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Sample records for national guard hospital

  1. The National Guard: State versus National Control.

    ERIC Educational Resources Information Center

    Newland, Samuel J.

    1989-01-01

    Provides historical perspectives on control of the National Guard by examining early writings to determine the original intent for what was the militia. Argues that it was established to defend the nation, but current governors are attempting to assert a stronger state role. Such actions could undermine national defense. (Author/CH)

  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. 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.

  4. 78 FR 11676 - Notice of Inventory Completion: National Guard Bureau/A7AN, Air National Guard, Joint Base...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... National Park Service Notice of Inventory Completion: National Guard Bureau/A7AN, Air National Guard, Joint... American Graves Protection and Repatriation Act (NAGPRA), 25 U.S.C. 3003, of the completion of an inventory... recovered from disarticulate burials (at minimum 43 individuals) as well as from formal interments...

  5. 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)

  6. 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,…

  7. 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. 728.25 Section 728.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care....

  8. 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. 728.25 Section 728.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care....

  9. 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. 728.25 Section 728.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care....

  10. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Army and Air Force National Guard personnel. 728.25 Section 728.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care....

  11. 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... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care....

  12. 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.

  13. 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…

  14. 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.

  15. The “Suicide Guard Rail”: a minimal structural intervention in hospitals reduces suicide jumps

    PubMed Central

    2012-01-01

    Background Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital’s windows, a metal guard rail was installed at each window of the high-rise building. Results In the 114?months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital’s windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78?months immediately following the installation of the rails at the hospital’s windows (?2?=?4.34, df?=?1, p?=?.037). Conclusions Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps. PMID:22862804

  16. 32 CFR 536.100 - Applicable law for claims under the National Guard Claims Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Applicable law for claims under the National Guard Claims Act. 536.100 Section 536.100 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard Claims Act § 536.100 Applicable law...

  17. 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

  18. 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

  19. 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!

  20. 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

  1. 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…

  2. 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...

  3. 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 County, OR; Danger Zone AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Notice of proposed rulemaking and request for comments. SUMMARY: The U.S. Army Corps of Engineers is proposing to establish a...

  4. 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…

  5. 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,…

  6. 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…

  7. 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...

  8. 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...

  9. 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...

  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. 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

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. South dakota Air National Guard Joe Foss Field, Sioux Falls, SD remedial investigation. Final report

    SciTech Connect

    Not Available

    1990-09-01

    This report describes the remedial actions on sites confirmed to contain hazardous wastes at Joe Foss Field, Sioux Falls, South Dakota. The report describes the actions taken and the follow-up testing to insure no contamination exists that will endanger human heath. The study was conducted under the Air National Guard's Installation Restoration Program. Partial contents of this report includes: geology; hydrology; surface water quality; ground water; climate and air quality; natural resources; land use; soil tests (drilling, core sampling); storage and disposal; recovery of soils; and water reclamation and recovery.

  2. 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.

  3. 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.

  4. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  5. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  6. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  7. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  8. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  9. Stationwide environmental baseline survey and related environmental factors, Ontario Air National Guard Station, California

    SciTech Connect

    1996-11-26

    This Environmental Baseline Survey (EBS) has been prepared to document the environmental condition of real property at Ontario Air National Guard Station (ANGS), California, resulting from the storage, release, and disposal of hazardous substances and petroleum products and their derivatives over the installations history. This EBS is also used by the Air Force to meet its obligations under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), 42 United States Code Section 9620(h), as amended by the Community Environmental Response Facilitation Act (CERFA) (Public Law 102-426). Table ES-1 list all uncontaminated property based on information obtained through a records search, interviews, and visual site inspections at Ontario ANGS. Figure ES-1 depicts their respective locations.

  10. 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

  11. Line-of-duty injury or illness in an Air National Guard unit.

    PubMed

    Lorich, Michael F; Marshall, Muriel; Walker, William; Clark, Sharon E; Rene, Antonio; Ivanovskis, George

    2002-09-01

    Line-of-duty injuries or illnesses (LODs) suffered by members of Air National Guard units may demonstrate the status of unit safety, unit readiness and deployability, a potentially significant area of unit expenditures, and areas of needed health promotion. This descriptive pilot study was conducted at the unit commander's request to investigate an apparent doubling of the expected number of LODs over a recent quarterly period. Twenty cases were investigated. The vast majority of LODs were musculoskeletal in nature. Decreased fitness level (identified as increased body mass index) among males and increased age were related to increased LODs. Recommendations are given to improve tracking, identify individuals at increased risk, provide pretraining assessment, and institute health promotion focused on musculoskeletal injuries. PMID:12363163

  12. Baseline prevalence of Axis I diagnosis in the Ohio Army National Guard.

    PubMed

    Tamburrino, Marijo B; Chan, Philip; Prescott, Marta; Calabrese, Joseph; Liberzon, Israel; Slembarski, Renee; Shirley, Edwin; Fine, Thomas; Goto, Toyomi; Wilson, Kimberly; Derus, Alphonse; Ganocy, Stephen; Beth Serrano, Mary; Galea, Sandro

    2015-03-30

    The goal of this study is to determine the pre-existing lifetime and current prevalence of DSM-IV Axis I disorders within the Ohio Army National Guard (OHARNG). Data was analyzed from the clinical subsample of the Ohio Army National Guard Mental Health Initiative (OHARNG MHI). Five hundred participants were provided with an in-depth clinical assessment using the Clinician-Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM-IV-TR (SCID). Logistic regression examined the relationship between Axis I disorders and the number of deployments and gender. Prevalence of at least one DSM-IV lifetime disorder was 66.2%; substance use disorders were 52.2%, followed by mood disorders (30.0%) and anxiety disorders (22.0%). Prevalence of at least one current disorder was 24.8%; anxiety disorders (13.2%), mood disorders (7.6%), and substance use disorders (7.0%) were most frequent. Number of deployments was associated with PTSD (OR=8.27, 95% CI 2.10-32.59, p=0.003), alcohol use disorder (OR=1.77, 95% CI 1.07-2.92, p=0.025), and any substance use disorder (OR=1.85, 95% CI 1.12-3.05, p=0.016). Gender (OR=2.02, 95% CI 1.10-3.73, p=0.024) was associated with any mood disorder. The results provide baseline information on the most prevalent mental disorders within the OHARNG. PMID:25623021

  13. 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

  14. 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

  15. 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.

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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

    ... greatest generations. As essential components of our military, the National Guard and Reserve have helped... opportunities and support they have earned. Of the more than 2 million Americans who have gone to war since... military families, businesses nationwide are helping them meet the challenges they face and defend...

  2. 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

  3. 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

  4. 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

  5. Prevalence of mental disorders among high school students in National Guard Housing, Riyadh, Saudi Arabia

    PubMed Central

    Al-Sughayr, Abdulrhman M.; Ferwana, Mazen S.

    2012-01-01

    Background: Adolescents experience rapid biological, psychological, and social transitions that can be associated with mental health problems. During the high school period there are also more academic stressors. Objective: (1) To study the prevalence of mental disorders in high school (grade 12) students. (2) To study some related sociodemographic data. Materials and Methods: A cross-sectional study, using GHQ-28, that included 354 students randomly selected from grade 12 in four high schools – two male and two female high schools – in the National Guard Housing (Iskan), in Kashmalaan (suburb of Riyadh). Results: The overall prevalence of mental disorders was found to be 48% (41% in males and 51% in females); more than 80% of these cases were mild to moderate. Females showed significantly more severe disorders than males (P = 0.017) and students with excellent performance degrees showed a significantly lower rate of mental disorders than others (P = 0.021). However, our study did not show a significant association between psychiatric disorders and other social variables (family size, birth order, and polygamous family) or smoking. Conclusion: The adolescent age groups in our community had high rates of mental disorders, which required more attention from the family, as well as the educational and health institutes in our country. PMID:22518359

  6. 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

  7. 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.

  8. 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.

  9. Former warehouse area, site investigation report; Volume 2 (appendices): Buckley Air National Guard Base, Aurura, Colorado. Final report

    SciTech Connect

    1997-12-22

    This Site Investigation (SI) Report presents the results of the Former Warehouse Area (FWA) Site Investigation at the Buckley Air National Guard Base (Buckley ANGB or Base) located in Aurora, Colorado. Work was conducted under the Installation Restoration Program (IRP). The purpose of the SI was to confirm the presence and determine the nature of soil and groundwater COPC at the FWA. The FWA SI was accomplished by conducting a sequential environmental field investigation involving a geophysical survey, followed by a drilling and sampling program that included collecting and analyzing soil gas, soil, and groundwater samples within the FWA. This FWA SI report defines the nature of COPC present at the FWA, identifies potential source areas for COPC, and characterizes site geology and hydrogeology. All site investigation activities were conducted in accordance with the Final Former Warehouse Area Site Investigation Work Plan, dated October 4, 1996, prepared by Stone Webster for the Departments of the Army and the Air Force National Guard Bureau. The methods and procedures presented in the Work Plan followed U.S. EPA guidance documents and Air National Guard (ANG) requirements. Detailed background information based on previous investigations conducted at the Buckley ANGB are not presented in this report. Instead, summary information is presented and documents containing the detailed site information are referenced.

  10. Former warehouse area, site investigation report; Volume 1 (report): Buckley Air National Guard Base, Aurura, Colorado. Final report

    SciTech Connect

    1997-12-22

    This Site Investigation (SI) Report presents the results of the Former Warehouse Area (FWA) Site Investigation at the Buckley Air National Guard Base (Buckley ANGB or Base) located in Aurora, Colorado. Work was conducted under the Installation Restoration Program (IRP). The purpose of the SI was to confirm the presence and determine the nature of soil and groundwater COPC at the FWA. The FWA SI was accomplished by conducting a sequential environmental field investigation involving a geophysical survey, followed by a drilling and sampling program that included collecting and analyzing soil gas, soil, and groundwater samples within the FWA. This FWA SI report defines the nature of COPC present at the FWA, identifies potential source areas for COPC, and characterizes site geology and hydrogeology. All site investigation activities were conducted in accordance with the Final Former Warehouse Area Site Investigation Work Plan, dated October 4, 1996, prepared by Stone Webster for the Departments of the Army and the Air Force National Guard Bureau. The methods and procedures presented in the Work Plan followed U.S. EPA guidance documents and Air National Guard (ANG) requirements. Detailed background information based on previous investigations conducted at the Buckley ANGB are not presented in this report. Instead, summary information is presented and documents containing the detailed site information are referenced.

  11. 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

  12. 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.

  13. 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

  14. 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

  15. Bird guard

    DOEpatents

    Fairchild, Dana M. (Armour, SD)

    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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. NAPPH (National Association of Private Psychiatric Hospitals) statement of principles of psychiatric hospital practice ethics.

    PubMed

    1989-01-01

    A competitive and dynamic healthcare environment requires that psychiatric hospital administrators and physicians continually monitor their hospital's ability to deliver quality services to their patients. To ensure that hospitals stand for and abide by psychiatric hospital practice ethics, the National Association of Private Psychiatric Hospitals (NAPPH) Board of Trustees has formally approved and distributed to the industry a "Statement of Principles of Psychiatric Hospital Practice Ethics." Adopted at the June 22, 1989, Board meeting, the guidelines not only summarize views long held in the industry, but are a condition of NAPPH membership. Nine critical areas are identified in the NAPPH statement: admissions, advertising, marketing and referral development, resource allocation and appropriateness of care, treatment rendered, patients' rights, family rights and involvement, competition, and financial resources. Central to ethical hospital practice is a moral responsibility--shared among administrators, trustees, physicians and staff--to ensure access to care, quality of care, and fair treatment of patients. NAPPH represents more than 300 private psychiatric hospitals throughout the United States, and the NAPPH mission includes the promotion of high-quality care and treatment, efficient hospital operation, and advocacy for the patients served by its member hospitals. Each NAPPH hospital actively supports the appropriate, safe, and compassionate treatment of the mentally ill. PMID:10296960

  7. 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…

  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. 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…

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. Rural hospitals' experience with the National Practitioner Data Bank.

    PubMed Central

    Neighbor, W E; Baldwin, L M; West, P A; Hart, L G

    1997-01-01

    OBJECTIVES: This study examined hospital administrators' experiences with the National Practitioner Data Bank. METHODS: One hundred forty-nine rural hospital administrators completed questionnaires assessing their perceptions of the data bank. RESULTS: Nearly 90% of respondents rated the data bank as an important source of information for credentialing. Three percent indicated it had directly affected privileging decisions; 43% and 34%, respectively, believed the costs exceeded or equaled the benefits. Twenty percent reported changes that could decrease disciplinary action reports to the data bank. CONCLUSIONS: While the National Practitioner Data Bank is an important source of information to rural hospitals, it may, affect few credentialing decisions and motivate behavioral changes that could have a paradoxical effect on quality assurance. Images FIGURE 1 PMID:9146450

  1. 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

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 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, 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. 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…

  9. 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…

  10. Installation restoration program final remedial investigation report IRP sites 8 and 10. 151st air refueling group Utah Air National Guard, Salt Lake City, Utah. Final report

    SciTech Connect

    1996-06-01

    This report presents the results from a Remedial Investigation (RI) for two sites at the Utah Air National Guard (UANG) Base located in Salt Lake City, Utah. The two sites investigated are identified as Installation Restoration Program (IRP) Site 8, a former underground storage tank (UST) location, and IRP Site 10, an existing petroleum, oil, and lubricants (POL) yard. The RI was conducted as outlined in the Remedial Investigation/Feasibility Study (RI/FS) Work Plan prepared by Stone Webster and submitted to and approved by the ANG in May 1993. The field work associated with the RI was performed in June, July, and August 1995.

  11. 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

  12. 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.

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

    PubMed

    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

  14. 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.

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

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

    MedlinePLUS

    ... 2000 and 2005, and for 70% in 2010. Did the length of stay for hospitalizations ending in ... hospital in the years 2000–2010 decreased, as did the rate of hospitalizations ending in death, but ...

  1. Installation restoration program: Closure investigation report. Site 1: Former base landfill; Stewart Air National Guard Base, Newburgh, New York. Volume I. Final report

    SciTech Connect

    1997-04-01

    A Closure Investigation (Cl) of Site 1, the former Base Landfill at Stewart Air National Guard Base (the Base) located at the Stewart International Airport (lAP), was performed by Aneptek Corporation (ANEPTEK). Site 1 is located southeast of the airport complex. Site 1 and Site 2 (the former pesticide pit disposal area) have been the subject of several previous investigations by both the New York State Department of Environmental Conservation (NYSDEC) and the National Guard Bureau. Scope of Investigation. The CI field program included air monitoring and the sampling of subsurface soils, surface water and groundwater to provide data for an evaluation of site geology, hydrogeology, and potential environmental impacts from the Site 1 landfill. Ml groundwater and surface water samples submitted for off-site laboratory analysis were analyzed for the full list of Baseline Parameters provide in Chapter 6 of the New York Codes, Rules, and Regulations (6 NYCRR) Part 360-2.11. Physical characteristics of the fill and cover material were defined through the installation and monitoring of slope stability monuments and settlement pads. Test pits were excavated to determine the lateral extent of waste. Soil samples collected from the existing interim cover were submitted to an off-site laboratory for grain size analyses. Slug tests were performed on monitoring wells to provide estimates of formation hydraulic conductivity. In accordance with the requirements of 6 NYCRR Part 360-2.15, an explosive gas investigation was conducted using a slam-bar and monitoring gasses with a flame ionization detector (FID) and a meter capable of detecting percent oxygen, percent lower explosive limit (LEL), carbon monoxide, and hydrogen sulfide. A complete site walkover of the landfill was made to locate any areas of leachate outbreak; and a vector survey was conducted by a field biologist.

  2. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Department of the Air Force Record of Decision for the 158th Fighter Wing's Proposed Realignment of National...: On November 18, 2010, the United States Air Force signed the ROD for the 158th Fighter...

  3. 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

    ..., the 9/11 Generation has borne the burden of war with courage and valor, continuing the legacy of the... opportunities they deserve, the First Lady and Dr. Jill Biden announced Joining Forces, a comprehensive national initiative to support and honor these patriots. As part of this initiative, we issued a challenge to...

  4. 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.

  5. 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

  6. 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.

  7. 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)

  8. 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....

  9. 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....

  10. 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....

  11. 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....

  12. 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... 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....

  13. [Historical origins between National Medical Association of China and Boji Hospital in Guangzhou].

    PubMed

    Liu, Pinming

    2015-09-01

    In 2015, National Medical Association of China, now being called the Chinese Medical Association, celebrates its centennial and Boji Hospital in Guangzhou ( also known as Canton Hospital, or the Canton Pok Tsai Hospital, and now Sun Yat-sen Memorial Hospital of Sun Yat-sen University ) marks its 180th anniversary. Three major historical events establish the role of Boji Hospital in the founding and development of the National Medical Association of China during the last 100 years, viz.: ?hosting and participating in the establishment of the Medical Missionary Association of China and its official journal: the China Medical Missionary Journal; ?holding the 11th scientific sessions of the National Medical Association of China; ?nominating Dr. Wu Lien-teh as a candidate for the Nobel Prize in Physiology or Medicine in 1935 by William Warder Cadbury, the president of Boji Hospital. PMID:26813092

  14. [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

  15. Prey abundance and food habits of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training site, California

    SciTech Connect

    Logan, C.G.; Berry, W.H.; Standley, W.G.; Kato, T.T.

    1992-09-01

    Prey abundance and food habits of the San Joaquin kit fox (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training site, California, from November 1988 through September 1991. The sampling methods initially used to assess abundance of prey species resulted in indices too low to be of value. Because of this, the relationship between relative abundance and frequency of occurrence of prey species could not be examined. Six hundred forty-nine fecal samples (scats) were analyzed to determine the frequency of occurrence of prey items. California ground squirrels (Spermophilus beecheyi) and lagomorphs primarily desert cottontails (Sylvilagus audubonii) and black-tailed jackrabbits (Lepus californicus) were the most frequently occurring mammalian prey items found in scats (35.0% and 12.2%, respectively). The frequency of occurrence of ground squirrel (but not lagomorph) remains in scats collected from juveniles was significantly higher than in scats collected from adults. The frequency of occurrence of ground squirrel and lagomorph remains in scats collected from males was not significant different than in scats collected from females. There were significant variations in the frequency of ground squirrel remains among the years 1989--1991 and during the June--November periods between 1989 and 1990 and between 1990 and 1991. The frequency of lagomorph remains collected during the June--November period differed significantly among the years 1989--1991 and between 1990 and 1991.

  16. 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.

  17. Drug-positive rates for the Army from fiscal years 1991 to 2000 and for the National Guard from Fiscal years 1997 to 2000.

    PubMed

    Bruins, Mark R; Okano, Catherine K; Lyons, Timothy P; Lukey, Brian J

    2002-05-01

    This article examines the positive rate by drug for all urinalysis specimens tested by the U.S. Army from fiscal year 1991 (FY91) to FY00 and for the Army National Guard (NG) from FY97 to FY00. The average positive rate for the Army from FY91 to FY00 was 0.84%. In FY00, the Army rate reached a 10-year high of 1.04%. From FY97 to FY00, the NG positive rate declined from 3.4% to 2.16% but was significantly (p < 0.05) higher than the Army rate during the same period. Marijuana and cocaine are the most abused drugs for both the Army and NG. The positive rate for marijuana in the Army from FY91 to FY00 was 0.51%, and the cocaine rate was 0.19%. The NG marijuana-positive rate from FY97 to FY00 was 1.70%, and the cocaine rate was 0.51%. The positive rate for all other drugs of abuse tested was less than 0.3% for both the Army and NG during the same periods. The overall positive rate for the Army and NG are below those estimated (6.3%) in the civilian population. PMID:12053845

  18. 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

  19. 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

  20. Are the nation's hospitals facing a capital crisis?

    PubMed

    Johnsson, J

    1990-07-20

    Are hospitals facing a capital crisis? Wall Street is taking a long, hard look at hospitals' bottom lines--and many analysts don't like what they see. Hospitals' increasing reliance on long-term debt, lower debt-service coverage ratios, and weakening performance indicators all signal a potentially volatile situation for some sectors of the field. Which hospitals are at risk? Experts point to hospitals in Southern California and New York. But others say that hospitals in moderate-size cities with 250 beds and $40 million or more in long-term debt are vulnerable. However, 40 percent of the 600 CEOs who responded to our Hamilton/KSA survey agree that the continued erosion of reimbursement will require a government bailout similar to the savings and loan industry. "A great deal depends on public policy," says Darrel Brownell, executive vice-president and chief financial officer, Memorial Health Services, a two-hospital system based in Long Beach, CA. "The government has the ability to maintain the industry in a stable condition, or it has the ability to force it into a bailout situation." PMID:2370036

  1. 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.

  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. 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

  4. 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...

  5. 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...

  6. 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

  7. 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

  8. 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

  9. Installation restoration program: Remedial investigation report addendum for IRP site number 6. Volume 1. 161st Air Refueling Group Arizona Air National Guard Sky Harbor International Airport Phoenix, Arizona

    SciTech Connect

    1996-05-01

    This document is the Remedial Investigation Report Addendum for IRP Site No. 6, Arizona National Guard, 161st Air Refueling Group, Sky Harbor International Airport, Phoenix, Arizona. This is the first volume of a two volume addendum to the Remedial Investigation Report, May 1996. Site 6. POL Facility was investigated under the Installation Restoration Program. Soil and groundwater samples were collected and analyzed. Remedial Action was recommended for both groundwater and soil associated with the site.

  10. Installation restoration program: Remedial investigation report addendum for IRP site number 6. Volume 2. 161st Air Refueling Group Arizona Air National Guard Sky Harbor International Airport Phoenix, Arizona

    SciTech Connect

    1996-05-01

    This document is the Remedial Investigation Report Addendum for IRP Site No. 6, Arizona National Guard, 161st Air Refueling Group, Sky Harbor International Airport, Phoenix, Arizona. This is the first volume of a two volume addendum to the Remedial Investigation Report, May 1996. Site 6. POL Facility was investigated under the Installation Restoration Program. Soil and groundwater samples were collected and analyzed. Remedial Action was recommended for both groundwater and soil associated with the site.

  11. [Access to hospitalization in Brazilian municipalities in 2000: territorial distribution in the Unified National Health System].

    PubMed

    Oliveira, Evangelina X G de; Travassos, Cláudia; Carvalho, Marilia Sá

    2004-01-01

    This article investigates the effect of external factors on hospitalization patterns in Brazilian municipalities (or counties): supply, spatial configuration, socioeconomic aspects, and political context. Inpatient data from 2000 for individuals 15 years and over and most frequent hospital procedures, obtained from the National Hospital Information System (SIH-SUS), were aggregated by place of residence at the municipal level. Nested generalized additive mixed models were fitted using Bayesian inference. Probability of hospitalization is shown to increase with hospital bed supply and with primary care and local capacity, and to decrease with increasing distances and in larger and wealthier municipalities. Inclusion of random, State, and spatial patterns effects reveals regional differences in the probability of hospitalization and the main factors explaining such different patterns. PMID:15608942

  12. Trends in hospital admissions for adverse drug reactions in England: analysis of national hospital episode statistics 1998–2005

    PubMed Central

    Patel, Hitesh; Bell, Derek; Molokhia, Mariam; Srishanmuganathan, Janakan; Patel, Mitesh; Car, Josip; Majeed, Azeem

    2007-01-01

    Background Adverse drug reactions (ADRs) are a frequent cause of mortality and morbidity to patients worldwide, with great associated costs to the healthcare providers including the NHS in England. We examined trends in hospital admissions associated with adverse drug reaction in English hospitals and the accuracy of national reporting. Methods Data from the Hospital Episode Statistics database (collected by the Department of Health) was obtained and analysed for all English hospital episodes (1998–2005) using ICD-10 codes with a primary (codes including the words ('drug-induced' or 'due to') or secondary diagnosis of ADR (Y40–59). More detailed analysis was performed for the year 2004–2005 Results Between 1998 and 2005 there were 447 071 ADRs representing 0.50% of total hospital episodes and over this period the number of ADRs increased by 45%. All ADRs with an external code increased over this period. In 2005 the total number of episodes (all age groups) was 13,706,765 of which 76,692 (0.56%) were drug related. Systemic agents, which include anti-neoplastic drugs, were the most implicated class (15.7%), followed by analgesics (11.7%) and cardiovascular drugs (10.1%). There has been a 6 fold increase in nephropathy secondary to drugs and a 65% decline in drug induced extra-pyramidal side effects. 59% of cases involving adverse drug reactions involved patients above 60 years of age. Conclusion ADRs have major public health and economic implications. Our data suggest that national Hospital Episode Statistics in England have recognised limitations and that consequently, admissions associated with adverse drug reactions continue to be under-recorded. External causes of ADR have increased at a greater rate than the increase in total hospital admissions. Improved and more detailed reporting combined with educational interventions to improve the recording of ADRs are needed to accurately monitor the morbidity caused by ADRs and to meaningfully evaluate national initiatives to reduce adverse drug reactions. PMID:17894876

  13. 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

  14. [The hospital-borne tetanus in the reference service of the Donka National Hospital in Conakry (2001-2011)].

    PubMed

    Traoré, F A; Youla, A S; Sako, F B; Sow, M S; Keita, M; Kpamy, D O; Traoré, M

    2013-05-01

    Become almost non-existent in the developed countries, the hospital-borne tetanus always stays of current events in our country in spite of the forensic problem which it puts. The objectives of this study were to determine prevalence of this affection, to describe its clinical picture and to determine its lethality. It is about a retrospective study of a duration of 11 years realized in the service of the infectious diseases of Conakry. Among 8649 hospitalizations from 2001 till 2012 we brought together 239 cases of tetanus (2.7%) among which 60 hospital-borne tetanus (0.7%). Men represented 73% of these cases, with a sex-ratio M/F of 2.7. The age bracket of 20-40 years was the most affected with 32 cases (53.3%). A single patient had begun his vaccinal calendar which had remained incomplete. Both national hospitals of the CHU of Conakry and private hospitals were the biggest suppliers of this hospital-borne tetanus with respectively 22 and 27 cases (36.6 and 45%). Tetanus related to IM of quinine represented 26 cases (43.3%) whereas the hernial cure was found in 16 cases (26.6%). The average duration of invasion and incubation was respectively 1.5 days and 6 days for the dead (n = 45.7%) and 2 days and 10.5 days for the survivors. Three-quarters of 60 patients died. The fight against this type of tetanus passes inevitably by an improvement of the working conditions, a strict application of the rules of asepsis and the in-service training of the medical and paramedical staff. PMID:23435871

  15. 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.

  16. 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

  17. 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

  18. ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2002.

    PubMed

    Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

    2003-01-01

    Results of the 2002 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1101 general and children's medical-surgical hospitals in the United States were 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 46.7%. During 2002, both inpatient and outpatient hours of service increased compared with 2001. Paradoxically, there was an 8.5% decrease in pharmacy staffing and a 7% vacancy rate, suggesting that pharmacists are busier. Most hospitals (80%) had a centralized inpatient dispensing system, but 44% were planning to become more decentralized. Automated dispensing cabinets were used by 58% of hospitals with decentralized drug distribution systems. Most hospitals (81.4%) dispensed more than three quarters of oral doses as unit doses and 63.3% of injectable doses to non-critical care patients, increases from 1999. A large percentage of hospitals (89%) repackaged both oral and injectable medications. More hospitals were repackaging medications than three years ago, primarily because of lack of commercial availability. Approximately 20% of pharmacies either partially or completely outsourced drug preparation activities. Nurses administered medications in virtually all hospitals (99.7%). Despite widespread recommendations to use bar-code technology to check and document doses administered, only 1.5% of hospitals used this technology, an increase from 1.1% in 1999. Nearly two thirds of hospitals used computer-generated medication administration records. While pharmaceutical services are expanding, workforce issues continue to challenge pharmacists trying to maintain and enhance safe medication systems. Safe systems continue to be in place in most hospitals, but the adoption of new technology to improve safety is slow. PMID:12533978

  19. 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...

  20. 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...

  1. 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...

  2. Hospital cardiac arrest resuscitation practice in the US: a nationally representative survey

    PubMed Central

    Edelson, Dana P.; Yuen, Trevor C; Mancini, Mary E; Davis, Daniel P; Hunt, Elizabeth A; Miller, Joseph A; Abella, Benjamin S

    2014-01-01

    Background In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals. Objective To describe current US hospital practices with regard to resuscitation care. Design A nationally representative mail survey. Setting A random sample of 1,000 hospitals from the American Hospital Association database, stratified into nine categories by hospital volume tertile and teaching status (major teaching, minor teaching and non-teaching). Subjects Surveys were addressed to each hospital's CPR Committee Chair or Chief Medical/Quality Officer. Measurements A 27-item questionnaire. Results Responses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (p=0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a Hospitalist. High frequency practices included having a Rapid Response Team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR Committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least one barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common. Conclusions There is wide variability between hospitals and within practices for resuscitation care in the US with opportunities for improvement. PMID:24550202

  3. 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

  4. Nosocomial infections at Kenyatta National Hospital Intensive-Care Unit in Nairobi, Kenya.

    PubMed

    Ngumi, Z W W

    2006-01-01

    The objective of this study was to identify the common bacteria isolated from patients, antibiotics used, sensitivity patterns, therapeutic procedures and cleaning protocols practised in Kenyatta National Hospital Intensive-Care Unit (ICU). Kenyatta National Hospital is a 1,800-bed referral and tertiary-care hospital which is also the Teaching University Hospital. The ICU has 20 beds. Two members of staff, a consultant and a senior nurse, did the study. Out of 195 patients admitted to the unit during the study period, 137 (70.3%) received antibiotics. The most frequently prescribed antibiotics included meropenem, ceftazidime, cefuroxime, piperacillin tazobactam, vancomycin, Augmentin and Flagyl. The most common bacteria isolated were Pseudomonas aeruginosa,Klebsiella, Citrobacter, Staphylococcus aureus, Staphylococcus pneumoniae, Acinetobactor and Escherichia coli isolated from tracheal aspirate, urine, blood and pus swabs. PMID:16490968

  5. National Quality Forum 30 safe practices: priority and progress in Iowa hospitals.

    PubMed

    Ward, Marcia M; Evans, Thomas C; Spies, Arthur J; Roberts, Lance L; Wakefield, Douglas S

    2006-01-01

    The National Quality Forum (NQF) recently released a list of "30 Safe Practices" that were identified as relevant for all hospitals. The purpose of the present analysis was to assess hospitals' perceptions of each of the NQF 30 Safe Practices in terms of priority and progress. One hundred of Iowa's hospitals (86%) completed a survey. The highest progress ratings were for items involving hand washing, unit-dose medication dispensing, influenza vaccinations, implementing protocols to prevent wrong-site procedures, and standardized methods for labeling and storing medications. The lowest progress ratings were for intensive care units staffed by intensivists and implementing a computerized provider order entry system. Overall, safe practices that have been recommended for some time had higher priority and progress ratings. Most safe practices were equally endorsed by large and small hospitals, suggesting that the NQF goal of identifying safe hospital practices may be attainable for most of the safe practices. PMID:16533901

  6. [Fates at the psychiatric hospital of Klagenfurt during National Socialism].

    PubMed

    Oberlerchner, Herwig; Stromberger, Helge

    2013-01-01

    In this article the fate of Mr. B. is described as an example for the fate of hundreds of mentally ill patients of the "Landes-Irrenanstalt of Klagenfurt", murdered during the era of National Socialism. This extraordinary fate marks two outstanding aspects of history of medicine, the treatment of syphilis with malaria and the organised mass murder of mentally ill people during the cynic era of National Socialism. Beyond this historical perspective reconstructive biographical work together with relatives is presented as a proactive duty of psychiatric institutions. PMID:22990646

  7. 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...

  8. 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...

  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. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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.

  16. Development of hospital-integrated large-scale PACS in Seoul National University Hospital

    NASA Astrophysics Data System (ADS)

    Kim, JongHyo; Yeon, Kyoung M.; Han, Man Chung; Lee, Dong Hyuk; Cho, Han I.

    1997-05-01

    The SNUH has started a PACS project with three main goals: to develop a fully hospital-integrated PACS, to develop a cost effective PACS using open systems architecture, and to extend PACS' role to the advanced application such as image guided surgery, multi-media assisted education and research. In order to achieve these goals, we have designed a PACS architecture which takes advantage of client-server computing, high speed communication network, computing power of up-to-date high-end PC, and advanced image compression method. We have installed ATM based communication network in radiology department and in-patient wards, and implemented DICOM compliant acquisition modules, image storage and management servers, and high resolution display workstations based on high-end PC and Microsoft Windows 95 and Windows NT operating systems. The SNUH PACS is in partial scale operation now, and will be expanded to full scale by the end of 1998.

  17. 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

  18. 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.

  19. Nosocomial Cholera Outbreak in a Mental Hospital: Challenges and Lessons Learnt from Butabika National Referral Mental Hospital, Uganda.

    PubMed

    Bwire, Godfrey; Malimbo, Mugagga; Kagirita, Atek; Makumbi, Issa; Mintz, Eric; Mengel, Martin A; Orach, Christopher Garimoi

    2015-09-01

    During the last four decades, Uganda has experienced repeated cholera outbreaks in communities; no cholera outbreaks have been reported in Ugandan health facilities. In October 2008, a unique cholera outbreak was confirmed in Butabika National Mental Referral Hospital (BNMRH), Uganda. This article describes actions taken to control the outbreak, challenges, and lessons learnt. We reviewed patient and hospital reports for clinical symptoms and signs, treatment and outcome, patient mental diagnosis, and challenges noted during management of patients and contacts. Out of 114 BNMRH patients on two affected wards, 18 cholera cases and five deaths were documented for an attack rate of 15.8% and a case fatality rate of 28%. Wards and surroundings were intensively disinfected and 96 contacts (psychiatric patients) in the affected wards received chemoprophylaxis with oral ciprofloxacin 500 mg twice daily until November 5, 2008. We documented a nosocomial cholera outbreak in BNMRH with a high case fatality of 28% compared with the national average of 2.4% for cholera outbreaks in communities. To avoid cholera outbreaks and potentially high mortality among patients in mental institutions, procedures for prompt diagnosis, treatment, disinfection, and prophylaxis are needed and preemptive use of oral cholera vaccines should be considered. PMID:26195468

  20. 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

  1. Laser beam guard clamps

    DOEpatents

    Dickson, Richard K. (Stockton, CA)

    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.

  2. 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,...

  3. 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,...

  4. 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,...

  5. 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,...

  6. 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,...

  7. 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

  8. Jet engine test stand and soil stockpile. 107th fighter-interceptor group Niagara Falls Air Force Reserve Station, New York Air National Guard, Niagara Falls, New York. Final site assessment addendum report, 9-12 February 1993

    SciTech Connect

    Not Available

    1994-03-01

    THis report outlines additional site assessment activities which were conducted at the Jet Engine Test Stand (JETS), Building No. 852 located at the 197th Fighter-Interceptor Group, Niagara Falls Air National Guard Station (NFANGS), Air Force Reserve Facility (AFRF) approximately 6 miles northeast of Niagara Falls, New York (Figure 1.1). The additional site assessment activities were performed in response to requests, dated February 9 and 12, 1993, by the New York State Department of Environmental Conservation (NYSDEC) to further investigate contaminated soil and groundwater conditions at the JETS and at an existing soil stockpile (Appendix A).

  9. Building an FTP guard

    SciTech Connect

    Sands, P.D.

    1998-08-01

    Classified designs usually include lesser classified (including unclassified) components. An engineer working on such a design needs access to the various sub-designs at lower classification levels. For simplicity, the problem is presented with only two levels: high and low. If the low-classification component designs are stored in the high network, they become inaccessible to persons working on a low network. In order to keep the networks separate, the component designs may be duplicated in all networks, resulting in a synchronization problem. Alternatively, they may be stored in the low network and brought into the high network when needed. The latter solution results in the use of sneaker-net (copying the files from the low system to a tape and carrying the tape to a high system) or a file transfer guard. This paper shows how an FTP Guard was constructed and implemented without degrading the security of the underlying B3 platform. The paper then shows how the guard can be extended to an FTP proxy server or an HTTP proxy server. The extension is accomplished by allowing the high-side user to select among items that already exist on the low-side. No high-side data can be directly compromised by the extension, but a mechanism must be developed to handle the low-bandwidth covert channel that would be introduced by the application.

  10. 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

  11. 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

  12. 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.

  13. National Trends in Incidence Rates of Hospitalization for Stroke in Children With Sickle Cell Disease

    PubMed Central

    McCavit, Timothy L.; Xuan, Lei; Zhang, Song; Flores, Glenn; Quinn, Charles T.

    2014-01-01

    Background The success of primary stroke prevention for children with sickle cell disease (SCD) throughout the United States is unknown. Therefore, we aimed to generate national incidence rates of hospitalization for stroke in children with sickle cell disease (SCD) before and after publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998. Procedure We performed a retrospective trend analysis of the 1993–2009 Nationwide Inpatient Sample and Kids’ Inpatient Databases. Hospitalizations for SCD patients 0–18 years old with stroke were identified by ICD-9CM code. The primary outcome, the trend in annual incidence rate of hospitalization for stroke in children with SCD, was analyzed by linear regression. Incidence rates of hospitalization for stroke before and after 1998 were compared by the Wilcoxon rank-sum test. Results From 1993 to 2009, 2,024 hospitalizations were identified for stroke. Using the mean annual incidence rate of hospitalization for stroke from 1993 to 1998 as the baseline, the rate decreased from 1993 to 2009 (point estimate = ?0.022/100 patient years [95% CI, ?0.039, ?0.005], P = 0.027). The mean annual incidence rate of hospitalization stroke decreased by 45% from 0.51 per 100 patient years in 1993–1998 to 0.28 per 100 patient years in 1999–2009 (P = 0.008). Total hospital days and charges attributed to stroke also decreased by 45% and 24%, respectively. Conclusions After publication of the STOP trial and hydroxyurea licensure in 1998, the incidence of hospitalization for stroke in children with SCD decreased across the United States, suggesting that primary stroke prevention has been effective nationwide, but opportunity for improvement remains. PMID:23151905

  14. 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

  15. 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

  16. 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

  17. [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

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. The impact of ongoing national terror on the community of hospital nurses in Israel.

    PubMed

    Ron, Pnina; Shamai, Michal

    2014-04-01

    The main goal of this study was to explore the connections between the exposure of nurses in Israel to national terror and the levels of distress experienced due to ongoing terror attacks. The data were collected from 214 nurses from various parts of Israel who work in three types of heath services (mainly hospital departments) and provide help to victims of terror. The nurses reported very high levels of burnout, high levels of stress and medium-to high levels of intrusive memories. Levels of exposure were associated with burnout, intrusive memories and level of stress. More professional attention should be given to hospital nurses who provide care for trauma patients. PMID:23982180

  9. National trends and determinants of hospitalization costs and lengths-of-stay for uterine fibroids procedures.

    PubMed

    Becker, Edmund R

    2007-01-01

    Uterine fibroid admissions in the nation's hospitals have grown more than 20 percent over the past five years. Substantial variations exist in inpatient treatment patterns. In spite of this dramatic growth, there are no national studies of the hospital costs associated with the treatment of uterine fibroids in the hospital setting. Using 11 years of data (1993-2003) from the Healthcare Cost and Utilization Project, a nationally representative 20 percent sample of the nation's inpatient admissions, trends in hospital charges, costs, and lengths of stay (LOSs) are reported. For 2001 to 2003, determinants of hospital costs and LOS for inpatients with a primary diagnosis of uterine fibroids were analyzed using univariate analyses and regression techniques. Hysterectomies for women with a primary diagnosis of uterine fibroids have in-hospital costs of over $1.5 billion. Among the major procedures for treating uterine fibroids, in 2003, total abdominal hysterectomy had the longest LOS, averaging 2.9 days with a mean cost of $6331. In contrast, the treatment with the shortest LOS, 1.72 days, was laparoscopically assisted vaginal hysterectomy but it had the highest mean costs of $7108. In 2003, supracervical hysterectomies and myomectomies had mean costs of $6809 and $6707, respectively. Multivariate results show that patient characteristics and structural aspects of the hospital are strong predictors of lengths of stay and cost per day but there are major differences across some of the surgical procedures. Although the patient characteristics-insulin-dependent, non-insulin dependent diabetes, obesity, morbid obesity, smoker, hypertension, congestive heart failure, chronic obstructive pulmonary disease-all have significant impacts on LOS and cost per day for some of the major uterine fibroid treatments, they are not consistent. Compared with white women, black, Hispanic, and Asian/Pacific Island women all had higher lengths of stay and costs per day. Bedsize and teaching status are generally positively associated with lengths of stay and costs per day; for-profit status always had a significant positive association with LOS and cost per day. Hospital costs for treating women with uterine fibroids are continuing to grow. Further research on the determinants of the resource utilization could be helpful in predicting and alleviating these costs and improving patient care. PMID:19175228

  10. 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

  11. The development of the nation's oldest operating civilian hospital-sponsored aeromedical helicopter service.

    PubMed

    Thomas, F

    1988-06-01

    The Vietnam War heightened civilian awareness as to the use of helicopters for medical evacuations. This led to the initiation of federally funded projects aimed at determining whether helicopters were practical for civilian aeromedical transports. In 1972, a Department of Transportation (DOT) summary concluded that helicopters for civilian medical transports were largely economically prohibitive and provided limited medical benefits in limited locales. Despite this report, in 1972 St. Anthony Hospital initiated a hospital-based emergency medical helicopter service (HEMS). This paper provides a historical review of the individuals and events responsible for the early success of the nation's longest operating civilian hospital-sponsored helicopter service. The author concludes that the early success of this program was due in part to the selection of an affordable, high altitude, helicopter; rapid response times to the scene of injury; the development of excellent EMS communications systems; the use of specialty trained flight crewmembers; and integration of HEMS into the existing EMS system. PMID:3291847

  12. Has cost containment after the National Health Insurance system been successful? Determinants of Taiwan hospital costs.

    PubMed

    Hung, Jung-Hua; Chang, Li

    2008-03-01

    Taiwan implemented the National Health Insurance system (NHI) in 1995. After the NHI, the insurance coverage expanded and the quality of healthcare improved, however, the healthcare costs significantly escalated. The objective of this study is to determine what factors have direct impact on the increased costs after the NHI. Panel data analysis is used to investigate changes and factors affecting cost containment at Taipei municipal hospitals from 1990 to 2001. The results show that the expansion of insured healthcare coverage (especially to the elderly and the treatment of more complicated types of diseases), and the increased competition (requiring the growth of new technology and the longer average length of stay) are important driving forces behind the increase of hospital costs, directly influenced by the advent of the NHI. Therefore, policymakers should emphasize health prevention activities and disease management programs for the elderly to improve cost containment. In addition, hospital managers should find ways to improve the hospital efficiency (shorten the LOS) to reduce excess services and medical waste. They also need to better understand their market position and acquire suitable new-tech equipment earlier, to be a leader, not a follower. Finally, policymakers should establish related benchmark indices for what drivers up hospital costs (micro-aspect) and to control healthcare expenditures (macro-level). PMID:17949848

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. National Estimates of Insulin-related Hypoglycemia and Errors Leading to Emergency Department Visits and Hospitalizations

    PubMed Central

    Geller, Andrew I.; Shehab, Nadine; Lovegrove, Maribeth C.; Kegler, Scott R.; Weidenbach, Kelly N.; Ryan, Gina J.; Budnitz, Daniel S.

    2015-01-01

    Importance Detailed, nationally-representative data describing high-risk populations and circumstances involved in insulin-related hypoglycemia and errors (IHEs) can inform approaches to individualizing glycemic targets. Objective Describe U.S. burden, rates, and characteristics of emergency department (ED) visits and emergent hospitalizations for IHEs. Design Nationally-representative, public health surveillance of adverse drug events and a national, household survey of insulin use. Setting National Electronic Injury Surveillance System—Cooperative Adverse Drug Event Surveillance (NEISS-CADES), 2007–2011 and National Health Interview Survey (NHIS), 2007–2011. Participants Insulin-treated patients seeking ED care. Main outcome(s) and Measures Estimated annual numbers and estimated annual rates of ED visits and hospitalizations for IHEs among insulin-treated patients with diabetes. Results Based on 8,100 cases, an estimated 97,648 (95% confidence interval [CI], 64,410–130,887) ED visits for IHEs occurred annually; almost one-third (29.3% [CI, 21.8%–36.8%]) resulted in hospitalization. Severe neurologic sequelae were documented in an estimated 60.6% (CI, 51.3%–69.9%) of ED visits for IHEs, and glycemic levels ?50 mg/dL were recorded in over one-half of cases (53.4%). Insulin-treated patients aged ?80 years were more than twice as likely to visit the ED (rate ratio, 2.5; CI, 1.5–4.3) and nearly five times as likely to be subsequently hospitalized (rate ratio, 4.9; CI, 2.6–9.1) for IHEs than those aged 45–64 years. The most commonly-identified IHE precipitants were reduced food intake and administration of the wrong insulin product. Conclusions and Relevance Rates of ED visits and subsequent hospitalizations for IHEs were highest in patients aged ?80 years; the risks of hypoglycemic sequelae in this age group should be considered in decisions to prescribe and intensify insulin. Meal-planning and insulin product mix-up misadventures are important targets for hypoglycemia prevention efforts. PMID:24615164

  19. Installation restoration program. Final abbreviated site investigation site 3 and 4, sections 1 - 8. 158th Fighter Wing, Vermont Air National Guard, South Burlington, Vermont. Volume 1. Site Investigation report

    SciTech Connect

    1996-11-01

    This Abbreviated Site Investigation (ASI) Report presents the results of field investigation activities conducted by The Earth Technology Corporation (EARTH TECH) from August through October 1994 at Installation Restoration Program (IRP) Sites 3 and 4, located at Vermont Air National Guard (ANG) Base, South Burlington, Vermont, as requested by the Air National Guard Readiness Center. lRP Site 3 - Dry Well and nearby lRP Site 4 - Drainage Ditch Area are located in the north-central portion of the Vermont ANG Base, in the vicinity of the base petroleum, oil, and lubricants (POL) facility, and south of the northern base boundary adjacent to Poor Farm Road. Site 3 consists of an abandoned dry well located adjacent to the west wall of the transfer pump house (Building 205) at the base POL facility. Reportedly, as much as 20,000 gallons of Jet Propellant Number 4 (JP-4) fuel were discharged to the dry well from 1954 to 1984. Site 4 consists of a covered and open drainage ditch area, located immediately south of Poor Farm Road along the northern base boundary, northeast of Site 3. Excavation above the dry well in 1986 indicated JP-4 fuel contaminated soil. Prior to 1981, the ditch received surface water run-off from the flightline and parking apron areas, which periodically included fuel spills. A 2,000 gallon spill of JP-4 fuel at the POL facility in 1967 was the largest documented spill which drained into the ditch. Excavation for sanitary sewer lines in the western (covered) portion of the ditch in 1988 revealed JP-4 fuel contaminated soil.

  20. Healthcare-associated infections in Finnish acute care hospitals: a national prevalence survey, 2005.

    PubMed

    Lyytikäinen, O; Kanerva, M; Agthe, N; Möttönen, T; Ruutu, P

    2008-07-01

    The objectives of the first national prevalence survey on healthcare-associated infections (HAIs) in Finland were to assess the extent of HAI, distribution of HAI types, causative organisms, prevalence of predisposing factors and use of antimicrobial agents. The voluntary survey was performed during February-March 2005 in 30 hospitals, including tertiary and secondary care hospitals and 10 (25%) other acute care hospitals in the country. The overall prevalence of HAI was 8.5% (703/8234). Surgical site infection was the most common HAI (29%), followed by urinary tract infection (19%) and primary bloodstream infection or clinical sepsis (17%). HAI prevalence was higher in males, among intensive care and surgical patients, and increased with age and severity of underlying illness. The most common causative organisms, identified in 56% (398/703) of patients with HAIs, were Escherichia coli (13%), Staphylococcus aureus (10%) and Enterococcus faecalis (9%). HAIs caused by multi-resistant microbes were rare (N = 6). A total of 122 patients were treated in contact isolation due to the carriage of multi-resistant microbes. At the time of the survey, 19% of patients had a urinary catheter, 6% central venous line and 1% were ventilated. Antimicrobial treatment was given to 39% of patients. These results can be used for prioritising infection control measures and planning more detailed incidence surveillance of HAI. The survey was a useful tool to increase the awareness of HAI in participating hospitals and to train infection control staff in diagnosing HAIs. PMID:18439716

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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,...

  10. 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...

  11. 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...

  12. 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...

  13. 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,...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  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...

  2. 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...

  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 4.40-35 - 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...

  5. 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,...

  6. 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...

  7. 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... 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,...

  8. 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...

  9. 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...

  10. 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...

  11. Private hospital accreditation and inducement of care under the ghanaian national insurance scheme

    PubMed Central

    2011-01-01

    The Ghanaian National Health Insurance Scheme pays providers according to the fee for service payment scheme, a method of payment that is likely to encourage inducement of care. The goal of this paper is to test for the presence of supplier induced demand among patients who received care in private, for profit, hospitals accredited to provide care to insured patients. An instrumental variable Poisson estimation was used to compare the demand curves for health care by insured outpatients in the public and private hospitals. The results showed that supplier induced demand existed in the private sector among patients within the ages 18 and 60 years. Impact on cost of care and patients' welfare is discussed. PMID:22827881

  12. Dutch Hospital Drug Formularies: pharmacotherapeutic variation and conservatism, but concurrence with national pharmacotherapeutic guidelines

    PubMed Central

    Fijn, R; Engels, S A G; Brouwers, J R B J; Knaap, R J; De Jong-Van den Berg, L T W

    2000-01-01

    Aims This research examines current hospital drug formularies (HDFs) of all Dutch general hospitals. It assesses the extent to which they recommend the same drugs, the breadth of their coverage in terms of therapeutic areas, drug groups incorporated and individuals drugs included, and their extent of conservatism by considering the year of introduction of the drugs included within groups. Furthermore, it considers the extent to which their recommendations concur and comply with those of national pharmacotherapeutic guidelines and the WHO Essential Drugs List (EDL). Methods Seventy-eight (81%) out of all 96 current Dutch HDFs were received of which 62 were suitable for study. Differences between HDFs and eventual associations with hospital characteristics were researched by statistical testing and case-control studies. To evaluate HDFs' concurrence with national guidelines and compliance with the WHO EDL, nine drug groups were studied in detail: benzodiazepines, calcium channel blockers, ?-adrenoceptor blocking agents, ACE-inhibitors, angiotensin-II inhibitors, NSAIDs, H2-receptor antagonists, 5HT3-antagonists, and H+-pump inhibitors. Concurrence and compliance with national guidelines and the WHO EDL was defined as inclusion of recommended drugs. Non-concurrence was defined as inclusion of nonrecommended drugs. Results The total number of indications addressed and drug groups incorporated within HDFs varied from 28 to 72 (median 56) and from 30 to 123 (median 97), respectively. The total number of individual drug entities (pharmacological substances) included ranged from 239 to 658 (median 430) and the total number of drug products, including all different dosage forms, from 412 to 1121 (median 655). Within drug groups, drug entities first marketed were most frequently included. Teaching hospitals were most likely to include recently marketed drugs. Depending on the drug group, HDFs' concurrence and compliance with national guidelines and the WHO EDL ranged from 35% to 100%. Conclusions Findings indicate that Dutch HDFs are rather uniform in the indications addressed and the drug groups incorporated. However, the number of individual drug entities and drug products included within groups varies considerably. Furthermore, Dutch HDFs are considered rather conservative, as older drugs are favoured over more recent drugs. Generally, with some drug exceptions, Dutch HDFs concur and comply with recommendations in national pharmacotherapeutic guidelines and with the WHO EDL over 90%. PMID:10718781

  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 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

  15. 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…

  16. Profiles of acute bacterial meningitis isolates in children in National Hospital, Abuja

    PubMed Central

    Iregbu, Kenneth C.; Abdullahi, N.

    2015-01-01

    Background: Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality throughout the world. It is an acute medical emergency that requires urgent rational antibiotic therapy, especially in neonates and young infants. Determining the pattern and susceptibility of isolates of ABM among children for prompt treatment of this important cause of mortality and morbidity is very important. This study determined the types and the antimicrobial susceptibility pattern of ABM isolates among children at the National Hospital, Abuja. Materials and Methods: This is a retrospective study carried out at the National Hospital Abuja (NHA), Nigeria. Laboratory data for a period of 3 years, January 2010-December 2013 were reviewed, and all bacterial isolates and their antibiotics sensitivity testing results for children aged 0-15 years, and other relevant information extracted and analyzed. Study center was the NHA. Results: Twenty-eight bacterial pathogens were isolated from a total of 542 cerebrospinal specimens over the study period, giving a yield of 5.2%. The four most common pathogens isolated were Staphylococcus aureus (32.2%), Klebsiella pneumoniae (21.5%), Streptococcus pneumoniae (17.6%), and Escherichia coli (14.3%). Whereas, 28.6% of all the infections occurred in neonates alone, children 2 years and below had 85.7% of all the infections, with male preponderance. Isolates of S. aureus and S. pneumonia tested were both 100% susceptible to amoxicillin-clavulanic acid and Cefuroxime; S. pneumoniae was equally sensitive to Ceftriaxone. K. pneumoniae was 100% sensitive to Imipenem, but 83% to ceftriaxone. 75% of the isolated E. coli strains were sensitive to ceftriaxone, amoxicillin-clavulanic acid, and amikacin, 100% sensitive to imipenem. Conclusion: Meningitis in children as seen in the National hospital is almost equally caused by both Gram-positive and Gram-negative organisms, predominantly by S. aureus, S. pneumoniae, K. pneumoniae, and E. coli. Available drugs remain active against these organisms. PMID:26759518

  17. Management of postoperative pain: experience of the Niamey National Hospital, Niger

    PubMed Central

    Chaibou, Maman Sani; Sanoussi, Samuila; Sani, Rachid; Toudou, Nouhou A; Daddy, Hadjara; Madougou, Moussa; Abdou, Idrissa; Abarchi, Habibou; Chobli, Martin

    2012-01-01

    Objective The aim of this study was to evaluate the management of postoperative pain at the Niamey National Hospital. Methods A prospective study was conducted in the Department of Anesthesiology and Intensive Care at the Niamey National Hospital from March to June, 2009. Data collected included age, sex, literacy, American Society of Anesthesiologists (ASA) physical status classification, type of anesthesia, type of surgery, postoperative analgesics used, and the cost of analgesics. Three types of pain assessment scale were used depending on the patient’s ability to describe his or her pain: the verbal rating scale (VRS), the numerical rating scale (NRS), or the visual analog scale (VAS). Patients were evaluated during the first 48 hours following surgery. Results The sample included 553 patients. The VRS was used for the evaluation of 72% of patients, the NRS for 14.4%, and the VAS for 13.6%. Of the VRS group, 33.9%, 8.3%, and 2.1% rated their pain as 3 or 4 out of 4 at 12, 24, and 48 hours postoperatively, respectively. For the NRS group, 33.8%, 8.8%, and 2.5% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. For the VAS group, 29.3%, 5.4%, and 0% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. Conclusion Postoperative pain assessment and management in developing countries has not been well described. Poverty, illiteracy, and inadequate training of physicians and other health personnel contribute to the underutilization of postoperative analgesia. Analysis of the results gathered at the Niamey National Hospital gives baseline data that can be the impetus to increase training in pain management and to establish standardized protocols. PMID:23271923

  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. 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

  20. Follow up of infants born to women with hepatitis B in the National Maternity Hospital.

    PubMed

    Travers, C P; Connell, J; Thornton, L; Keane, E; Knowles, S; Murphy, J F A

    2015-05-01

    Infants born to women with hepatitis B virus (HBV) are at risk of vertical transmission. This risk is significantly reduced with correct post-natal treatment After initial perinatal management and neonatal treatment, these infants receive subsequent follow up HBV immunisations at two, four and six months. These infants then require post vaccination serological testing. This review was conducted to determine the number of infants born to mothers with HBV in the National Maternity Hospital who had appropriate post vaccination serological testing. There were seventy-eight HBV infections identified antenatally in the years 2010 and 2011 resulting in seventy live born infants at our institution. Thirteen (18.6%) infants had evidence of post vaccination serological testing. This is below international rates of follow up. There is an urgent need for a centralised national programme to ensure adequate follow up and management of all infants born to women with HBV in Ireland. PMID:26062242

  1. 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... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  2. 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... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  3. 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... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  4. 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... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  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... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  6. Challenges in Evaluating All-Cause Hospital Readmission Measures for Use as National Consensus Standards

    PubMed Central

    Morgan, Alexis; Khan, Adeela; Amin, Taroon

    2013-01-01

    Context: The National Quality Forum (NQF) aims to improve the quality of health care for all Americans through fulfillment of its three-part mission. The NQF uses its formal Consensus Development Process to evaluate and endorse consensus standards, including performance measures, best practices, frameworks, and reporting guidelines. Objective: To understand the opportunities and challenges in endorsing measures addressing all-cause readmissions to hospitals for use as national voluntary consensus standards for accountability and quality-improvement purposes. Design: Report of standards development process. Main Outcome Measures: The Consensus Development Process was used to evaluate 3 candidate standards using the NQF Measure Evaluation Criteria. A 21-member steering committee rated each standard according to the criteria and made initial endorsement recommendations for all measures. Results: Through the evaluation of measures for endorsement, several overarching issues in measuring all-cause readmissions were identified, including statistical modeling and the usability of the measures for quality improvement and accountability. Additionally, it was decided that, for the first time, quality monitoring and accountability of readmissions will take place at the health-plan level. Measuring at various levels of accountability reinforces the idea that multiple stakeholders have a responsibility and a role to reduce readmissions. Conclusions: These NQF-endorsed measures are a major step in promoting better understanding of readmissions and a reduction in hospital readmission rates, when appropriate. These measures can help reduce the substantial financial and emotional stress that readmissions place on the health care system, and patients will be able to communicate hospital-level performance on this important quality indicator. PMID:24361014

  7. 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

  8. 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

  9. 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

  10. 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. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 104-112, 2016. PMID:26190587

  11. [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

  12. New millennium hospital management information system: experience of the National Cancer Institute--Cairo University.

    PubMed

    El Hattab, E

    2001-01-01

    The National Cancer Institute-Cairo University (NCI) is a leading cancer center in the Middle East and Africa. It serves more than 15,000 new cases and more than 250,000 patient visit every year. The implementation of its Hospital Management Information System was completed and the system was operational in 1992. Although different modules were added to the HMIS, the core of the system has never been changed or updated. NCI evaluated its current system. NCI also evaluated the modern tools in databases and programming. NCI came to the conclusion that a new HMIS need to be installed. The needs of NCI staff were analyzed with consideration to budget issues and the limitations of a developing country. Different hardware, networking and software issues had to be considered in the updating. Arabization and customization were main factors in decision making. PMID:11604832

  13. Patterns of psychiatric hospital service use in Finland: a national register study of hospital discharges in the early 1990s.

    PubMed

    Korkeila, J A; Lehtinen, V; Tuori, T; Helenius, H

    1998-05-01

    We were interested in studying the possible concurrent changes in the psychiatric inpatient population during a rapid phase of deinstitutionalisation, and severe economic recession with a record level unemployment rate, and after the amendment of the mental health legislation. Although there were 4540 fewer beds in the psychiatric hospitals in 1993 compared to 1990, the rate of patient admissions remained the same. There was a significant increase in readmissions (P < 0.001) to the psychiatric hospitals, and particularly in multiple (three or more) readmissions among new inpatients (P < 0.001). The prevalence of inpatients with major depression increased by 0.2/1000 in the whole cohort and by 0.12/1000 among first-timers from 1990 to 1993 (P < 0.001). In addition, the rate of involuntary admissions decreased significantly (P < 0.001). PMID:9604671

  14. Holmium Laser Enucleation of Prostate for Benign Prostatic Hyperplasia: Seoul National University Hospital Experience

    PubMed Central

    Bae, Jungbum; Choo, Minsoo; Park, Ji Hyun; Oh, Jin Kyu; Paick, Jae-Seung

    2011-01-01

    Purpose The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH). Methods A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations. Results The patients' mean age was 68.3 (±6.5) years and mean prostate volume was 55.6 (±23.6) mL. Mean enucleation time was 56.2 (±25.1) minutes, mean morcellation time was 11.3 (±9.5) minutes, and the mean resected weight of the prostate was 20.8 (±16.9) g. The mean catheter indwelling period was 1.9 (±1.7) days and mean hospital stay was 2.9 (±1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation. Conclusions Our study showed that HoLEP is a safe and effective therapeutic modality for BPH. PMID:21468284

  15. 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.

  16. 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,…

  17. 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…

  18. 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…

  19. 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,…

  20. 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

  1. Hospitalization for Hypoglycemia in Japanese Diabetic Patients: A Retrospective Study Using a National Inpatient Database, 2008-2012.

    PubMed

    Sako, Akahito; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Hamasaki, Hidetaka; Katsuyama, Hisayuki; Tsujimoto, Tetsuro; Goto, Atsushi; Yanai, Hidekatsu

    2015-06-01

    We aimed to elucidate the epidemiology, patient demographics, and clinical outcomes of hospitalization for hypoglycemia in diabetic patients using a Japanese large-scale database.We conducted a retrospective study using a national inpatient database of acute care hospitals in Japan. Diabetic patients ages ?15 years with hypoglycemia as a main diagnosis for hospitalization were eligible. We estimated the annual number of hospitalizations in Japan and compared the annual admission rate by age and treatment groups. We also analyzed the association between patient characteristics and in-hospital mortality.Among 22.7 million discharge records from July 2008 and March 2013, a total of 25,071 patients were eligible. The mean age was 73.4 years, and the mean body mass index (BMI) was 22.3? kg/m(2). The estimated annual hospitalization for hypoglycemia in Japan was ?20,000. Annual admission rates for hypoglycemia per 1000 diabetic patients and 1000 diabetic patients receiving insulin or oral hypoglycemic agents were 2.1 and 4.1, respectively. Patients <40 years and >70 years old were at a higher risk of hospitalization. In-hospital mortality was 3.8%, and risk factors associated with poor survival were male sex, older age, lower bed capacity, community hospital, low BMI, coma at admission, and higher Charlson Comorbidity Index.To prevent severe hypoglycemia that leads to death and complications, individualized and careful glycemic control are important, especially in very old or young patients and in those with comorbid conditions or low BMI. PMID:26107672

  2. 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

  3. 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

  4. 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

  5. Posttransfusion Haematocrit Equilibration: Timing Posttransfusion Haematocrit Check in Neonates at the National Hospital, Abuja, Nigeria

    PubMed Central

    Audu, L. I.; Otuneye, A. T.; Mairami, A. B.; Mshelia, L. J.; Nwatah, V. E.

    2015-01-01

    Anaemia is a common morbidity in the NICU and often requires transfusion of packed red blood cells. Haematocrit equilibration following red cell transfusion occurs over time ultimately resulting in a stable packed cell volume (PCV). Knowledge of this equilibration process is pertinent in the accurate timing of posttransfusion (PT) PCV. We conducted a prospective study to determine an appropriate timing for PT PCV estimation on 47 stable anaemic babies at the Neonatal Unit of National Hospital, Abuja. Values of PCV were determined before transfusion and at 1, 6, 12, 24, and 48 hours posttransfusion. Forty of the recruited neonates and young infants were analyzed. Their gestational age range was 26 to 40 weeks. 1-hour PT PCV (48.5% ± 5.5%) was similar to the 6-hour PT PCV (47.8% ± 5.6%) P = 0.516, but both were significantly different from the 12-hour (46.8% ± 5.9%), 24-hour (45.9 ± 5.8%), and 48-hour (45.4% ± 6.2%) PT PCVs. The 12-hour PT PCV was similar to the 24-hour and 48-hour PT PCVs (P = 0.237 and 0.063, resp.). We concluded that, in stable nonhaemorrhaging and nonhaemolysing young infants, the estimated timing of haematocrit equilibration and, consequently, posttransfusion PCV is 12 hours after red blood cell transfusion. PMID:25861284

  6. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 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...

  7. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 7 2011-07-01 2011-07-01 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...

  8. 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...

  9. 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... (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...

  10. 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... (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...

  11. 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

  12. Epidemiological changes in oesophageal cancer at National Hospital, Bloemfontein: 1995, 2000 and 2005

    PubMed Central

    van der Merwe, Tian; van der Walt, Ruan; Esterhuizen, Jován; Botha, Stephani; Goedhals, Louis

    2010-01-01

    ABSTRACT Background Oesophageal cancer is a common malignancy with a high mortality rate. The two main histological types are squamous cell and adenocarcinoma. An increase in oesophageal adenocarcinoma has been noted, especially in developed countries. Objectives The aim of this retrospective study was to investigate the profile of oesophageal cancer by reviewing medical records of patients diagnosed with oesophageal cancer in 1995, 2000 and 2005. Method The study sample consisted of 474 files of patients diagnosed, for the first time, with oesophageal cancer in 1995, 2000 and 2005, at the National Hospital in Bloemfontein and the outreach clinics in surrounding areas. Information reviewed from patient files included: age, race and gender of the patient, as well as topography, size, histological grade and type of the tumour. Results The number of newly diagnosed cases of oesophageal carcinoma decreased over the 10-year period. The mean age of patients was > 57 years. The majority of cases were Black patients: 90.5% in 1995, 93.2% in 2000 and 87.7% in 2005. More male patients were seen (71.5% in 1995, 70.1% in 2000 and 64.2% in 2005), although the number of female patients diagnosed with this malignancy increased by 7.3% from 1995 to 2005. The mid- and lower third of the oesophagus were affected most commonly, most lesions were 6 cm – 10 cm in length and classified as Grade II, moderately differentiated tumours. Squamous cell carcinoma was diagnosed in 76.9% of patients in 1995, 90.5% in 2000 and 94.3% in 2005. Conclusion The number of newly diagnosed cases of oesophageal carcinoma decreased over the 10-year period, but demographic and disease characteristics remained constant.

  13. 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

  14. Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania

    PubMed Central

    Kidanto, Hussein L; Mogren, Ingrid; van Roosmalen, Jos; Thomas, Angela N; Massawe, Siriel N; Nystrom, Lennarth; Lindmark, Gunilla

    2009-01-01

    Background Perinatal death is a devastating experience for the mother and of concern in clinical practice. Regular perinatal audit may identify suboptimal care related to perinatal deaths and thus appropriate measures for its reduction. The aim of this study was to perform a qualitative perinatal audit of intrapartum and early neonatal deaths and propose means of reducing the perinatal mortality rate (PMR). Methods From 1st August, 2007 to 31st December, 2007 we conducted an audit of perinatal deaths (n = 133) with birth weight 1500 g or more at Muhimbili National Hospital (MNH). The audit was done by three obstetricians, two external and one internal auditors. Each auditor independently evaluated the cases narratives. Suboptimal factors were identified in the antepartum, intrapartum and early neonatal period and classified into three levels of delay (community, infrastructure and health care). The contribution of each suboptimal factor to adverse perinatal outcome was identified and the case graded according to possible avoidability. Degree of agreement between auditors was assessed by the kappa coefficient. Results The PMR was 92 per 1000 total births. Suboptimal factors were identified in 80% of audited cases and half of suboptimal factors were found to be the likely cause of adverse perinatal outcome and were preventable. Poor foetal heart monitoring during labour was indirectly associated with over 40% of perinatal death. There was a poor to fair agreement between external and internal auditors. Conclusion There are significant areas of care that need improvement. Poor monitoring during labour was a major cause of avoidable perinatal mortality. This type of audit was a good starting point for quality assurance at MNH. Regular perinatal audits to identify avoidable causes of perinatal deaths with feed back to the staff may be a useful strategy to reduce perinatal mortality. PMID:19765312

  15. Stomatal Guard Cells Are Totipotent.

    PubMed Central

    Hall, R. D.; Riksen-Bruinsma, T.; Weyens, G.; Lefebvre, M.; Dunwell, J. M.; Krens, F. A.

    1996-01-01

    It has been successfully demonstrated, using epidermis explants of sugar beet (Beta vulgaris L.), that stomatal guard cells retain full totipotent capacity. Despite having one of the highest degrees of morphological adaptation and a unique physiological specialization, it is possible to induce a re-expression of full (embryogenic) genetic potential in these cells in situ by reversing their highly differentiated nature to produce regenerated plants via a callus stage. The importance of these findings both to stomatal research and to our understanding of cytodifferentiation in plants is discussed. PMID:12226426

  16. In-hospital care for low-risk childbirth. Comparison with results from the National Birth Center Study.

    PubMed

    Fullerton, J T; Severino, R

    1992-01-01

    The largest prospective study of freestanding birth centers was reported in 1989. This article reports on data from a comparison group of over 2,000 low-risk women who were admitted to hospital-care settings during the same period. The data on the hospitalized women were collected using the research methodology and data collection instruments developed for the birth center study. Consequently, these data offer the opportunity to observe differences that can be associated with birth site. Both groups of women experienced similar rates of serious antepartum and intrapartum health problems and maternal morbidity. However, even when controlling for complications and differences in sociodemographic characteristics, women in hospitals were more likely to receive an interventive style of labor and birth management. Neonatal outcomes were also similar, although the incidence of sustained fetal distress, prolapsed cord, and difficulty in establishing respirations were significantly greater in the hospital sample. Hospital care did not offer any advantage for women at lowest risk, and it was associated with increased intervention. The results of this study provide support for the National Birth Center Study's conclusion that birth centers offer a safe and acceptable alternative for selected pregnant women. PMID:1403178

  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. 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

  20. 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

  1. 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

  2. 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

  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. 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. 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

  6. 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.

  7. 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

  8. 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

  9. 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…

  10. 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

  11. 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

  12. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  13. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  14. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  15. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  16. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  17. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  18. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  19. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  20. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  1. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  2. 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.

  3. 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…

  4. 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

  5. National Trends in Main Causes of Hospitalization: A Multi-Cohort Register Study of the Finnish Working-Age Population, 1976–2010

    PubMed Central

    Kouvonen, Anne; Koskinen, Aki; Varje, Pekka; Kokkinen, Lauri; De Vogli, Roberto; Väänänen, Ari

    2014-01-01

    Background The health transition theory argues that societal changes produce proportional changes in causes of disability and death. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change. Methodology National trends in all-cause hospitalization and hospitalizations for the five main diagnostic categories were investigated in the data obtained from the Finnish Hospital Discharge Register. The seven-cohort sample covered the period from 1976 to 2010 and consisted of 3,769,356 randomly selected Finnish residents, each cohort representing 25% sample of population aged 18 to 64 years. Principal Findings Over the period of 35 years, the risk of hospitalization for cardiovascular diseases and respiratory diseases decreased. Hospitalization for musculoskeletal diseases increased whereas mental and behavioral hospitalizations slightly decreased. The risk of cancer hospitalization decreased marginally in men, whereas in women an upward trend was observed. Conclusions/Significance A considerable health transition related to hospitalizations and a shift in the utilization of health care services of working-age men and women took place in Finland between 1976 and 2010. PMID:25379723

  6. 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

  7. 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

  8. Quality of care for people with dementia in general hospitals: national cross-sectional audit of patient assessment.

    PubMed

    Souza, Renata; Gandesha, Aarti; Hood, Chloe; Chaplin, Robert; Young, John; Crome, Peter; Crawford, Mike J

    2014-10-01

    There have been recent reports of poor quality care in the National Health Service in the UK, and older people with dementia are particularly vulnerable. This study aims to examine the quality of assessment of people with dementia admitted to hospital. Cross-sectional case-note audit of key physical and psychosocial assessments was carried out in 7,934 people with dementia who were discharged from 206 general hospitals. Most people had no record of a standardised assessment of their cognitive state (56.8%, 95% confidence interval [CI] = 55.8-58.0) or functioning (74.2%, 95% CI = 73.2-75.1). Information from carers was documented in 39.0% of cases (95% CI = 37.9-40.1). There was considerable variation across hospital sites. Key assessments were less likely when people were admitted to surgical wards. Assessments fall well below recommended standards especially with regard to social and cognitive functioning. Problems are particularly marked on surgical wards. PMID:25301908

  9. ‘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

  10. 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

  11. Trends in the incidence and treatment of necrotizing soft tissue infections: an analysis of the National Hospital Discharge Survey.

    PubMed

    Soltani, Ali M; Best, Matthew J; Francis, Cameron S; Allan, Bassan J; Askari, Morad; Panthaki, Zubin J

    2014-01-01

    Necrotizing soft tissue infections are a rare but potentially fatal condition of the soft tissues caused by virulent, toxin-producing bacteria. In the United States, there is an estimated annual incidence of 0.04 cases per 1000 annually, but previous estimates of the Centers for Disease Control and Prevention had the incidence at 500 to 1500 cases yearly. Early reports of mortality were variable with rates ranging from 46 to 76% but outcomes have been improving over time. The National Hospital Discharge Survey was analyzed to study current trends in the demographics, incidence, use, and mortality of patients diagnosed with necrotizing soft tissue infections. The authors analyzed the 1999, 2002, and 2007 National Hospital Discharge Survey by using a sampling weighting method. A total of 13,648 cases of necrotizing soft tissue infections were identified in 2007. This represents an increase from 12,153 cases in 2002 and 6612 cases in 1999. In the 9 years from 1999 to 2007 the gross incidence of necrotizing soft tissue infections more than doubled. Hospital stay was essentially unchanged within study years, at 16 days. Mean age increased from approximately 50 years in 1999 to 54 years in 2007. Further, mortality went from 10.45% in 1999 to 9.75% in the 2007 survey. The population-adjusted incidence rate increased 91% in the studied years. Rising use of immunosupression, exponential growth in the incidence of obesity, and type 2 diabetes could be a major contributing factor. The mortality rate is far below the rate in reports published from as early as 20 years ago, and at 9.75% compares with modern case series, but is a more accurate measure of mortality in this condition. PMID:25144805

  12. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 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, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 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. 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...

  15. 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...

  16. 76 FR 53329 - Eleventh Coast Guard District Annual Marine Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Eleventh Coast Guard District Annual Marine Events AGENCY: Coast Guard, DHS. ACTION: Final rule. SUMMARY: The Coast Guard is updating and consolidating the list of marine events occurring annually within the Eleventh Coast Guard District. These...

  17. 76 FR 30575 - Eleventh Coast Guard District Annual Marine Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Eleventh Coast Guard District Annual Marine Events AGENCY: Coast Guard, DHS. ACTION: Supplemental notice of proposed rulemaking. SUMMARY: The Coast Guard... regulated area. DATES: Comments and related material must be received by the Coast Guard on or before...

  18. 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...

  19. Fluorescence Properties of Guard Cell Chloroplasts

    PubMed Central

    Zeiger, Eduardo; Armond, Paul; Melis, Anastasios

    1981-01-01

    The presence of chloroplasts in guard cells from leaf epidermis, coleoptile, flowers, and albino portions of variegated leaves was established by incident fluorescence microscopy, thus confirming the notion that guard cell chloroplasts are remarkably conserved. Room temperature emission spectra from a few chloroplasts in a single guard cell of Vicia faba showed one major peak at around 683 nanometers. Low-temperature (77 K) emission spectra from peels of albino portions of Chlorophytum comosum leaves and from mesophyll chloroplasts of green parts of the same leaves showed major peaks at around 687 and 733 nanometers, peaks usually attributed to photosystem II and photosystem I pigment systems, respectively. Spectra of peels of V. faba leaves showed similar peaks. However, fluorescence microscopy revealed that the Vicia peels, as well as those from Allium cepa and Tulipa sp., were contaminated with non-guard cell chloroplasts which were practically undetectable under bright field illumination. These observations pose restrictions on the use of epidermal peels as a source of isolated guard cell chloroplasts. Studies on the 3-(3,4-dichlorophenyl)-1,1-dimethylurea-sensitive variable fluorescence kinetics of uncontaminated epidermal peels of C. comosum indicated that guard cell chloroplasts operate a normal, photosystem II-dependent, linear electron transport. The above properties in combination with their reported inability to fix CO2 photosynthetically may render the guard cell chloroplasts optimally suited to supply the reducing and high-energy phosphate equivalents needed to sustain active ion transport during stomatal opening in daylight. PMID:16661620

  20. 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

  1. 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

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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…

  13. 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

  14. 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

  15. 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

  16. 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

  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 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 46 CFR 108.223 - Guards on exposed equipment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Guards on exposed equipment. 108.223 Section 108.223 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Construction and Arrangement Rails § 108.223 Guards on exposed equipment. Each unit must have hand covers, guards, or rails...

  10. 46 CFR 177.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Guards for exposed hazards. 177.960 Section 177.960... TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.960 Guards for exposed hazards. An exposed hazard, such as gears or rotating machinery, must be properly protected by a cover, guard, or rail....

  11. 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... TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.960 Guards for exposed hazards. An exposed hazard, such as gears or rotating machinery, must be properly protected by a cover, guard, or rail....

  12. 46 CFR 116.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Guards for exposed hazards. 116.960 Section 116.960 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.960 Guards for exposed hazards. An exposed hazard, such as gears...

  13. 46 CFR 116.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Guards for exposed hazards. 116.960 Section 116.960 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.960 Guards for exposed hazards. An exposed hazard, such as gears...

  14. 46 CFR 177.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Guards for exposed hazards. 177.960 Section 177.960... TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.960 Guards for exposed hazards. An exposed hazard, such as gears or rotating machinery, must be properly protected by a cover, guard, or rail....

  15. 46 CFR 177.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Guards for exposed hazards. 177.960 Section 177.960... TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.960 Guards for exposed hazards. An exposed hazard, such as gears or rotating machinery, must be properly protected by a cover, guard, or rail....

  16. 46 CFR 116.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Guards for exposed hazards. 116.960 Section 116.960 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.960 Guards for exposed hazards. An exposed hazard, such as gears...

  17. 46 CFR 177.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Guards for exposed hazards. 177.960 Section 177.960... TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.960 Guards for exposed hazards. An exposed hazard, such as gears or rotating machinery, must be properly protected by a cover, guard, or rail....

  18. 46 CFR 116.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Guards for exposed hazards. 116.960 Section 116.960 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.960 Guards for exposed hazards. An exposed hazard, such as gears...

  19. 46 CFR 116.960 - Guards for exposed hazards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Guards for exposed hazards. 116.960 Section 116.960 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.960 Guards for exposed hazards. An exposed hazard, such as gears...

  20. 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...

  1. 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...

  2. 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...

  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 108.223 - Guards on exposed equipment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Guards on exposed equipment. 108.223 Section 108.223 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Construction and Arrangement Rails § 108.223 Guards on exposed equipment. Each unit must have hand covers, guards, or rails...

  5. 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...

  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 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...

  8. 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...

  9. 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...

  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 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...

  12. 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 Symbol means that impression stamped on the...

  13. 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…

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  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. 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...

  20. 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...

  1. 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 means that number assigned to boilers and...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 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. 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...

  8. 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...

  9. 76 FR 7123 - Eleventh Coast Guard District Annual Marine Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-09

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Eleventh Coast Guard District Annual Marine Events AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY: The Coast Guard proposes to update and consolidate the list of marine events occurring annually within the Eleventh Coast...

  10. 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...

  11. 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...

  12. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 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...

  13. 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...

  14. 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...

  15. 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

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 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. 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

  4. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 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...

  5. 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...

  6. 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...

  7. 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...

  8. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 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...

  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...

  10. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 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...

  11. 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...

  12. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 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...

  13. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 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...

  14. [Optimalisation of the antibiotic policy in The Netherlands. XI. The national electronic antibiotic guide'SWAB-ID' for use in hospitals].

    PubMed

    van Vonderen, M G A; Gyssens, I C; Hartwig, N G; Kullberg, B J; Leverstein-van Hall, M A; Natsch, S; Prins, J M

    2006-11-18

    The 'Stichting Werkgroep Antibioticabeleid' (Dutch Working Party on Antibiotic Policy) has developed an electronic national antibiotic guide for the antibiotic treatment and prophylaxis of common infectious diseases in hospitals. This guide also contains information on the most important characteristics of antimicrobial drugs. Advice on antibiotic treatment is based on existing national evidence-based guidelines, where available. Where no guideline is available, the advice is based on an inventory of the antibiotic policies of the 12 Dutch centres with an infectious disease or medical microbiology training programme. The national antibiotic guide can be accessed through the SWAB website (www.swab.nl) and can also be downloaded on PDA/PocketPC, free of charge. Every hospital antibiotic formulary committee in the Netherlands will be offered the opportunity to edit The national version for local use. PMID:17152335

  15. Efficacy of hand rubs with a low alcohol concentration listed as effective by a national hospital hygiene society in Europe

    PubMed Central

    2013-01-01

    Background Some national hospital hygiene societies in Europe such as the French society for hospital hygiene (SFHH) have positive lists of disinfectants. Few hand disinfectants with a rather low concentration of ethanol are listed by one society as effective for hygienic hand disinfection with 3 mL in 30 s including a virucidal activity in 30 s or 60 s, but published data allow having doubts. We have therefore evaluated the efficacy of three commonly used hand disinfectants according to EN 1500 and EN 14476. Methods Products 1 (Aniosgel 85 NPC) and 2 (Aniosrub 85 NPC) were based on 70% ethanol, product 3 (ClinoGel derma+) on 60% ethanol and 15% isopropanol (all w/w). They were tested in 3 laboratories according to EN 1500. Three mL were applied for 30 s and compared to the reference treatment of 2 × 3 mL applications of isopropanol 60% (v/v), on hands artificially contaminated with Escherichia coli. Each laboratory used a cross-over design against the reference alcohol with 15 or 20 volunteers. The virucidal activity of the products was evaluated (EN 14476) in one laboratory against adenovirus and poliovirus in different concentrations (80%, 90%, 97%), with different organic loads (none; clean conditions; phosphate-buffered saline) for up to 3 min. Results Product 1 revealed a mean log10-reduction of 3.87 ± 0.79 (laboratory 1) and 4.38 ± 0.87 (laboratory 2) which was significantly lower compared to the reference procedure (4.62 ± 0.89 and 5.00 ± 0.87). In laboratory 3 product 1 was inferior to the reference disinfection (4.06 ± 0.86 versus 4.99 ± 0.90). Product 2 revealed similar results. Product 3 fulfilled the requirements in one laboratory but failed in the two other. None of the three products was able to reduce viral infectivity of both adenovirus and poliovirus by 4 log10 steps in 3 min according to EN 14476. Conclusions Efficacy data mentioned in a positive list published by a society for hospital hygiene should still be regarded with caution if they quite obviously contradict published data on the same or similar products. PMID:23759059

  16. Help prevent hospital errors

    MedlinePLUS

    ... Vogus TJ. Reducing hospital errors: interventions that build safety culture. Annu Rev Public Health . 2013;34:373-396. The Joint Commission. Hospital: 2014 National Patient Safety Goals. Available at: www.jointcommission.org/hap_2014_ ...

  17. 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...

  18. 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...

  19. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  20. 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...

  1. 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...

  2. 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…

  3. 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…

  4. 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…

  5. 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)

  6. 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…

  7. 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…

  8. 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…

  9. 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

  10. 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

  11. HBV and HCV Coinfection among HIV/AIDS Patients in the National Hospital of Tropical Diseases, Vietnam.

    PubMed

    Huy, Bùi V?; Vernavong, Kanxay; Kính, Nguy?n V?n

    2014-01-01

    Aim. To examine prevalence and characterization of HBV and HCV coinfection among HIV/AIDS patients. Methods. This cross-sectional, retrospective study analyzed 724 HIV/AIDS patients in the HIV clinic at the National Hospital of Tropical Diseases (NHTD), from 5/2005 to 4/2011. Results. The prevalence of HBV, HCV, and HIV coinfection was 50.3% (364/724), of which HbsAg, HCV, and both of HbsAg, and HCV positivity were 8.4%, 35.4%, and 6.5%, respectively. The cohort (364 patients) with HBV, HCV, and HIV coinfection live in the 30 provinces/cities in the North and Central area of Vietnam. We found statistically significant associations between heightened risk of coinfection with HIV and HCV in the age group 30-39 years (P < 0.001), male gender (P < 0.001), never married patients (P < 0.001), patients with a history of injection drug use (P < 0.001), and clinical stages 2-4 (P < 0.001). Coinfection with HBV/HIV was statistically significant associations between heightened risk of marital status (never married) (P < 0.001) and those who reported transmission through sexual intercourse. Conclusion. Coinfection with viral hepatitis is common in HIV patients; further study of the impact and evolution of coinfection is necessary to find effective treatment algorithms. PMID:25580287

  12. HBV and HCV Coinfection among HIV/AIDS Patients in the National Hospital of Tropical Diseases, Vietnam

    PubMed Central

    Huy, Bùi V?; Vernavong, Kanxay; Kính, Nguy?n V?n

    2014-01-01

    Aim. To examine prevalence and characterization of HBV and HCV coinfection among HIV/AIDS patients. Methods. This cross-sectional, retrospective study analyzed 724 HIV/AIDS patients in the HIV clinic at the National Hospital of Tropical Diseases (NHTD), from 5/2005 to 4/2011. Results. The prevalence of HBV, HCV, and HIV coinfection was 50.3% (364/724), of which HbsAg, HCV, and both of HbsAg, and HCV positivity were 8.4%, 35.4%, and 6.5%, respectively. The cohort (364 patients) with HBV, HCV, and HIV coinfection live in the 30 provinces/cities in the North and Central area of Vietnam. We found statistically significant associations between heightened risk of coinfection with HIV and HCV in the age group 30–39 years (P < 0.001), male gender (P < 0.001), never married patients (P < 0.001), patients with a history of injection drug use (P < 0.001), and clinical stages 2–4 (P < 0.001). Coinfection with HBV/HIV was statistically significant associations between heightened risk of marital status (never married) (P < 0.001) and those who reported transmission through sexual intercourse. Conclusion. Coinfection with viral hepatitis is common in HIV patients; further study of the impact and evolution of coinfection is necessary to find effective treatment algorithms. PMID:25580287

  13. 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

  14. 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

  15. 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

  16. 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…

  17. 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…

  18. 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

  19. 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

  20. Speed-Selector Guard For Machine Tool

    NASA Technical Reports Server (NTRS)

    Shakhshir, Roda J.; Valentine, Richard L.

    1992-01-01

    Simple guardplate prevents accidental reversal of direction of rotation or sudden change of speed of lathe, milling machine, or other machine tool. Custom-made for specific machine and control settings. Allows control lever to be placed at only one setting. Operator uses handle to slide guard to engage or disengage control lever. Protects personnel from injury and equipment from damage occurring if speed- or direction-control lever inadvertently placed in wrong position.

  1. Compliance of St Joseph's Hospital Roma, Lesotho with the National Tuberculosis Programme of Lesotho, 2007 and 2008

    PubMed Central

    Samuel, Oladoyinbo O.

    2014-01-01

    Abstract Background In 2009 Lesotho had an estimated TB prevalence of 696 cases/100 000 population – the 4th highest in the world. This epidemic was characterised by high rates of death, treatment failure and unknown treatment outcomes. These adverse outcomes were attributable to a high rate of TB and/or HIV co-infection and weaknesses in the implementation of Lesotho's National Tuberculosis Programme (NTP). This study was conducted in St Joseph's Hospital, Roma (SJHR) to assess the implementation of the NTP. Method Records of 993 patients entered into the SJHR TB register between 2007 and 2008 were reviewed. Patients’ treatment details were extracted from the register, validated and analysed by STATA 10.0. Results Of 993 patients registered: 88% were new patients, 37% were diagnosed on sputum smear microscopy alone, 35% were diagnosed on sputum smear microscopy with chest X-ray, whilst 25% were diagnosed on chest X-ray alone. In addition: 33% were sputum smear positive, 45% were sputum smear negative, and 22% had extra-pulmonary TB. As to treatment outcome: 26% were cured, 51% completed treatment, and 51% converted from sputum smear positive to sputum smear negative over six months, whilst 16% died. Regarding HIV, 77% of patients were tested for HIV and 59% had TB and/or HIV co-infection. Of ten NTP targets only the defaulter and treatment failure rate targets were met. Conclusion Whilst only two out of ten NTP targets were met at SJHR in 2007–2008, improvements in TB case management were noted in 2008 which were probably due to the positive effects of audit on staff performance. PMID:26245409

  2. 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

  3. Transfer of hospitals and "additional premises" to the state: questionable morality in the implementation of the National Health Service Act (1946)

    PubMed Central

    Cook, G

    2004-01-01

    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

  4. 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

  5. 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

  6. 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

  7. S316, GUARD TOWER ON KOLEKOLE PASS RD. Naval Magazine ...

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

    S316, GUARD TOWER ON KOLEKOLE PASS RD. - Naval Magazine Lualualei, Headquarters Branch, Guard-Watch Tower Type, Off Dent Road & on Kolekole Road near north boundary of installation, Pearl City, Honolulu County, HI

  8. S316, GUARD TOWER INTERIOR. Naval Magazine Lualualei, Headquarters Branch, ...

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

    S316, GUARD TOWER INTERIOR. - Naval Magazine Lualualei, Headquarters Branch, Guard-Watch Tower Type, Off Dent Road & on Kolekole Road near north boundary of installation, Pearl City, Honolulu County, HI

  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. 31. GUARD LOCKS VIEWED FROM THE NORTHWEST BANK SHOWING UPSTREAM ...

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

    31. GUARD LOCKS VIEWED FROM THE NORTHWEST BANK SHOWING UPSTREAM SIDE: GATE HOUSE AT LEFT CENTER, POINT OF ISLAND IN CENTER, AND LOCK HOUSE ON RIGHT 1976 - Pawtucket Canal, Guard Locks, Lowell, Middlesex County, MA

  11. 15. GUARD LOCKS VIEWED FROM THE NORTHWEST BANK: SHOWS UPSTREAM ...

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

    15. GUARD LOCKS VIEWED FROM THE NORTHWEST BANK: SHOWS UPSTREAM SIDE. GATEHOUSE ON THE LEFT, ISLAND IN THE CENTER, AND LOCK HOUSE ON THE RIGHT 1976 - Pawtucket Canal, Guard Locks, Lowell, Middlesex County, MA

  12. 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

  13. 75 FR 80064 - National Offshore Safety Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HOMELAND SECURITY Coast Guard National Offshore Safety Advisory Committee AGENCY: Coast Guard, DHS. ACTION: Notice of teleconference meeting. SUMMARY: The National Offshore Safety Advisory Committee (NOSAC) will...

  14. 75 FR 47311 - National Offshore Safety Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOMELAND SECURITY Coast Guard National Offshore Safety Advisory Committee AGENCY: Coast Guard, DHS. ACTION: Notice of open teleconference meeting. SUMMARY: The National Offshore Safety Advisory Committee (NOSAC)...

  15. File Transfer Protocol Guard Version 1.5

    Energy Science and Technology Software Center (ESTSC)

    1999-01-13

    The FTP Guard provides a means for securely transferring files from an unclassified network to a classified network. Files are moved using the FTP protocol. To a user, the FTP Guard appears to be an FTP proxy server. The FTP Guard does not move files from the classified network to the unclassified network.

  16. 30 CFR 57.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MINES Machinery and Equipment Safety Devices and Maintenance Requirements § 57.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Construction and maintenance of guards....

  17. 30 CFR 56.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Construction and maintenance of guards. 56... Machinery and Equipment Safety Devices and Maintenance Requirements § 56.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock,...

  18. 30 CFR 56.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Construction and maintenance of guards. 56... Machinery and Equipment Safety Devices and Maintenance Requirements § 56.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock,...

  19. 30 CFR 56.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Construction and maintenance of guards. 56... Machinery and Equipment Safety Devices and Maintenance Requirements § 56.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock,...

  20. 30 CFR 57.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MINES Machinery and Equipment Safety Devices and Maintenance Requirements § 57.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Construction and maintenance of guards....

  1. 30 CFR 57.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MINES Machinery and Equipment Safety Devices and Maintenance Requirements § 57.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Construction and maintenance of guards....

  2. 30 CFR 56.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Construction and maintenance of guards. 56... Machinery and Equipment Safety Devices and Maintenance Requirements § 56.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock,...

  3. 30 CFR 57.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MINES Machinery and Equipment Safety Devices and Maintenance Requirements § 57.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Construction and maintenance of guards....

  4. 30 CFR 57.14112 - Construction and maintenance of guards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MINES Machinery and Equipment Safety Devices and Maintenance Requirements § 57.14112 Construction and maintenance of guards. (a) Guards shall be constructed and maintained to— (1) Withstand the vibration, shock... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Construction and maintenance of guards....

  5. 16 CFR 1512.9 - Requirements for protective guards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REGULATIONS REQUIREMENTS FOR BICYCLES Regulations § 1512.9 Requirements for protective guards. (a) Chain guard. Bicycles having a single front sprocket and a single rear sprocket shall have a chain guard that shall... the bicycle in any direction within 45° from a line normal to the sprocket. (b) Derailleur...

  6. 28 CFR 97.14 - Guard-to-prisoner ratio.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Guard-to-prisoner ratio. 97.14 Section 97... PRISONER OR DETAINEE SERVICES § 97.14 Guard-to-prisoner ratio. Companies covered under this part must... entity from establishing more stringent guard-to-prisoner ratios....

  7. USGS with U.S. and Canadian Coast Guard

    USGS Multimedia Gallery

    Waiting to board the Canadian helicopter from U.S. Coast Guard Cutter Healy and visit Canadian Coast Guard Ship Louis S. St. Laurent. From left to right: USGS scientist Jonathan Childs, chief scientist for this expedition on Healy; U.S. Coast Guard Lieutenant Commander Douglas Petrusa; Canadian Coas...

  8. 30 CFR 57.11036 - Ladderway trap doors and guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Ladderway trap doors and guards. 57.11036... and Escapeways Travelways-Underground Only § 57.11036 Ladderway trap doors and guards. Trap doors or adequate guarding shall be provided in ladderways at each level. Doors shall be kept operable....

  9. 30 CFR 57.11036 - Ladderway trap doors and guards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Ladderway trap doors and guards. 57.11036... and Escapeways Travelways-Underground Only § 57.11036 Ladderway trap doors and guards. Trap doors or adequate guarding shall be provided in ladderways at each level. Doors shall be kept operable....

  10. Collector/collector guard ring balancing circuit eliminates edge effects

    NASA Technical Reports Server (NTRS)

    Lieb, D. P.

    1966-01-01

    Circuit in which an emitter is maintained opposite a concentric collector and guard structure is achieved by matching the temperature and potential of the guard with that of the collector over the operating range. This control system is capable of handling up to 100 amperes in the guard circuit and 200 amperes in the collectors circuit.

  11. 46 CFR 167.40-30 - Guards and rails.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards and rails. 167.40-30 Section 167.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS PUBLIC NAUTICAL SCHOOL SHIPS Certain Equipment Requirements § 167.40-30 Guards and rails. On nautical school ships all exposed and dangerous places, such as gears and...

  12. 41 CFR 50-204.5 - Machine guarding.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Machine guarding. 50-204... General Safety and Health Standards § 50-204.5 Machine guarding. (a) One or more methods of machine guarding shall be provided to protect the operator and other employees in the machine area from...

  13. 41 CFR 50-204.5 - Machine guarding.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Machine guarding. 50-204... General Safety and Health Standards § 50-204.5 Machine guarding. (a) One or more methods of machine guarding shall be provided to protect the operator and other employees in the machine area from...

  14. 41 CFR 50-204.5 - Machine guarding.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Machine guarding. 50-204... General Safety and Health Standards § 50-204.5 Machine guarding. (a) One or more methods of machine guarding shall be provided to protect the operator and other employees in the machine area from...

  15. 41 CFR 50-204.5 - Machine guarding.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Machine guarding. 50-204... General Safety and Health Standards § 50-204.5 Machine guarding. (a) One or more methods of machine guarding shall be provided to protect the operator and other employees in the machine area from...

  16. 41 CFR 50-204.5 - Machine guarding.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Machine guarding. 50-204... General Safety and Health Standards § 50-204.5 Machine guarding. (a) One or more methods of machine guarding shall be provided to protect the operator and other employees in the machine area from...

  17. 46 CFR 28.215 - Guards for exposed hazards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Guards for exposed hazards. 28.215 Section 28.215 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL....215 Guards for exposed hazards. (a) Each space on board a vessel must meet the requirements of...

  18. 46 CFR 28.215 - Guards for exposed hazards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Guards for exposed hazards. 28.215 Section 28.215 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL....215 Guards for exposed hazards. (a) Each space on board a vessel must meet the requirements of...

  19. 46 CFR 28.215 - Guards for exposed hazards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Guards for exposed hazards. 28.215 Section 28.215 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL....215 Guards for exposed hazards. (a) Each space on board a vessel must meet the requirements of...

  20. 46 CFR 28.215 - Guards for exposed hazards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Guards for exposed hazards. 28.215 Section 28.215 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL....215 Guards for exposed hazards. (a) Each space on board a vessel must meet the requirements of...