kept at SRC sites included items purchased (96.9%), items given free of charge (65.6%) and customer demographics (50%). 56.3% of SRCs provided formal injury prevention education classes. The SRCs’ directors’ most important needs were finances (46.9%), staffing (50%) and space (46.9%). All of the directors were ‘somewhat interested’ or ‘very interested’ in each of the following: creation of a common SRC listserv, national SRC data bank and multisite SRC research platform. Conclusions SRCs are located in many US children's hospitals, and can be characterised as heterogeneous in location, products sold, data kept and ability to be financially sustained. Further research is needed to determine best practices for SRCs to maximise their impact on injury prevention. PMID:24667383

  5. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Frog guard rails and guard faces; gage. 213.143... and guard faces; gage. The guard check and guard face gages in frogs shall be within the limits... frog to the guard line 1 of its guard rail or guarding face, measured across the track at right...

  6. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Frog guard rails and guard faces; gage. 213.143... and guard faces; gage. The guard check and guard face gages in frogs shall be within the limits... frog to the guard line 1 of its guard rail or guarding face, measured across the track at right...

  7. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Frog guard rails and guard faces; gage. 213.143... and guard faces; gage. The guard check and guard face gages in frogs shall be within the limits... frog to the guard line 1 of its guard rail or guarding face, measured across the track at right...

  8. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Frog guard rails and guard faces; gage. 213.143... and guard faces; gage. The guard check and guard face gages in frogs shall be within the limits... frog to the guard line 1 of its guard rail or guarding face, measured across the track at right...

  9. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Frog guard rails and guard faces; gage. 213.143... and guard faces; gage. The guard check and guard face gages in frogs shall be within the limits... frog to the guard line 1 of its guard rail or guarding face, measured across the track at right...

  10. National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK

    PubMed Central

    Dixon, Peter A; Kirkham, Jamie J; Marson, Anthony G; Pearson, Mike G

    2015-01-01

    Objectives About 100 000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013. Setting 154 emergency departments (EDs) across the UK. Participants Data from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure. Primary and secondary outcome measures Details were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level. Results Of those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability. Conclusions These results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients. PMID:25829372

  11. Activity-based funding for National Health Service hospitals in England: managers' experience and expectations.

    PubMed

    Sussex, Jonathan; Farrar, Shelley

    2009-05-01

    Activity-based funding of hospital services has been introduced progressively since 2003 in the National Health Service (NHS) in England, under the name 'Payment by Results' (PbR). It represents a major change from previous funding arrangements based on annual "block" payments for large bundles of services. We interviewed senior local NHS managers about their experience and expectations of the impact of PbR. A high degree of 'NHS solidarity' was apparent, and competition between NHS hospitals was muted. PbR has been introduced against a background of numerous other efficiency incentives, and managers did not detect a further PbR-specific boost to efficiency. No impact on care quality, either positive or negative, is yet evident. PMID:18679733

  12. National Trends in Pediatric Lupus Hospitalizations in the United States: 2000-2009

    PubMed Central

    Knight, Andrea M; Weiss, Pamela F; Morales, Knashawn H; Keren, Ron

    2016-01-01

    Objective In the setting of recent healthcare advances and emphasis on reduced spending, we aimed to characterize US trends in inpatient healthcare utilization and mortality for pediatric SLE. Methods We performed a retrospective, serial, cross-sectional analysis of the national Kids’ Inpatient Database (years 2000, 2003, 2006 & 2009). We identified patients aged 2 up to 21 years with SLE using an International Classification of Diseases, Ninth Revision [ICD-9] code of 710.0 listed as a discharge diagnosis. Using sampling weights, we estimated trends in hospitalization, inpatient mortality, procedure rates and length of stay (LOS). We analyzed patient and hospital-specific risk factors for mortality and LOS, and compared these outcomes to those without SLE. Results We identified 26,903 estimated pediatric SLE hospitalizations. The hospitalization rate of 8.6 (95% confidence interval [CI] 7.6-9.6) per 100,000 population and mean LOS of 5.9 days (95%CI 5.6-6.2) were stable over time. We found a significant downward trend in mortality, decreasing from 1% to 0.6% (p=0.04), which paralleled a less pronounced trend for those without SLE. The rate of dialysis, blood transfusions, and vascular catheterization procedures increased. Patients with SLE nephritis and non-White race were at risk for increased healthcare utilization and death. Conclusion Pediatric SLE hospitalization rate and LOS remained stable, but inpatient mortality decreased as the rate of common therapeutic procedures increased. More research is needed to understand the drivers of these relationships. PMID:24488419

  13. Predictive Factors of Hospital Mortality Due to Myocardial Infarction: A Multilevel Analysis of Iran's National Data

    PubMed Central

    Ahmadi, Ali; Soori, Hamid; Mehrabi, Yadollah; Etemad, Koorosh; Sajjadi, Homeira; Sadeghi, Mehraban

    2015-01-01

    Background: Regarding failure to establish the statistical presuppositions for analysis of the data by conventional approaches, hierarchical structure of the data as well as the effect of higher-level variables, this study was conducted to determine the factors independently associated with hospital mortality due to myocardial infarction (MI) in Iran using a multilevel analysis. Methods: This study was a national, hospital-based, and cross-sectional study. In this study, the data of 20750 new MI patients between April, 2012 and March, 2013 in Iran were used. The hospital mortality due to MI was considered as the dependent variable. The demographic data, clinical and behavioral risk factors at the individual level and environmental data were gathered. Multilevel logistic regression models with Stata software were used to analyze the data. Results: Within 1-year of study, the frequency (%) of hospital mortality within 30 days of admission was derived 2511 (12.1%) patients. The adjusted odds ratio (OR) of mortality with (95% confidence interval [CI]) was derived 2.07 (95% CI: 1.5–2.8) for right bundle branch block, 1.5 (95% CI: 1.3–1.7) for ST-segment elevation MI, 1.3 (95% CI: 1.1–1.4) for female gender, and 1.2 (95% CI: 1.1–1.3) for humidity, all of which were considered as risk factors of mortality. But, OR of mortality was 0.7 for precipitation (95% CI: 0.7–0.8) and 0.5 for angioplasty (95% CI: 0.4–0.6) were considered as protective factors of mortality. Conclusions: Individual risk factors had independent effects on the hospital mortality due to MI. Variables in the province level had no significant effect on the outcome of MI. Increasing access and quality to treatment could reduce the mortality due to MI. PMID:26730342

  14. National Epidemiologic Surveys of Enterobacter aerogenes in Belgian Hospitals from 1996 to 1998

    PubMed Central

    De Gheldre, Y.; Struelens, M. J.; Glupczynski, Y.; De Mol, P.; Maes, N.; Nonhoff, C.; Chetoui, H.; Sion, C.; Ronveaux, O.; Vaneechoutte, M.

    2001-01-01

    Two national surveys were conducted to describe the incidence and prevalence of Enterobacter aerogenes in 21 Belgian hospitals in 1996 and 1997 and to characterize the genotypic diversity and the antimicrobial resistance profiles of clinical strains of E. aerogenes isolated from hospitalized patients in Belgium in 1997 and 1998. Twenty-nine hospitals collected 10 isolates of E. aerogenes, which were typed by arbitrarily primed PCR (AP-PCR) using two primers and pulsed-field gel electrophoresis. MICs of 10 antimicrobial agents were determined by the agar dilution method. Beta-lactamases were detected by the double-disk diffusion test and characterized by isoelectric point. The median incidence of E. aerogenes colonization or infection increased from 3.3 per 1,000 admissions in 1996 to 4.2 per 1000 admissions in the first half of 1997 (P < 0.01). E. aerogenes strains (n = 260) clustered in 25 AP-PCR types. Two major types, BE1 and BE2, included 36 and 38% of strains and were found in 21 and 25 hospitals, respectively. The BE1 type was indistinguishable from a previously described epidemic strain in France. Half of the strains produced an extended-spectrum beta-lactamase, either TEM-24 (in 86% of the strains) or TEM-3 (in 14% of the strains). Over 75% of the isolates were resistant to ceftazidime, piperacillin-tazobactam, and ciprofloxacin. Over 90% of the strains were susceptible to cefepime, carbapenems, and aminoglycosides. In conclusion, these data suggest a nationwide dissemination of two epidemic multiresistant E. aerogenes strains in Belgian hospitals. TEM-24 beta-lactamase was frequently harbored by one of these epidemic strains, which appeared to be genotypically related to a TEM-24-producing epidemic strain from France, suggesting international dissemination. PMID:11230400

  15. 9. VIEW OF GUARD HOUSE AT LAUNCH PAD, LOOKING NORTH ...

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

    9. VIEW OF GUARD HOUSE AT LAUNCH PAD, LOOKING NORTH Marilyn Ziemer, photographer, April 1988 - Los Pinetos Nike Missile Site, Santa Clara Road, Los Angeles National Forest, Sylmar, Los Angeles County, CA

  16. 6. VIEW SHOWING GUARD HOUSE, STORAGE, AND TWO LAUNCH PAD ...

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

    6. VIEW SHOWING GUARD HOUSE, STORAGE, AND TWO LAUNCH PAD UNITS, LOOKING NORTH Marilyn Ziemer, photographer, April 1988 - Los Pinetos Nike Missile Site, Santa Clara Road, Los Angeles National Forest, Sylmar, Los Angeles County, CA

  17. Epidemiological and clinical aspects of carcinoma of penis at Kenyatta National Hospital.

    PubMed

    Magoha, G A; Kaale, R F

    1995-06-01

    Thirty one patients with carcinoma of penis were studied retrospectively at Kenyatta National Hospital, Nairobi, over a 20-year period (1971-1990). The majority of patients presented late with symptomatology of over one year duration. 88% of patients with carcinoma were uncircumcised, while the three (12%) patients who were circumcised but developed carcinoma were all circumcised late in adolescence and adulthood, confirming that late circumcision may not protect one from developing penile carcinoma as reported in literature. These findings also indicate that carcinoma of penis may be rare in this locality but is still common among the uncircumcised African tribes. PMID:7498003

  18. Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

    PubMed Central

    Petrie, J; Easton, S; Naik, V; Lockie, C; Brett, S J; Stümpfle, R

    2015-01-01

    Objectives There is a scarcity of literature reporting hospital costs for treating out of hospital cardiac arrest (OOHCA) survivors, especially within the UK. This is essential for assessment of cost-effectiveness of interventions necessary to allow just allocation of resources within the National Health Service. We set out primarily to calculate costs stratified against hospital survival and neurological outcomes. Secondarily, we estimated cost effectiveness based on estimates of survival and utility from previous studies to calculate costs per quality adjusted life year (QALY). Setting We performed a single centre (London) retrospective review of in-hospital costs of patients admitted to the intensive care unit (ICU) following return of spontaneous circulation (ROSC) after OOHCA over 18 months from January 2011 (following widespread introduction of targeted temperature management and primary percutaneous intervention). Participants Of 69 successive patients admitted over an 18-month period, survival and cerebral performance category (CPC) outcomes were obtained from review of databases and clinical notes. The Trust finance department supplied ICU and hospital costs using the Payment by Results UK system. Results Of those patients with ROSC admitted to ICU, survival to hospital discharge (any CPC) was 33/69 (48%) with 26/33 survivors in CPC 1–2 at hospital discharge. Cost per survivor to hospital discharge (including total cost of survivors and non-survivors) was £50 000, cost per CPC 1–2 survivor was £65 000. Cost and length of stay of CPC 1–2 patients was considerably lower than CPC 3–4 patients. The majority of the costs (69%) related to intensive care. Estimated cost per CPC 1–2 survivor per QALY was £16 000. Conclusions The costs of in-hospital patient care for ICU admissions following ROSC after OOHCA are considerable but within a reasonable threshold when assessed from a QALY perspective. PMID:25838503

  19. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  20. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty Investigations § 4.40-30 Procedures for...

  1. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  2. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  3. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  4. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  5. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  6. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  7. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty Investigations § 4.40-35 Records of the...

  8. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  9. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  10. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  11. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  12. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  13. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  14. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty Investigations § 4.40-10...

  15. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  16. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  17. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  18. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty...

  19. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  20. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  1. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty Investigations § 4.40-25...

  2. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  3. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  4. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  5. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  6. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  7. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  8. 'Shell shock' revisited: an examination of the case records of the National Hospital in London.

    PubMed

    Linden, Stefanie Caroline; Jones, Edgar

    2014-10-01

    During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain's leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient's military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria. PMID:25284893

  9. Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings

    PubMed Central

    Jena, Anupam B.; Prasad, Vinay; Goldman, Dana P.; Romley, John

    2014-01-01

    IMPORTANCE Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. OBJECTIVE To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57 471 during 492 nonmeeting days; heart failure, 19 282 during meeting days and 11 4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low-and high-risk patients. Differences in treatment utilization were assessed. EXPOSURES Hospitalization during cardiology meeting dates. MAIN OUTCOMES AND MEASURES Thirty-day mortality, procedure rates, charges, length of stay. RESULTS Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%–21.2%] vs 24.8% [95% CI, 22.9%–26.6%]; P < .001; cardiac arrest, 59.1% [95% CI, 51.4%–66.8%] vs 69.4% [95% CI, 66.2%–72.6%]; P = .01). Adjusted mortality for high-risk AMI in teaching hospitals was similar between meeting and nonmeeting dates (39.2% [95% CI, 31.8%–46.6%] vs 38.5% [95% CI, 35.0%–42.0%]; P = .86), although adjusted percutaneous coronary intervention (PCI) rates were lower during meetings (20.8% vs 28.2%; P = .02). No mortality or utilization differences existed for low-risk patients in teaching hospitals or high- or low-risk patients in nonteaching hospitals. In sensitivity analyses, cardiac mortality was not affected by hospitalization during oncology, gastroenterology, and orthopedics meetings, nor was gastrointestinal hemorrhage or hip fracture mortality affected by hospitalization during cardiology meetings. CONCLUSIONS AND RELEVANCE High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive PCI, without any mortality effect. PMID:25531231

  10. Suicide and War: The Mediating Effects of Negative Mood, Posttraumatic Stress Disorder Symptoms, and Social Support among Army National Guard Soldiers

    ERIC Educational Resources Information Center

    Griffith, James

    2012-01-01

    The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard…

  11. Helper, Guard or Mediator? Teachers' Space for Action in "The Cultural Rucksack," a Norwegian National Program for Arts and Culture in Schools

    ERIC Educational Resources Information Center

    Christophersen, Catharina

    2013-01-01

    Arts encounters in schools are often portrayed as encounters between art/artists and children. However, in such encounters, teachers are most often involved. The study presented discusses teachers' experiences with and space for action within The Cultural Rucksack; a national program for arts and culture in Norwegian schools. Observations and…

  12. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    PubMed

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease. PMID:24443075

  13. Are primary care factors associated with hospital episodes for adverse drug reactions? A national observational study

    PubMed Central

    McKay, Ailsa J; Newson, Roger B; Soljak, Michael; Riboli, Elio; Car, Josip

    2015-01-01

    Objective Identification of primary care factors associated with hospital admissions for adverse drug reactions (ADRs). Design and setting Cross-sectional analysis of 2010–2012 data from all National Health Service hospitals and 7664 of 8358 general practices in England. Method We identified all hospital episodes with an International Classification of Diseases (ICD) 10 code indicative of an ADR, in the 2010–2012 English Hospital Episode Statistics (HES) admissions database. These episodes were linked to contemporary data describing the associated general practice, including general practitioner (GP) and patient demographics, an estimate of overall patient population morbidity, measures of primary care supply, and Quality and Outcomes Framework (QOF) quality scores. Poisson regression models were used to examine associations between primary care factors and ADR-related episode rates. Results 212 813 ADR-related HES episodes were identified. Rates of episodes were relatively high among the very young, older and female subgroups. In fully adjusted models, the following primary care factors were associated with increased likelihood of episode: higher deprivation scores (population attributable fraction (PAF)=0.084, 95% CI 0.067 to 0.100) and relatively poor glycated haemoglobin (HbA1c) control among patients with diabetes (PAF=0.372; 0.218 to 0.496). The following were associated with reduced episode likelihood: lower GP supply (PAF=−0.016; −0.026 to −0.005), a lower proportion of GPs with UK qualifications (PAF=−0.035; −0.058 to −0.012), lower total QOF achievement rates (PAF=−0.021; −0.042 to 0.000) and relatively poor blood pressure control among patients with diabetes (PAF=−0.144; −0.280 to −0.022). Conclusions Various aspects of primary care are associated with ADR-related hospital episodes, including achievement of particular QOF indicators. Further investigation with individual level data would help develop understanding of the associations identified. Interventions in primary care could help reduce the ADR burden. ADRs are candidates for primary care sensitive conditions. PMID:26715478

  14. Public hospital quality report awareness: evidence from National and Californian Internet searches and social media mentions, 2012

    PubMed Central

    Huesch, Marco D; Currid-Halkett, Elizabeth; Doctor, Jason N

    2014-01-01

    Objectives Publicly available hospital quality reports seek to inform consumers of important healthcare quality and affordability attributes, and may inform consumer decision-making. To understand how much consumers search for such information online on one Internet search engine, whether they mention such information in social media and how positively they view this information. Setting and design A leading Internet search engine (Google) was the main focus of the study. Google Trends and Google Adwords keyword analyses were performed for national and Californian searches between 1 August 2012 and 31 July 2013 for keywords related to ‘top hospital’, best hospital’, and ‘hospital quality’, as well as for six specific hospital quality reports. Separately, a proprietary social media monitoring tool was used to investigate blog, forum, social media and traditional media mentions of, and sentiment towards, major public reports of hospital quality in California in 2012. Primary outcome measures (1) Counts of searches for keywords performed on Google; (2) counts of and (3) sentiment of mentions of public reports on social media. Results National Google search volume for 75 hospital quality-related terms averaged 610 700 searches per month with strong variation by keyword and by state. A commercial report (Healthgrades) was more commonly searched for nationally on Google than the federal government's Hospital Compare, which otherwise dominated quality-related search terms. Social media references in California to quality reports were generally few, and commercially produced hospital quality reports were more widely mentioned than state (Office of Statewide Healthcare Planning and Development (OSHPD)), or non-profit (CalHospitalCompare) reports. Conclusions Consumers are somewhat aware of hospital quality based on Internet search activity and social media disclosures. Public stakeholders may be able to broaden their quality dissemination initiatives by advertising on Google or Twitter and using social media interactively with consumers looking for relevant information. PMID:24618223

  15. High Survival Rates and Associated Factors Among Ebola Virus Disease Patients Hospitalized at Donka National Hospital, Conakry, Guinea

    PubMed Central

    Qureshi, Adnan I.; Chughtai, Morad; Bah, Elhadj Ibrahima; Barry, Moumié; Béavogui, Kézély; Loua, Tokpagnan Oscar; Malik, Ahmed A.

    2015-01-01

    Background Anecdotal reports suggesting that survival rates among hospitalized patients with Ebola virus disease in Guinea are higher than the 29.2% rate observed in the current epidemic in West Africa. Methods Survival after symptom onset was determined using Kaplan Meier survival methods among patients with confirmed Ebola virus disease treated in Conakry, Guinea from March 25, 2014, to August 5, 2014. We analyzed the relationship between survival and patient factors, including demographics and clinical features. Results Of the 70 patients analyzed [mean age ± standard deviation (SD), 34 ± 14.1; 44 were men], 42 were discharged alive with a survival rate among hospitalized patients of 60% (95% confidence interval, 41.5–78.5%). The survival rate was 28 (71.8%) among 39 patients under 34 years of age, and 14 (46.7%) among 30 patients aged 35 years or greater (p = 0.034). The rates of myalgia (3 of 42 versus 7 of 28, p = 0.036) and hiccups (1 of 42 versus 5 of 28, p = 0.023) were significantly lower among patients who survived. Conclusions Our results provide insights into a cohort of hospitalized patients with Ebola virus disease in whom survival is prominently higher than seen in other cohorts of hospitalized patients. PMID:25992182

  16. Biomaterials use in Mulago National Referral Hospital in Kampala, Uganda: Access and affordability.

    PubMed

    Bakwatanisa, Bosco; Enywaku, Alfred; Kiwanuka, Martin; Lamunu, Claire; Mbowa, Nicholas; Mukiibi, Denis; Namayega, Catherine; Ngabirano, Beryl; Ntambi, Henry; Reichert, William

    2016-01-01

    Students in Biomaterials BBE3102 at Makerere University in Kampala, Uganda were assigned semester long group projects in the first semester of the 2014-15 academic year to determine the biomaterials type and usage in Mulago National Referral Hospital, which is emblematic of large public hospitals across East Africa. Information gathering was conducted through student interviews with Mulago physicians because there were no archival records. The students divided themselves into seven project groups covering biomaterials use in the areas of wound closure, dental and oral surgery, cardiology, burn care, bone repair, ophthalmology and total joint replacement. As in the developed world, the majority of biomaterials used in Mulago are basic wound closure materials, dental materials, and bone fixation materials, all of which are comparatively inexpensive, easy to store, and readily available from either the government or local suppliers; however, there were significant issues with the implant supply chain, affordability, and patient compliance and follow-up in cases where specialty expertise and expensive implants were employed. PMID:26190587

  17. The New Zealand national junior doctors' strike: implications for the provision of acute hospital medical services.

    PubMed

    Robinson, Geoffrey; McCann, Kieran; Freeman, Peter; Beasley, Richard

    2008-06-01

    The New Zealand junior doctors' strike provided an opportunity to consider strategies that might be employed to overcome the international shortage of junior doctors. This article reports the experience of the emergency department (ED) and internal medicine (IM) services at Wellington Hospital during the national strike, in which medical services were primarily provided by specialist consultants in addition to, or as part of, their routine work. During the strike, elective admissions and outpatient clinics were mostly cancelled. In the ED, the waiting times and length of stay were markedly reduced. In IM, the proportion of patients admitted to the short stay unit rather than the general medical wards increased. Notwithstanding the different work circumstances, in both services one senior doctor carried the workload of at least two junior doctors. The deployment of additional senior medical staff to acute hospital services could greatly reduce the total number of doctors required. This strategy would have implications in terms of supporting acute medicine specialty initiatives, training, quality of care and funding. PMID:18624033

  18. [From the medieval hospitals hospices to modern National public Health Institutes].

    PubMed

    de Micheli, Alfredo

    2016-01-01

    Since the most ancient times, hospital constructions and progresses in the clinical practice advanced pari passu. We can find exampless of this statement in Greek regions as well as in Greek citie overseas. Thus, during the renaissance, great figures ot that time converged in Italy: The genius Leonardo da Vinci (1452-1519) and Leon Battista Alberti (1404-1472), a humanist and innovator of architecture. Michelangelo Buonarroti (1475-1564) and his contemporany artists performed anatomical dissection to perfect their art by studying the human body. Anatomical studies flourished at the University of Padua, driven by the Flemish Master. Based on the rigorous study of the anatomical substrate, the studies on the function of the already known organic structures excelled in the xvii century. That century started with the revelation of the major blood circulation by the British physician William Harvey, alumni of the University of Padua, and continued with the description of the minior or pulmonary circulation by ancient or contemporany authors and of the peripheral connections between the arterial and the venous system (Marcelo Malpighi, 1661). All these researchers, and others, were membres of the University of Padua, were the beneficial influence of the teachings of Galileo persisted. In the following centuries, together with the embryological and normal anatomy, the pathological anatomy, systematized by G.B. Morgani, became the cornerstone of the clinical practice. The model of the ancient hospitals evolved to ward the National Institutes of Health in Mexico fostered by Dr. Ignacio Chávez. PMID:25862293

  19. Aetiology and distribution of mandibular fractures in the National University Hospital, Singapore.

    PubMed

    Tan, W K; Lim, T C

    1999-09-01

    Sixty-seven consecutive mandibular fractures treated mainly in 1998 were surveyed retrospectively. Treatment was performed at the National University Hospital, Singapore. Males outnumbered females by 5:1, with Chinese the commonest racial group involved (56.7%). Most patients were between 20 and 29 years of age. Road traffic accidents formed the largest proportion (61.2%) followed by industrial accidents and assaults. The symphyseal and parasymphyseal regions were most commonly fractured (46.5%). Almost a third of the patients sustained other facial fractures. Treatment was commonly administered within one to two days of discovery of the fracture and open reduction was the treatment plan of choice in 79.1% of the time. Discussion on how aetiology affects the fracture pattern in Singapore is carried out. PMID:10597344

  20. [Acute abdomen in patients with HIV/AIDS seen in a national hospital of Lima, Peru].

    PubMed

    Montoya, Leonor; Rodríguez, Ericka; Zúñiga, Grace; Yamamoto, Gaby; González, Elsa

    2014-01-01

    The aim of this study was to describe the features in the presentation and management of acute abdomen (AA) in patients with human immunodeficiency virus (HIV). We reviewed the medical records of 97 HIV patients who presented with AA and were seen in 2006-2011 at Cayetano Heredia National Hospital in Lima, Peru. 1.6% of immunosuppressed patients underwent surgery. Appendectomy was the most common surgical procedure (33.3%). Morbidity was 28.1% and postoperative mortality was 9.4%. Infection by mycobacterium tuberculosis was the most common cause of acute abdominal pain, at 26.8%. Data suggest that an early surgical decision for cases of AA in HIV patients may prevent significant morbidity and mortality. PMID:25418651

  1. Does hospital competition harm equity? Evidence from the English National Health Service.

    PubMed

    Cookson, Richard; Laudicella, Mauro; Li Donni, Paolo

    2013-03-01

    Increasing evidence shows that hospital competition under fixed prices can improve quality and reduce cost. Concerns remain, however, that competition may undermine socio-economic equity in the utilisation of care. We test this hypothesis in the context of the pro-competition reforms of the English National Health Service progressively introduced from 2004 to 2006. We use a panel of 32,482 English small areas followed from 2003 to 2008 and a difference in differences approach. The effect of competition on equity is identified by the interaction between market structure, small area income deprivation and year. We find a negative association between market competition and elective admissions in deprived areas. The effect of pro-competition reform was to reduce this negative association slightly, suggesting that competition did not undermine equity. PMID:23419634

  2. Dying in two acute hospitals: would usual care meet Australian national clinical standards?

    PubMed

    Clark, Katherine; Byfieldt, Naomi; Green, Malcolm; Saul, Peter; Lack, Jill; Philips, Jane L

    2014-05-01

    The Australian Commission for Quality and Safety in Health Care (ACQSHC) has articulated 10 clinical standards with the aim of improving the consistency of quality healthcare delivery. Currently, the majority of Australians die in acute hospitals. But despite this, no agreed standard of care exists to define the minimum standard of care that people should accept in the final hours to days of life. As a result, there is limited capacity to conduct audits that focus on the gap between current care and recommended care. There is, however, accumulating evidence in the end of life literature to define which aspects of care are likely to be considered most important to those people facing imminent death. These themes offer standards against which to conduct audits. This is very apt given the national recommendation that healthcare should be delivered in the context of considering people's wishes while always treating people with dignity and respect. PMID:24589365

  3. Time, expectation and satisfaction: Patients’ experience at National Hospital Abuja, Nigeria

    PubMed Central

    Mora, Muhammad

    2012-01-01

    Abstract Background Long patient-clinic encounter time is typical of many hospital general outpatient departments (OPD) in Nigeria. Objectives The objectives of our study were to determine the time spent by patients at the service points in the general OPD of the National Hospital Abuja (NHA), to establish the perception of patients regarding the patient–clinic encounter time, and to describe the level of satisfaction of patients with the services received. Methods A cross-sectional study was conducted at the general OPD of the NHA. Information relating to the time spent at the various service points amongst others were obtained from 320 randomly selected patients using a patient administered validated questionnaire. Results Two hundred and seventy (84.4%) patients responded adequately and were analysed. The median patient–clinic encounter time was 2.7 hours (range 0.2–7.2 hours). The long patient–clinic encounter time was accounted for mainly by the waiting time to see a doctor which was a median of 1 hour (range 0–5.6 hours) and time spent at the medical records with median of 0.5 hours (range 0–5 hours). There was a significant relationship between a short waiting time as perceived by patients, clinic visit encounters where patients’ expectations were met or surpassed, and overall patient satisfaction with the clinic visit encounter (p < 0.001). Conclusion Reduction in patient–clinic encounter time and meeting patients’ pre-visit expectations could significantly improve patient satisfaction after clinic visit encounter at the general OPD of NHA.

  4. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

  5. The Implications of the National Minimum Wage for Training Practices and Skill Utilisation in the United Kingdom Hospitality Industry

    ERIC Educational Resources Information Center

    Norris, Gill; Williams, Steve; Adam-Smith, Derek

    2003-01-01

    Two key issues thrown up by the 1999 introduction of the National Minimum Wage (NMW) in the United Kingdom are its likely impact on employers' training practices in low paying sectors of the economy and the implications for skills. Based on a study of the hospitality industry, this article assesses the limited significance of the differential,…

  6. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM

  7. Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Kim, Seok; Kim, Taegi; Kim, Jon Soo; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb

    2012-01-01

    Objectives The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. Methods Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. Results Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. Conclusions Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation. PMID:23346476

  8. A national study of the efficiency of hospitals in urban markets.

    PubMed Central

    Ozcan, Y A; Luke, R D

    1993-01-01

    Using a sample of 3,000 urban hospitals, this article examines the contributions of selected hospital characteristics to variations in hospital technical efficiencies, while it accounts for multiple products and inputs, and controls for local environmental variations. Four hospital characteristics are examined: hospital size, membership in a multihospital system, ownership, and payer mix (managed care contracts, percent Medicare, and percent Medicaid). Ownership and percent Medicare are consistently found to be related significantly to hospital efficiency. Within the ownership variable, government hospitals tend to be more efficient and for-profit hospitals less efficient than other hospitals. Higher percentages of Medicare payment are negatively related to efficiency. While not consistently significant across all five of the MSA size categories in which the analyses are conducted, possession of managed care contracts, membership in a multihospital system, and size all are consistently related positively to hospital technical efficiency. These variables are also all significant when the hospitals are examined in a combined analysis. Percent Medicaid was not significant in any of the analyses. Implications for policy and the need for methodological work are discussed. PMID:8428810

  9. Challenges of implementing national guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus colonization or infection in acute care hospitals in the Republic of Ireland.

    PubMed

    Fitzpatrick, Fidelma; Roche, Fiona; Cunney, Robert; Humphreys, Hilary

    2009-03-01

    Of the 49 acute care hospitals in Ireland that responded to the survey questionnaire drafted by the Infection Control Subcommittee of the Health Protection Surveillance Centre's Strategy for the Control of Antimicrobial Resistance in Ireland, 43 reported barriers to the full implementation of national guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus infection; these barriers included poor infrastructure (42 hospitals), inadequate laboratory resources (40 hospitals), inadequate staffing (39 hospitals), and inadequate numbers of isolation rooms and beds (40 hospitals). Four of the hospitals did not have an educational program on hand hygiene, and only 17 had an antibiotic stewardship program. PMID:19193017

  10. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false The Commandant of the Coast Guard. 700.602 Section 700.602 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The United States Coast Guard (When Operating as a Service...

  11. National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.

    PubMed

    Best, Matthew J; Buller, Leonard T; Miranda, Alejandro

    2015-01-01

    Foot and ankle arthrodesis reliably reduces pain and functional disability among patients with arthritis and deformity. Since its introduction in 1953, improvements in surgical technique have enhanced the outcomes and reduced complications. However, little is known regarding US national trends of foot and ankle arthrodesis. The present study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the usage of inpatient and ambulatory foot and ankle arthrodesis. Cases of foot and ankle arthrodesis were identified using the National Hospital Discharge Survey and National Survey of Ambulatory Surgery, and the data were analyzed for trends in demographics, treatment, and usage. From 1994 to 2006, the population-adjusted rates of foot and ankle arthrodeses increased by 146% (8.2/100,000 capita to 20.2/100,000 capita). The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858%. The population-adjusted rate of outpatient and inpatient procedures increased by 415% and 17%, respectively. The gender-adjusted rates increased by 59% for males and 209% for females. The age-adjusted rates increased among patients >35 years old in both settings. The use of peripheral nerve blocks during ambulatory procedures increased from 3.3% to 10.1%. Private insurance was the largest compensator. In conclusion, the rate of foot and ankle arthrodesis increased dramatically from 1990 to 2007 using the most up-to-date publicly available data. Knowledge of these national practice patterns could aid policy-makers and surgeons in appropriately allocating healthcare resources to ensure quality patient care. PMID:26213159

  12. User inspection of National Taiwan University Hospital's telehealth care information system.

    PubMed

    Wu, Pei Hsuan; Chen, Chi-Huang; Chen, Hui-Te; Shu, Che-Hsuan; Lin, Feng-Sheng; Wang, Yi-Van; Li, Hao-Jhun; Wu, Yuan-Ting; Lai, Feipei

    2010-01-01

    The telehealth care system has been important in the healthcare world for several decades; however, Taiwan only began work on telehealth care this past year. This paper outlines the effectiveness of the telehealth care system developed by the National Taiwan University Hospital (NTUH). The usability of the integrated telehealth care system was analyzed through of heuristic evaluation and its usefulness. By using the heuristic evaluation form as developed by Nielsen, it is possible to examine the telehealth care system from the user's perspective. In addition, in assessing the usefulness through lists of criteria, system developers can determine the pros and the cons of the database. Ultimately, the heuristic evaluation revealed several violations on the system, but are not prohibitive to the development of such as system. Similarly, evaluation of the usefulness comes out positive; despite the fact that the suggested changes proposed by the users can be said are the main weaknesses of the system. With some improvements, the telehealth care system can be used efficiently in NTUH's healthcare system. PMID:21095791

  13. Clinical and conventional pharmacy services in Polish hospitals: a national survey.

    PubMed

    Pawłowska, Iga; Pawłowski, Leszek; Kocić, Ivan; Krzyżaniak, Natalia

    2016-04-01

    Background Pharmacist-led care services within the hospital pharmacy setting have a significant impact on efficient drug management processes. The work of pharmacists is directly associated with the provision of drugs and medical supplies along with additional clinical, administrative, organizational and educational duties. Depending on the country, these practice roles may differ to a significant extent. Objective The aim of this research was to explore the role of the hospital pharmacist and the provision of both clinical and traditional pharmaceutical services for patients and medical staff in Polish general hospitals. Setting Hospital pharmacies from all general hospitals in Poland. Method A cross-sectional study was conducted, utilizing an anonymous questionnaire as the research instrument. Heads of hospital pharmacies were requested to participate in this study and complete the questionnaire. The survey was initially piloted to improve the research method. Main outcome measure The types of pharmaceutical services performed in Polish general hospitals. Results 166 hospital pharmacies took part in this survey. The overall response rate was 60.8 %. The total number of full-time equivalent (FTE) professionals employed within the surveyed hospital pharmacies was approximately 833. The procurement and distribution of drugs were identified as pharmaceutical services performed by most of the participants. The significant majority of pharmacists were also involved in compounding, adverse drug reaction monitoring and rational drug management services. Eleven (7 %) of the responding pharmacists had direct contact with patients and 7 (4 %) pharmacists took part in ward rounds. More precise legal regulations regarding hospital pharmacy practice were measures indicated by most pharmacists as necessary changes required in the hospital pharmacy system. Conclusion Polish hospital pharmacists provide various pharmaceutical services. Their work is closely related with direct provision of drugs. There is an observed inadequate level of clinical services provided in comparison to clinical settings in other countries. PMID:26739130

  14. A Qualitative Exploration of Workarounds Related to the Implementation of National Electronic Health Records in Early Adopter Mental Health Hospitals

    PubMed Central

    Ser, Gloria; Robertson, Ann; Sheikh, Aziz

    2014-01-01

    Aims To investigate the perceptions and reported practices of mental health hospital staff using national hospital electronic health records (EHRs) in order to inform future implementations, particularly in acute mental health settings. Methods Thematic analysis of interviews with a wide range of clinical, information technology (IT), managerial and other staff at two early adopter mental health National Health Service (NHS) hospitals in London, UK, implementing national EHRs. Results We analysed 33 interviews. We first sought out examples of workarounds, such as delayed data entry, entering data in wrong places and individuals using the EHR while logged in as a colleague, then identified possible reasons for the reported workarounds. Our analysis identified four main categories of factors contributing to workarounds (i.e., operational, cultural, organisational and technical). Operational factors included poor system integration with existing workflows and the system not meeting users' perceived needs. Cultural factors involved users' competence with IT and resistance to change. Organisational factors referred to insufficient organisational resources and training, while technical factors included inadequate local technical infrastructure. Many of these factors, such as integrating the EHR system with day-to-day operational processes, staff training and adequate local IT infrastructure, were likely to apply to system implementations in various settings, but we also identified factors that related particularly to implementing EHRs in mental health hospitals, for example: EHR system incompatibility with IT systems used by mental health–related sectors, notably social services; the EHR system lacking specific, mental health functionalities and options; and clinicians feeling unable to use computers while attending to distressed psychiatric patients. Conclusions A better conceptual model of reasons for workarounds should help with designing, and supporting the implementation and adoption of, EHRs for use in hospital mental health settings. PMID:24454678

  15. Prevalence and Characterization of Carbapenem-Resistant Enterobacteriaceae Isolated from Mulago National Referral Hospital, Uganda

    PubMed Central

    Okoche, Deogratius; Asiimwe, Benon B.; Katabazi, Fred Ashaba; Kato, Laban; Najjuka, Christine F.

    2015-01-01

    Introduction Carbapenemases have increasingly been reported in enterobacteriaceae worldwide. Most carbapenemases are plasmid encoded hence resistance can easily spread. Carbapenem-resistant enterobacteriaceae are reported to cause mortality in up to 50% of patients who acquire bloodstream infections. We set out to determine the burden of carbapenem resistance as well as establish genes encoding for carbapenemases in enterobacteriaceae clinical isolates obtained from Mulago National Referral Hospital, Uganda. Methods This was a cross-sectional study with a total of 196 clinical isolates previously collected from pus swabs, urine, blood, sputum, tracheal aspirates, cervical swabs, endomentrial aspirates, rectal swabs, Vaginal swabs, ear swabs, products of conception, wound biopsy and amniotic fluid. All isolates were subjected to phenotypic carbapenemase screening using Boronic acid-based inhibition, Modified Hodge and EDTA double combined disk test. In addition, all the isolates were subjected to PCR assay to confirm presence of carbapenemase encoding genes. Results The study found carbapenemase prevalence of 22.4% (44/196) in the isolates using phenotypic tests, with the genotypic prevalence slightly higher at 28.6% (56/196). Over all, the most prevalent gene was blaVIM (21,10.7%), followed by blaOXA-48 (19, 9.7%), blaIMP (12, 6.1%), blaKPC (10, 5.1%) and blaNDM-1 (5, 2.6%). Among 56 isolates positive for 67 carbapenemase encoding genes, Klebsiella pneumonia was the species with the highest number (52.2%). Most 32/67(47.7%) of these resistance genes were in bacteria isolated from pus swabs. Conclusion There is a high prevalence of carbapenemases and carbapenem-resistance encoding genes among third generation cephalosporins resistant Enterobacteriaceae in Uganda, indicating a danger of limited treatment options in this setting in the near future. PMID:26284519

  16. Validation of stroke diagnosis in the National Hospital Discharge Register and the Register of Causes of Death in Finland.

    PubMed

    Leppälä, J M; Virtamo, J; Heinonen, O P

    1999-02-01

    The validity of stroke diagnosis in the National Hospital Discharge Register and the Register of Causes of Death was examined among 546 middle-aged men in Finland. The subjects were cases of cerebrovascular diseases of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study and identified by record linkage to the registers. In all, 375 events with cerebrovascular disease as hospital discharge diagnosis and 218 events with cerebrovascular disease as the underlying cause of death were reviewed using specific criteria modified from the classifications of the National Survey of Stroke and the WHO MONICA Study. For hospital stroke diagnoses, there was agreement on diagnosis for all strokes in 90%, for subarachnoid hemorrhage in 79%, intracerebral hemorrhage in 82%, and cerebral infarction in 90%. The respective agreement rates for stroke as the underlying cause of death were 97%, 95%, 91%, and 92%. The data were insufficient for review in 1% and 3% of the stroke events, respectively. Age, observation year and trial supplementation with alphatocopherol or beta-carotene had no effect on validity. In conclusion, the validity of stroke diagnosis was good in registers of hospital diagnoses and causes of death justifying their use for endpoint assessment in epidemiological studies. PMID:10204645

  17. Framing in policy processes: a case study from hospital planning in the National Health Service in England.

    PubMed

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

    This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. PMID:25461877

  18. Changes in the monitoring and oversight practices of not-for-profit hospital governing boards 1989-2005: evidence from three national surveys.

    PubMed

    Alexander, Jeffrey A; Lee, Shoou-Yih D; Wang, Virginia; Margolin, Frances S

    2009-04-01

    Despite the legal and practical importance of monitoring and oversight of management by hospital governing boards, there is little empirical evidence of how hospital boards fulfill these roles and the extent to which these practices have changed over time. We utilize data from three national surveys of hospital governance to examine how oversight and monitoring practices in public and private not-for-profit (NFP) hospital boards have changed over time. Findings suggest that board relations with CEOs in NFP hospitals display important but potentially contradictory patterns. On the one hand, NFP hospital boards appear to be exercising more stringent oversight of management and hospital performance. On the other hand, management is more actively involved with governance matters with less separation of board and management. This general pattern varies by the dimension of oversight and monitoring practice and by specific characteristics of NFP hospitals. PMID:19052168

  19. Best practices of hospital security planning for patient surge--a comparative analysis of three national systems.

    PubMed

    Downey, Erin; Hebert, Anjanette

    2010-01-01

    This paper examines three international healthcare security systems as they relate to patient surge in Canada, Israel, and the United States. Its purpose is to compare the systems, to highlight unique characteristics that define those systems, and to initiate the development of best practices that transcend national boundaries. Several significant national characteristics of demographics, healthcare systems, and political climate, among others, present challenges to translating best practices among these three countries. However, we have found that best practice strategies exist in areas of communications, coordination, building design, space adaptability, and patient routing (both from the community to the hospital, as well as within the hospital) that can be shared and incorporated into the healthcare preparedness efforts in all three countries. PMID:20873500

  20. Guard Dark for MCT Programs

    NASA Astrophysics Data System (ADS)

    Long, Knox

    2012-10-01

    The goal of the Guard Dark program is to collect WFC3/IR dark current data prior to each visit in two of the Multi-Cycle Treasury {MCT} programs in Cycle 19. By scheduling a dark current observation between the last pre-MCT observation and the first MCT visit, we will be able to measure any residual persistent signal resulting from the former which may affect the latter.

  1. National Trends in the Use of Inpatient Hospitalization for Combined Abdominoplasty and Breast Surgery

    PubMed Central

    Shaterian, Ashkaun; Masoomi, Hossein; B Martin, Jenna; Paydar, Keyianoosh; A. Wirth, Garrett

    2015-01-01

    BACKGROUND Combined procedures involving elective breast surgery at the time of abdominoplasty are frequently performed procedures in aesthetic plastic surgery. While found to be safe outpatient procedures, many surgeons elect to perform combined abdominoplasty/breast surgery as inpatient surgery. This study was performed to explore the practice of performing the combined procedure as an inpatient in the United States. METHODS The Nationwide Inpatient Sample database was evaluated using ICD-9CM procedural codes to identify hospitalizations where patients underwent abdominoplasty combined with breast surgery. We trended the frequency of this combined procedure, and evaluated the rate of acute post-operative complications, length of inpatient hospitalization, and total hospital charges. RESULTS Between 2004 and 2011, 29,235 combined abdominoplasty/breast procedures were performed as inpatient in United States. The rate of major post-operative complications in the acute hospitalization period was 1.12% and included CVA (0.02%), respiratory failure (0.6%), pneumonia (0.3%), VTE (0.1%), and myocardial infarction (0.1%). Hospitalization averaged 1.8 days and resulted in $31,177 of hospital charges. The demographics of the combined procedure transitioned as i) frequency of inpatient surgeries decreased, ii) percent of patients >50 yr increased, and iii) hospital charges increased from 2004 to 2011. CONCLUSION A significant number of surgeons are performing combined abdominoplasty and elective breast surgery as inpatient procedures in United States. The combined surgery is safe but is associated with small risk of major post-operative complications. A short inpatient hospitalization may be beneficial for high-risk patients interested in combined procedures, but must be analyzed against the rising costs of inpatient surgery. PMID:26284180

  2. Signalling drought in guard cells.

    PubMed

    Luan, S.

    2002-02-01

    A number of environmental conditions including drought, low humidity, cold and salinity subject plants to osmotic stress. A rapid plant response to such stress conditions is stomatal closure to reduce water loss from plants. From an external stress signal to stomatal closure, many molecular components constitute a signal transduction network that couples the stimulus to the response. Numerous studies have been directed to resolving the framework and molecular details of stress signalling pathways in plants. In guard cells, studies focus on the regulation of ion channels by abscisic acid (ABA), a chemical messenger for osmotic stress. Calcium, protein kinases and phosphatases, and membrane trafficking components have been shown to play a role in ABA signalling process in guard cells. Studies also implicate ABA-independent regulation of ion channels by osmotic stress. In particular, a direct osmosensing pathway for ion channel regulation in guard cells has been identified. These pathways form a complex signalling web that monitors water status in the environment and initiates responses in stomatal movements. PMID:11841666

  3. Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

    PubMed Central

    Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

    2015-01-01

    Objectives To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Design Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. Setting 31 English NHS trusts. Participants 12 506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Main outcome measure Patient satisfaction. Results The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Conclusions Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. PMID:26634400

  4. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 7 2014-07-01 2014-07-01 false Machine guarding. 1917.151 Section 1917.151 Labor... (CONTINUED) MARINE TERMINALS Related Terminal Operations and Equipment § 1917.151 Machine guarding. (a...) Danger zones on machines and equipment used by employees shall be guarded. (2) Where chips and...

  5. Profile of women presenting for abortions in Singapore at the National University Hospital.

    PubMed

    Singh, Kuldip; Fong, Y F; Loh, S Y

    2002-07-01

    The study was conducted to profile women seeking abortions at the National University Hospital, with particular interest in the trend of teenage pregnancies with the aim of identifying risk factors for late presentation for abortions. All patients who underwent an abortion at our center from January 1, 1996 to December 31, 2000 were recruited. Data were entered into a prepared questionnaire during the mandatory pre-abortion counseling sessions and completed at the 6-week post-abortion follow-up. This was then keyed into a database (SPSS Version 10), and the results were analyzed. Multivariate analysis was used in identifying risk factors associated with late presentation for abortions. Chi-square analysis of variables was used where relevant. A total of 1370 women presented for induced abortions during the period of study. The mean age of women was 29.6 years. Most women were either homemakers (35.3%) or semi-skilled workers (28.5%) with at least a secondary school education (58.3%). The majority were married (75.5%). There was a significant trend in the proportion of single women seeking abortions, from 18.3% in 1996 to 27.8% in 2000 (p < 0.05). At the same time, the proportion of women presenting for repeat abortions also increased from 13.8% in 1996 to 33.2% in 2000 (p < 0.05). Teenage abortions made up 117 (8.5%) of the study group, of which 95% were single women. Significant proportions (52.1%) were students at the time of abortion. In contrast to women above 20 years of age, pregnant teenagers were more likely not to have used any contraception (67.1% vs. 37.3%) and more likely to present late for abortion (18.8% vs. 10.4%). Teenage pregnancies are a major risk factor for late presentation for abortions. This emphasizes the need for availability and easy access to early abortion counseling, and the need for sex education with use of contraception starting in schools, to reduce abortions among teenagers. PMID:12169380

  6. A&M. Guard house (TAN638), contextual view. Built in 1968. Camera ...

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

    A&M. Guard house (TAN-638), contextual view. Built in 1968. Camera faces south. Guard house controlled access to radioactive waste storage tanks beyond and to left of view. Date: February 4, 2003. INEEL negative no. HD-33-4-1 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  7. Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data

    PubMed Central

    von Theobald, Peter; Cottenet, Jonathan; Iacobelli, Silvia; Quantin, Catherine

    2016-01-01

    We aimed to assess the prevalence of hospitalization for endometriosis in the general population in France and in each French region and to describe temporal trends, rehospitalization rates, and prevalence of the different types of endometriosis. The analyses were carried out on French hospital discharge data and covered the period 2008–2012 and a population of 14,239,197 women of childbearing age. In this population, the prevalence of hospitalization for endometriosis was 0.9%, ranging from 0.4% to 1.6% between regions. Endometriosis affected 1.5% of hospitalized women of childbearing age, ranging from 1.0% to 2.4% between regions. The number of patients hospitalized for endometriosis significantly increased over the study period (p < 0.01). Of these, 4.2% were rehospitalized at least once at one year: ranging from 2.7% to 6.3% between regions. The cumulative rehospitalization rate at 3 years was 6.9%. The types of endometriosis according to the procedures performed were as follows: ovarian (40–50%), peritoneal (20–30%), intestinal (10–20%), and ureteral or bladder (<10%), with significant differences between regions. This is the first detailed epidemiological study of endometriosis in France. Further studies are needed to assess the reasons for the increasing prevalence of endometriosis and for the significant differences in regional prevalence of this disease. PMID:27148550

  8. The National Accreditation Board for Hospital and Health Care Providers accreditation programme in India.

    PubMed

    Gyani, Girdhar J; Krishnamurthy, B

    2014-01-01

    Quality in health care is important as it is directly linked with patient safety. Quality as we know is driven either by regulation or by market demand. Regulation in most developing countries has not been effective, as there is shortage of health care providers and governments have to be flexible. In such circumstances, quality has taken a back seat. Accreditation symbolizes the framework for quality governance of a hospital and is based on optimum standards. Not only is India establishing numerous state of the art hospitals, but they are also experiencing an increase in demand for quality as well as medical tourism. India launched its own accreditation system in 2006, conforming to standards accredited by ISQua. This article shows the journey to accreditation in India and describes the problems encountered by hospitals as well as the benefits it has generated for the industry and patients. PMID:24938026

  9. Final report of the National Health and Hospitals Reform Commission: will we get the health care governance reform we need?

    PubMed

    Stoelwinder, Johannes U

    2009-10-01

    The National Health and Hospitals Reform Commission (NHHRC) has recommended that Australia develop a "single health system", governed by the federal government. Steps to achieving this include: a "Healthy Australia Accord" to agree on the reform framework; the progressive takeover of funding of public hospitals by the federal government; and the possible implementation of a consumer-choice health funding model, called "Medicare Select". These proposals face significant implementation issues, and the final solution needs to deal with both financial and political sustainability. If the federal and state governments cannot agree on a reform plan, the Prime Minister may need to go to the electorate for a mandate, which may be shaped by other economic issues such as tax reform and intergenerational challenges. PMID:19807630

  10. Still making progress to improve the hospital workplace environment? Results from the 2008 National Survey of Registered Nurses.

    PubMed

    Buerhaus, Peter I; DesRoches, Catherine; Donelan, Karen; Hess, Robert

    2009-01-01

    Despite the majority of RNs perceiving a shortage of nurses, findings from the 2008 National Survey of RNs indicate the hospital workplace improved in several areas compared to a 2006 survey. Improvements included the time RNs spend with patients, quality of nursing care, and a decreasing impact of the shortage on delaying nurses' responses to pages or calls, staff communication, patients' wait time for surgery, and timeliness and efficiency of care. Areas the environment was perceived to have worsened included overtime hours, sexual harassment/hostile, and physical violence. RNs hold mixed views about the consequences of reporting errors and mistakes with a majority agreeing that reporting them had led to positive changes to prevent future errors, but that mistakes were held against them. Overall, results suggest that hospital managers can be reassured that their efforts to improve the workplace environment are having their intended effect but, at the same time, important areas for improvement remain. PMID:19927444

  11. Life of a partnership: the process of collaboration between the National Tuberculosis Program and the hospitals in Yogyakarta, Indonesia.

    PubMed

    Probandari, Ari; Utarini, Adi; Lindholm, Lars; Hurtig, Anna-Karin

    2011-11-01

    Public-private partnerships (PPP) for improving the health of populations are currently attracting attention in many countries with limited resources. The Public-Private Mix for Tuberculosis Control is an example of an internationally supported PPP that aims to engage all providers, including hospitals, to implement standardized diagnosis and treatment. This paper explores mainly the local actors' views and experiences of the process of PPP in delivering TB care in hospitals in Yogyakarta Province, Indonesia. The study used a qualitative research design. By maximum variation sampling, 33 informants were purposefully selected. The informants were involved in the Public-Private Mix for Tuberculosis Control in Yogyakarta Province. Data were collected during 2008-2009 by in-depth interview and analyzed using content analysis techniques. Triangulation, reference group checking and peer debriefing were conducted to improve the trustworthiness of the data. This analysis showed that the process of partnership was dynamic. In the early phase of partnership, the National Tuberculosis Program and hospital actors perceived barriers to interaction such as low enthusiasm, lack of confidence, mistrust and inequality of relationships. The existence of an intermediary actor was important for approaching the National Tuberculosis Program and hospitals. After intensive interactions, compromises and acceptance were reached among the actors and even enabled the growth of mutual respect and feelings of programme ownership. However, the partnership faced declining interactions when faced with scarce resources and weak governance. The strategies, power and interactions between actors are important aspects of the process of collaboration. We conclude that good partnership governance is needed for the partnership to be effective and sustainable. PMID:21940084

  12. Melanoma in the Italian Population and Regional Environmental Influences: A National Retrospective Survey on 2001–2008 Hospitalization Records

    PubMed Central

    Piscitelli, Prisco; Neglia, Cosimo; Falco, Andrea; Rivezzi, Matteo; Agnello, Nadia; Argentiero, Alberto; Chitano, Giovanna; Distante, Chiara; Della Rosa, Giulia; Vinci, Giorgia; De Donno, Antonella; Distante, Alessandro; Romanini, Antonella

    2015-01-01

    Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presented by age groups (absolute number of cases from 20 to ≥80 years old) and per Region (rates per 100,000 inhabitants) for each year. Results: The overall number of new hospitalizations due to malignant Melanoma increased by 16.8% from 2001 (n = 4846) to 2008 (n = 5823), with the rate per 100,000 inhabitants passing from 10.5 to almost 12.0 at a national level. The majority of new diagnoses of malignant Melanoma was observed in two age groups: 61–70 years old (from 979 in 2001 up to 1209 in 2008, corresponding to 15.1 and 18.1 new cases per 100,000 inhabitants, respectively) and 71–80 years old (from 954 in 2001 up to 1141 in 2008, corresponding to 19.5 and 21.8 new cases per 100,000 inhabitants, respectively). The number of hospitalizations due to Melanoma increased in all age groups with the only exception of the youngest patients aged 20–30 years old. The highest increases over the 8-year period were observed in people aged ≥81 years old (+34%), 61–70 years old (+20%) and surprisingly in the age group 31–40 years old (+17%). Southern Regions showed lower hospitalization rates compared to Northern Italy and Region Lazio. The highest increases between 2001 and 2008 were observed in Trentino/Alto Adige, Friuli Venezia Giulia, Valla d’Aosta and Veneto Region. Conclusions: Hospitalizations due to malignant Melanoma in Italy seem to be influenced by environmental or population-related factors showing a decreasing incidence rate from the Northern to Southern Regions. PMID:26251915

  13. Language, Literacy and Numeracy in National Training Packages: Case Studies in Aged Care and Hospitality.

    ERIC Educational Resources Information Center

    Haines, Christine; Brand, Jennie Bickmore

    The implementation and effectiveness of the inclusion of literacy and numeracy in industry training packages was examined in case studies of three programs in Western Australia. Two were certificate programs in cooking and food and beverage as specified in the hospitality training package, and the third was an aged care program based on the…

  14. Risk Factors for Violent Offending in Autism Spectrum Disorder: A National Study of Hospitalized Individuals

    ERIC Educational Resources Information Center

    Langstrom, Niklas; Grann, Martin; Ruchkin, Vladislav; Sjostedt, Gabrielle; Fazel, Seena

    2009-01-01

    Little is known about risk factors for violence among individuals with autism spectrum disorder (ASD). This study uses data from Swedish longitudinal registers for all 422 individuals hospitalized with autistic disorder or Asperger syndrome during 1988-2000 and compares those committing violent or sexual offenses with those who did not. Thirty-one…

  15. 1. General view of guard house and entrance to Coast ...

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

    1. General view of guard house and entrance to Coast Guard Base from La Putilla Street, looking southwest - U.S. Coast Guard Base, San Juan, Guard House, La Puntilla Finalle, San Juan, San Juan Municipio, PR

  16. Variations in Implementation of Acute Care Surgery: Results from a national survey of university-affiliated hospitals

    PubMed Central

    Santry, Heena P.; Madore, John C.; Collins, Courtney E.; Ayturk, M. Didem; Velmahos, George C.; Britt, LD; Kiefe, Catarina I.

    2015-01-01

    BACKGROUND To date, no studies have reported nationwide adoption of Acute Care Surgery (ACS) or identified structural and/or process variations for the care of emergency general surgery (EGS) patients within such models. METHODS We surveyed surgeons responsible for EGS coverage at University HealthSystems Consortium hospitals using an 8-page postal/email questionnaire querying respondents on hospital and EGS structure/process measures. Survey responses were analyzed using descriptive statistics, univariate comparisons, and multivariable regression models. RESULTS 258 of 319 (81%) potential respondents completed surveys. 81 hospitals (31%) had implemented ACS while 134 (52%) had a traditional general surgeon on-call model (GSOC). 38 (15%) hospitals had another model (HYBRID). Larger bed, university-based, teaching hospitals with Level 1 trauma center verification status located in urban areas were more likely to have adopted ACS. In multivariable modeling, hospital type, setting, and trauma center verification predicted ACS implementation. EGS processes of care varied with 28% GSOC having block time vs 67% ACS (p<0.0001); 45% GSOC providing ICU care to EGS patients in a surgical/trauma ICU vs 93% ACS (p<0.0001); GSOC sharing call among 5.7 (+/− 3.2) surgeons vs 7.9 (+/−2.3) ACS surgeons (p<0.0001); and 13% GSOC taking in-house EGS call vs 75% ACS (p<0.0001). Among ACS hospitals there were variations in patient cohorting (25% EGS patients alone; 21% EGS+trauma; 17% EGS+elective; 30% EGS+trauma+elective), data collection (26% had prospective EGS registries), and patient handoffs (56% had attending surgeon presence), call responsibilities (averaging 4.8 (+/− 1.3) calls per month with 60% providing extra call stipend and 40% with no post-call clinical duties). CONCLUSION The potential of the ACS on the national crisis in access to EGS care is not fully met. Variations in EGS processes of care among adopters of ACS suggest that standardized criteria for ACS implementation, much like trauma center verification criteria, may be beneficial. LEVEL OF EVIDENCE Survey results, Level III PMID:25539204

  17. National Estimates of Noncanine Bite and Sting Injuries Treated in US Hospital Emergency Departments, 2001–2010

    PubMed Central

    Langley, Ricky; Mack, Karin; Haileyesus, Tadesse; Proescholdbell, Scott; Annest, Joseph L.

    2015-01-01

    Objective Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Methods The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population. Results From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9–447.3). Insects accounted for 67.5% (95% CI, 45.8–89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8–27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold—from 2156 visits in 2007 to 15,945 visits in 2010. Conclusions This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated $7.5 billion annually. PMID:24433776

  18. 2. View northwest of main hospital building complex, hospital building ...

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

    2. View northwest of main hospital building complex, hospital building (Building 90), administration and clinical hospital building (Building 88), and hospital building (Building 91) - National Home for Disabled Volunteer Soldiers Western Branch, 4101 South Fourth Street, Leavenworth, Leavenworth County, KS

  19. Nurses' perceptions of and attitudes toward an electronic medical record system at Seoul National University Hospital.

    PubMed

    Ahn, Tae-Sa; Park, Ihn Sook; You, Ock-Su; Shin, Hyeon-Ju; Woo, Kyung-Shun; Jo, Eun-Mee

    2006-01-01

    In an effort to investigate nurses' perceptions of and attitudes toward the use of electronic medical record (EMR) systems, 904 nurses in a university hospital were surveyed for demographic data and their perceptions of and attitudes toward an EMR system 6 months after its implementation. The questionnaire consisted of demographic information, perception statements relating to the effect of an EMR system, and attitude statements toward an EMR system (assessed on 4-point Likert scales, Cronbach's alpha = 0.979). Nurses' perceptions and attitudes were generally positive and correlated with the type of nursing unit, and their age, years of nursing experience, and job title. This result reinforces that nurses are generally accepting of the implementation of a new EMR system. However, strategies are needed for improving the satisfaction of nurses who have a negative perception of and attitude toward EMR systems. It is recommended that the findings of our study be implemented in other hospitals with ongoing EMR projects. PMID:17102423

  20. [The Hospital Information System of the Brazilian Unified National Health System: a performance evaluation for auditing maternal near miss].

    PubMed

    Nakamura-Pereira, Marcos; Mendes-Silva, Wallace; Dias, Marcos Augusto Bastos; Reichenheim, Michael E; Lobato, Gustavo

    2013-07-01

    This study aimed to investigate the performance of the Hospital Information System of the Brazilian Unified National Health System (SIH-SUS) in identifying cases of maternal near miss in a hospital in Rio de Janeiro, Brazil, in 2008. Cases were identified by reviewing medical records of pregnant and postpartum women admitted to the hospital. The search for potential near miss events in the SIH-SUS database relied on a list of procedures and codes from the International Classification of Diseases, 10th revision (ICD-10) that were consistent with this diagnosis. The patient chart review identified 27 cases, while 70 potential occurrences of near miss were detected in the SIH-SUS database. However, only 5 of 70 were "true cases" of near miss according to the chart review, which corresponds to a sensitivity of 18.5% (95%CI: 6.3-38.1), specificity of 94.3% (95%CI: 92.8-95.6), area under the ROC of 0.56 (95%CI: 0.48-0.63), and positive predictive value of 10.1% (IC95%: 4.7-20.3). These findings suggest that SIH-SUS does not appear appropriate for monitoring maternal near miss. PMID:23843001

  1. Reduction Mammoplasty in a Developing Country: A 10-year Review (2001-2010) at the National Orthopaedic Hospital, Enugu

    PubMed Central

    Isiguzo, Chimaobi; Ogbonnaya, Sunday Iheuko; Udezue, Anthonia O

    2015-01-01

    Context: Large breast is a major problem because of associated symptomatology and aesthetic concerns. Reduction mammoplasty (RM) resolves the symptom and at the same time improves the aesthetic appearance of the breast, hence improving self-esteem and social integration. Aims: To describe the pattern of RM in a hospital in the developing world and its impact on postgraduate surgical training. Settings and Design: A retrospective review of all the RMs done in the National Orthopaedic Hospital, Enugu (a major plastic surgery training center in Nigeria) over a ten-year period (2001–2010), in the developing country of Nigeria. Subjects and Methods: All RMs done in the hospital were reviewed after retrieving their records from operation register and medical records department. Fifteen (15) cases were retrieved and analyzed. Data Analysis: Data was analyzed with Microsoft excel 2007. Results: Average age of female patients who had RM was 26.5 years and 83.3% were single. The most common complaint was abnormally large breast (macromastia). Inferior pedicle technique was commonly used. Conclusions: The results of RM are remarkable as it impact positively on the quality of life of the patients. However, the level of awareness about the availability of this service is still low in the region as shown by few cases done over the period of review and this impacts negatively on the training. The need for public awareness cannot be overemphasized. PMID:25838761

  2. 7. VIEW SHOWING STORAGE BUILDING/GUARD HOUSE AT LAUNCH AREA, LOOKING ...

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

    7. VIEW SHOWING STORAGE BUILDING/GUARD HOUSE AT LAUNCH AREA, LOOKING WEST Everett Weinreb, photographer, April 1988 - Los Pinetos Nike Missile Site, Santa Clara Road, Los Angeles National Forest, Sylmar, Los Angeles County, CA

  3. US Coast Guard organization for response to oil and hazardous chemical discharges

    SciTech Connect

    Yaroch, G.N.

    1980-01-01

    The authority, organization, responsibilities and marine pollution prevention and control activities of the US Coast Guard and its National Response Team, Regional Response Teams, and Emergency Port Task Forces are discussed.

  4. IET. Exclusion guard house, 71.8% complete. Camera facing northerly. Pumice ...

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

    IET. Exclusion guard house, 71.8% complete. Camera facing northerly. Pumice block walls, canopy over concrete slabs. Date: October 20, 1954. INEEL negative no. 12541 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  5. ‘Shell shock’ Revisited: An Examination of the Case Records of the National Hospital in London

    PubMed Central

    Linden, Stefanie Caroline; Jones, Edgar

    2014-01-01

    During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain’s leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient’s military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria. PMID:25284893

  6. A Retrospective Case Series of Surgical Implant Generation Network (SIGN) Placement at the Afghan National Police Hospital, Kabul, Afghanistan.

    PubMed

    Ertl, Christian W; Royal, David; Arzoiey, Humayoon Abdul; Shefa, Azizullah; Sultani, Salim; Mosafa, Mohammed Omar; Sadat, Safiullah; Zirkle, Lewis

    2016-01-01

    In Afghanistan, adequate and cost-effective medical care for even routine conditions is lacking; especially for complex injuries like long-bone fractures. The Surgical Implant Generation Network (SIGN) intramedullary nail is used for treatment of long-bone fractures from blunt injuries and does not require imaging. We are reporting for the first time results of the SIGN intramedullary nail at the Afghan National Police Hospital, a tertiary care facility in Kabul. 71 records from the SIGN Online Surgical Database were reviewed for gender, age, date of injury, implant date, patient's home of record, and type/ mechanism of injury. Mean age was 26.7 years, all but one being male; time from injury to implant ranged 1 to 401 days, with mean of 40.6 days. Long-bone fractures from motor vehicle accidents remained constant, and war injuries peaked in summer. Follow-up is limited because of security and financial burdens of travel. However, personal communication with Afghan National Police Hospital surgeons suggests that patients included in the current study have not experienced any adverse outcomes. While it remains to be seen if the SIGN Online Surgical Database will facilitate more comprehensive outcome studies, our results provide support for the efficacy of SIGN nails in treating long-bone fractures from war injuries. PMID:26741473

  7. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    PubMed Central

    2011-01-01

    Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively. Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH. PMID:21276264

  8. Haunted by Enron's ghost. National Century Financial Enterprises files for Chapter 11, leaving a string of broken healthcare chains and hospitals.

    PubMed

    Taylor, Mark

    2002-11-25

    Some are calling it the Enron of the healthcare industry. Ryder trucks hauled possible evidence from embattled financier National Century Financial Enterprises during an FBI raid. NCFE filed for Chapter 11 bankruptcy protection last week, sending ripples through the industry and contributing to the bankruptcies of a string of national healthcare chains and at least six hospitals. PMID:12510558

  9. The early history of hand surgery in the Philippines and highlights in my experience at the National Orthopaedic Hospital Mandaluyong and the Our Lady of Lourdes Hospital, Manila.

    PubMed

    Inocentes, Eugenio M

    2006-01-01

    Several years ago, while attending a Philippines Orthopaedic Association (PDA) Annual Convention, held at the Westin Philippine Plaza Hotel, Manila in December, I had the opportunity to meet with Professor Yoshikazu Ikuta, a well-known microsurgery and hand surgeon from Japan and one of the foreign guest speakers. I had been invited to work with him at the Armed Forces of the Philippines (AFP) Medical Center on the case of a high ranking general of the AFP, with a hand contracture disability problem. The case was referred to him by Dr. Evaristo Sanchez, Chief of Orthopaedics and the Commanding General of the AFP Medical Center. He had been pre-scheduled for surgery the next day, a Sunday morning, the day before Prof. Ikuta was due to return to Japan. After a brief examination and evaluation of the generals affected hand, in the operating room with Prof. Ikuta, just before he was placed under general anaesthesia, we performed the operation together. The operation did not involve microsurgery. The procedures done were multiple combined Bunnell-Zancolli pulley advancements and MP-joint volar capsulorraphies plus flexor tendon releases in the volar forearm, which although quite extensive, were only palliative, to minimise and improve on the contracture deformities, in preparation for a final re-evaluation for possible later, more definitive tendon transfers for hand function. However, I never received any further information regarding the results of our surgery. Recently, I have been honoured and invited again by Prof. Ikuta, presently the Editor-in-Chief of the Hand Surgery Journal (Asian Volume), this time to write the history of hand surgery in the Philippines and add to it, "Highlights in my experience at the National Orthopaedic Hospital, Mandaluyong, and the Our Lady of Lourdes Hospital, Manila", the last portion of which is on paralytic disabilities of the Hand. I am deeply grateful to Prof. Ikuta for giving me this honour and opportunity to present the total experience, favourable and unfavourable, of a hand surgeon from a developing country, like the Philippines. Furthermore, this would afford me also, the chance to be able to make known to readers of this now prestigious journal, the philosophical thoughts which led me to unwittingly originate or come up with and develop a few of my own "Long Tendon Rerouting Procedures" which may possibly and hopefully merit as this author's title contribution to surgery of the hands. PMID:17405193

  10. Social inequalities and women's satisfaction with childbirth care in Brazil: a national hospital-based survey.

    PubMed

    d'Orsi, Eleonora; Brüggemann, Odaléa Maria; Diniz, Carmen Simone Grilo; Aguiar, Janaina Marques de; Gusman, Christine Ranier; Torres, Jacqueline Alves; Angulo-Tuesta, Antonia; Rattner, Daphne; Domingues, Rosa Maria Soares Madeira

    2014-08-01

    The objective is to identify factors associated with women's satisfaction towards the care provided by the health professionals during hospital assisted delivery and identify how those factors influence their general levels of satisfaction. The cohort hospital based study was carried out in connection with the Birth in Brazil research. 15,688 women were included, interviewed at home, through the phone, from March 2011 to February 2012. All the variables that compose the professional/pregnant woman relationship (waiting time, respect, privacy, clarity of explanations, possibility of asking questions and participating in the decisions) and schooling remained independently associated with general satisfaction towards delivery care, in the adjusted model. The white women assisted in the southeastern and southern regions of the country, by the private sector and with a companion present gave a better evaluation of the care provided. Women value the way in which they are assisted by the health professionals, and there are inequalities in the way they are treated based on skin color, geographic region and financial situation. PMID:25167175

  11. Hospital-level factors associated with use of pediatric radiation dose reduction protocols for head CT: Results from a national survey

    PubMed Central

    Kanal, Kalpana M.; Vavilala, Monica S.; Applegate, Kimberly E.; Jarvik, Jeffrey G.; Rivara, Frederick P.

    2014-01-01

    Objectives To examine hospital-level factors associated with the use of a dedicated pediatric dose-reduction protocol and protective shielding for head CT in a national sample of hospitals. Materials and Methods A mixed-mode (online and paper) survey was administered to a stratified random sample of U.S. community hospitals (N=751). Respondents provided information on pediatric head CT scanning practices, including use of a dose-reduction protocol. Modified Poisson regression analyses describe the relative risk (RR) of not reporting the use of a pediatric dose reduction protocol or protective shielding; multivariable analyses adjust for census region, trauma level, children’s hospital status, and bed size. Results Of hospitals that were contacted, 38 were ineligible (no CT scanner, hospital closed, do not scan infants), 1 refused, and 253 responded (35.5% response rate). Across all hospitals, 92.6% reported using a pediatric dose reduction protocol. Modified Poisson regression showed that small hospitals (0–50 beds) were 20% less likely to report using a protocol than large hospitals (>150 beds) (RR: 0.80, 95% CI: 0.65–0.99; adjusted for covariates). Teaching hospitals were more likely to report using a protocol (RR: 1.10, 95% CI: 1.02–1.19; adjusted for covariates). After adjusting for covariates, children’s hospitals were significantly less likely to report using protective shielding than non-children’s hospitals (RR: 0.64, 95% CI: 0.56–0.73), though this may be due to more advanced scanner type. Conclusion Results from this study provide guidance for tailored educational campaigns and quality improvement interventions to increase the adoption of pediatric dose-reduction efforts. PMID:24993537

  12. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  13. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  14. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  15. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  16. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 7 2012-07-01 2012-07-01 false Machine guarding. 1917.151 Section 1917.151 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) MARINE TERMINALS Related Terminal Operations and Equipment § 1917.151 Machine guarding. (a) Definition. “Guarded” means shielded,...

  17. Guards, Galleries, Fortresses, and the Octoplex

    ERIC Educational Resources Information Center

    Michael, T. S.

    2011-01-01

    The art gallery problem asks for the maximum number of stationary guards required to protect the interior of a polygonal art gallery with "n" walls. This article explores solutions to this problem and several of its variants. In addition, some unsolved problems involving the guarding of geometric objects are presented.

  18. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Machine guarding. 1917.151 Section 1917.151 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) MARINE TERMINALS Related Terminal Operations and Equipment § 1917.151 Machine guarding. (a) Definition. “Guarded” means shielded,...

  19. Systems Engineering of Coast Guard Aviator Training.

    ERIC Educational Resources Information Center

    Hall, Eugene R.; Caro, Paul W.

    This paper describes a total-program application of the systems engineering concept of the U.S. Coast Guard aviation training programs. The systems approach used treats all aspects of the training to produce the most cost-effective integration of academic, synthetic, and flight training for the production of graduate Coast Guard aviators. The…

  20. Performance of an active inspired hypoxic guard.

    PubMed

    Ghijselings, Idris E; De Cooman, Sofie; Carette, Rik; Peyton, Philip J; De Wolf, Andre M; Hendrickx, Jan F A

    2016-02-01

    Current hypoxic guards systems fail to maintain the inspired O2 concentration (FIO2) ≥ 21 % across the entire fresh gas flow (FGF) range when a second carrier gas is used (N2O or air). We examined the performance of the Maquet O2 Guard(®), a smart hypoxic guard that increases O2 delivery if an inspired hypoxic mixture is formed. After obtaining IRB approval and informed consent, 12 ASA I-II patients were enrolled. During anesthesia with sevoflurane in O2/air, the O2 Guard(®) was tested by administering O2/air at the following delivered hypoxic guard limits [expressed as (total FGF in L min(-1); FDO2 in %)] for 4 min each: [0.3;67], [0.4;50], [0.6;34], [0.8;25], [1.0;21], [1.2;21], [1.5;21], [2;21], [3;21], and [5;21]. The following data were collected: (1) time from FIO2 = 30 to 20 %; (2) time from FIO2 = 20 % to O2 Guard(®) activation; (3) time from O2 Guard(®) activation to FIO2 = 25 %; (4) FGF and FDO2 used by the O2 Guard. If SpO2 was <90 % for 10 s or longer at any time, the patient was excluded. Three patients were excluded for low SpO2. The incidence of FIO2 < 21 % was 100 % within the 1-2 L min(-1) FGF range. The O2 Guard(®) was activated within 20 s after FIO2 became 20 %, except in one patient where FIO2 oscillated between 20 and 21 %. FDO2 was increased to 60 % and FGF to 1 L min(-1) (the latter only if it was lower than 1 L min(-1) prior to activation of the O2 Guard). FIO2 increased to 25 % within 55 s after O2 Guard activation in all patients. The O2 Guard(®), an active inspired hypoxic guard, rapidly reverses and limits the duration of inspired hypoxic episodes when the delivered hypoxic guard fails to do so. PMID:25757405

  1. Intertwined Epidemics: National Demographic Trends in Hospitalizations for Heroin- and Opioid-Related Overdoses, 1993–2009

    PubMed Central

    Unick, George Jay; Rosenblum, Daniel; Mars, Sarah; Ciccarone, Daniel

    2013-01-01

    The historical patterns of opiate use show that sources and methods of access greatly influence who is at risk. Today, there is evidence that an enormous increase in the availability of prescription opiates is fuelling a rise in addiction nationally, drawing in new initiates to these drugs and changing the geography of opiate overdoses. Recent efforts at supply-based reductions in prescription opiates may reduce harm, but addicted individuals may switch to other opiates such as heroin. In this analysis, we test the hypothesis that changes in the rates of Prescription Opiate Overdoses (POD) are correlated with changes in the rate of heroin overdoses (HOD). ICD9 codes from the Nationwide Inpatient Sample and population data from the Census were used to estimate overall and demographic specific rates of POD and HOD hospital admissions between 1993 and 2009. Regression models were used to test for linear trends and lagged negative binomial regression models were used to model the interrelationship between POD and HOD hospital admissions. Findings show that whites, women, and middle-aged individuals had the largest increase in POD and HOD rates over the study period and that HOD rates have increased in since 2007. The lagged models show that increases in a hospitals POD predict an increase in the subsequent years HOD admissions by a factor of 1.26 (p<0.001) and that each increase in HOD admissions increase the subsequent years POD by a factor of 1.57 (p<0.001). Our hypothesis of fungibility between prescription opiates and heroin was supported by these analyses. These findings suggest that focusing on supply-based interventions may simply lead to a shift in use to heroin rather minimizing the reduction in harm. The alternative approach of using drug abuse prevention resources on treatment and demand-side reduction is likely to be more productive at reducing opiate abuse related harm. PMID:23405084

  2. Positive predictive value of the ICD-10 hospital diagnosis of pleural empyema in the Danish National Registry of Patients

    PubMed Central

    Søgaard, Mette; Kornum, Jette Brommann; Schønheyder, Henrik Carl; Thomsen, Reimar Wernich

    2011-01-01

    Objective: Health care databases are a valuable source for epidemiological research in respiratory diseases if diagnoses are valid. We validated the International Classification of Diseases, 10th revision (ICD-10) diagnosis of pleural empyema in the Danish National Registry of Patients (DNRP). Methods: We randomly selected hospitalized patients registered in the DNRP with a discharge diagnosis of pleural empyema between 1995 and 2009 in the North Denmark Region. We retrieved and reviewed medical records and estimated the positive predictive value (PPV) of the empyema diagnosis. Analyses were stratified by study period, hospital type (referral versus district), department type (pulmonary medicine or thoracic surgery versus other), cause of empyema (medical, surgical, or traumatic), and age group. To assess changes over time, we included chi-square tests for linear trend. Results: We retrieved the medical records of 224/225 sampled patients with empyema (99.6%). Of those, 182 were classified as being definite cases, and 21 were probable cases, yielding a PPV of 90.6% (95% confidence interval [CI]: 86.0–94.1). The PPV decreased from 95.7% in patients aged 15–39 years to 87.5% in patients aged 80 years and over but was uniformly high regardless of study period, hospital or department type, or cause of empyema. Conclusion: Our finding of a high overall PPV indicated good agreement between ICD-10 codes for pleural empyema and medical records. Registry-based discharge codes may be a suitable source of data on pleural empyema for epidemiological research. PMID:21386977

  3. Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

    PubMed Central

    Nyongole, Obadia; Akoko, Larry; Mwanga, Ally; Mchembe, Mabula; Kamala, Benjamin; Mbembati, Naboth

    2015-01-01

    Introduction Antimicrobial prophylaxis for urologic procedures is a major issue, as potential advantages of antibiotic administration should be carefully weighed against potential side effects, microbial resistance, and health care costs. This study aimed to review a six years trend of antibiotic use in urological surgeries at Muhimbili National Hospital (MNH) being an experience in a typical third world environment. Methods This was a six years hospital based descriptive, retrospective study conducted of which all case notes of urological patients operated on in between January 2007 to December, 2012 were reviewed by using a structured data collecting tool. The data were analyzed using SPSS software. Results Male patients were the majority at 62% (450). The age range was 0 - 90 years, with a mean of 30 ± 22.09. Among the urological surgeries done at MNH 86.5% (628) received prophylactic antibiotics regardless of the type surgery done. Majority 63.7% (463) received antibiotics during induction. Ceftriaxone was the commonly given antibiotic regardless of the type of urological surgery done. Most of patients (86.4%) were given antibiotics for five days regardless whether it was for prophylactic or treatment intention. Conclusion Antibiotic use is still a challenge at our hospital with over use of prophylactic antibiotics without obvious indications. Prolonged use of prophylactic antibiotics beyond five days was the main finding. Ceftriaxone was the most given antibiotic regardless of the urological surgery done and its level of contamination. Antibiotic stewardship needs to be addressed urgently to avoid serious drug resistances leaving alone the cost implication.

  4. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27175280

  5. Mammography: a review of records in the Department of Radiology at a National Referral Hospital in Uganda

    PubMed Central

    Kiguli-Malwadde, Elsie; Mubuuke, Roy Gonzaga; Bugeza, Sam; Mutungi, Brian

    2014-01-01

    Introduction Breast cancer is one of the leading cancers amongst women world-wide. Although mortality has been reduced and survival rates increased in developed countries, mortality rates from breast cancer are still a major health challenge for many developing countries. In Uganda, there are no screening programmes and in many cases mammography is used for diagnostic purposes. The purpose of this study was to describe the clinical presentations and mammographic breast density patterns amongst women that presented to the radiology department for mammography at a national referral hospital. Methods This was a retrospective study carried out at Mulago Hospital in Uganda between January 2011 and January 2012. Records for patients who had mammography during this period were reviewed. Results The total number of patients was 382 with a mean age of 46 years. Majority presented with breast pain and masses. Mammograms done were normal in majority of the women with fatty breast density dominating. In Uganda, mammography was mainly performed for diagnostic purposes. Conclusion There is no mammography screening programme in Uganda and many women cannot access the service due to its limited availability and costs despite its significance in breast cancer management. There is therefore need for governments in Uganda, but in other areas as well to support regular mammography screening as a way of reducing mortality from breast cancer. PMID:25400856

  6. Peer mentors, mobile phone and pills: collective monitoring and adherence in Kenyatta National Hospital's HIV treatment programme

    PubMed Central

    Moyer, Eileen

    2014-01-01

    In 2006, the Kenyan state joined the international commitment to make antiretroviral treatment free in public health institutions to people infected with HIV. Less than a decade later, treatment has reached over 60% of those who need it in Kenya. This paper, which is based on an in-depth ethnographic case study of the HIV treatment programme at Kenyatta National Hospital, conducted intermittently between 2008 and 2014, examines how HIV-positive peer mentors encourage and track adherence to treatment regimens within and beyond the clinic walls using mobile phones and computer technology. This research into the everyday practices of patient monitoring demonstrates that both surveillance and adherence are collective activities. Peer mentors provide counselling services, follow up people who stray from treatment regimens, and perform a range of other tasks related to patient management and treatment adherence. Despite peer mentors’ involvement in many tasks key to encouraging optimal adherence, their role is rarely acknowledged by co-workers, hospital administrators, or public health officials. Following a biomedical paradigm, adherence at Kenyatta and in Kenya is framed by programme administrators as something individual clients must do and for which they must be held accountable. This framing simultaneously conceals the sociality of adherence and undervalues the work of peer mentors in treatment programmes. PMID:25175291

  7. Analysis of heart donation for cardiac transplantation at the National Taiwan University Hospital: fifteen-year cases review.

    PubMed

    Liao, W C; Hwang, S L; Ko, W J; Wang, S S

    2004-10-01

    The demand for organ transplantation is disparate to the supply of organ donors. The organ shortage is a limitation for transplantation. This study analyzed the status of heart donors at the National Taiwan University Hospital (NTUH) from July 1987 through November 2001 using registry records. One hundred ninety-four total heart donors yielded about 25 donors per year in the late era (years of 1995-2001). The majority of heart donors were men (78.4%) of O blood type (46.9%) with a mean age of 29.8 (SD = 11.9) years. Though head injury was the main source of heart donors (78.4%), cerebrovascular accident patients have increased (15%) since 1995. However, the number of donors from head injury decreased in the year of 1997, when Taiwan passed a law to force motorcycle drivers to wear safety helmets. The average interval from brain death to donation was 75.4 (SD = 71.2) hours. One hundred fifty-six (80.4%) of the 194 donor hearts came from outside hospitals. However, the majority of heart transplantations (166 cases, 85.6%) were done at the NTUH. Implementing a program for a smooth donation and organ procurement processes should provide better donor management in cardiac transplantation. PMID:15561250

  8. Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UK.

    PubMed

    O'Brien, Terri; Ackroyd, Stephen

    2012-03-01

    This paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long-term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy-makers. PMID:22212369

  9. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

    PubMed Central

    Langan Martin, Julie; McLean, Gary; Cantwell, Roch; Smith, Daniel J

    2016-01-01

    Objective To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates. Methods Scottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum period (6 weeks after birth) and late postpartum period (up to 2 years after birth), and compared with pre-pregnancy rates (up to 2 years before pregnancy). Admission rates were generated by calculating the total number of admissions for each time period divided by the number of weeks in the period. Incidence rate ratios (IRRs) were generated for each time period, using deprivation, age, parity and record of previous psychiatric hospital care-adjusted Poisson regression models. Results Women from more deprived social quintiles accounted for the largest proportion of admissions across all time periods. Compared with pre-pregnancy period, admission rates fell during pregnancy, increased markedly during the early postpartum period, and remained elevated for 2 years after childbirth. Within the most affluent quintile, admission IRRs were higher in the early postpartum period (IRR=1.29, 95% CI 1.02 to 1.59) than in the late postpartum period (IRR=0.87, 95% CI 0.74 to 0.98). For the late postpartum period, there was a positive association between higher maternal age and admission IRRs (ages 20–35 years, IRR=1.35, 95% CI 1.16 to 1.54 and age>40 years IRR=1.72, 95% CI 1.41 to 2.09). Conclusions Rates of psychiatric admission fell during pregnancy and increased in the early postpartum period (particularly during the first 2 weeks after birth), and remained elevated above baseline during the 2-year late postpartum period. An understanding of how social deprivation, age and parity might influence risk of psychiatric admission at different time points could help to target perinatal mental health services more effectively. PMID:26733566

  10. Catering & Hospitality, Serving Food & Drink, Levels 1-3. 2nd Edition. Catering & Hospitality, Reception & Housekeeping, Levels 1-3. Catering & Hospitality, Supervisory Management, Level 3. Catering & Hospitality Management, Level 4. 2nd Edition. National Vocational Qualifications.

    ERIC Educational Resources Information Center

    Business and Technology Education Council, London (England).

    Britain's National Vocational Qualifications (NVQs) are work qualifications that measure what an employee or potential employee can do as well as how much he or she knows and understands about a particular job. Used as written proof of usable workplace skills that can be put to profitable use by an employer, NVQs range from basic Level 1, for…

  11. 46 CFR 190.25-15 - Guards in dangerous places.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards in dangerous places. 190.25-15 Section 190.25-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS CONSTRUCTION AND ARRANGEMENT Rails and Guards § 190.25-15 Guards in dangerous places. (a) Suitable hand covers, guards, or rails shall be installed...

  12. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  13. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  14. 75 FR 79956 - Protection for Whistleblowers in the Coast Guard

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... SECURITY Coast Guard 33 CFR Part 53 RIN 1625-AB33 Protection for Whistleblowers in the Coast Guard AGENCY: Coast Guard, DHS. ACTION: Direct final rule; request for comments. SUMMARY: By this direct final rule, the Coast Guard is amending its ``Coast Guard Whistleblower Protection'' regulations to conform...

  15. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  16. Reliability and validity of the American Hospital Association's national longitudinal survey of health information technology adoption

    PubMed Central

    Everson, Jordan; Lee, Shoou-Yih D; Friedman, Charles P

    2014-01-01

    Objective To evaluate the internal consistency, construct validity, and criterion validity of a battery of items measuring information technology (IT) adoption, included in the American Hospital Association (AHA) IT Supplement Survey. Methods We analyzed the 2012 release of the AHA IT Supplement Survey. We performed reliability analysis using Cronbach's α and part-whole correlations, construct validity analysis using principal component analysis (PCA), and criterion validity analysis by assessing the items’ sensitivity and specificity of predicting attestation to Medicare Meaningful Use (MU). Results Twenty-eight items of the 31-item instrument and five of six functionality subcategories defined by the AHA all produced reliable scales (α’s between 0.833 and 0.958). PCA mostly confirmed the AHA's categorization of functionalities; however, some items loaded only weakly onto the factor most associated with their survey category, and one category loaded onto two separate factors. The battery of items was a valid predictor of attestation to MU, producing a sensitivity of 0.82 and a specificity of 0.72. Discussion The battery of items performed well on most indices of reliability and validity. However, they lack some components of ideal survey design, leaving open the possibility that respondents are not responding independently to each item in the survey. Despite measuring only a portion of the objectives required for attestation to MU, the items are a moderately sensitive and specific predictor of attestation. Conclusions The analyzed instrument exhibits satisfactory reliability and validity. PMID:24623194

  17. Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili national hospital, Tanzania

    PubMed Central

    2014-01-01

    Background Surgical site infections (SSIs) remain a common and widespread problem contributing to a significant morbidity and mortality, attributed partly by the increase in antimicrobial resistance among the etiological agents. This study was done to determine the spectrum of bacterial isolates and their susceptibility patterns causing SSIs at Muhimbili National Hospital, Tanzania. Methods This descriptive cross sectional study was conducted between September, 2011 and February, 2012. Pus swabs or pus were cultured on blood agar (Oxoid, UK) and MacConkey agar (Oxoid, UK) and incubated aerobically at 37°C for 18–24 hours. Bacterial identification was done using API 20E and VITEK and antimicrobial susceptibility was determined by Kirby Bauer disc diffusion. Results Of the 100 patients, from whom wound swabs were collected, 90 (90%) had positive aerobic bacterial growth. A total of 147 pathogenic bacteria were isolated, including 114 (77.5%) gram negative and 33(22.5%) gram positive organisms. The most prevalent bacterial species were Pseudomonas aeruginosa (16.3%), followed by Staphylococcus aureus (12.2%) and Klebsiella pneumoniae (10.8%). Of the 18 S. aureus , 8 (44%) were methicillin resistant Staphylococcus aureus (MRSA) and three of them (17%) were carrying both MRSA and induced clindamycin resistance (ICR). Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were observed in 23 (79.3%) of the 29 isolates tested. Majority of Escherichia coli 12 (92.3%) and K. pneumoniae 11 (69%) isolates were ESBL producers. About 63% (93/147) were multiple-drug resistance (MDR) isolates, and the overall MDR among Gram positive and Gram negative bacteria was 60.6% (20/33) and 61.4%, (73/114), respectively. The prevalence of MDR for E. coli, A. baumannii and P. stuartii was 100% each. Majority (97%) of the Gram negative bacteria were resistant to more than four categories (classes) of antibiotics. Conclusion A high proportion (63%) of the isolates causing SSIs in this tertiary hospital were MDR, of which (90%) were resistant to more than four classes of antibiotics. In the light of these findings, an urgent and significant change in antibiotic prescription policy is required at this National hospital. PMID:25100042

  18. Recent experience with cancer of the ampulla of Vater in a national hospital group.

    PubMed

    el-Ghazzawy, A G; Wade, T P; Virgo, K S; Johnson, F E

    1995-07-01

    A total of 64 resections, 24 operative bypasses and 35 nonoperative biliary intubations, were performed for ampullary carcinoma in U.S. Dept. of Veterans Affairs hospitals from 1987 to 1991. Mean survival after resection was 702 days, significantly higher (ANOVA, P < or = 0.005) than that after bypass (345 days) or intubation (385 days). Operative mortality rates were similar: resection or intubation = 14%, bypass = 12%. Operative (30-day) mortality was zero in four local resections, 10% in 51 Whipples and 44% in nine total pancreatectomies. TNM staging was available for 74 patients, and mean survival after resection exceeded 2 years in 34 patients with Stage I-II (localized) cancers, was 532 days in 10 patients with Stage III (regional nodes +) and 77 days in two patients with Stage IV (metastatic) disease. However, mean survival without resection was 498 days in 14 patients with localized cancer, 634 days in two patients with regional and 215 days in 11 patients with distant metastases. Resection clearly increased survival only for Stage I cancers (P < or = 0.02). Predicted 5-year survival rates by stage after resection were: I-II = 21%, III < 10%, IV = 0%. Complications were recorded in 29 per cent of resected patients, with sepsis the most common (21% of resections). Both sepsis and GI bleeding significantly decreased mean survival (P < or = 0.05, ANOVA), but pneumonia, pancreatic fistula, or wound problems did not. Ampullary cancer is a favorable subtype of peri-ampullary cancers, but prolonged survival is also seen without resection and may be largely limited to tumors that do not involve regional nodes. PMID:7793742

  19. Adherence to medication: A nation-wide study from the Children’s Cancer Hospital, Egypt

    PubMed Central

    El Malla, Hanan; Ylitalo Helm, Nathalie; Wilderäng, Ulrica; El Sayed Elborai, Yasser; Steineck, Gunnar; Kreicbergs, Ulrika

    2013-01-01

    AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt. METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children’s Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read the questions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child’s medical journal. The study period consisted of 7 mo (February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher’s exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows (SAS Institute Inc., Cary, NC, United States). RESULTS: Two hundred and eighty-one (90%) parents answered the second questionnaire, regarding their child’s adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment (181/281, 64%). Sixty-eight percent (123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance (111/123, 90%) and inadequate information (100/123, 81%). In the adherent group, 20% of the parents (n = 12/58) reported trust in their child’s doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123 (7%) for both their child’s doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment (116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child’s life (70%) (P = 0.005) and worry that their child would die if they discontinued the treatment (81%) (P < 0.0001). CONCLUSION: Non-adherence to medical regimen is common among children diagnosed with cancer in Egypt, the main reasons being child resistance and inadequate information. PMID:24175183

  20. 30 CFR 75.1722 - Mechanical equipment guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... may cause injury to persons shall be guarded. (b) Guards at conveyor-drive, conveyor-head, and... guards. (a) Gears; sprockets; chains; drive, head, tail, and takeup pulleys; flywheels; couplings,...

  1. Evaluation of US rear underride guard regulation for large trucks using real-world crashes.

    PubMed

    Brumbelow, Matthew L; Blanar, Laura

    2010-11-01

    Current requirements for rear underride guards on large trucks are set by the National Highway Traffic Safety Administration in Federal Motor Vehicle Safety Standards (FMVSS) 223 and 224. The standards have been in place since 1998, but their adequacy has not been evaluated apart from two series of controlled crash tests. The current study used detailed reviews of real-world crashes from the Large Truck Crash Causation Study to assess the ability of guards that comply with certain aspects of the regulation to mitigate passenger vehicle underride. It also evaluated the dangers posed by underride of large trucks that are exempt from guard requirements. For the 115 cases meeting the inclusion criteria, coded data, case narratives, photographs, and measurements were used to examine the interaction between study vehicles. The presence and type of underride guard was determined, and its performance in mitigating underride was categorized. Overall, almost one-half of the passenger vehicles had underride damage classified as severe or catastrophic. These vehicles accounted for 23 of the 28 in which occupants were killed. For the cases involving trailers with underride guards compliant with one or both FMVSS, guard deformation or complete failure was frequent and most commonly due to weak attachments, buckling of the trailer chassis, or bending of the lateral end of the guard under narrow overlap loading. Most of the truck units studied qualified for at least one of the FMVSS exemptions. The two largest groups were trailers with small wheel setbacks and single-unit straight trucks. Dump trucks represented a particularly hazardous category of straight truck. The current study suggests several weaknesses in the rear underride guard regulation. The standard allows too much ground clearance, the quasi-static test conditions allow guard designs that fail in narrow overlap crashes, and certifying guards independent of trailers leads to systems with inadequate attachment and chassis strength. Additionally, the regulation should be expanded to cover a higher percentage of the large truck fleet. PMID:21512906

  2. Treatment of Gastric Adenocarcinoma May Differ Among Hospital Types in the United States, a Report from the National Cancer Data Base

    PubMed Central

    Gay, Greer; Patel-Parekh, Lina; Ajani, Jaffer A.; Donohue, John H.

    2007-01-01

    The concept that complex surgical procedures should be performed at high-volume centers to improve surgical morbidity and mortality is becoming widely accepted. We wanted to determine if there were differences in the treatment of patients with gastric cancer between community cancer centers and teaching hospitals in the United States. Data from the 2001 Gastric Cancer Patient Care Evaluation Study of the National Cancer Data Base comprising 6,047 patients with gastric adenocarcinoma treated at 691 hospitals were assessed. The mean number of patients treated was larger at teaching hospitals (14/year) when compared to community centers (5–9/year) (p < 0.05). The utilization of laparoscopy and endoscopic ultrasonography were significantly more common at teaching centers (p < 0.01). Pathologic assessment of greater than 15 nodes was documented in 31% of specimen at community hospitals and 38% at teaching hospitals (p < 0.01). Adjusted for cancer stage, chemotherapy and radiation therapy were utilized with equal frequency at all types of treatment centers. The 30-day postoperative mortality was lowest at teaching hospitals (5.5%) and highest at community hospitals (9.9%) (p < 0.01). These data support previous publications demonstrating that patients with diseases requiring specialized treatment have lower operative mortality when treated at high-volume centers. PMID:17436123

  3. Security: Detection, Emergency System, Guard Services

    ERIC Educational Resources Information Center

    Nation's Schools and Colleges, 1974

    1974-01-01

    Three short articles describe (respectively) a student security advisory council at one high school that involves students in security work, emergency telephone systems on two university campuses, and tips for hiring security guards for colleges. (Author/DN)

  4. 'Sunscreen' Gene May Guard Against Skin Cancer

    MedlinePlus

    ... news/fullstory_158935.html 'Sunscreen' Gene May Guard Against Skin Cancer Researchers hope their discovery will lead ... so-called "sunscreen" gene that may help protect against skin cancer. They say the finding potentially could ...

  5. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... restarting upon restoration of power. (7) The power supply to machines shall be turned off, locked out, and... contact with moving parts. (2) Belt, rope and chain drives shall be guarded to prevent employees...

  6. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... restarting upon restoration of power. (7) The power supply to machines shall be turned off, locked out, and... contact with moving parts. (2) Belt, rope and chain drives shall be guarded to prevent employees...

  7. Patient-Safety-Related Hospital Deaths in England: Thematic Analysis of Incidents Reported to a National Database, 2010–2012

    PubMed Central

    Donaldson, Liam J.; Panesar, Sukhmeet S.; Darzi, Ara

    2014-01-01

    Background Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. Methods and Findings The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%), failure of prevention (26%), deficient checking and oversight (11%), dysfunctional patient flow (10%), equipment-related errors (6%), and other (12%). The most common incident types were failure to act on or recognise deterioration (23%), inpatient falls (10%), healthcare-associated infections (10%), unexpected per-operative death (6%), and poor or inadequate handover (5%). Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. Conclusions Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives. Please see later in the article for the Editors' Summary PMID:24959751

  8. The evaluation of hospital laboratory information management systems based on the standards of the American National Standard Institute

    PubMed Central

    Isfahani, Sakineh Saghaeiannejad; Khajouei, Reza; Jahanbakhsh, Maryan; Mirmohamadi, Mahboubeh

    2014-01-01

    Introduction: Nowadays, modern laboratories are faced with a huge volume of information. One of the goals of the Laboratory Information Management System (LIMS) is to assist in the management of the information generated in the laboratory. This study intends to evaluate the LIMS based on the standards of the American National Standard Institute (ANSI). Materials and Methods: This research is a descriptive–analytical study, which had been conducted in 2011, on the LIMSs in use, in the teaching and private hospitals in Isfahan. The data collecting instrument was a checklist, which was made by evaluating three groups of information components namely: ‘System capabilities’, ‘work list functions,’ and ‘reporting’ based on LIS8-A. Data were analyzed using the SPSS 20. Data were analyzed using (relative) frequency, percentage. To compare the data the following statistical tests were used: Leven test, t-test, and Analysis of Variance (ANOVA). Results: The results of the study indicated that the LIMS had a low conformity (30%) with LIS8-A (P = 0.001), with no difference between teaching and private hospitals (P = 0.806). The ANOVA revealed that in terms of conformity with the LIS8-A standard, there was a significant difference between the systems produced by different vendors (P = 0.023). According to the results, a Kowsar system with more than %57 conformity in the three groups of information components had a better conformity to the standard, compared to the other systems. Conclusions: This study indicated that none of the LIMSs had a good conformity to the standard. It seems that system providers did not pay sufficient attention to many of the information components required by the standards when designing and developing their systems. It was suggested that standards from certified organizations and institutions be followed in the design and development process of health information systems. PMID:25077154

  9. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    PubMed Central

    2011-01-01

    Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills, strategies that promote evidence-based practice and managerial leadership skills. Conclusions Although there are numerous barriers to delivery of quality health services at MNRH, many barriers could be addressed by strengthening the relationship between the Hospital and MakCHS. Strategic partnerships and creative use of existing resources, both human and financial, could improve the quality of care and service delivery at MNRH. Improving services and providing more skills training could better prepare MakCHS graduates for leadership roles in other health care facilities, ultimately improving health outcomes throughout Uganda. PMID:21411007

  10. Ca2+signalling in stomatal guard cells.

    PubMed

    McAinsh, M R; Gray, J E; Hetherington, A M; Leckie, C P; Ng, C

    2000-01-01

    Ca(2+) is a ubiquitous second messenger in the signal transduction pathway(s) by which stomatal guard cells respond to external stimuli. Increases in guard-cell cytosolic free Ca(2+) concentration ([Ca(2+)](cyt)) have been observed in response to stimuli that cause both stomatal opening and closure. In addition, several important components of Ca(2+)-based signalling pathways have been identified in guard cells, including the cADP-ribose and phospholipase C/Ins(1, 4,5)P(3)-mediated Ca(2+)-mobilizing pathways. The central role of stimulus-induced increases in [Ca(2+)](cyt) in guard-cell signal transduction has been clearly demonstrated in experiments examining the effects of modulating increases in [Ca(2+)](cyt) on alterations in guard-cell turgor or the activity of ion channels that act as effectors in the guard-cell turgor response. In addition, the paradox that Ca(2+) is involved in the transduction of signals that result in opposite end responses (stomatal opening and closure) might be accounted for by the generation of stimulus-specific Ca(2+) signatures, such that increases in [Ca(2+)](cyt) exhibit unique spatial and temporal characteristics. PMID:10961943

  11. Envisioning electronic health record systems as change management: the experience of an English hospital joining the National Programme for Information Technology.

    PubMed

    Takian, Amirhossein

    2012-01-01

    The historical National Programme for Information Technology (NPfIT) in England was the most expensive (~$20billion) and ambitious politically-driven IT-based transformations of public services ever undertaken. Nation-wide implementation of integrated electronic health record (EHR) systems in hospitals was at the heart of the NPfIT (~$10billion). We conducted the first longitudinal, prospective, and sociotechnical case study implementation and adoption of national EHRs implementations in 12 'early adopter' hospitals across England. This paper reports the arrival, implementation process, and stakeholders' experiences of one EHR software (Millennium) at a National Health Service's (NHS) general hospital participating in NPfIT, hereafter called Alpha. From the outset, Alpha envisioned the implementation of EHR as a practice of change management to improve its performance. This vision attributed to the establishment of a 'design authority' at Alpha, including users from various capacities and levels. The 'design authority' was perceived a key contributor to appropriate (compared to other hospitals we studied) clinical engagement and bottom-up approach to deploying EHR. Through conducting several hundreds of group and individual workflow familiarization, Alpha adopted a novel approach to training staff on EHR software. This led to greater local configuration and high sense of ownership among users, which transformed work practices towards overall better performance of the hospital. Contrary to painful and turbulent experiences of EHR implementation via NPfIT route in the English hospitals, this in-depth case study revealed the importance of vision (change management) and insightful leadership in 'working out' EHR. We advocate envisioning EHRs as change management endeavors to enhance their complex, multi-dimensional, and sociotechnical adoption in healthcare settings. PMID:22874323

  12. Guard tower structural design concept for perimeter security systems

    SciTech Connect

    Risse, J.T.

    1983-07-01

    Facilities that require outdoor perimeter sensor fields to furnish perimeter penetration alarms can often benefit by the inclusion of manned guard towers in the total security plan. Acquisition and maintenance costs of closed circuit television to provide adequate visual assessment may be too costly and perhaps tower personnel could perform other functions such as monitoring vehicles or personnel in the vicinity of the protected area. Because there appeared to be no uniformity of design features for guard towers being built for nominally identical purposes, a program has been undertaken at Sandia National Laboratories to identify functions and features of towers, and to find a standard design such that security organizations, wishing to build a tower, would not find it necessary to start anew for each application. A tower design using prestressed concrete ''double tees'' has been worked out and reduced to practice that accomplishes many of the desired characteristics of a guard tower at reasonable cost. The prestressed concrete technology is available throughout the CONUS, Canada, Europe, etc. One such design is described and discussed.

  13. Task-Shifting and Quality of HIV Testing Services: Experiences from a National Reference Hospital in Zambia

    PubMed Central

    Mwangala, Sheila; Moland, Karen M.; Nkamba, Hope C.; Musonda, Kunda G.; Monze, Mwaka; Musukwa, Katoba K.; Fylkesnes, Knut

    2015-01-01

    Background With new testing technologies, task-shifting and rapid scale-up of HIV testing services in high HIV prevalence countries, assuring quality of HIV testing is paramount. This study aimed to explore various cadres of providers’ experiences in providing HIV testing services and their understanding of elements that impact on quality of service in Zambia. Methods Sixteen in-depth interviews and two focus group discussions were conducted with HIV testing service providers including lay counselors, nurses and laboratory personnel at purposively selected HIV testing sites at a national reference hospital in Lusaka. Qualitative content analysis was adopted for data analysis. Results Lay counselors and nurses reported confidentiality and privacy to be greatly compromised due to limited space in both in- and out-patient settings. Difficulties in upholding consent were reported in provider-initiated testing in in-patient settings. The providers identified non-adherence to testing procedures, high workload and inadequate training and supervision as key elements impacting on quality of testing. Difficulties related to testing varied by sub-groups of providers: lay counselors, in finger pricking and obtaining adequate volumes of specimen; non-laboratory providers in general, in interpreting invalid, false-negative and false-positive results. The providers had been participating in a recently established national HIV quality assurance program, i.e. proficiency testing, but rarely received site supervisory visits. Conclusion Task-shifting coupled with policy shifts in service provision has seriously challenged HIV testing quality, protection of confidentiality and the process of informed consent. Ways to better protect confidentiality and informed consent need careful attention. Training, supervision and quality assurance need strengthening tailored to the needs of the different cadres of providers. PMID:26605800

  14. Parallel Quality Assessment of Emergency Departments by European Foundation for Quality Management Model and Iranian National Program for Hospital Evaluation

    PubMed Central

    IMANI NASAB, Mohammad Hasan; MOHAGHEGH, Bahram; KHALESI, Nader; JAAFARIPOOYAN, Ebrahim

    2013-01-01

    Background European Foundation for Quality Management (EFQM) model is a widely used quality management system (QMS) worldwide, including Iran. Current study aims to verify the quality assessment results of Iranian National Program for Hospital Evaluation (INPHE) based on those of EFQM. Methods: This cross-sectional study was conducted in 2012 on a sample of emergency departments (EDs) affiliated with Tehran University of Medical Sciences (TUMS), Iran. The standard questionnaire of EFQM (V-2010) was used to gather appropriate data. The results were compared with those of INPHE. MS Excel was used to classify and display the findings. Results: The average assessment score of the EDs based on the INPHE and EFQM model were largely different (i.e. 86.4% and 31%, respectively). In addition, the variation range among five EDs’ scores according to each model was also considerable (22% for EFQM against 7% of INPHE), especially in the EDs with and without prior record of applying QMSs. Conclusion: The INPHE’s assessment results were not confirmed by EFQM model. Moreover, the higher variation range among EDs’ scores using EFQM model could allude to its more differentiation power in assessing the performance comparing with INPHE. Therefore, a need for improvement in the latter drawing on other QMSs’ (such as EFQM) strengths, given the results emanated from its comparison with EFQM seems indispensable. PMID:23967429

  15. Supplement use by women during pregnancy: data from the Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics.

    PubMed

    Freeman, Marlene P; Sosinsky, Alexandra Z; Moustafa, Danna; Viguera, Adele C; Cohen, Lee S

    2016-06-01

    Women of reproductive age commonly use integrative treatments. However, the reproductive safety for most complementary products lacks systematic study. We aimed to study the use of supplements by women in a prospective pregnancy registry. The Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics was established to evaluate the reproductive safety of atypical antipsychotics. Exposed and control participants were systematically queried about the use of vitamins and supplements. Slightly greater than half (53.2 %) of the participants eligible for analysis (N = 534) were using at least one vitamin or supplement at the time of enrollment, not including prenatal vitamins or folic acid. The most common supplements used were omega-3 fatty acids (38.0 %), vitamin D (11.0 %), calcium (8.2 %), and iron (4.7 %). Probiotics and melatonin were used by 2.6 and 0.9 %, respectively. In this prospective pregnancy registry, we found that over half of the participants were taking supplements or vitamins other than prenatal vitamins and folic acid. These findings underscore the need for active query on the part of health care providers about the use of supplements during pregnancy, and the need to obtain rigorous reproductive safety and efficacy data for supplements used by pregnant women and reproductive aged women. PMID:26472040

  16. [Unified National Health System costs in São José dos Campos, São Paulo State, Brazil, for hospital admissions due to external causes].

    PubMed

    Melione, Luís Paulo Rodrigues; Mello-Jorge, Maria Helena Prado de

    2008-08-01

    The objective of this study was to identify direct expenditures for hospitalizations due to external causes in the Unified National Health System (SUS) in the city of São José dos Campos, São Paulo State, Brazil. Admissions to the Dr. José de Carvalho Florence Municipal Hospital resulting from external causes or injuries - ICD-10, chapters XIX and XX respectively - were analyzed for the first semester of 2003. 976 patient admission forms were analyzed, after data evaluation. Admissions with the highest total cost were those resulting from motor vehicle accidents and falls. The highest mean cost for hospitalization for injury was due to motor vehicle accidents (BRL 614.63), followed by assault (BRL 594.90). The highest mean cost for hospitalization due to injury was for cervical fractures (BRL 1,191.42) and head injuries (BRL 1,000.44). Hospitalizations with the highest daily cost were skull and facial fractures (BRL 166.72) and abdominal trauma (BRL 148.26). The study confirmed that motor vehicle accidents, falls, and assault are an important source of costs due to hospitalization for injuries. PMID:18709222

  17. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Powers with respect to the Coast Guard. 700.307 Section 700.307 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Secretary of the Navy The Secretary of the Navy...

  18. Hypnotics and the Occurrence of Bone Fractures in Hospitalized Dementia Patients: A Matched Case-Control Study Using a National Inpatient Database

    PubMed Central

    Tamiya, Hiroyuki; Yasunaga, Hideo; Matusi, Hiroki; Fushimi, Kiyohide; Ogawa, Sumito; Akishita, Masahiro

    2015-01-01

    Background Preventing falls and bone fractures in hospital care is an important issue in geriatric medicine. Use of hypnotics is a potential risk factor for falls and bone fractures in older patients. However, data are lacking on the association between use of hypnotics and the occurrence of bone fracture. Methods We used a national inpatient database including 1,057 hospitals in Japan and included dementia patients aged 50 years or older who were hospitalized during a period of 12 months between April 2012 and March 2013. The primary outcome was the occurrence of bone fracture during hospitalization. Use of hypnotics was compared between patients with and without bone fracture in this matched case-control study. Results Of 140,494 patients, 830 patients suffered from in-hospital fracture. A 1:4 matching with age, sex and hospital created 817 cases with fracture and 3,158 matched patients without fracture. With adjustment for the Charlson comorbidity index, emergent admission, activities of daily living, and scores for level walking, a higher occurrence of fractures were seen with short-acting benzodiazepine hypnotics (odds ratio, 1.43; 95% confidence interval, 1.19–1.73; P<0.001), ultrashort-acting non-benzodiazepine hypnotics (1.66; 1.37–2.01; P<0.001), hydroxyzine (1.45; 1.15–1.82, P=0.001), risperidone and perospirone (1.37; 1.08–1.73; P=0.010). Other drug groups were not significantly associated with the occurrence of in-hospital fracture. Conclusions Short-acting benzodiazepine hypnotics and ultrashort-acting non-benzodiazepine hypnotics may increase risk of bone fracture in hospitalized dementia patients. PMID:26061231

  19. Compliance with a time-out procedure intended to prevent wrong surgery in hospitals: results of a national patient safety programme in the Netherlands

    PubMed Central

    van Schoten, Steffie M; Kop, Veerle; de Blok, Carolien; Spreeuwenberg, Peter; Groenewegen, Peter P; Wagner, Cordula

    2014-01-01

    Objective To prevent wrong surgery, the WHO ‘Safe Surgery Checklist’ was introduced in 2008. The checklist comprises a time-out procedure (TOP): the final step before the start of the surgical procedure where the patient, surgical procedure and side/site are reviewed by the surgical team. The aim of this study is to evaluate the extent to which hospitals carry out the TOP before anaesthesia in the operating room, whether compliance has changed over time, and to determine factors that are associated with compliance. Design Evaluation study involving observations. Setting Operating rooms of 2 academic, 4 teaching and 12 general Dutch hospitals. Participants A random selection was made from all adult patients scheduled for elective surgery on the day of the observation, preferably involving different surgeons and different procedures. Results Mean compliance with the TOP was 71.3%. Large differences between hospitals were observed. No linear trend was found in compliance during the study period. Compliance at general and teaching hospitals was higher than at academic hospitals. Compliance decreased with the age of the patient, general surgery showed lower compliance in comparison with other specialties and compliance was higher when the team was focused on the TOP. Conclusions Large differences in compliance with the TOP were observed between participating hospitals which can be attributed at least in part to the type of hospital, surgical specialty and patient characteristics. Hospitals do not comply consistently with national guidelines to prevent wrong surgery and further implementation as well as further research into non-compliance is needed. PMID:24993761

  20. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  1. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  2. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  3. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  4. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  5. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  6. 46 CFR 177.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards for exposed hazards. 177.960 Section 177.960 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.960 Guards for exposed hazards. An exposed hazard, such as gears or rotating...

  7. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed hazard, such as gears or machinery, must...

  8. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  9. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  10. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  11. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  12. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  13. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  14. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  15. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  16. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  17. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  18. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  19. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  20. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  1. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  2. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  3. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  4. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  5. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  6. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  7. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  8. 2. General view of guard house and entrance to Coast ...

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

    2. General view of guard house and entrance to Coast Guard Base from La Putilla Street, with view of Motor Pool (Building 122) on right side looking west - U.S. Coast Guard Base, San Juan, Guard House, La Puntilla Finalle, San Juan, San Juan Municipio, PR

  9. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  10. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  11. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  12. 5. AERIAL VIEW TO NORTHEAST OF ENTIRE COAST GUARD AIR ...

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

    5. AERIAL VIEW TO NORTHEAST OF ENTIRE COAST GUARD AIR STATION SAN FRANCISCO. 8X10 black and white silver gelatin print. United States Coast Guard Official Photograph, 12th Coast Guard District, San Francisco. 1960. - U.S. Coast Guard Air Station San Francisco, 1020 North Access Road, San Francisco, San Francisco County, CA

  13. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  14. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  15. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the geographical areas whose boundaries are described...

  16. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  17. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  18. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  19. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  20. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  1. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  2. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  3. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  4. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  5. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  6. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  7. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  8. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  9. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying insignia. (a) The distinctive identification...

  10. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  11. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  12. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  13. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  14. The U.S. Coast Guard Academy Curricula; An Evaluation.

    ERIC Educational Resources Information Center

    Powers, Theodore R.; And Others

    This report presents the results of research that had as its objective the evaluation of the curricula of the U.S. Coast Guard Academy. Over 125 Coast Guard officers and men were interviewed to gather detailed background information about the Coast Guard, the Coast Guard Academy, and job requirements of Academy graduates. These data were developed…

  15. 30 CFR 75.827 - Guarding of trailing cables.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Guarding of trailing cables. 75.827 Section 75...-Voltage Longwalls § 75.827 Guarding of trailing cables. (a) Guarding. (1) The high-voltage cable must be guarded in the following locations: (i) From the power center cable coupler for a distance of 10 feet...

  16. 30 CFR 75.827 - Guarding of trailing cables.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Guarding of trailing cables. 75.827 Section 75...-Voltage Longwalls § 75.827 Guarding of trailing cables. (a) Guarding. (1) The high-voltage cable must be guarded in the following locations: (i) From the power center cable coupler for a distance of 10 feet...

  17. 30 CFR 75.827 - Guarding of trailing cables.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Guarding of trailing cables. 75.827 Section 75...-Voltage Longwalls § 75.827 Guarding of trailing cables. (a) Guarding. (1) The high-voltage cable must be guarded in the following locations: (i) From the power center cable coupler for a distance of 10 feet...

  18. GUARD/WATCH TOWER #S84 Naval Magazine Lualualei, Waikele Branch, GuardWatch ...

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

    GUARD/WATCH TOWER #S84 - Naval Magazine Lualualei, Waikele Branch, Guard-Watch Tower Type, On ridge above Tunnel CE-1, on Prime Road on ridge above Tunnel B-11, & on ridge above Tunnel C-17, Pearl City, Honolulu County, HI

  19. GUARD/WATCH TOWER #S68 Naval Magazine Lualualei, Waikele Branch, GuardWatch ...

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

    GUARD/WATCH TOWER #S68 - Naval Magazine Lualualei, Waikele Branch, Guard-Watch Tower Type, On ridge above Tunnel C-11, on Prime Road on ridge above Tunnel B-5, & on ridge above Tunnel D-14, Pearl City, Honolulu County, HI

  20. GUARD/WATCH TOWER #S82 Naval Magazine Lualualei, Waikele Branch, GuardWatch ...

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

    GUARD/WATCH TOWER #S82 - Naval Magazine Lualualei, Waikele Branch, Guard-Watch Tower Type, On ridge above Tunnel CE-1, on Prime Road on ridge above Tunnel B-11, & on ridge above Tunnel C-17, Pearl City, Honolulu County, HI

  1. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other Offices § 52.42 Views of the Coast Guard. (a)...

  2. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  3. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  4. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  5. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  6. 46 CFR 108.209 - Hospital spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve...

  7. The 23-Hour Observation Unit Admissions Within the Emergency Service at a National Tertiary Psychiatric Hospital: Clarifying Clinical Profiles, Outcomes, and Predictors of Subsequent Hospitalization

    PubMed Central

    San Thinn, Daw San; Kuswanto, Carissa Nadia; Sum, Min Yi; Chai, Suet Bin; Doris Sok, Hian Koh; Xu, Changqing; Chuan Su, Alex Hsin; Sengupta, Somnath; Jacob, Rajesh

    2015-01-01

    Objective: We examined health care utilization, clinical profiles (such as sociodemographic features, clinical severity), and outcomes (inpatient admission, revisit within 24 hours of discharge) of patients who were admitted to a 23-hour observation unit within the emergency service of a tertiary psychiatric hospital and hypothesized that a specific clinical profile (greater clinical severity, lower psychosocial functioning) predicted subsequent inpatient hospitalization. Method: The medical records of all patients admitted to the observation unit from February 5, 2007, to February 4, 2012 (N = 2,158) were assessed for relevant data. Clinical severity and level of psychosocial functioning were assessed using Clinical Global Impressions–Severity (CGI-S) and Global Assessment of Functioning (GAF) scales, respectively. Results: Overall, the patients seen were predominantly Chinese males > 36 years old who had diagnoses including stress-related, anxiety, affective spectrum, and psychotic disorders. The clinical severity score (CGI-S) improved significantly following discharge from the observation unit (t1,1848 = 23.316; P < .001). Logistic regression analyses revealed that self-referred (P = .001), older patients (P = .007) with past psychiatric history (P = .019), lower GAF scores (P = .025), and less improvement of CGI-S scores (P = .001) were associated with inpatient admission after a 23-hour stay in the observation unit. Conclusions: Our study findings affirmed our hypothesis and supported the utility of the observation unit in monitoring the overall clinical status of patients, which was linked with subsequent inpatient admissions. Better management of these patients at the outpatient level can potentially decrease unnecessary hospitalization and reduce health care cost as well as illness burden on patients and caregivers. PMID:26693048

  8. Understanding the Determinants of Australian Hospital Nurses' Hand Hygiene Decisions Following the Implementation of a National Hand Hygiene Initiative

    ERIC Educational Resources Information Center

    White, Katherine M.; Starfelt, Louise C.; Jimmieson, Nerina L.; Campbell, Megan; Graves, Nicholas; Barnett, Adrian G.; Cockshaw, Wendell; Gee, Phillip; Page, Katie; Martin, Elizabeth; Brain, David; Paterson, David

    2015-01-01

    Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The "5 critical moments" of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this…

  9. Understanding the Determinants of Australian Hospital Nurses' Hand Hygiene Decisions Following the Implementation of a National Hand Hygiene Initiative

    ERIC Educational Resources Information Center

    White, Katherine M.; Starfelt, Louise C.; Jimmieson, Nerina L.; Campbell, Megan; Graves, Nicholas; Barnett, Adrian G.; Cockshaw, Wendell; Gee, Phillip; Page, Katie; Martin, Elizabeth; Brain, David; Paterson, David

    2015-01-01

    Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The "5 critical moments" of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this

  10. Drug-resistant tuberculosis in HIV-infected patients in a national referral hospital, Phnom Penh, Cambodia

    PubMed Central

    Walls, Genevieve; Bulifon, Sophie; Breysse, Serge; Daneth, Thol; Bonnet, Maryline; Hurtado, Northan; Molfino, Lucas

    2015-01-01

    Background and objective There are no recent data on the prevalence of drug-resistant tuberculosis (DR TB) in Cambodia. We aim to describe TB drug resistance amongst adults with pulmonary and extra-pulmonary TB and human immunodeficiency virus (HIV) co-infection in a national referral hospital in Phnom Penh, Cambodia. Design Between 22 November 2007 and 30 November 2009, clinical specimens from HIV-infected patients suspected of having TB underwent routine microscopy, Mycobacterium tuberculosis culture, and drug susceptibility testing. Laboratory and clinical data were collected for patients with positive M. tuberculosis cultures. Results M. tuberculosis was cultured from 236 HIV-infected patients. Resistance to any first-line TB drug occurred in 34.7% of patients; 8.1% had multidrug resistant tuberculosis (MDR TB). The proportion of MDR TB amongst new patients and previously treated patients was 3.7 and 28.9%, respectively (p<0.001). The diagnosis of MDR TB was made after death in 15.8% of patients; in total 26.3% of patients with MDR TB died. The diagnosis of TB was established by culture of extra-pulmonary specimens in 23.6% of cases. Conclusions There is significant resistance to first-line TB drugs amongst new and previously treated TB–HIV co-infected patients in Phnom Penh. These data suggest that the prevalence of DR TB in Cambodia may be higher than previously recognised, particularly amongst HIV-infected patients. Additional prevalence studies are needed. This study also illustrates the feasibility and utility of analysis of non-respiratory specimens in the diagnosis of TB, even in low-resource settings, and suggests that extra-pulmonary specimens should be included in TB diagnostic algorithms. PMID:25623609

  11. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

    PubMed Central

    2012-01-01

    Background While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery (< 2 days from admission) and in-hospital mortality, controlling for several confounding factors. Results Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%). However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not. PMID:22257790

  12. Transfer of hospitals and "additional premises" to the state: questionable morality in the implementation of the National Health Service Act (1946).

    PubMed

    Cook, G C

    2004-12-01

    The National Health Service Act of 1946, pioneered by Aneurin Bevan, came into being on the "appointed day", 5 July 1948. Hospitals with their "additional premises" throughout Britain were "seized" by the state and incorporated into this vast socialist enterprise. While the majority of the population welcomed this new initiative in the creation of a welfare state, associated with medical care from cradle to grave, not all (especially members of various Hospital Boards of Management) were so enthusiastic. The hospitals for "incurables" (long stay patients) were unhappy and lost a vast proportion of their income owing to a great deal of procrastination; but most of them ultimately managed to escape nationalisation after a prolonged period of negotiation, by a claim that they were "homes" rather than "hospitals". The confiscation of property which had been built as a result of voluntary subscription was another huge and highly contentious matter, which has been highlighted in recent years. The future of the Seamen's Hospital Society's properties represents a good example of this. PMID:15579611

  13. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data

    PubMed Central

    2015-01-01

    Background The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. Methods This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. Findings 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55), p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80) p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about incidents and giving feedback on safety initiatives increased reporting rates [r = 0.26 (p<0.01), r = 0.17 (p = 0.04), r = 0.23 (p = 0.01), r = 0.20 (p = 0.02)]. Conclusion The NRLS is the largest patient safety reporting system in the world. This study did not demonstrate many hospital characteristics to significantly influence overall reporting rate. There were no association between size of hospital, number of staff, mortality outcomes or patient satisfaction outcomes and incident reporting rate. The study did show that hospitals where staff reported more incidents had reduced litigation claims and when clinician staffing is increased fewer incidents reporting patient harm are reported, whilst near misses remain the same. Certain specialties report more near misses than others, and doctors report more harm incidents than near misses. Staff survey results showed that open environments and reduced fear of punitive response increases incident reporting. We suggest that reporting rates should not be used to assess hospital safety. Different healthcare professionals focus on different types of safety incidents and focusing on these areas whilst creating a responsive, confidential learning environment will increase staff engagement with error disclosure. PMID:26650823

  14. 78 FR 55089 - National Maritime Security Advisory Committee; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-09

    ... Federal Register (73 FR 3316). Docket: Any background information or presentations available prior to the... SECURITY Coast Guard National Maritime Security Advisory Committee; Meeting AGENCY: Coast Guard, DHS. ACTION: Notice of Federal Advisory Committee Meeting. SUMMARY: The National Maritime Security...

  15. Turf Guarding the School Testing Arena.

    ERIC Educational Resources Information Center

    Mardell-Czudnowski, Carol D.

    1982-01-01

    A survey of 579 special education professionals investigated the perceived roles of the professionals who use tests and the functions that various tests serve. The issue of turf guarding in assessment responsibilities among professionals working with the learning disabled was considered. (SW)

  16. The Mechanism of Guard Cell Movement

    ERIC Educational Resources Information Center

    Marques, M.; Arrabaca, J.; Chagas, I.

    2005-01-01

    Leaves of higher terrestrial plants have small pores--stomata--responsible for gas exchange. The opening of each stoma results from the osmotic uptake of water by two specialised cells--the guard cells. Because of the involvement in this mechanism of ATPase-proton pumps and active transport of ions across membranes, we have designed an Exploring…

  17. Coast Guard's Response to Spilled Oil

    ERIC Educational Resources Information Center

    Ard, R. W., Jr.

    1976-01-01

    The Coast Guard utilizes a number of monitoring detectors, sensors, and techniques to find, recover and identify oil spills. Discussed in this article are in-situ and airborne sensors, systems developed to provide clean-up capability such as air deployable anti-pollution transfer system (ADAPTS), and techniques which will determine the source of a

  18. Coast Guard's Response to Spilled Oil

    ERIC Educational Resources Information Center

    Ard, R. W., Jr.

    1976-01-01

    The Coast Guard utilizes a number of monitoring detectors, sensors, and techniques to find, recover and identify oil spills. Discussed in this article are in-situ and airborne sensors, systems developed to provide clean-up capability such as air deployable anti-pollution transfer system (ADAPTS), and techniques which will determine the source of a…

  19. General Education at the Coast Guard Academy.

    ERIC Educational Resources Information Center

    Sanders, William A.

    In seeking the most effective presentation of the liberal arts in curricula such as the heavily technical and professional curricula at the U.S. Coast Guard Academy, which leave little room for general education, general education course design must capture the imagination of students and motivate them for continuing self-education. Development of…

  20. The Mechanism of Guard Cell Movement

    ERIC Educational Resources Information Center

    Marques, M.; Arrabaca, J.; Chagas, I.

    2005-01-01

    Leaves of higher terrestrial plants have small pores--stomata--responsible for gas exchange. The opening of each stoma results from the osmotic uptake of water by two specialised cells--the guard cells. Because of the involvement in this mechanism of ATPase-proton pumps and active transport of ions across membranes, we have designed an Exploring

  1. Influential Factors for and Outcomes of Hospitalized Patients with Suicide-Related Behaviors: A National Record Study in Taiwan from 1997–2010

    PubMed Central

    Lin, Yu-Wen; Huang, Hui-Chuan; Lin, Mei-Feng; Shyu, Meei-Ling; Tsai, Po-Li; Chang, Hsiu-Ju

    2016-01-01

    Background Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors. Objectives To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records. Design This is a cohort study of Taiwan’s national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010. Participants The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950–E959) according to the International Classification of Disease, Ninth Revision, Clinical Modification. Results Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder), had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide-related behaviors, had a catastrophic illness, or had adopted a single lethal method had an increased risk of death by suicide. Conclusions High-risk factors should be considered when devising suicide-prevention strategies. PMID:26900930

  2. Behavioral differences between public and private not-for-profit hospitals in the Italian National Health Service.

    PubMed

    Barbetta, Gian Paolo; Turati, Gilberto; Zago, Angelo M

    2007-01-01

    In this paper we attempt to identify behavioral differences between public and private not-for-profit hospitals, by exploiting the introduction of the DRG-based payment system in the Italian NHS during the second half of the 1990s. We estimate the technical efficiency of a sample of hospitals for the period 1995-2000 considering an output distance function, and adopting both parametric (COLS and SF) and nonparametric (DEA) approaches. Our results show a convergence of mean efficiency scores between not-for-profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. We also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates. PMID:16929498

  3. Creating a “culture of research” in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program

    PubMed Central

    St. Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

    2015-01-01

    Background The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute’s Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. Methods To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. Limitations The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important component yet often challenging to identify and collect. The model requires a strong emphasis on outreach that challenges hospitals to improve and expand their reach, particularly into underrepresented populations and catchment areas. These efforts build on trust and a referral pipeline within the community which take time and significant commitment to establish. Conclusion The National Cancer Institute Community Cancer Centers Program experience provides a relevant model to broadly address creating a culture of research in community hospitals that are increasingly networked via systems and consortiums. The strategies used align well with the National Cancer Institute—American Society of Clinical Oncology Accrual Symposium recommendations for patient-/community-, physician-/provider-, and site-/organizational-level approaches to clinical trials; they helped sites achieve organizational culture shifts that enhanced their cancer research programs. The National Cancer Institute Community Cancer Centers Program hospitals reported that the strategies were challenging to implement yet proved valuable as they provided useful metrics for programmatic assessment, planning, reporting, and growth. While focused on oncology trials, these concepts may be useful within other disease-focused research as well. PMID:25691600

  4. Impact of tobacco control policies in hospitals: Evaluation of a national smoke-free campus ban in Spain

    PubMed Central

    Sureda, Xisca; Ballbè, Montse; Martínez, Cristina; Fu, Marcela; Carabasa, Esther; Saltó, Esteve; Martínez-Sánchez, Jose M.; Fernández, Esteve

    2014-01-01

    Introduction On January 2, 2011, the Spanish government passed a new smoking law that banned smoking in hospital campuses. The objective of this study was to evaluate the implementation of smoke-free campuses in the hospitals of Catalonia based on both airborne particulate matter and observational data. Methods This cross-sectional study included the hospitals registered in the Catalan Network of Smoke-free Hospitals. We measured the concentration of particulate matter < 2.5 µm in μg/m3 at different locations, both indoors and outdoors before (2009) and after (2011) the implementation of the tobacco law. During 2011, we also assessed smoke-free zone signage and indications of smoking in the outdoor areas of hospital campuses. Results The overall median particulate matter < 2.5 µm concentration fell from 12.22 μg/m3 (7.80–19.76 μg/m3) in 2009 to 7.80 μg/m3 (4.68–11.96 μg/m3) in 2011. The smoke-free zone signage within the campus was moderately implemented after the legislation in most hospitals, and 55% of hospitals exhibited no indications of tobacco consumption around the grounds. Conclusions After the law, particulate matter < 2.5 µm concentrations were much below the values obtained before the law and below the annual guideline value recommended by the World Health Organization for outdoor settings (10 μg/m3). Our data showed the feasibility of implementing a smoke-free campus ban and its positive effects. PMID:26844041

  5. Implementation and adoption of nationwide electronic health records in secondary care in England: final qualitative results from prospective national evaluation in early adopter hospitals

    PubMed Central

    2011-01-01

    Objectives To evaluate the implementation and adoption of the NHS detailed care records service in early adopter hospitals in England. Design Theoretically informed, longitudinal qualitative evaluation based on case studies. Setting 12 early adopter NHS acute hospitals and specialist care settings studied over two and a half years. Data sources Data were collected through in depth interviews, observations, and relevant documents relating directly to case study sites and to wider national developments that were perceived to impact on the implementation strategy. Data were thematically analysed, initially within and then across cases. The dataset consisted of 431 semistructured interviews with key stakeholders, including hospital staff, developers, and governmental stakeholders; 590 hours of observations of strategic meetings and use of the software in context; 334 sets of notes from observations, researchers field notes, and notes from national conferences; 809 NHS documents; and 58 regional and national documents. Results Implementation has proceeded more slowly, with a narrower scope and substantially less clinical functionality than was originally planned. The national strategy had considerable local consequences (summarised under five key themes), and wider national developments impacted heavily on implementation and adoption. More specifically, delays related to unrealistic expectations about the capabilities of systems; the time needed to build, configure, and customise the software; the work needed to ensure that systems were supporting provision of care; and the needs of end users for training and support. Other factors hampering progress included the changing milieu of NHS policy and priorities; repeatedly renegotiated national contracts; different stages of development of diverse NHS care records service systems; and a complex communication process between different stakeholders, along with contractual arrangements that largely excluded NHS providers. There was early evidence that deploying systems resulted in important learning within and between organisations and the development of relevant competencies within NHS hospitals. Conclusions Implementation of the NHS Care Records Service in early adopter sites proved time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients. Although our results might not be directly transferable to later adopting sites because the functionalities we evaluated were new and untried in the English context, they shed light on the processes involved in implementing major new systems. The move to increased local decision making that we advocated based on our interim analysis has been pursued and welcomed by the NHS, but it is important that policymakers do not lose sight of the overall goal of an integrated interoperable solution. PMID:22006942

  6. Factors associated with major structural birth defects among newborns delivered at Muhimbili National Hospital and Municipal Hospitals in Dar Es Salaam, Tanzania 2011 – 2012

    PubMed Central

    Kishimba, Rogath Saika; Mpembeni, Rose; Mghamba, Janneth

    2015-01-01

    Introduction Ninety-four percent of all birth defects and 95% of deaths due to the birth defects occur in low and middle income countries, Tanzania among them. In Tanzania there are currently limited birth defects prevention strategies in place due to limited information on factors associated with the occurrence of birth defects. Methods We conducted a case control study that included newborns born from October, 2011 through February, 2012 at 4 participating hospitals. A case was defined as any newborn of a Dar es salaam resident with a neural tube defect, orofacial clefts, limb reduction defects or musculo-skeletal defects (SBD) born during the study period. A control was defined as the next three newborns (delivered after the case) without birth defects. Univariate, bivariate and multivariate analysis were done using Epi Info version 3.5.1. Results A total of 400 newborns participated in the study, 100 cases and 300 controls. Factors associated with higher odds of a SBD included maternal fever (adjusted odds ratio (AOR) = 1.99; 95% confidence interval (CI): 1.14-3.52), maternal hypertension (AOR = 3.99; 95% CI: 1.67-9.54), and low birth weight (AOR = 3.48; 95% CI: 1.77-6.85). Antimalarial use during pregnancy was protective (AOR = 0.48; 95% CI: 0.28-0.84). Folic acid supplementation was protective only in bivariate analysis (OR = 0.56; 95% CI: 0.32-0.96). Conclusion Maternal fever, hypertension, and low birth weight are associated with higher odds of SBD. Antimalarial use during pregnancy was associated with lower odds of SBD. Early screening of pregnant mothers for hypertension and other causes of low birth weight may reduce SBD in Dar Es Salaam. PMID:26525082

  7. 30 CFR 75.816 - Guarding of cables.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.816 Guarding of cables. (a) High-voltage cables must be guarded at the following...

  8. 30 CFR 75.827 - Guarding of trailing cables.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.827 Guarding of trailing cables. (a) Guarding. (1) The high-voltage cable must...

  9. 30 CFR 75.816 - Guarding of cables.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.816 Guarding of cables. (a) High-voltage cables must be guarded at the following...

  10. 1. GUARD RESIDENCE, GARAGE, NORTHWEST FRONT AND NORTHEAST SIDE LOOKING ...

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

    1. GUARD RESIDENCE, GARAGE, NORTHWEST FRONT AND NORTHEAST SIDE LOOKING SOUTH - Union Ranger District Compound, Garage-Guard Residence, Fronting State Highway 203, at West edge of Union, Union, Union County, OR

  11. 30 CFR 77.400 - Mechanical equipment guards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hazardous to persons below. (c) Guards at conveyor-drive, conveyor-head, and conveyor-tail pulleys shall... between the belt and the pulley. (d) Except when testing the machinery, guards shall be securely in...

  12. Cell block one and southeast guard tower, looking from the ...

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

    Cell block one and southeast guard tower, looking from the central guard tower, facing southeast (note view also includes cell block ten (left) and cell block nine (right)) - Eastern State Penitentiary, 2125 Fairmount Avenue, Philadelphia, Philadelphia County, PA

  13. MAPK Cascades in Guard Cell Signal Transduction

    PubMed Central

    Lee, Yuree; Kim, Yun Ju; Kim, Myung-Hee; Kwak, June M.

    2016-01-01

    Guard cells form stomata on the epidermis and continuously respond to endogenous and environmental stimuli to fine-tune the gas exchange and transpirational water loss, processes which involve mitogen-activated protein kinase (MAPK) cascades. MAPKs form three-tiered kinase cascades with MAPK kinases and MAPK kinase kinases, by which signals are transduced to the target proteins. MAPK cascade genes are highly conserved in all eukaryotes, and they play crucial roles in myriad developmental and physiological processes. MAPK cascades function during biotic and abiotic stress responses by linking extracellular signals received by receptors to cytosolic events and gene expression. In this review, we highlight recent findings and insights into MAPK-mediated guard cell signaling, including the specificity of MAPK cascades and the remaining questions. PMID:26904052

  14. MAPK Cascades in Guard Cell Signal Transduction.

    PubMed

    Lee, Yuree; Kim, Yun Ju; Kim, Myung-Hee; Kwak, June M

    2016-01-01

    Guard cells form stomata on the epidermis and continuously respond to endogenous and environmental stimuli to fine-tune the gas exchange and transpirational water loss, processes which involve mitogen-activated protein kinase (MAPK) cascades. MAPKs form three-tiered kinase cascades with MAPK kinases and MAPK kinase kinases, by which signals are transduced to the target proteins. MAPK cascade genes are highly conserved in all eukaryotes, and they play crucial roles in myriad developmental and physiological processes. MAPK cascades function during biotic and abiotic stress responses by linking extracellular signals received by receptors to cytosolic events and gene expression. In this review, we highlight recent findings and insights into MAPK-mediated guard cell signaling, including the specificity of MAPK cascades and the remaining questions. PMID:26904052

  15. A&M. Guard house (TAN638). Detail of west facade and front ...

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

    A&M. Guard house (TAN-638). Detail of west facade and front door. Flood light bent below eave. Traffic control signal in view. Camera facing east. Date: February 4, 2003. INEEL negative no. HD-33-6-3 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  16. 49 CFR 571.223 - Standard No. 223; Rear impact guards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 6 2014-10-01 2014-10-01 false Standard No. 223; Rear impact guards. 571.223 Section 571.223 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR VEHICLE SAFETY STANDARDS Federal Motor Vehicle Safety Standards §...

  17. 49 CFR 571.223 - Standard No. 223; Rear impact guards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Standard No. 223; Rear impact guards. 571.223 Section 571.223 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR VEHICLE SAFETY STANDARDS Federal Motor Vehicle Safety Standards §...

  18. 49 CFR 571.223 - Standard No. 223; Rear impact guards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 6 2011-10-01 2011-10-01 false Standard No. 223; Rear impact guards. 571.223 Section 571.223 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR VEHICLE SAFETY STANDARDS Federal Motor Vehicle Safety Standards §...

  19. 13. MASONRY GUARD WALL AND CONCRETE CRIBBING. ROAD VIEW 1.5 ...

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

    13. MASONRY GUARD WALL AND CONCRETE CRIBBING. ROAD VIEW 1.5 MILES NORTH OF TREE HOUSE. SOUTH OF PIERCY, HUMBOLDT COUNTY, CALIFORNIA. LOOKING SE. - Redwood National & State Parks Roads, California coast from Crescent City to Trinidad, Crescent City, Del Norte County, CA

  20. 121. ARAI Guard house (ARA628). Drawing shows north, south, east, ...

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

    121. ARA-I Guard house (ARA-628). Drawing shows north, south, east, and west elevations, floor plan, counter details, and roof plan. Norman Engineering Corporation 961-area/SF-628-A-1. Date: January 1959. Ineel index code no. 063-0628-00-613-102772. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID