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  1. The burden of co-existing dermatological disorders and their tendency of being overlooked among patients admitted to muhimbili national hospital in Dar es Salaam, Tanzania

    PubMed Central

    2011-01-01

    Background Skin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice. Many patients are hospitalized with co-existing dermatological conditions which may not be detected and managed by the attending physicians. The objective of this study was to determine the burden of co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili National hospital in Dar es Salaam. Study design and settings A hospital-based descriptive cross-sectional study conducted at Muhimbili National hospital in Dar es Salaam, Tanzania. Methods Patients were consecutively recruited from the medical wards. Detailed interview to obtain clinico-demographic characteristics was followed by a complete physical examination. Dermatological diagnoses were made mainly clinically. Appropriate confirmatory laboratory investigations were performed where necessary. Data was analyzed using the 'Statistical Package for Social Sciences' (SPSS) program version 10.0. A p-value of < 0.5 was statistically significant. Results Three hundred and ninety patients admitted to medical wards were enrolled into the study of whom, 221(56.7%) were females. The mean age was 36.7 ± 17.9 (range 7-84 years). Overall, 232/390 patients (59.5%) had co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. A wide range of co-existing skin diseases was encountered, the most diverse being non-infectious conditions which together accounted for 36.4% (142/390) while infectious dermatoses accounted for 31.5% (123/390). The leading infectious skin diseases were superficial fungal infections accounting for 18%. Pruritic papular eruption of HIV/AIDS (PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%. Of the 232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by their referring and admitting

  2. Prevalence of erectile dysfunction and associated factors among diabetic men attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania

    PubMed Central

    Mutagaywa, Reuben Kato; Lutale, Janeth; Aboud, Muhsin; Kamala, Benjamin Anathory

    2014-01-01

    Introduction There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital. Methods A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011. Results More than half (55.1%) of the patients were found to have some form of ED (12.8% had mild dysfunction, 11.5% moderate and 27.9% severe dysfunction). The severity of ED was correlated with increased age. Multivariate logistic regression revealed that ED was significantly predicted by old age (odds ratio (OR) = 7.1, 95% CI 1.2-40.7), evidence of peripheral neuropathy (OR) =5.9, 95% CI 1.6-21.3), and evidence of peripheral vascular disease (OR =2.5, 95% CI 1.2-5.3). Also longer duration of DM was marginally associated with ED (p=0.056). Patients with ED were also more likely to suffer other sexual domains (p<0.001). No lifestyle factor was associated with ED. Conclusion The prevalence of ED is high among DM patients. Interventions aimed at prevention, early diagnosis and detection of DM and its complications, and adherence to treatment to prevent complications should be implemented. Further studies should emphasize on temporal variation to show true causality of DM on erectile dysfunction. PMID:25170371

  3. Morbidity and Mortality following Traditional Uvulectomy among Children Presenting to the Muhimbili National Hospital Emergency Department in Dar es Salaam, Tanzania

    PubMed Central

    Sawe, H. R.; Mfinanga, J. A.; Ringo, F. H.; Mwafongo, V.; Reynolds, T. A.; Runyon, M. S.

    2015-01-01

    Background. Traditional uvulectomy is performed as a cultural ritual or purported medical remedy. We describe the associated emergency department (ED) presentations and outcomes. Methods. This was a subgroup analysis of a retrospective review of all pediatric visits to our ED in 2012. Trained abstracters recorded demographics, clinical presentations, and outcomes. Results. Complete data were available for 5540/5774 (96%) visits and 56 (1.0%, 95% CI: 0.7–1.3%) were related to recent uvulectomy, median age 1.3 years (interquartile range: 7 months–2 years) and 30 (54%) were male. Presenting complaints included cough (82%), fever (46%), and hematemesis (38%). Clinical findings included fever (54%), tachypnea (30%), and tachycardia (25%). 35 patients (63%, 95% CI: 49–75%) received intravenous antibiotics, 11 (20%, 95% CI: 10–32%) required blood transfusion, and 3 (5%, 95% CI: 1–15%) had surgical intervention. All were admitted to the hospital and 12 (21%, 95% CI: 12–34%) died. By comparison, 498 (9.1%, 95% CI: 8–10%) of the 5484 children presenting for reasons unrelated to uvulectomy died (p = 0.003). Conclusion. In our cohort, traditional uvulectomy was associated with significant morbidity and mortality. Emergency care providers should advocate for legal and public health interventions to eliminate this dangerous practice. PMID:26161270

  4. Factors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania

    PubMed Central

    2010-01-01

    Background Effective maternal and perinatal audits are associated with improved quality of care and reduction of severe adverse outcome. Although audits at the level of care were formally introduced in Tanzania around 25 years ago, little information is available about their existence, performance, and practical barriers to their implementation. This study assessed the structure, process and impacts of maternal and perinatal death audit systems in clinical practice and presents a detailed account on how they could be improved. Methods A cross sectional descriptive study was conducted in eight major hospitals in Dar es Salaam in January 2009. An in-depth interview guide was used for 29 health managers and members of the audit committees to investigate the existence, structure, process and outcome of such audits in clinical practice. A semi-structured questionnaire was used to interview 30 health care providers in the maternity wards to assess their awareness, attitude and practice towards audit systems. The 2007 institutional pregnancy outcome records were reviewed. Results Overall hospital based maternal mortality ratio was 218/100,000 live births (range: 0 - 385) and perinatal mortality rate was 44/1000 births (range: 17 - 147). Maternal and perinatal audit systems existed only in 4 and 3 hospitals respectively, and key decision makers did not take part in audit committees. Sixty percent of care providers were not aware of even a single action which had ever been implemented in their hospitals because of audit recommendations. There were neither records of the key decision points, action plan, nor regular analysis of the audit reports in any of the facilities where such audit systems existed. Conclusions Maternal and perinatal audit systems in these institutions are poorly established in structure and process; and are less effective to improve the quality of care. Fundamental changes are urgently needed for successful audit systems in these institutions. PMID

  5. Hyperspectral and LiDAR remote sensing of fire fuels in Hawaii Volcanoes National Park.

    PubMed

    Varga, Timothy A; Asner, Gregory P

    2008-04-01

    Alien invasive grasses threaten to transform Hawaiian ecosystems through the alteration of ecosystem dynamics, especially the creation or intensification of a fire cycle. Across sub-montane ecosystems of Hawaii Volcanoes National Park on Hawaii Island, we quantified fine fuels and fire spread potential of invasive grasses using a combination of airborne hyperspectral and light detection and ranging (LiDAR) measurements. Across a gradient from forest to savanna to shrubland, automated mixture analysis of hyperspectral data provided spatially explicit fractional cover estimates of photosynthetic vegetation, non-photosynthetic vegetation, and bare substrate and shade. Small-footprint LiDAR provided measurements of vegetation height along this gradient of ecosystems. Through the fusion of hyperspectral and LiDAR data, a new fire fuel index (FFI) was developed to model the three-dimensional volume of grass fuels. Regionally, savanna ecosystems had the highest volumes of fire fuels, averaging 20% across the ecosystem and frequently filling all of the three-dimensional space represented by each image pixel. The forest and shrubland ecosystems had lower FFI values, averaging 4.4% and 8.4%, respectively. The results indicate that the fusion of hyperspectral and LiDAR remote sensing can provide unique information on the three-dimensional properties of ecosystems, their flammability, and the potential for fire spread. PMID:18488621

  6. National Hospital Input Price Index

    PubMed Central

    Freeland, Mark S.; Anderson, Gerard; Schendler, Carol Ellen

    1979-01-01

    The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 percent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies. PMID:10309052

  7. Supporting Indonesia's National Forest Monitoring System with LiDAR Observations

    NASA Astrophysics Data System (ADS)

    Hagen, S. C.

    2015-12-01

    Scientists at Applied GeoSolutions, Jet Propulsion Laboratory, Winrock International, and the University of New Hampshire are working with the government of Indonesia to enhance the National Forest Monitoring System in Kalimantan, Indonesia. The establishment of a reliable, transparent, and comprehensive NFMS has been limited by a dearth of relevant data that are accurate, low-cost, and spatially resolved at subnational scales. In this NASA funded project, we are developing, evaluating, and validating several critical components of a NFMS in Kalimantan, Indonesia, focusing on the use of LiDAR and radar imagery for improved carbon stock and forest degradation information. Applied GeoSolutions and the University of New Hampshire have developed an Open Source Software package to process large amounts LiDAR data quickly, easily, and accurately. The Open Source project is called lidar2dems and includes the classification of raw LAS point clouds and the creation of Digital Terrain Models (DTMs), Digital Surface Models (DSMs), and Canopy Height Models (CHMs). Preliminary estimates of forest structure and forest damage from logging from these data sets support the idea that comprehensive, well documented, freely available software for processing LiDAR data can enable countries such as Indonesia to cost effectively monitor their forests with high precision.

  8. Mapping Vegetation Canopy Structure and Distribution for Great Smoky Mountains National Park Using LiDAR

    NASA Astrophysics Data System (ADS)

    Wu, Z.; Weiner, J.; Kumar, J.; Norman, S. P.; Hargrove, W. W.; Collier, N.; Hoffman, F. M.

    2015-12-01

    A major challenge in forest management is the inaccessibility of large swaths of land, which makes accurate monitoring of forest change difficult. Remote sensing methods can help address this issue by allowing investigators to monitor remote or inaccessible regions using aerial or satellite-based platforms. However, most remote sensing methods do not provide a full three-dimensional (3D) description of the area. Rather, they return only a single elevation point or landcover description. Multiple-return LiDAR (Light Detection and Ranging) gathers data in a 3D point cloud, which allows forest managers to more accurately characterize and monitor changes in canopy structure and vegetation-type distribution. Our project used high-resolution aerial multiple-return LiDAR data to determine vegetation canopy structures and their spatial distribution in Great Smoky Mountains National Park. To ensure sufficient data density and to match LANDSAT resolution, we gridded the data into 30m x 30m cells. The LiDAR data points within each cell were then used to generate the vertical canopy structure for that cell. After vertical profiles had been created, we used a k-means cluster analysis algorithm to classify the landscape based on the canopy structure. The spatial distribution of distinct and unique canopy structures was mapped across the park and compared to a vegetation-type map to determine the correlation of canopy structure to vegetation types. Preliminary analysis conducted at a number of phenology sites maintained by the Great Smoky Mountains Institute at Tremont shows strong correspondence between canopy structure and vegetation type. However, more validation is needed in other regions of the park to establish this method as a reliable tool. LiDAR data has a unique ability to map full 3D structures of vegetation and the methods developed in this project offer an extensible tool for forest mapping and monitoring.

  9. National survey of hospital patients.

    PubMed Central

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

    1994-01-01

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

  10. Birth prevalence of selected external structural birth defects at four hospitals in Dar es Salaam, Tanzania, 2011–2012

    PubMed Central

    Kishimba, Rogath Saika; Mpembeni, Rose; Mghamba, Janneth M; Goodman, David; Valencia, Diana

    2015-01-01

    Background 94% of all birth defects (BD) and 95% of deaths due to the BD occur in low and middle income countries, many of which are preventable. In Tanzania, there is currently a paucity of BD data necessary to develop data informed prevention activities. Methods A cross-sectional analysis was conducted of deliveries identified with BD in the labor ward registers at four Dar es Salaam hospitals between October, 2011 and February, 2012. The birth prevalence of structural BD, case fatality proportion, and the distribution of structural defects associated deaths within total deaths were calculated. Results A total of 28 217 resident births were encountered during the study period. Overall birth prevalence of selected defects was 28.3/10 000 live births. Neural tube defects and indeterminate sex were the most and least common defects at birth (9.9 and 1.1/10 000 live births, respectively). Among stillbirths (66.7%) and deaths that occurred within less than 5 days of an affected live birth (18.5%), neural tube defects were the most frequently associated structural defect. Conclusion Structural BD is common and contributes to perinatal mortality in Dar es Salaam. More than half of perinatal deaths encountered among the studied selected external structural BD are associated with neural tube defects, a birth defect with well–established evidence based prevention interventions. By establishing a population–based BD surveillance program, Tanzania would have the information about neural tube defects and other major structural BD needed to develop and monitor prevention activities. PMID:26361541

  11. Improving LiDAR Data Post-Processing Techniques for Archaeological Site Management and Analysis: A Case Study from Canaveral National Seashore Park

    NASA Astrophysics Data System (ADS)

    Griesbach, Christopher

    Methods used to process raw Light Detection and Ranging (LiDAR) data can sometimes obscure the digital signatures indicative of an archaeological site. This thesis explains the negative effects that certain LiDAR data processing procedures can have on the preservation of an archaeological site. This thesis also presents methods for effectively integrating LiDAR with other forms of mapping data in a Geographic Information Systems (GIS) environment in order to improve LiDAR archaeological signatures by examining several pre-Columbian Native American shell middens located in Canaveral National Seashore Park (CANA).

  12. Characterization and classification of vegetation canopy structure and distribution within the Great Smoky Mountains National Park using LiDAR

    SciTech Connect

    Kumar, Jitendra; HargroveJr., William Walter; Norman, Steven P; Hoffman, Forrest M; Newcomb, Doug

    2015-01-01

    Vegetation canopy structure is a critically important habit characteristic for many threatened and endangered birds and other animal species, and it is key information needed by forest and wildlife managers for monitoring and managing forest resources, conservation planning and fostering biodiversity. Advances in Light Detection and Ranging (LiDAR) technologies have enabled remote sensing-based studies of vegetation canopies by capturing three-dimensional structures, yielding information not available in two-dimensional images of the landscape pro- vided by traditional multi-spectral remote sensing platforms. However, the large volume data sets produced by airborne LiDAR instruments pose a significant computational challenge, requiring algorithms to identify and analyze patterns of interest buried within LiDAR point clouds in a computationally efficient manner, utilizing state-of-art computing infrastructure. We developed and applied a computationally efficient approach to analyze a large volume of LiDAR data and to characterize and map the vegetation canopy structures for 139,859 hectares (540 sq. miles) in the Great Smoky Mountains National Park. This study helps improve our understanding of the distribution of vegetation and animal habitats in this extremely diverse ecosystem.

  13. Uncertainty estimation in integrated LiDAR- and radar-derived biomass maps at key national-level map scales

    NASA Astrophysics Data System (ADS)

    Joshi, N.; Fensholt, R.; Saatchi, S. S.; Mitchard, E. T.

    2013-12-01

    The international Reducing Emissions from Deforestation and Degradation (REDD) program requires accurate and cost-effective techniques of national-level mapping of above-ground biomass (AGB) and ground-sampling strategies. This paper explores a multi-sensor (radar and low-density airborne LiDAR) integration approach for country-wide AGB estimation and mapping in Denmark, selected as a test-country due to the unique availability of country-wide remote sensing and forest inventory data. We assess the potential use of ALOS PALSAR L-band radar and ENVISAT ASAR C-band radar in prediction and mapping of AGB with accuracies similar to LiDAR-derived AGB estimates at different map scales. We start by creating a LiDAR-based ';ground truth' map, using LiDAR-derived 95th Percentile of heights >1 m weighted by the Canopy Density ratio, together with 113 AGB plots to map AGB at a 0.25 ha resolution across the country. A leave-20%-out cross-validation indicates that the AGB estimates have a mean absolute error of 41 Mg ha-1 and a negative mean bias error of 1.7 Mg ha-1. Though the LiDAR model appears to have an overall species-specific bias for conifers and broadleaf (-5.2 Mg ha-1 and +12.3 Mg ha-1 respectively), these are found to be insignificant (p>0.05) when accounting for species sampling bias and the under-prediction of plots containing high-biomass (> 350 Mg ha-1). Using the LiDAR-derived biomass map as a ';truth-map', biomass-backscatter relations will be quantified at three map scales (0.25 ha, 1 ha and 100 ha) and using three spatial sampling frameworks (full-dataset, stratified random sampling equally representing low and high biomass pixels, clustered sampling). The approach aims to derive a minimal-sampling and mapping strategy for L- and C-band radar that achieves at least 20% accuracy in AGB estimation, along with quantified sources of error from ground-AGB estimates, scaling and sampling. It is expected that mapping techniques, uncertainty quantification and

  14. Financial Analysis of National University Hospitals in Korea

    PubMed Central

    Lee, Munjae

    2015-01-01

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

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

    PubMed

    Oates, B; Murray, J; Hindle, D

    1998-01-01

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

  16. 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

  17. 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

  18. Mapping tropical forest biomass with radar and spaceborne LiDAR in Lopé National Park, Gabon: overcoming problems of high biomass and persistent cloud

    NASA Astrophysics Data System (ADS)

    Mitchard, E. T. A.; Saatchi, S. S.; White, L. J. T.; Abernethy, K. A.; Jeffery, K. J.; Lewis, S. L.; Collins, M.; Lefsky, M. A.; Leal, M. E.; Woodhouse, I. H.; Meir, P.

    2012-01-01

    Spatially-explicit maps of aboveground biomass are essential for calculating the losses and gains in forest carbon at a regional to national level. The production of such maps across wide areas will become increasingly necessary as international efforts to protect primary forests, such as the REDD+ (Reducing Emissions from Deforestation and forest Degradation) mechanism, come into effect, alongside their use for management and research more generally. However, mapping biomass over high-biomass tropical forest is challenging as (1) direct regressions with optical and radar data saturate, (2) much of the tropics is persistently cloud-covered, reducing the availability of optical data, (3) many regions include steep topography, making the use of radar data complex, (5) while LiDAR data does not suffer from saturation, expensive aircraft-derived data are necessary for complete coverage. We present a solution to the problems, using a combination of terrain-corrected L-band radar data (ALOS PALSAR), spaceborne LiDAR data (ICESat GLAS) and ground-based data. We map Gabon's Lopé National Park (5000 km2) because it includes a range of vegetation types from savanna to closed-canopy tropical forest, is topographically complex, has no recent contiguous cloud-free high-resolution optical data, and the dense forest is above the saturation point for radar. Our 100 m resolution biomass map is derived from fusing spaceborne LiDAR (7142 ICESat GLAS footprints), 96 ground-based plots (average size 0.8 ha) and an unsupervised classification of terrain-corrected ALOS PALSAR radar data, from which we derive the aboveground biomass stocks of the park to be 78 Tg C (173 Mg C ha-1). This value is consistent with our field data average of 181 Mg C ha-1, from the field plots measured in 2009 covering a total of 78 ha, and which are independent as they were not used for the GLAS-biomass estimation. We estimate an uncertainty of ±25% on our carbon stock value for the park. This error term

  19. Tuberculosis treatment outcomes among hospital workers at a public teaching and national referral hospital in Kenya

    PubMed Central

    Makori, L.; Gikera, M.; Wafula, J.; Chakaya, J.; Edginton, M. E.; Kumar, A. M. V.

    2013-01-01

    Setting: Kenyatta National Hospital (KNH), Nairobi, Ken-ya, a large referral and teaching hospital. Objective: 1) To document tuberculosis (TB) case notification rates and trends; 2) to describe demographic, clinical and workplace characteristics and treatment outcomes; and 3) to examine associations between demographic and clinical characteristics, HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) treatment and anti-tuberculosis treatment outcomes among hospital workers with TB at KNH during the period 2006–2011. Design: A retrospective cohort study involving a review of medical records. Results: The TB case notification rate among hospital staff ranged between 413 and 901 per 100 000 staff members per year; 51% of all cases were extra-pulmonary TB; 74% of all cases were among medical, paramedical and support staff. The TB-HIV coinfection rate was 60%. Only 75% had a successful treatment outcome. Patients in the retreatment category, those with unknown HIV status and those who were support staff had a higher risk of poor treatment outcomes. Conclusion: The TB case rate among hospital workers was unacceptably high compared to that of the general population, and treatment outcomes were poor. Infection control in the hospital and management of staff with TB requires urgent attention. PMID:26393055

  20. 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…

  1. Few Hospital Palliative Care Programs Meet National Staffing Recommendations.

    PubMed

    Spetz, Joanne; Dudley, Nancy; Trupin, Laura; Rogers, Maggie; Meier, Diane E; Dumanovsky, Tamara

    2016-09-01

    The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard. Larger palliative care programs were more likely than smaller ones to include a funded physician position, while smaller programs were more reliant upon advanced practice and registered nurses. To meet current and future palliative care needs, expanded and enhanced education, as well as supportive financing mechanisms for consultations, are needed. PMID:27605652

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

    MedlinePlus

    ... Has the inpatient hospital death rate decreased for all patients and for those with selected first-listed ... 2010 differ from the length of stay for all hospitalizations? Inpatients who died in the hospital stayed ...

  3. High-resolution digital elevation dataset for Crater Lake National Park and vicinity, Oregon, based on LiDAR survey of August-September 2010 and bathymetric survey of July 2000

    USGS Publications Warehouse

    Robinson, Joel E.

    2012-01-01

    Crater Lake partially fills the caldera that formed approximately 7,700 years ago during the eruption of a 12,000-foot volcano known as Mount Mazama. The caldera-forming or climactic eruption of Mount Mazama devastated the surrounding landscape, left a thick deposit of pumice and ash in adjacent valleys, and spread a blanket of volcanic ash as far away as southern Canada. Because the Crater Lake region is potentially volcanically active, knowledge of past events is important to understanding hazards from future eruptions. Similarly, because the area is seismically active, documenting and evaluating geologic faults is critical to assessing hazards from earthquakes. As part of the American Recovery and Reinvestment Act (ARRA) of 2009, the U.S. Geological Survey was awarded funding for high-precision airborne LiDAR (Light Detection And Ranging) data collection at several volcanoes in the Cascade Range through the Oregon LiDAR Consortium, administered by the Oregon Department of Geology and Mineral Industries (DOGAMI). The Oregon LiDAR Consortium contracted with Watershed Sciences, Inc., to conduct the data collection surveys. Collaborating agencies participating with the Oregon LiDAR Consortium for data collection in the Crater Lake region include Crater Lake National Park (National Park Service) and the Federal Highway Administration. In the immediate vicinity of Crater Lake National Park, 798 square kilometers of LiDAR data were collected, providing a digital elevation dataset of the ground surface beneath forest cover with an average resolution of 1.6 laser returns/m2 and both vertical and horizontal accuracies of ±5 cm. The LiDAR data were mosaicked in this report with bathymetry of the lake floor of Crater Lake, collected in 2000 using high-resolution multibeam sonar in a collaborative effort between the U.S. Geological Survey, Crater Lake National Park, and the Center for Coastal and Ocean Mapping at the University of New Hampshire. The bathymetric survey

  4. Full PACS installation in Seoul National University Hospital, Korea

    NASA Astrophysics Data System (ADS)

    Lim, HyunWoo; Kim, DongOok; Ahn, JinYoung; Lee, DongHyuk; Lee, JinHyung; Park, HeeJung; Kim, JongHyo; Han, Jungu

    2002-05-01

    Seoul National University Hospital (SNUH) is composed of two buildings and has more than 1500 beds for patients needing hospitalization. Marotech has provided full PACS to SNUH with total HIS Integration in this year. In this paper, the installation process and management experience for seven months will be presented. At SNUH, 1643.8 exams were held per day during seven month after PACS installation. It is about 40 Gigabytes per day. Two acquisition servers (ACQ 1, 2), two database servers (DB 1, 2), two storage servers (LTA, network attached storage-NAS), one backup server (DLT) totally 8 servers were installed. SNUH has 11 CRs, 4 CTs, 3 MRIs, 9 NMs, 4 RFs, 20 USs, 7 ESs, 4 SCs, 5 XAs, and 5 Film Ditigers. All these modalities were integrated with PACS. DICOM 3.0 standard was conformed for images. DICOM Gateways were installed for modalities that do not support DICOM. The doctor can query and view Endoscopes, pathologic and anatomic data as well as radiological data. All the past five years exams is accessed less than 10 Seconds via on-line. Through the cooperation with SNUH and Marotech, HIS and PACS work together in stable state. These systems were integrated with HL7 standards and IHE.

  5. Assessing fire effects on forest spatial structure using a fusion of Landsat and airborne LiDAR data in Yosemite National Park

    USGS Publications Warehouse

    Kane, Van R.; North, Malcolm P.; Lutz, James A.; Churchill, Derek J.; Roberts, Susan L.; Smith, Douglas F.; McGaughey, Robert J.; Kane, Jonathan T.; Brooks, Matthew L.

    2014-01-01

    Mosaics of tree clumps and openings are characteristic of forests dominated by frequent, low- and moderate-severity fires. When restoring these fire-suppressed forests, managers often try to reproduce these structures to increase ecosystem resilience. We examined unburned and burned forest structures for 1937 0.81 ha sample areas in Yosemite National Park, USA. We estimated severity for fires from 1984 to 2010 using the Landsat-derived Relativized differenced Normalized Burn Ratio (RdNBR) and measured openings and canopy clumps in five height strata using airborne LiDAR data. Because our study area lacked concurrent field data, we identified methods to allow structural analysis using LiDAR data alone. We found three spatial structures, canopy-gap, clump-open, and open, that differed in spatial arrangement and proportion of canopy and openings. As fire severity increased, the total area in canopy decreased while the number of clumps increased, creating a patchwork of openings and multistory tree clumps. The presence of openings > 0.3 ha, an approximate minimum gap size needed to favor shade-intolerant pine regeneration, increased rapidly with loss of canopy area. The range and variation of structures for a given fire severity were specific to each forest type. Low- to moderate-severity fires best replicated the historic clump-opening patterns that were common in forests with frequent fire regimes. Our results suggest that managers consider the following goals for their forest restoration: 1) reduce total canopy cover by breaking up large contiguous areas into variable-sized tree clumps and scattered large individual trees; 2) create a range of opening sizes and shapes, including ~ 50% of the open area in gaps > 0.3 ha; 3) create multistory clumps in addition to single story clumps; 4) retain historic densities of large trees; and 5) vary treatments to include canopy-gap, clump-open, and open mosaics across project areas to mimic the range of patterns found for each

  6. 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

  7. Classification of savanna tree species, in the Greater Kruger National Park region, by integrating hyperspectral and LiDAR data in a Random Forest data mining environment

    NASA Astrophysics Data System (ADS)

    Naidoo, L.; Cho, M. A.; Mathieu, R.; Asner, G.

    2012-04-01

    The accurate classification and mapping of individual trees at species level in the savanna ecosystem can provide numerous benefits for the managerial authorities. Such benefits include the mapping of economically useful tree species, which are a key source of food production and fuel wood for the local communities, and of problematic alien invasive and bush encroaching species, which can threaten the integrity of the environment and livelihoods of the local communities. Species level mapping is particularly challenging in African savannas which are complex, heterogeneous, and open environments with high intra-species spectral variability due to differences in geology, topography, rainfall, herbivory and human impacts within relatively short distances. Savanna vegetation are also highly irregular in canopy and crown shape, height and other structural dimensions with a combination of open grassland patches and dense woody thicket - a stark contrast to the more homogeneous forest vegetation. This study classified eight common savanna tree species in the Greater Kruger National Park region, South Africa, using a combination of hyperspectral and Light Detection and Ranging (LiDAR)-derived structural parameters, in the form of seven predictor datasets, in an automated Random Forest modelling approach. The most important predictors, which were found to play an important role in the different classification models and contributed to the success of the hybrid dataset model when combined, were species tree height; NDVI; the chlorophyll b wavelength (466 nm) and a selection of raw, continuum removed and Spectral Angle Mapper (SAM) bands. It was also concluded that the hybrid predictor dataset Random Forest model yielded the highest classification accuracy and prediction success for the eight savanna tree species with an overall classification accuracy of 87.68% and KHAT value of 0.843.

  8. [Issues related to national university medical schools: focusing on the low wages of university hospital physicians].

    PubMed

    Takamuku, Masatoshi

    2015-01-01

    University hospitals, bringing together the three divisions of education, research, and clinical medicine, could be said to represent the pinnacle of medicine. However, when compared with physicians working at public and private hospitals, physicians working at university hospitals and medical schools face extremely poor conditions. This is because physicians at national university hospitals are considered to be "educators." Meanwhile, even after the privatization of national hospitals, physicians working for these institutions continue to be perceived as "medical practitioners." A situation may arise in which physicians working at university hospitals-performing top-level medical work while also being involved with university and postgraduate education, as well as research-might leave their posts because they are unable to live on their current salaries, especially in comparison with physicians working at national hospitals, who focus solely on medical care. This situation would be a great loss for Japan. This potential loss can be prevented by amending the classification of physicians at national university hospitals from "educators" to "medical practitioners." In order to accomplish this, the Japan Medical Association, upon increasing its membership and achieving growth, should act as a mediator in negotiations between national university hospitals, medical schools, and the government. PMID:25842820

  9. Is anybody managing the store? National trends in hospital performance.

    PubMed

    Griffith, John R; Pattullo, Andrew; Alexander, Jeffrey A; Jelinek, Richard C; Foster, David A

    2006-01-01

    Nine standardized measures compiled from Medicare data show trends in the safety, quality, financial management, and efficiency for more than 2,500 community hospitals over five years ending in 2003. Although much public attention has been given to hospital performance, along with exhortations to improve, few measures show substantial positive trends, either in variance reduction or overall improvement. The authors conclude that environmental forces are not stimulating improvement and that the overall picture is one of randomness rather than management. PMID:17184003

  10. Abortion a business hurdle for nation's Catholic hospitals.

    PubMed

    Burda, D

    1989-08-25

    Abortion is the foremost moral issue for 626 Catholic hospitals nationwide since church teachings prohibit the performance of elective abortions. This and the fact that Catholic hospitals can not do voluntary sterilizations can hinder their ability to get managed care contracts. In some cases a hospital will not join a network because abortions and sterilizations are done in other hospitals in the network. In other cases they have been in plans where abortions are performed in other contract facilities; this does not violate the Catholic church policy since the abortions are not performed in their facility. When a Catholic and secular hospital plan a merger, Catholic ideals seem to take precedence. A Catholic hospital that went bankrupt in Philadelphia, was turned over to investors, and was under no obligation to follow the Catholic church's directives, but did not perform abortions anyway. In Washington state there are merger talks going on between a secular facility and the Franciscan Health System. The cessation of abortion and sterilization services appear to be outweighed by the financial benefits. Besides, these procedures can be performed through other providers in the area. In Michigan similar merger talks may fail because of the abortion issue. The government justice system is investigating and is likely to challenge any merger there. PMID:10294510

  11. 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

  12. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    PubMed

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods. PMID:27601396

  13. 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

  14. Estimating Mangrove Canopy Height and Above-Ground Biomass in Everglades National Park with Airbone LiDAR and TanDEM-X Data.

    NASA Astrophysics Data System (ADS)

    Feliciano, E. A.; Wdowinski, S.; Potts, M. D.; Fatoyinbo, T. E.; Lee, S. K.

    2014-12-01

    The coastal mangroves forests of Everglades National Park (ENP) are well protected from development. Nevertheless, climate change, hurricanes and other anthropogenic disturbances have affected these intertidal ecosystems. Understanding and monitoring forest structural parameters such as canopy height and above-ground biomass (AGB) are important for the establishment of an historical database for past, present and future ecosystem comparison. Forest canopy height has a well understood and directly proportional correlation with AGB. It is possible to derive it using (1) airborne LiDAR/Laser Scanning (ALS) or (2) space-borne radar systems such as Shuttle Radar Topography Mission (SRTM) and TanDEM-X (TDX). A previous study of the mangrove canopy height and AGB in the ENP was conducted a decade ago based on ALS data acquired in 2004 in conjunction with SRTM data, which were acquired in 2000 (Simard et al. 2006). In this study we estimated canopy height and AGB using an ALS dataset acquired in 2012 and TDX data acquired during the years 2012-2014. The ALS dataset was acquired along a 16.5 x 1.5 km swath of mangrove forest with variable canopy height. The sampled areas were representative of mangrove stature and structure in the whole ENP. Analysis of the ALS dataset showed that mangrove canopy height can reach up to ~25 meters close to the coastal ENP waters. Additionally, by comparing our ALS results with those of a previous study by Simard et al. (2006) we identified areas where mangrove height changes greater than ± 3 meters occurred. To expand the study area to the full ENP mangrove ecosystem we processed single-polarization TDX data to obtain a Digital Canopy Model (DCM) that represents the mangrove canopy height. In order to obtain the true canopy height we calibrated the TDX phase center height with ALS true canopy height. Preliminary results of a corrected single-polarized (HH) TDX scene show that mangrove canopy height can reach up to ~25 meters in the western

  15. Predictors of patient satisfaction with inpatient hospital pain management across the United States: A national study.

    PubMed

    McFarland, Daniel C; Shen, Megan Johnson; Holcombe, Randall F

    2016-07-01

    Satisfactory pain management of hospitalized patients remains a national unmet need for the United States. Although prior research indicates that inpatient pain management may be improving nationally, not all populations of patients rate pain management as equally satisfactory. County-level predictors, such as demographics and population density, and hospital-level predictors (eg, hospital-bed number), are understudied determinants of pain management patient satisfaction. We created a multivariate regression model of pain management patient satisfaction scores as indicated by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results based on county and hospital level predictors. Number of hospital beds (β = -0.16), percent foreign-born (β = -0.16), and population density (β = -0.08) most strongly predicted unfavorable ratings, whereas African American (β = 0.23), white (β= 0.23), and younger population (β = 0.08) most strongly predicted favorable ratings. Greater attention should be placed on pain management in larger hospitals that serve foreign-born patients in population-dense areas. Journal of Hospital Medicine 2016;11:498-501. © 2016 Society of Hospital Medicine. PMID:26970075

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

    PubMed

    Kim, Tae Hyun; Thompson, Jon M

    2012-01-01

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

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

    PubMed

    Drees, Laurie Meijer

    2010-01-01

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

  18. 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

  19. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data

    PubMed Central

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-01-01

    Background The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. Objective To determine whether primary care access is associated with the route of emergency admission—via a GP versus via an A and E department. Methods Retrospective analysis of national administrative data from English hospitals for 2011–2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access—the percentage of patients able to get a general practice appointment on their last attempt—was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. Results The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Conclusions Among hospital inpatients admitted as an emergency, patients

  20. 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.

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

    PubMed

    Lin, Hsien-Cheng

    2015-06-01

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

  2. 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

  3. 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

  4. 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

  5. Tuberculosis Hospitalization Fees and Bed Utilization in China from 1999 to 2009: The Results of a National Survey of Tuberculosis Specialized Hospitals

    PubMed Central

    Ma, Yan; Mi, Fengling; Liu, Yuhong; Li, Liang

    2015-01-01

    Background China is transitioning towards concentrating tuberculosis (TB) diagnostic and treatment services in hospitals, while the Centers of Disease Control and Prevention (CDC) system will retain important public health functions. Patient expenditure incurred through hospitalization may lead to barriers to TB care or interruption of treatment. Methodology/Principal Findings We conducted a national survey of TB specialized hospitals to determine hospitalization fees and hospital bed utilization in 1999, 2004, and 2009. Hospitalization of TB patients increased 185.3% from 1999 to 2009. While the average hospitalization fees also increased, the proportion of those fees in relation to GDP per capita decreased. Hospitalization fees differed across the three regions (eastern, central, and western). Using a least standard difference (LSD) paired analysis, in 2004, the difference in hospitalization fees was significant when comparing eastern and central provinces (p<0.001) as well as to western provinces (p<0.001). In 2009, the difference remained statistically significant when comparing eastern province hospitalization fees with central provinces (p<0.001) and western provinces (p = 0.008). In 2004 and 2009, the cost associated with hospitalization as a proportion of GDP per capita was highest in the western region. The average in-patient stay decreased from 33 days in 1999 to 26 and 27 days in 2004 and 2009 respectively. Finally, hospital bed utilization in all three regions increased over this period. Conclusions/Significance Our findings show that both the total number of in-patients and hospitalization fees increased from 1999 to 2009, though the proportion of hospitalization fees to GDP per capita decreased. As diagnostic services move to hospitals, regulatory and monitoring mechanisms should be established, and hospitals should make use of the experience garnered by the CDC system through continued strong collaborations. Infrastructure and social protection

  6. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Other national accreditation programs for hospitals and other providers and suppliers. 488.6 Section 488.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES...

  7. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  8. Exploring tree species signature using waveform LiDAR data

    NASA Astrophysics Data System (ADS)

    Zhou, T.; Popescu, S. C.; Krause, K.

    2015-12-01

    Successful classification of tree species with waveform LiDAR data would be of considerable value to estimate the biomass stocks and changes in forests. Current approaches emphasize converting the full waveform data into discrete points to get larger amount of parameters and identify tree species using several discrete-points variables. However, ignores intensity values and waveform shapes which convey important structural characteristics. The overall goal of this study was to employ the intensity and waveform shape of individual tree as the waveform signature to detect tree species. The data was acquired by the National Ecological Observatory Network (NEON) within 250*250 m study area located in San Joaquin Experimental Range. Specific objectives were to: (1) segment individual trees using the smoothed canopy height model (CHM) derived from discrete LiDAR points; (2) link waveform LiDAR with above individual tree boundaries to derive sample signatures of three tree species and use these signatures to discriminate tree species in a large area; and (3) compare tree species detection results from discrete LiDAR data and waveform LiDAR data. An overall accuracy of the segmented individual tree of more than 80% was obtained. The preliminary results show that compared with the discrete LiDAR data, the waveform LiDAR signature has a higher potential for accurate tree species classification.

  9. [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

  10. 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

  11. 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

  12. 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

  13. 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

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

    PubMed

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

    2011-01-01

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

  15. 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

  16. HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study

    PubMed Central

    Sawe, Hendry R; Mfinanga, Juma A; Ringo, Faith H; Mwafongo, Victor; Reynolds, Teri A; Runyon, Michael S

    2016-01-01

    Objectives To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. Setting The ED of a large east African national referral hospital. Participants This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. Primary and secondary outcome measures The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Results Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Conclusions Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. PMID:26880672

  17. Longitudinal Association of Registered Nurse National Nursing Specialty Certification and Patient Falls in Acute Care Hospitals

    PubMed Central

    Boyle, Diane K.; Cramer, Emily; Potter, Catima; Staggs, Vincent S.

    2015-01-01

    Background Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification. Objective The aim of the study was to examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level. Methods We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators. The sample consisted of 7,583 units in 903 hospitals. Relationships over time were examined using multilevel (units nested in hospitals) latent growth curve modeling. Results The model indices indicated a good fit of the data to the model. At the unit level, there was a small statistically significant inverse relationship (r = −.08, p = .04) between RN national nursing specialty certification rates and total fall rates; increases in specialty certification rates over time tended to be associated with improvements in total fall rates over time. Discussion Our findings may be supportive of promoting national nursing specialty certification as a means of improving patient safety. Future study recommendations are (a) modeling organizational leadership, culture, and climate as mediating variables between national specialty certification rates and patient outcomes and (b) investigating the association of patient safety and specific national nursing specialty certifications which test plans include patient safety, quality improvement, and diffusion of innovation methods in their certifying examinations. PMID:26049719

  18. Facial Bone Fracture Patients Visiting Pusan National University Hospital in Busan and Yangsan: Trends and Risks

    PubMed Central

    Kim, Hyo-Geon; Son, Yong-Hyun; Chung, In-Kyo

    2014-01-01

    Purpose: This study examined patients with facial bone fracture visiting Pusan National University Dental Hospital to understand the trends, and to enhance appropriate care and treatment for patients with facial bone fracture. Methods: We investigated 531 patients presenting with facial bone fracture in Yangsan and 802 patients in Busan from January 2010 to December 2013. We divided the patients by year, month, gender, age, site, and cause to compare with historic data and other studies. Results: The gender ratio was 3.58:1 in Yangsan and 4.31:1 in Busan. Patients aged in their 20s had the highest number of facial bone fractures in both Yangsan and Busan. The most frequent fracture site was the mandible, and the most frequent cause was slip down in both Yangsan and Busan. Conclusion: The investigation and comparison of patients with facial bone fracture who visited Pusan National University Hospital located at Yangsan and Busan from 2010 to 2013 found a difference in the total number of patients at each hospital, but the trends were not significantly different. PMID:27489825

  19. 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

  20. Modelling the standing timber volume of Baden-Württemberg-A large-scale approach using a fusion of Landsat, airborne LiDAR and National Forest Inventory data

    NASA Astrophysics Data System (ADS)

    Maack, Joachim; Lingenfelder, Marcus; Weinacker, Holger; Koch, Barbara

    2016-07-01

    Remote sensing-based timber volume estimation is key for modelling the regional potential, accessibility and price of lignocellulosic raw material for an emerging bioeconomy. We used a unique wall-to-wall airborne LiDAR dataset and Landsat 7 satellite images in combination with terrestrial inventory data derived from the National Forest Inventory (NFI), and applied generalized additive models (GAM) to estimate spatially explicit timber distribution and volume in forested areas. Since the NFI data showed an underlying structure regarding size and ownership, we additionally constructed a socio-economic predictor to enhance the accuracy of the analysis. Furthermore, we balanced the training dataset with a bootstrap method to achieve unbiased regression weights for interpolating timber volume. Finally, we compared and discussed the model performance of the original approach (r2 = 0.56, NRMSE = 9.65%), the approach with balanced training data (r2 = 0.69, NRMSE = 12.43%) and the final approach with balanced training data and the additional socio-economic predictor (r2 = 0.72, NRMSE = 12.17%). The results demonstrate the usefulness of remote sensing techniques for mapping timber volume for a future lignocellulose-based bioeconomy.

  1. Suicide in the Dar es Salaam region, Tanzania, 2005.

    PubMed

    Mgaya, Edward; Kazaura, Method R; Outwater, Anne; Kinabo, Lina

    2008-04-01

    Suicide surveillance was launched at the Muhimbili National Hospital mortuary in Dar es Salaam Region, Tanzania from 1st January to 31st December, 2005 to determine its magnitude and characteristics. Following the WHO guidelines with minor modifications, information on sex, dates of birth and death, places of residence and death, occupation, reasons and means of suicide were collected. There were 65 (2.3 per 100,000 population) suicides recorded in 2005. The suicide rate for males was 3.4/100,000 and for females was 1.2/100,000 which maybe some of the lowest rates ever reported in the world. The mean age at suicide was 32.9 (SD=13.1) years. Males were about three times more likely to commit suicide as females. The main motive behind suicide was recorded for 26 (40%) victims as family-related and for 11 (17%) as health related. Although there was a wide range of ages at which people committed suicide, the average age seems to be very low. Since reasons for suicide are coated with family problems, strategies to improve awareness of psychological and mental health services and to provide alternative economic and social support networks are advocated. PMID:18313013

  2. 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

  3. Implementation of computerized physician order entry in National Guard hospitals: Assessment of critical success factors

    PubMed Central

    Altuwaijri, Majid M.; Bahanshal, Abdullah; Almehaid, Mona

    2011-01-01

    Objective: The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia. Materials and Methods: The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. Results: The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The “before go-live training”, the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. Conclusion: The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to

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

    PubMed Central

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

    2014-01-01

    IMPORTANCE Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. OBJECTIVE To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57 471 during 492 nonmeeting days; heart failure, 19 282 during meeting days and 11 4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low-and high-risk patients. Differences in treatment utilization were assessed. EXPOSURES Hospitalization during cardiology meeting dates. MAIN OUTCOMES AND MEASURES Thirty-day mortality, procedure rates, charges, length of stay. RESULTS Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%–21.2%] vs 24.8% [95% CI, 22.9%–26.6%]; P < .001; cardiac arrest, 59.1% [95% CI, 51.4%–66.8%] vs 69.4% [95% CI, 66.2%–72.6%]; P = .01). Adjusted mortality for high-risk AMI in teaching hospitals was similar between meeting and nonmeeting dates (39.2% [95% CI, 31.8%–46.6%] vs 38.5% [95% CI, 35.0%–42.0%]; P = .86), although adjusted percutaneous

  5. 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

  6. 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

  7. 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

  8. National Veterans Health Administration inpatient risk stratification models for hospital-acquired acute kidney injury

    PubMed Central

    Cronin, Robert M; VanHouten, Jacob P; Siew, Edward D; Eden, Svetlana K; Fihn, Stephan D; Nielson, Christopher D; Peterson, Josh F; Baker, Clifton R; Ikizler, T Alp; Speroff, Theodore

    2015-01-01

    Objective Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention. Materials and Methods A national retrospective cohort of 1,620,898 patient hospitalizations from 116 Veterans Affairs hospitals was assembled from electronic health record (EHR) data collected from 2003 to 2012. HA-AKI was defined at stage 1+, stage 2+, and dialysis. EHR-based predictors were identified through logistic regression, least absolute shrinkage and selection operator (lasso) regression, and random forests, and pair-wise comparisons between each were made. Calibration and discrimination metrics were calculated using 50 bootstrap iterations. In the final models, we report odds ratios, 95% confidence intervals, and importance rankings for predictor variables to evaluate their significance. Results The area under the receiver operating characteristic curve (AUC) for the different model outcomes ranged from 0.746 to 0.758 in stage 1+, 0.714 to 0.720 in stage 2+, and 0.823 to 0.825 in dialysis. Logistic regression had the best AUC in stage 1+ and dialysis. Random forests had the best AUC in stage 2+ but the least favorable calibration plots. Multiple risk factors were significant in our models, including some nonsteroidal anti-inflammatory drugs, blood pressure medications, antibiotics, and intravenous fluids given during the first 48 h of admission. Conclusions This study demonstrated that, although all the models tested had good discrimination, performance characteristics varied between methods, and the random forests models did not calibrate as well as the lasso or logistic regression models. In addition, novel modifiable risk factors were explored and found to be significant. PMID:26104740

  9. [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

  10. Strategies used by hospital nurses to cope with a national crisis: a manager's perspective.

    PubMed

    Hendel, T; Fish, M; Aboudi, S

    2000-12-01

    This article explores the anxiety level of, and coping strategies used by, hospital nurses, during a national state of emergency. The study was guided by a stress and coping framework, developed by Lazarus & Folkman, and was conducted at a large teaching hospital, located in the centre of Israel, during the Iraqi crisis in January and February, 1998. Data were collected from a sample of 100 female nurses, and a descriptive correlational design was used. The findings indicated that approximately 33% of the nurses expressed feelings of stress, tension and a sense of discomfort. The dominant coping strategy used by the nurses was direct-active, which was found to be the most effective strategy. As they were unable to remove or control the stressor, stress management intervention by nursing managers focused mainly on communicating with staff and providing social support - informational and emotional--to buffer the stressful experience. Providing support and help in finding practical solutions is important for maintaining emotional stability of staff, thereby helping them to improve their nursing interventions in assisting people to cope with stressful situations. PMID:11153519

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

    PubMed

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

    2008-06-01

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

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

    PubMed

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

    2014-05-01

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

  13. Hospital work and pregnancy outcomes: a study in the Danish National Birth Cohort.

    PubMed

    Suárez-Varela, María M Morales; Kaerlev, Linda; Zhu, Jin Liang; Bonde, Jens Peter; Nøhr, Ellen-Aagaard; Llopis-González, Agustín; Olsen, Jørn

    2009-01-01

    In hospitals, women of reproductive age do a range of work tasks, some of which are known to carry potential risks. Tasks such as working with radiation, chemicals, and infectious agents, as well as performing heavy lifting or tasks requiring erratic sleep patterns have been reported to increase the risk of reproductive failures. Our aim was to study pregnancy outcomes in female hospital workers in Denmark. We performed a cohort study of 5976 female hospital workers and used as a reference group 60,890 women employed outside of hospitals. The reproductive health of hospital workers working during pregnancy is comparable to those of non-hospital workers for the majority of reproductive failures studied. However, an increased prevalence of congenital abnormalities was noted in some subgroups of hospital workers, which may indicate that some hospital work still entails fetotoxic hazards. PMID:19886351

  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. Associations Between Vitamin D Level and Hospitalizations With and Without an Infection in a National Cohort of Medicare Beneficiaries.

    PubMed

    Kempker, Jordan A; Magee, Matthew J; Cegielski, J Peter; Martin, Greg S

    2016-05-15

    Research has implicated low 25-hydroxyvitamin D (25(OH)D) level as a risk factor for infection; however, results have not been consistent. To further determine the nature of this relationship, we conducted a cohort study using Medicare beneficiaries participating in the 2001-2002 and 2003-2004 cycles of the National Health and Nutrition Examination Survey with data individually linked to hospital records from the Centers for Medicare and Medicaid Services. The primary exposure was a 25(OH)D level of <15 ng/mL versus ≥15 ng/mL. The outcomes were a hospitalization with or without an infection within 1 year of participation in the National Health and Nutrition Examination Survey, as determined from the final hospital discharge codes (International Classification of Diseases, Ninth Revision, Clinical Modification). Of 1,713 individuals, 348 had a baseline serum 25(OH)D level of <15 ng/mL, 77 experienced a hospitalization with an infection, and 287 experienced a hospitalization without an infection. In multivariable analyses, a serum 25(OH)D level of <15 ng/mL was associated with a higher risk of hospitalization with an infection (risk ratio = 2.8, 95% confidence interval: 1.3, 5.9, P < 0.01) but not of hospitalization without an infection (risk ratio = 1.4, 95% confidence interval: 0.9, 2.1, P = 0.1). In this study, we found an association between a serum 25(OH)D concentration of <15 ng/mL and a higher subsequent risk for hospitalization with an infection among Medicare beneficiaries. PMID:27189328

  16. 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…

  17. 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,…

  18. 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

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

    PubMed Central

    Ozcan, Y A; Luke, R D

    1993-01-01

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

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

    PubMed

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

    2015-01-01

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

  1. 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

  2. Associations of mental, and medical illnesses with against medical advice discharges: the National Hospital Discharge Survey, 1988-2006.

    PubMed

    Tawk, Rima; Freels, Sally; Mullner, Ross

    2013-03-01

    This study examined the association of mental and medical illnesses with the odds for leaving against medical advice (AMA) in a national sample of adult patients who left general hospitals between 1988 and 2006. Leaving AMA was first examined as a function of year and mental illness. Multiple logistic regression analysis was then used to adjust for patient and hospital characteristics when associating mental and major medical diagnoses with AMA discharges. The results indicated that leaving AMA was most strongly associated with mental health problems. However, the impact of mental illness was attenuated after adjusting for medical illnesses, patient and hospital characteristics. The strongest predictors of AMA discharge included being self-pay, having Medicaid insurance, being young and male, and the regional location of the hospital (Northeast). When substance abuse conditions were excluded from the mental illness discharge diagnoses, mental illness had lower odds for leaving AMA. The results may be of value to clinicians, and hospital administrators in helping to profile and target patients at risk for treatment-compliance problems. Prospective primary data collection that would include patient, physician, and hospital variables is recommended. PMID:22057857

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

    PubMed

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

    2016-04-01

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

  4. Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study

    PubMed Central

    Kim, Seoyoung C.; Kim, Mi-Sook; Sanfélix-Gimeno, Gabriel; Song, Hong Ji; Liu, Jun; Hurtado, Isabel; Peiró, Salvador; Lee, Joongyub; Choi, Nam-Kyong; Park, Byung-Joo; Avorn, Jerry

    2015-01-01

    Purpose While current osteoporosis management guidelines recommend use of pharmacologic treatment following hip fracture, the care of such patients has been suboptimal. The objective of this cross-national study is to quantify the use of and adherence to osteoporosis medication following hip fracture in three countries with different health care systems- the United States, Korea and Spain. Methods In three cohorts of patients aged ≥65 years hospitalized for hip fracture, we calculated the proportion receiving ≥1 osteoporosis drug after discharge. Adherence to osteoporosis treatment was measured as the proportion of days covered (PDC) during the first year following the hip fracture. Results We identified 86,202 patients with a hip fracture - 4,704 (U.S. Medicare), 6,700 (U.S. commercial), 57,631(Korea), and 17,167 (Spain). The mean age was 77–83 years and 74–78% were women. In the year prior to the index hip fracture, 16–18% were taking an osteoporosis medication. Within 3 months following the index hip fracture, 11% (U.S. Medicare), 13% (U.S. commercial), 39% (Korea), and 25% (Spain) of patients filled ≥1 prescription for osteoporosis medication. For those who filled one or more prescriptions for an osteoporosis medication, the mean PDC in the year following the fracture was 0.70 (U.S. Medicare), 0.67 (U.S. commercial), 0.43 (Korea) and 0.66 (Spain). Conclusions Regardless of differences in health care delivery systems and medication reimbursement plans, the use of osteoporosis medications for the secondary prevention of osteoporotic fracture was low. Adherence to osteoporosis treatment was also suboptimal with the PDC<0.70 in all three countries. PMID:25660252

  5. 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

  6. 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

  7. [Nosocomial infections associated to invasive devices in the intensive care units of a national hospital of Lima, Peru].

    PubMed

    Chincha, Omayra; Cornelio, Elia; Valverde, Violeta; Acevedo, Mónica

    2013-01-01

    In order to describe the incidence of nosocomial infections associated to invasive devices in intensive care units (UCI) of the National Hospital Cayetano Heredia, a retrospective observational study was conducted using the data from the Office of Epidemiology and Environmental Health from 2010 to 2012. A total number of 222 nosocomial infections were reported; the general medicine UCI reported the highest incidence of pneumonia cases associated to a mechanical ventilator in 1000 days of use of the device (28.6); infection of the blood stream associated to central venous catheter (11.9), and infection of the urinary tract associated to a catheter (8,1). The main infectious agents isolated were Pseudomona sp. (32.3%) in the emergency UCI, negative Staphylococcus coagulasa (36%) in the general medicine UCI and Candida sp (69.2%) in the Surgery UCI. The rates of infections associated to invasive devices were high as in other national hospitals with limited resources and infrastructure. PMID:24448938

  8. Radial forearm flaps as durable soft tissue coverage for local nationals being treated in the field hospital setting.

    PubMed

    Hanna, Kh; Jeffery, Sla

    2013-03-01

    The current conflict in Afghanistan has seen the increasing use of Improvised Explosive Devices (IED) in insurgency attacks. In addition to the coalition forces killed and injured from these devices, local national civilians are also injured. Injuries often include amputations, open fractures and large areas of skin affected by fragmentation. Local national access to long-term care after an IED injury is limited, and often when the patient leaves a coalition hospital this concludes the care the patient will receive. Definitive, durable treatment options are needed for these patients. In the IED-injured patient with open extremity wounds and open metacarpal fractures, pedicled radial forearm flaps offer a suitable soft tissue coverage option. Four cases are reported on IED- injured Afghan patients treated at a Role 3 hospital facility. PMID:23720555

  9. 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

  10. 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

  11. Work Hours and Self rated Health of Hospital Doctors in Norway and Germany. A comparative study on national samples

    PubMed Central

    2011-01-01

    Background The relationship between extended work hours and health is well documented among hospital doctors, but the effect of national differences in work hours on health is unexplored. The study examines the relationship between work hours and self rated health in two national samples of hospital doctors. Methods The study population consisted of representative samples of 1,260 German and 562 Norwegian hospital doctors aged 25-65 years (N = 1,822) who received postal questionnaires in 2006 (Germany) and 2008 (Norway). The questionnaires contained items on demography, work hours (number of hours per workday and on-call per month) and self rated subjective health on a five point scale - dichotomized into "good" (above average) and "average or below". Results Compared to Norway, a significantly higher proportion of German doctors exceeded a 9 hour work day (58.8% vs. 26.7%) and 60 hours on-call per month (63.4% vs. 18.3%). Every third (32.2%) hospital doctor in Germany worked more than this, while this pattern was rare in Norway (2.9%). In a logistic regression model, working in Norway (OR 4.17; 95% CI 3.02-5.73), age 25-44 years (OR 1.66; 95% CI 1.29-2.14) and not exceeding 9 hour work day and 60 hours on-call per month (OR 1.35; 95% CI 1.03-1.77) were all independent significant predictors of good self reported health. Conclusion A lower percentage of German hospital doctors reported self rated health as "good", which is partly explained by the differences in work time pattern. Initiatives to increase doctors' control over their work time are recommended. PMID:21338494

  12. The NAPPH (National Association of Private Psychiatric Hospitals) today--under new management. Interview by John Herrmann.

    PubMed

    Trachtenberg, R L

    1992-01-01

    When Robert L. Trachtenberg took over the executive directorship of the National Association of Private Psychiatric Hospitals some five months ago, he walked into a situation wherein several psychiatric specialty hospitals in Texas were under fire. "There were a lot of questions," Trachtenberg says, "and challenges to the credibility of psychiatric hospitals." He was referring to the Texas state investigation into abuses by personnel within psychiatric hospitals. Last year, the Texas Senate Interim Committee on Health and Human Services conducted an eight-month investigation into the conduct of the state's psychiatric hospitals after a newspaper article recounted the unconventional way in which a 14-year old boy was picked up and admitted to a psychiatric facility. After a number of public hearings, three private agencies overseeing Texas psychiatric hospitals adopted rules to prevent further problems in the areas of patient rights, fraudulent billing, patient recruitment and the admission and discharge process. The Senate Interim Committee, however, felt these rules needed to be codified into law and has drafted over 30 bills to be presented to the Texas legislature as omnibus legislation next January. Trachtenberg went to work to iron out methods to encourage better overseeing and state governance, as well as tackling the related issues of standards of care and managed care/utilization review. His background as Deputy Administrator of the Alcohol, Drug Abuse and Mental Health Administration within HHS provided him with a broad spectrum of knowledge about the field of psychiatry and its problems, and his vast experience in federal government--over 32 years of running domestic programs--enable him to have a keen sense of what can get done, and how. Health Systems REVIEW recently discussed the role of the NAPPH under its new leader, Bob Trachtenberg. What follows is an edited version of that conversation. PMID:10122848

  13. 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

  14. Does a referral from home to hospital affect satisfaction with childbirth? A cross-national comparison

    PubMed Central

    Christiaens, Wendy; Gouwy, Anneleen; Bracke, Piet

    2007-01-01

    Background The Belgian and Dutch societies present many similarities but differ with regard to the organisation of maternity care. The Dutch way of giving birth is well known for its high percentage of home births and its low medical intervention rate. In contrast, home births in Belgium are uncommon and the medical model is taken for granted. Dutch and Belgian maternity care systems are compared with regard to the influence of being referred to specialist care during pregnancy or intrapartum while planning for a home birth. We expect that a referral will result in lower satisfaction with childbirth, especially in Belgium. Methods Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first two weeks after childbirth, either at home or in a hospital. Of these, 563 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004–2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Results Belgian women are more satisfied than Dutch women and home births are more satisfying than hospital births. Women who are referred to the hospital while planning for a home birth are less satisfied than women who planned to give birth in hospital and did. A referral has a greater negative impact on satisfaction for Dutch women. Conclusion There is no reason to believe Dutch women receive hospital care of lesser quality than Belgian women in case of a referral. Belgian and Dutch attach different meaning to being referred, resulting in a different evaluation of childbirth. In the Dutch maternity care system home births lead to higher satisfaction, but once a referral to the hospital is necessary satisfaction drops and ends up lower than satisfaction with hospital births that were planned in advance. We need to understand more

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Gyani, Girdhar J; Krishnamurthy, B

    2014-01-01

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

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

    PubMed

    Stoelwinder, Johannes U

    2009-10-01

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

  18. Hospital Contacts With Infection and Risk of Schizophrenia: A Population-Based Cohort Study With Linkage of Danish National Registers

    PubMed Central

    Nielsen, Philip R.; Benros, Michael. E.; Mortensen, Preben B.

    2014-01-01

    Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Several studies have reported associations between maternal infections during pregnancy and the child’s risk of schizophrenia; however, infection during childhood and adolescence unrelated to maternal infection during pregnancy has not been studied to nearly the same extent and the results are far from conclusive. Data were drawn from 2 population-based registers, the Danish Psychiatric Central Register and the Danish National Hospital Register. We used a historical population-based cohort design and selected all individuals born in Denmark between 1981 and 1996 (n = 843 390). We identified all individuals with a first-time hospital contact with schizophrenia from 1991 through 2010. Out of the 3409 individuals diagnosed with schizophrenia, a total of 1549 individuals had had a hospital contact with infection before their schizophrenia diagnosis (45%). Our results indicate that individuals who have had a hospital contact with infection are more likely to develop schizophrenia (relative risk [RR] = 1.41; 95% CI: 1.32–1.51) than individuals who had not had such a hospital contact. Bacterial infection was the type of infection that was associated with the highest risk of schizophrenia (RR = 1.63; 95% CI: 1.47–1.82). Our study does not exclude that a certain type of infection may have a specific effect; yet, it does suggest that schizophrenia is associated with a wide range of infections. This association may be due to inflammatory responses affecting the brain or genetic and environmental risk factors aggregating in families. PMID:24379444

  19. 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

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

    ERIC Educational Resources Information Center

    Haines, Christine; Brand, Jennie Bickmore

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

  1. 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…

  2. 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

  3. Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania.

    PubMed

    Makubi, Abel N; Meda, Collins; Magesa, Alex; Minja, Peter; Mlalasi, Juliana; Salum, Zubeda; Kweka, Rumisha E; Rwehabura, James; Quaresh, Amrana; Magesa, Pius M; Robert, David; Makani, Julie; Kaaya, Ephata

    2012-10-01

    In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive cross-sectional study which audited laboratory practice in haematology and blood transfusion at Muhimbili National Hospital (MNH) aimed at assessing the pre-analytical stage of laboratory investigations including laboratory request forms and handling specimen processing in the haematology laboratory and assessing the chain from donor selection, blood component processing to administration of blood during transfusion. A national standard checklist was used to audit the laboratory request forms (LRF), phlebotomists' practices on handling and assessing the from donor selection to administration 6f blood during transfusion. Both interview and observations were used. A total of 195 LRF were audited and 100% of had incomplete information such as patients' identification numbers, time sample ordered, reason for request, summary of clinical assessment and differential diagnoses. The labelling of specimens was poorly done by phlebotomists/clinicians in 82% of the specimens. Also 65% (132/202) of the blood samples delivered in the haematology laboratory did not contain the recommended volume of blood. There was no laboratory request form specific for ordering blood and there were no guidelines for indication of blood transfusion in the wards/ clinics. The blood transfusion laboratory section was not participating in external quality assessment and the hospital transfusion committee was not in operation. It is recommended that a referral hospital like MNH should have a transfusion committee to provide an active forum to facilitate communication between those involved with transfusion, monitor, coordinate and audit blood transfusion practices as per national

  4. A Cyberinfrastructure Platform for Distribution of GeoEarthScope LiDAR Topography Data

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Nandigam, V.; Arrowsmith, J. R.; Balakrishnan, S.; Alex, N.; Baru, C.

    2008-12-01

    The recently completed GeoEarthScope airborne LiDAR (Light Detection And Ranging) topography acquisition will provide unprecedented data adjacent to active faults throughout the plate boundary region of western North America. Totaling more than 5000 square kilometers, these community-oriented data offer an high-resolution representation of fault zone topography and should be a revolutionary resource for researchers studying earthquake hazards, active faulting, landscape processes, and ground deformation. Since spring of 2007, the NSF-funded GeoEarthScope LiDAR project has acquired data for the San Andreas fault system in northern California, faults in southern California, the Yakima Fold and Thrust Belt in Washington, Yellowstone National Park, the Tetons, the Wasatch Front, and Alaska. These data will be made available via the OpenTopography Portal (www.opentopography.org), a domain-specific component of the GEON project, as they are processed and delivered by the National Center for Airborne Laser Mapping. The OpenTopography Portal (OpenToPo) provides access to a variety of GeoEarthScope LiDAR data products and uses several cyberinfrastructure components developed by the GEON project. These products range from simple Google Earth visualizations of LiDAR hillshades to standard digital elevation model (DEM) products as well as LiDAR point cloud data. The wide spectrum of LiDAR users have variable scientific applications, computing resources and technical experience and thus require a data distribution system that provides various levels of access to the data. Standard DEM products in OpenToPo are accessed via a Google Map and/or Google Earth-based interface that allow users to browse and download the data products. For users who wish to explore the full potential of the LiDAR data, we provide access to the raw LiDAR point data and a suite of DEM generation tools to enable users to create custom DEMs to best fit their science applications. Storage and management of

  5. 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

  6. LiDAR Applications in Resource Geology and Benefits for Land Management

    NASA Astrophysics Data System (ADS)

    Mikulovsky, R. P.; De La Fuente, J. A.

    2013-12-01

    The US Forest Service (US Department of Agriculture) manages a broad range of geologic resources and hazards on National Forests and Grass Lands throughout the United States. Resources include rock and earth materials, groundwater, caves and paleontological resources, minerals, energy resources, and unique geologic areas. Hazards include landslides, floods, earthquakes, volcanic eruptions, and naturally hazardous materials (e.g., asbestos, radon). Forest Service Geologists who address these issues are Resource Geologists. They have been exploring LiDAR as a revolutionary tool to efficiently manage all of these hazards and resources. However, most LiDAR applications for management have focused on timber and fuels management, rather than landforms. This study shows the applications and preliminary results of using LiDAR for managing geologic resources and hazards on public lands. Applications shown include calculating sediment budgets, mapping and monitoring landslides, mapping and characterizing borrow pits or mines, determining landslide potential, mapping faults, and characterizing groundwater dependent ecosystems. LiDAR can be used to model potential locations of groundwater dependent ecosystems with threatened or endangered plant species such as Howellia aquatilis. This difficult to locate species typically exists on the Mendocino National Forest within sag ponds on landslide benches. LiDAR metrics of known sites are used to model potential habitat. Thus LiDAR can link the disciplines of geology, hydrology, botany, archaeology and others for enhanced land management. As LiDAR acquisition costs decrease and it becomes more accessible, land management organizations will find a wealth of applications with potential far-reaching benefits for managing geologic resources and hazards.

  7. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., CERTIFICATION, AND ENFORCEMENT PROCEDURES General Provisions § 488.6 Other national accreditation programs for... health agency providers of outpatient physical therapy, occupational therapy or speech pathology...

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

    PubMed

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

    2006-01-01

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

  9. National Trends in Hospitalizations for Patients With Single-Ventricle Anatomy.

    PubMed

    Tabtabai, Sara; DeFaria Yeh, Doreen; Stefanescu, Ada; Kennedy, Kevin; Yeh, Robert W; Bhatt, Ami B

    2015-09-01

    Patients with single-ventricle (SV) anatomy now live to adulthood. Little is known about the cost of care and outcomes for patients with SV anatomy, especially those who develop heart failure (HF) cared for in adult hospitals in the United States. We analyzed the Nationwide Inpatient Sample from 2000 to 2011 for patients >14 years admitted to adult hospitals with the International Classifications of Diseases, Ninth Revision, codes for SV anatomy. Demographics, outcomes, co-morbidities, and cost were assessed. From 2000 to 2011, the number of SV admissions was stable with a trend toward increased cost per admission over time. Coexistent hypertension, obesity, and liver, pulmonary, and renal diseases significantly increased over time. The most common reason for admission was atrial arrhythmia followed by HF. Patients with SV with HF had significantly higher inhospital mortality, length of stay, and more medical co-morbidities than those with SV and without HF. In conclusion, the cohort of patients with SV admitted to adult hospitals has changed in the modern era. Patients with SV have medical co-morbidities including renal and liver diseases, hypertension, and obesity at a surprisingly young age. Aggressive and proactive management of HF and arrhythmia may reduce cost of care for this challenging population. Patients with SV with HF have particularly high mortality, more medical co-morbidities, and increased cost of care and deserve more focused attention to improve outcomes. PMID:26100589

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

    PubMed

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

    2013-07-01

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

  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. ‘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

  13. 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

  14. A healthier future for all Australians: an overview of the final report of the National Health and Hospitals Reform Commission.

    PubMed

    Bennett, Christine C

    2009-10-01

    After extensive community and health industry consultation, the final report of the National Health and Hospitals Reform Commission, A healthier future for all Australians, was presented to the Australian Government on 30 June 2009. The reform agenda aims to tackle major access and equity issues that affect health outcomes for people now; redesign our health system so that it is better positioned to respond to emerging challenges; and create an agile, responsive and self-improving health system for long-term sustainability. The 123 recommendations are grouped in four themes: Taking responsibility: supporting greater individual and collective action to build good health and wellbeing. Connecting care: delivering comprehensive care for people over their lifetime, by strengthening primary health care, reshaping hospitals, improving subacute care, and opening up greater consumer choice and competition in aged care services. Facing inequities: taking action to tackle the causes and impact of health inequities, focusing on Aboriginal and Torres Strait Islander people, people in rural and remote areas, and access to mental health and dental services. Driving quality performance: having leadership and systems to achieve the best use of people, resources and knowledge, including "one health system" with national leadership and local delivery, revised funding arrangements, and changes to health workforce education, training and practice. PMID:19807629

  15. 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

  16. Haunted by Enron's ghost. National Century Financial Enterprises files for Chapter 11, leaving a string of broken healthcare chains and hospitals.

    PubMed

    Taylor, Mark

    2002-11-25

    Some are calling it the Enron of the healthcare industry. Ryder trucks hauled possible evidence from embattled financier National Century Financial Enterprises during an FBI raid. NCFE filed for Chapter 11 bankruptcy protection last week, sending ripples through the industry and contributing to the bankruptcies of a string of national healthcare chains and at least six hospitals. PMID:12510558

  17. 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

  18. Independent evaluation of the SNODAS snow depth product using regional scale LiDAR-derived measurements

    NASA Astrophysics Data System (ADS)

    Hedrick, A.; Marshall, H.-P.; Winstral, A.; Elder, K.; Yueh, S.; Cline, D.

    2014-06-01

    Repeated Light Detection and Ranging (LiDAR) surveys are quickly becoming the de facto method for measuring spatial variability of montane snowpacks at high resolution. This study examines the potential of a 750 km2 LiDAR-derived dataset of snow depths, collected during the 2007 northern Colorado Cold Lands Processes Experiment (CLPX-2), as a validation source for an operational hydrologic snow model. The SNOw Data Assimilation System (SNODAS) model framework, operated by the US National Weather Service, combines a physically-based energy-and-mass-balance snow model with satellite, airborne and automated ground-based observations to provide daily estimates of snowpack properties at nominally 1 km resolution over the coterminous United States. Independent validation data is scarce due to the assimilating nature of SNODAS, compelling the need for an independent validation dataset with substantial geographic coverage. Within twelve distinctive 500 m × 500 m study areas located throughout the survey swath, ground crews performed approximately 600 manual snow depth measurements during each of the CLPX-2 LiDAR acquisitions. This supplied a dataset for constraining the uncertainty of upscaled LiDAR estimates of snow depth at the 1 km SNODAS resolution, resulting in a root-mean-square difference of 13 cm. Upscaled LiDAR snow depths were then compared to the SNODAS-estimates over the entire study area for the dates of the LiDAR flights. The remotely-sensed snow depths provided a more spatially continuous comparison dataset and agreed more closely to the model estimates than that of the in situ measurements alone. Finally, the results revealed three distinct areas where the differences between LiDAR observations and SNODAS estimates were most drastic, suggesting natural processes specific to these regions as causal influences on model uncertainty.

  19. 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

  20. 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

  1. 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

  2. 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…

  3. Implementation of WHO/CDC Guidelines for Intentional Injury Death Surveillance: A Mixed-Methods Approach in Dar es Salaam, Tanzania

    PubMed Central

    Outwater, Anne H.; Campbell, Jacquelyn C.; Mgaya, Edward

    2013-01-01

    A foundational implementation of the WHO/CDC Injury Surveillance Guidelines was conducted in Dar es Salaam region of the United Republic of Tanzania in 2005. The Guidelines were adapted to gather qualitative as well as quantitative data about intentional injury mortality which were collected concurrently at the Muhimbili National Hospital Mortuary. An interview schedule of 12 quantitative variables and one open-ended question, participant observation and newspaper reports were used. Mixed methods allowed an understanding of intentional injury mortality to emerge, even for those with the least amount of data, the 22% of homicides whose bodies were never claimed. Mixed methods made it possible to quantify intentional injury mortality rates, describe subpopulations with scanty data, and learn how to embed ongoing injury mortality surveillance into daily practice. PMID:24130432

  4. Implementation of WHO/CDC Guidelines for Intentional Injury Death Surveillance: A Mixed-Methods Approach in Dar es Salaam, Tanzania.

    PubMed

    Outwater, Anne H; Campbell, Jacquelyn C; Mgaya, Edward

    2011-08-01

    A foundational implementation of the WHO/CDC Injury Surveillance Guidelines was conducted in Dar es Salaam region of the United Republic of Tanzania in 2005. The Guidelines were adapted to gather qualitative as well as quantitative data about intentional injury mortality which were collected concurrently at the Muhimbili National Hospital Mortuary. An interview schedule of 12 quantitative variables and one open-ended question, participant observation and newspaper reports were used. Mixed methods allowed an understanding of intentional injury mortality to emerge, even for those with the least amount of data, the 22% of homicides whose bodies were never claimed. Mixed methods made it possible to quantify intentional injury mortality rates, describe subpopulations with scanty data, and learn how to embed ongoing injury mortality surveillance into daily practice. PMID:24130432

  5. Spinning a laser web: predicting spider distributions using LiDAR.

    PubMed

    Vierling, K T; Bässler, C; Brandl, R; Vierling, L A; Weiss, I; Müller, J

    2011-03-01

    LiDAR remote sensing has been used to examine relationships between vertebrate diversity and environmental characteristics, but its application to invertebrates has been limited. Our objectives were to determine whether LiDAR-derived variables could be used to accurately describe single-species distributions and community characteristics of spiders in remote forested and mountainous terrain. We collected over 5300 spiders across multiple transects in the Bavarian National Park (Germany) using pitfall traps. We examined spider community characteristics (species richness, the Shannon index, the Simpson index, community composition, mean body size, and abundance) and single-species distribution and abundance with LiDAR variables and ground-based measurements. We used the R2 and partial R2 provided by variance partitioning to evaluate the predictive power of LiDAR-derived variables compared to ground measurements for each of the community characteristics. The total adjusted R2 for species richness, the Shannon index, community species composition, and body size had a range of 25-57%. LiDAR variables and ground measurements both contributed >80% to the total predictive power. For species composition, the explained variance was approximately 32%, which was significantly greater than expected by chance. The predictive power of LiDAR-derived variables was comparable or superior to that of the ground-based variables for examinations of single-species distributions, and it explained up to 55% of the variance. The predictability of species distributions was higher for species that had strong associations with shade in open-forest habitats, and this niche position has been well documented across the European continent for spider species. The similar statistical performance between LiDAR and ground-based measures at our field sites indicated that deriving spider community and species distribution information using LiDAR data can provide not only high predictive power at

  6. Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili national hospital, Tanzania

    PubMed Central

    2014-01-01

    Background Surgical site infections (SSIs) remain a common and widespread problem contributing to a significant morbidity and mortality, attributed partly by the increase in antimicrobial resistance among the etiological agents. This study was done to determine the spectrum of bacterial isolates and their susceptibility patterns causing SSIs at Muhimbili National Hospital, Tanzania. Methods This descriptive cross sectional study was conducted between September, 2011 and February, 2012. Pus swabs or pus were cultured on blood agar (Oxoid, UK) and MacConkey agar (Oxoid, UK) and incubated aerobically at 37°C for 18–24 hours. Bacterial identification was done using API 20E and VITEK and antimicrobial susceptibility was determined by Kirby Bauer disc diffusion. Results Of the 100 patients, from whom wound swabs were collected, 90 (90%) had positive aerobic bacterial growth. A total of 147 pathogenic bacteria were isolated, including 114 (77.5%) gram negative and 33(22.5%) gram positive organisms. The most prevalent bacterial species were Pseudomonas aeruginosa (16.3%), followed by Staphylococcus aureus (12.2%) and Klebsiella pneumoniae (10.8%). Of the 18 S. aureus , 8 (44%) were methicillin resistant Staphylococcus aureus (MRSA) and three of them (17%) were carrying both MRSA and induced clindamycin resistance (ICR). Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were observed in 23 (79.3%) of the 29 isolates tested. Majority of Escherichia coli 12 (92.3%) and K. pneumoniae 11 (69%) isolates were ESBL producers. About 63% (93/147) were multiple-drug resistance (MDR) isolates, and the overall MDR among Gram positive and Gram negative bacteria was 60.6% (20/33) and 61.4%, (73/114), respectively. The prevalence of MDR for E. coli, A. baumannii and P. stuartii was 100% each. Majority (97%) of the Gram negative bacteria were resistant to more than four categories (classes) of antibiotics. Conclusion A high proportion (63%) of the isolates causing

  7. Conditions triggering local incident reviews in UK hospital maternity units: A national survey

    PubMed Central

    Mohamed-Ahmed, Olaa; McClymont, Charlotte; Knight, Marian

    2014-01-01

    Objectives In countries, such as the UK, where maternal deaths are rare, reviews of other severe complications of pregnancy and the puerperium can provide an additional perspective to help learn lessons to improve future care. The objective of this survey was to identify the types of incidents which triggered local reviews in the UK, in order to inform national safety reporting guidance. Design A national descriptive survey. Setting UK. Participants Consultant-led maternity units. Main outcome measure Seventy-one per cent of maternity units provided an incident review trigger list. The conditions included were classified by two assessors. Incidents that were listed by at least 5% of maternity units were reported and compared with incidents recommended for review by the Royal College of Obstetricians and Gynaecologists (RCOG). Results The conditions covered were highly variable, although those recommended by the RCOG were most highly represented. The most commonly listed conditions that had not been recommended for review by the RCOG included inadequate staffing levels (70%), cardiac arrest (69%) and maternal sepsis (64%). Conclusions Substantial variation exists in the types of incident listed for review by maternity units in the UK. Importantly, some units are not reviewing cases of severe infective complications even though this is a current major concern. Future guidance concerning local serious incident review processes should include how the list of conditions triggering a review should be managed in the light of changing clinical and safety priorities. PMID:25057407

  8. Treatment of Gastric Adenocarcinoma May Differ Among Hospital Types in the United States, a Report from the National Cancer Data Base

    PubMed Central

    Gay, Greer; Patel-Parekh, Lina; Ajani, Jaffer A.; Donohue, John H.

    2007-01-01

    The concept that complex surgical procedures should be performed at high-volume centers to improve surgical morbidity and mortality is becoming widely accepted. We wanted to determine if there were differences in the treatment of patients with gastric cancer between community cancer centers and teaching hospitals in the United States. Data from the 2001 Gastric Cancer Patient Care Evaluation Study of the National Cancer Data Base comprising 6,047 patients with gastric adenocarcinoma treated at 691 hospitals were assessed. The mean number of patients treated was larger at teaching hospitals (14/year) when compared to community centers (5–9/year) (p < 0.05). The utilization of laparoscopy and endoscopic ultrasonography were significantly more common at teaching centers (p < 0.01). Pathologic assessment of greater than 15 nodes was documented in 31% of specimen at community hospitals and 38% at teaching hospitals (p < 0.01). Adjusted for cancer stage, chemotherapy and radiation therapy were utilized with equal frequency at all types of treatment centers. The 30-day postoperative mortality was lowest at teaching hospitals (5.5%) and highest at community hospitals (9.9%) (p < 0.01). These data support previous publications demonstrating that patients with diseases requiring specialized treatment have lower operative mortality when treated at high-volume centers. PMID:17436123

  9. Patient-Safety-Related Hospital Deaths in England: Thematic Analysis of Incidents Reported to a National Database, 2010–2012

    PubMed Central

    Donaldson, Liam J.; Panesar, Sukhmeet S.; Darzi, Ara

    2014-01-01

    Background Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. Methods and Findings The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%), failure of prevention (26%), deficient checking and oversight (11%), dysfunctional patient flow (10%), equipment-related errors (6%), and other (12%). The most common incident types were failure to act on or recognise deterioration (23%), inpatient falls (10%), healthcare-associated infections (10%), unexpected per-operative death (6%), and poor or inadequate handover (5%). Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. Conclusions Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives. Please see later in the article for the Editors' Summary PMID:24959751

  10. The evaluation of hospital laboratory information management systems based on the standards of the American National Standard Institute

    PubMed Central

    Isfahani, Sakineh Saghaeiannejad; Khajouei, Reza; Jahanbakhsh, Maryan; Mirmohamadi, Mahboubeh

    2014-01-01

    Introduction: Nowadays, modern laboratories are faced with a huge volume of information. One of the goals of the Laboratory Information Management System (LIMS) is to assist in the management of the information generated in the laboratory. This study intends to evaluate the LIMS based on the standards of the American National Standard Institute (ANSI). Materials and Methods: This research is a descriptive–analytical study, which had been conducted in 2011, on the LIMSs in use, in the teaching and private hospitals in Isfahan. The data collecting instrument was a checklist, which was made by evaluating three groups of information components namely: ‘System capabilities’, ‘work list functions,’ and ‘reporting’ based on LIS8-A. Data were analyzed using the SPSS 20. Data were analyzed using (relative) frequency, percentage. To compare the data the following statistical tests were used: Leven test, t-test, and Analysis of Variance (ANOVA). Results: The results of the study indicated that the LIMS had a low conformity (30%) with LIS8-A (P = 0.001), with no difference between teaching and private hospitals (P = 0.806). The ANOVA revealed that in terms of conformity with the LIS8-A standard, there was a significant difference between the systems produced by different vendors (P = 0.023). According to the results, a Kowsar system with more than %57 conformity in the three groups of information components had a better conformity to the standard, compared to the other systems. Conclusions: This study indicated that none of the LIMSs had a good conformity to the standard. It seems that system providers did not pay sufficient attention to many of the information components required by the standards when designing and developing their systems. It was suggested that standards from certified organizations and institutions be followed in the design and development process of health information systems. PMID:25077154

  11. An assessment of composite measures of hospital performance and associated mortality for patients with acute myocardial infarction. Analysis of individual hospital performance and outcome for the National Institute for Cardiovascular Outcomes Research (NICOR)

    PubMed Central

    Baxter, Paul D; Cattle, Brian A; Batin, Phillip D; Wilson, John I; West, Robert M; Hall, Alistair S; Weston, Clive F; Deanfield, John E; Fox, Keith A; Gale, Chris P

    2013-01-01

    Aim: To investigate whether a hospital-specific opportunity-based composite score (OBCS) was associated with mortality in 136,392 patients with acute myocardial infarction (AMI) using data from the Myocardial Ischaemia National Audit Project (MINAP) 2008–2009. Methods and results: For 199 hospitals a multidimensional hospital OBCS was calculated on the number of times that aspirin, thienopyridine, angiotensin-converting enzyme inhibitor (ACEi), statin, β-blocker, and referral for cardiac rehabilitation was given to individual patients, divided by the overall number of opportunities that hospitals had to give that care. OBCS and its six components were compared using funnel plots. Associations between OBCS performance and 30-day and 6-month all-cause mortality were quantified using mixed-effects regression analysis. Median hospital OBCS was 95.3% (range 75.8–100%). By OBCS, 24.1% of hospitals were below funnel plot 99.8% CI, compared to aspirin (11.1%), thienopyridine (15.1%), β-blockers (14.7%), ACEi (19.1%), statins (12.1%), and cardiac rehabilitation (17.6%) on discharge. Mortality (95% CI) decreased with increasing hospital OBCS quartile at 30 days [Q1, 2.25% (2.07–2.43%) vs. Q4, 1.40% (1.25–1.56%)] and 6 months [Q1, 7.93% (7.61–8.25%) vs. Q4, 5.53% (5.22–5.83%)]. Hospital OBCS quartile was inversely associated with adjusted 30-day and 6-month mortality [OR (95% CI), 0.87 (0.80–0.94) and 0.92 (0.88–0.96), respectively] and persisted after adjustment for coronary artery catheterization [0.89 (0.82–0.96) and 0.95 (0.91–0.98), respectively]. Conclusions: Multidimensional hospital OBCS in AMI survivors are high, discriminate hospital performance more readily than single performance indicators, and significantly inversely predict early and longer-term mortality. PMID:24062929

  12. 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

  13. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    PubMed

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed. PMID:11887587

  14. Parallel Quality Assessment of Emergency Departments by European Foundation for Quality Management Model and Iranian National Program for Hospital Evaluation

    PubMed Central

    IMANI NASAB, Mohammad Hasan; MOHAGHEGH, Bahram; KHALESI, Nader; JAAFARIPOOYAN, Ebrahim

    2013-01-01

    Background European Foundation for Quality Management (EFQM) model is a widely used quality management system (QMS) worldwide, including Iran. Current study aims to verify the quality assessment results of Iranian National Program for Hospital Evaluation (INPHE) based on those of EFQM. Methods: This cross-sectional study was conducted in 2012 on a sample of emergency departments (EDs) affiliated with Tehran University of Medical Sciences (TUMS), Iran. The standard questionnaire of EFQM (V-2010) was used to gather appropriate data. The results were compared with those of INPHE. MS Excel was used to classify and display the findings. Results: The average assessment score of the EDs based on the INPHE and EFQM model were largely different (i.e. 86.4% and 31%, respectively). In addition, the variation range among five EDs’ scores according to each model was also considerable (22% for EFQM against 7% of INPHE), especially in the EDs with and without prior record of applying QMSs. Conclusion: The INPHE’s assessment results were not confirmed by EFQM model. Moreover, the higher variation range among EDs’ scores using EFQM model could allude to its more differentiation power in assessing the performance comparing with INPHE. Therefore, a need for improvement in the latter drawing on other QMSs’ (such as EFQM) strengths, given the results emanated from its comparison with EFQM seems indispensable. PMID:23967429

  15. Supplement use by women during pregnancy: data from the Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics.

    PubMed

    Freeman, Marlene P; Sosinsky, Alexandra Z; Moustafa, Danna; Viguera, Adele C; Cohen, Lee S

    2016-06-01

    Women of reproductive age commonly use integrative treatments. However, the reproductive safety for most complementary products lacks systematic study. We aimed to study the use of supplements by women in a prospective pregnancy registry. The Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics was established to evaluate the reproductive safety of atypical antipsychotics. Exposed and control participants were systematically queried about the use of vitamins and supplements. Slightly greater than half (53.2 %) of the participants eligible for analysis (N = 534) were using at least one vitamin or supplement at the time of enrollment, not including prenatal vitamins or folic acid. The most common supplements used were omega-3 fatty acids (38.0 %), vitamin D (11.0 %), calcium (8.2 %), and iron (4.7 %). Probiotics and melatonin were used by 2.6 and 0.9 %, respectively. In this prospective pregnancy registry, we found that over half of the participants were taking supplements or vitamins other than prenatal vitamins and folic acid. These findings underscore the need for active query on the part of health care providers about the use of supplements during pregnancy, and the need to obtain rigorous reproductive safety and efficacy data for supplements used by pregnant women and reproductive aged women. PMID:26472040

  16. 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

  17. Using regional-scale LiDAR surveys to validate operational snow models

    NASA Astrophysics Data System (ADS)

    Hedrick, A. R.; Marshall, H. P.; Winstral, A. H.; Elder, K.; Yueh, S. H.; Cline, D. W.

    2014-12-01

    As survey costs continue to plummet and storage capabilities soar, large-scale multitemporal airborne Light Detection and Ranging (LiDAR) surveys for high-resolution snow depth measurements are becoming commonplace in mountain research watersheds. Though there are disadvantages to the technique (e.g. poor temporal representation and high uncertainty in steep terrain and dense vegetation), the wealth of information with regard to previously unknown spatial snow depth distributions can be an valuable tool for assessing spatially distributed operational snow models. As a portion of NASA's second Cold Lands Processes Experiment (CLPX-2), two 750-km2 LiDAR surveys were conducted over Northern Colorado in December and February of the 2006/2007 winter season. The resulting 5-m gridded changes in snow depth overlay 980 individual pixels of the SNOw Data Assimilation System (SNODAS) spatial framework. As an important operational snow model developed by NOAA's National Operational Hydrologic Remote Sensing Center (NOHRSC), SNODAS generally lacks independent validation datasets due to the data assimilation step critical for adjusting the energy balance and downscaled Numerical Weather Prediction (NWP) model components. The influence of sub-grid variability on SNODAS performance is assessed using the independent high resolution CLPX-2 LiDAR changes in snow depth. This method provides a foundation for further studies to quantitatively address the affect of small-scale physiographic variables on various large-scale operational snow models by making use of forthcoming large-scale LiDAR datasets.

  18. Development of the Philippine Hydrologic Dataset (PHD) from LiDAR and other remotely-sensed data

    NASA Astrophysics Data System (ADS)

    Perez, A. M. C.; Gaspa, M. C.; Aloc, D. S.; Mahor, M. A. P.; Gonzalez, K. A. C.; Borlongan, N. J. B.; De La Cruz, R. M.; Olfindo, N. T.; Blanco, A. C.

    2015-10-01

    Water resource monitoring and management has been an important concern in the Philippines, considering that the country is archipelagic in nature and is exposed to a lot of disasters imposed by the global effects of climate change. The design and implementation of an effective management scheme relies heavily on accurate, complete, and updated water resource inventories, usually in the form of digital maps and geodatabases. With the aim of developing a detailed and comprehensive database of all water resources in the Philippines, the 3-year project "Development of the Philippine Hydrologic Dataset (PHD) for Watersheds from LiDAR Surveys" under the Phil-LiDAR 2 Program (National Resource Inventory), has been initiated by the University of the Philippines Diliman (UPD) and the Department of Science and Technology (DOST). Various workflows has already been developed to extract inland hydrologic features in the Philippines using accurate Light Detection and Ranging (LiDAR) Digital Terrain Models (DTMs) and LiDAR point cloud data obtained through other government-funded programs such as Disaster Risk and Exposure Assessment for Mitigation (DREAM) and Phil-LiDAR 1, supplemented with other remotely-sensed imageries and ancillary information from Local Government Units (LGUs) and National Government Agencies (NGAs). The methodologies implemented are mainly combinations of object-based image analysis, pixel-based image analysis, modeling, and field surveys. This paper presents the PHD project, the methodologies developed, and some sample outputs produced.

  19. Visualization of High-Resolution LiDAR Topography in Google Earth

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Nandigam, V.; Arrowsmith, R.; Blair, J. L.

    2009-12-01

    The growing availability of high-resolution LiDAR (Light Detection And Ranging) topographic data has proven to be revolutionary for Earth science research. These data allow scientists to study the processes acting on the Earth’s surfaces at resolutions not previously possible yet essential for their appropriate representation. In addition to their utility for research, the data have also been recognized as powerful tools for communicating earth science concepts for education and outreach purposes. Unfortunately, the massive volume of data produced by LiDAR mapping technology can be a barrier to their use. To facilitate access to these powerful data for research and educational purposes, we have been exploring the use of Keyhole Markup Language (KML) and Google Earth to deliver LiDAR-derived visualizations. The OpenTopography Portal (http://www.opentopography.org/) is a National Science Foundation-funded facility designed to provide access to Earth science-oriented LiDAR data. OpenTopography hosts a growing collection of LiDAR data for a variety of geologic domains, including many of the active faults in the western United States. We have found that the wide spectrum of LiDAR users have variable scientific applications, computing resources, and technical experience and thus require a data distribution system that provides various levels of access to the data. For users seeking a synoptic view of the data, and for education and outreach purposes, delivering full-resolution images derived from LiDAR topography into the Google Earth virtual globe is powerful. The virtual globe environment provides a freely available and easily navigated viewer and enables quick integration of the LiDAR visualizations with imagery, geographic layers, and other relevant data available in KML format. Through region-dependant network linked KML, OpenTopography currently delivers over 20 GB of LiDAR-derived imagery to users via simple, easily downloaded KMZ files hosted at the Portal

  20. Excessive working hours and health complaints among hospital physicians: a study based on a national sample of hospital physicians in Germany

    PubMed Central

    Rosta, Judith; Gerber, Andreas

    2007-01-01

    Objectives: To determine correlations between excessively long working hours and subjectively experienced somatic health complaints among hospital physicians. Methods: Quantitative data were collected as part of the survey “Working life, Lifestyle and Health of Hospital Physicians in Germany 2006” using self-reporting questionnaires. The individually experienced health was assessed on the basis of Zerssen’s [1] list of somatic complaints. The indicator of excessively long working hours was defined as 10 or more working hours per working day and 6 or more on-call shifts a month among full-time employees. The net sample consisted of 3295 randomly selected physicians from 515 hospitals. Results: The response rate was 58% (n=1917). Physicians with excessively long working hours (19%) had significantly higher sum score of health complaints (p=0.0001) and significantly increased mental and physical fatigue symptoms (feeling faint, languor, uneasiness, heavy legs, excessive need for sleep, trembling; p=0.0001 to 0.047), mood changes (irritability, brooding; p=0.008 to 0.014), gastrointestinal (nausea, loss of weight; p=0.0001 to 0.014) and heart disorders (lumpy sensation in the throat, chest pain; p=0.0001 to 0.042). When the sum score of health complaints was controlled for selected confounders, being female (B=-3.44, p=0.0001) and having excessively long working hours (B=2.76, p=0.0001) were significantly correlated with health complaints. In a separate gender analysis, being exposed to excessively long working hours remained a significant predictor for health complaints among both females (B=3.78, p=0.001) and males (B=2.28, p=0.004). Conclusions: Excessively long working hours are associated with an increased risk of health complaints. Reducing working hours may be the first step to improving physicians' health. PMID:19675717

  1. Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia

    PubMed Central

    2013-01-01

    Background Toxoplasmosis, a zoonotic disease distributed worldwide, is an infection caused by the ubiquitous obligatory intracellular coccidian protozoan organism, Toxoplasma gondii. It is a major public health concern because the disease is serious in terms of mortality or physical and /or psychological sequellae in patients with HIV disease. The aim of the study was to assess the seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in HIV infected and non-infected individuals attending Felege Hiwot referral hospital, Bahir Dar, Northwest Ethiopia. Methods A cross sectional study was conducted at Felege Hiwot referral hospital, Bahir Dar, Amhara National Regional State. Venous blood samples were collected from 103 HIV infected pre anti-retroviral therapy patients at Felege Hiwot referral hospital and 101 HIV negative apparently healthy voluntary blood donors at the blood bank. Serum samples were analyzed for anti-Toxoplasma gondii IgG and IgM antibodies using a commercially available ELISA kit. Socio-demographic and associated risk factors for Toxoplasmosis from each individual were also obtained and the data was analyzed using SPSS version 18. Results Of the examined HIV seropositive individuals, 87.4% (90/103) and 10.7% (11/103) were positive for anti-T. gondii IgG and IgM antibodies, respectively. Multivariate analysis using logistic regression showed that anti-T. gondii seropositivity was independently significantly associated with undercooked or raw meat consumption (adjusted OR=5.73, 95% CI=1.35-24.39; P=0.02) and having contact with cat (adjusted OR= 4.29, 95% CI=1.08-16.94; P=0.04) in HIV positive individuals. In HIV negative apparently healthy blood donors, prevalence of anti-T. gondii antibodies were 70.29% and 2.97% for IgG and IgM, respectively. Multivariate analysis showed that undercooked or raw meat consumption (adjusted OR=6.45, 95% CI=2.16-19.28; p=0.001) and sex (OR=6.79, 95% CI=2.14-21.60; p=0.001) were

  2. 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…

  3. Drug-resistant tuberculosis in HIV-infected patients in a national referral hospital, Phnom Penh, Cambodia

    PubMed Central

    Walls, Genevieve; Bulifon, Sophie; Breysse, Serge; Daneth, Thol; Bonnet, Maryline; Hurtado, Northan; Molfino, Lucas

    2015-01-01

    Background and objective There are no recent data on the prevalence of drug-resistant tuberculosis (DR TB) in Cambodia. We aim to describe TB drug resistance amongst adults with pulmonary and extra-pulmonary TB and human immunodeficiency virus (HIV) co-infection in a national referral hospital in Phnom Penh, Cambodia. Design Between 22 November 2007 and 30 November 2009, clinical specimens from HIV-infected patients suspected of having TB underwent routine microscopy, Mycobacterium tuberculosis culture, and drug susceptibility testing. Laboratory and clinical data were collected for patients with positive M. tuberculosis cultures. Results M. tuberculosis was cultured from 236 HIV-infected patients. Resistance to any first-line TB drug occurred in 34.7% of patients; 8.1% had multidrug resistant tuberculosis (MDR TB). The proportion of MDR TB amongst new patients and previously treated patients was 3.7 and 28.9%, respectively (p<0.001). The diagnosis of MDR TB was made after death in 15.8% of patients; in total 26.3% of patients with MDR TB died. The diagnosis of TB was established by culture of extra-pulmonary specimens in 23.6% of cases. Conclusions There is significant resistance to first-line TB drugs amongst new and previously treated TB–HIV co-infected patients in Phnom Penh. These data suggest that the prevalence of DR TB in Cambodia may be higher than previously recognised, particularly amongst HIV-infected patients. Additional prevalence studies are needed. This study also illustrates the feasibility and utility of analysis of non-respiratory specimens in the diagnosis of TB, even in low-resource settings, and suggests that extra-pulmonary specimens should be included in TB diagnostic algorithms. PMID:25623609

  4. Medico-social and socio-demographic factors associated with maternal mortality at Kenyatta National Hospital, Nairobi, Kenya.

    PubMed

    Makokha, A E

    1991-01-01

    To identify the most significant determinants of maternal mortality in Kenya, a prospective study involving 49,335 deliveries occurring at Kenyatta National Hospital from January 1978-87 was conducted. There were 156 maternal deaths in this series, for a maternal mortality rate of 3.2/1000 deliveries. The 5 most frequent causes of death were abortion (24%), hypertensive disease of pregnancy (13%), sepsis (13%), anemia (10%), and cardiac disease (7%). 24% of women who died were age 19 years or under, 27% were 20-24 years, 23% were 25-29 years, and 11% were 30-34 years. The largest percentage (24%) of deaths involved nulliparous women; 16% were to women of parity 5 and above. 28% of the women who died were single, and single women contributed the majority of deaths from abortion. 66% of the women who died had received no prenatal care. The proportion of avoidable deaths was 19% among clinic attenders compared to 29% among non-attenders. Overall, age, parity, and marital status--traditionally regarded as the key factors associated with maternal mortality--vary in their impact, given the cause of death and medical services received. The assumption that high parity is associated with maternal mortality was not confirmed in this study due to the significant number of deaths from abortion that involved single, nulliparous women. In addition, many women who died were in the optimum age group for childbearing, but were more prone to suffer from anemia, hypertension, ectopic pregnancy, and cardiac disease than women over 30 years old. Overall, 126 deaths were considered avoidable. Contributory factors were slowness of surgical management of emergencies, prolonged confinement of women with cardiac disease, and a lack of emergency supplies of blood and drugs for complicated deliveries. PMID:12316813

  5. 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

  6. 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

  7. Quantifying soil carbon loss and uncertainty from a peatland wildfire using multi-temporal LiDAR

    USGS Publications Warehouse

    Reddy, Ashwan D.; Hawbaker, Todd J.; Wurster, F.; Zhu, Zhiliang; Ward, S.; Newcomb, Doug; Murray, R.

    2015-01-01

    Peatlands are a major reservoir of global soil carbon, yet account for just 3% of global land cover. Human impacts like draining can hinder the ability of peatlands to sequester carbon and expose their soils to fire under dry conditions. Estimating soil carbon loss from peat fires can be challenging due to uncertainty about pre-fire surface elevations. This study uses multi-temporal LiDAR to obtain pre- and post-fire elevations and estimate soil carbon loss caused by the 2011 Lateral West fire in the Great Dismal Swamp National Wildlife Refuge, VA, USA. We also determine how LiDAR elevation error affects uncertainty in our carbon loss estimate by randomly perturbing the LiDAR point elevations and recalculating elevation change and carbon loss, iterating this process 1000 times. We calculated a total loss using LiDAR of 1.10 Tg C across the 25 km2 burned area. The fire burned an average of 47 cm deep, equivalent to 44 kg C/m2, a value larger than the 1997 Indonesian peat fires (29 kg C/m2). Carbon loss via the First-Order Fire Effects Model (FOFEM) was estimated to be 0.06 Tg C. Propagating the LiDAR elevation error to the carbon loss estimates, we calculated a standard deviation of 0.00009 Tg C, equivalent to 0.008% of total carbon loss. We conclude that LiDAR elevation error is not a significant contributor to uncertainty in soil carbon loss under severe fire conditions with substantial peat consumption. However, uncertainties may be more substantial when soil elevation loss is of a similar or smaller magnitude than the reported LiDAR error.

  8. 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

  9. Performance Ratio Analysis: A National Study on Iranian Hospitals Affiliated to Ministry of Health and Medical Education

    PubMed Central

    BASTANI, Peivand; VATANKHAH, Soudabeh; SALEHI, Masoud

    2013-01-01

    Background: This study was designed to present and compare Iranian hospitals` performance applying ratio analysis technique. Methods: This cross-sectional survey was conducted to present an instant image of 139 Iranian hospitals` performance status applying ratio analysis as one of the non parametric technical efficiency assessment methods in 2008. Data was collected using nine dimensional questionnaires supported by world wide web to achieve main hospital ratios. Final analysis was performed applying classic statistics and relevant statistical tests on significant level of 0.05. Results: Four hospital performance indicators were estimated in the studied hospitals as follows: Bed turnover rate (BTR) was fluctuated from 64.5 to 114.8 times for hospitals located in rich and poor areas respectively. Moreover Bed Interval Rate (BIT) was calculated 1.36 versus 2.4 in the poor and rich areas. Average length of stay (ALS) was computed 1.82 for the poor regions but 3.27 for the rich ones furthermore, a positive statistical significant correlation was seen between ALS and the hospital size (P=0.001, r=0.28). Average bed occupancy rate (BOR) was 57.8% and its variation was from 31.4% to 64.5% depending on the hospital size so that there was a positive statistical significant relationship between the hospital size and BOR (P=0.006, r=0.32). Conclusion: Regarding that BOR, ALS, BTR and BIT along with mortality rates are mentioned as the most considerable performance indicators, applying analytic frameworks more than considering single and raw indicators are severely recommended. PMID:26056642

  10. Influential Factors for and Outcomes of Hospitalized Patients with Suicide-Related Behaviors: A National Record Study in Taiwan from 1997–2010

    PubMed Central

    Lin, Yu-Wen; Huang, Hui-Chuan; Lin, Mei-Feng; Shyu, Meei-Ling; Tsai, Po-Li; Chang, Hsiu-Ju

    2016-01-01

    Background Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors. Objectives To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records. Design This is a cohort study of Taiwan’s national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010. Participants The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950–E959) according to the International Classification of Disease, Ninth Revision, Clinical Modification. Results Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder), had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide

  11. Provision of Vocational Skills Education to Orphans: Lessons from Orphanage Centres in Dar es Salaam City, Tanzania

    ERIC Educational Resources Information Center

    Meli, Benjamin Mbeba

    2015-01-01

    This paper utilises data from a study that investigated the efficacy of vocational skills training provided to orphans from three orphanages in Temeke District, Dar es Salaam. The three orphanage centres that were studied are Kurasini National Children Home, Saudia and Don Bosco Vocational Centre. The sample comprised of 45 orphans, an official…

  12. Comparison of Substance-Use Prevalence among Rhode Island and The Miriam Hospital Emergency Department Patients to State and National General Population Prevalence Estimates

    PubMed Central

    Bernardino, Vera L.; Baird, Janette R.; Liu, Tao; Merchant, Roland C.

    2016-01-01

    Objectives Compare the prevalence of recent alcohol, tobacco, and drug use among patients from two Rhode Island emergency departments (EDs) to Rhode Island state and United States national general population estimates between 2010 and 2012. Methods Secondary analysis of ED patient data and the National Survey of Drug Use and Health. Results Alcohol was the most commonly reported substance, and prevalence of its use was higher among ED patients than those in the national, but not the Rhode Island, general population. Drug use was higher among ED patients than in the state and national general population. For ED patients, tobacco and opioid use was highest among 26–34 year-olds, alcohol and marijuana highest among 18–25 years-olds, and cocaine highest among 35–49 years-olds. Conclusion Rhode Island Hospital and The Miriam Hospital ED patients report a greater prevalence of substance use than the national population and in many cases the state general population. PMID:25830171

  13. Using LiDAR to characterize logjams in lowland rivers

    NASA Astrophysics Data System (ADS)

    Abalharth, Mahdi; Hassan, Marwan A.; Klinkenberg, Brian; Leung, Vivian; McCleary, Richard

    2015-10-01

    Logjams significantly influence watershed hydrology, flow regime, channel morphology and stability, and processes in lowland rivers. Consequently, logjams play a major role in the existence and conservation of the riparian and aquatic ecosystems along major waterways. In this paper, we attempt to detect and quantify logjams in river channels using LiDAR technology in conjunction with traditional fieldwork. To the best of our knowledge, LiDAR-based analysis has not been used to characterize logjams in streams. Overall, when applied in a lowland river environment, LiDAR-based analysis demonstrates a comprehensive solution for detecting logjams in relation to the fieldwork, with a low rate of omission. A filtered approach predicted the presence of 95% of fieldwork-reported logjams (a 5% rate of omission), but also identified six logjams not identified in the field (a 10% rate of commission). A nonfiltered approach identified 87% of field-reported logjams, producing a 13% rate of omission and a 6.7% rate of commission. Dimension measurements were more consistent in the filtered LiDAR approach, showing 53%, 34%, and 90% of R2 improvements for the length, width, and height, respectively, over the unfiltered LiDAR values. As vegetation cover hindered accurate delineation of logjam boundaries by LiDAR, field and LiDAR measurements of nonvegetation-obstructed logjams were more highly correlated than the field and LiDAR measurements of partially and completely vegetation-obstructed logjams.

  14. Eleanor Roosevelt Resigns from the DAR: A Study in Conscience.

    ERIC Educational Resources Information Center

    Freeman, Elsie T.; And Others

    1984-01-01

    Because the Daughters of the American Revolution's (DAR) Black exclusion rule prevented Black singer Marion Anderson from performing in the DAR auditorium in 1939, Eleanor Roosevelt resigned from the organization. Primary source materials regarding this incident and learning activities for secondary level students are presented. (RM)

  15. Behavioral differences between public and private not-for-profit hospitals in the Italian National Health Service.

    PubMed

    Barbetta, Gian Paolo; Turati, Gilberto; Zago, Angelo M

    2007-01-01

    In this paper we attempt to identify behavioral differences between public and private not-for-profit hospitals, by exploiting the introduction of the DRG-based payment system in the Italian NHS during the second half of the 1990s. We estimate the technical efficiency of a sample of hospitals for the period 1995-2000 considering an output distance function, and adopting both parametric (COLS and SF) and nonparametric (DEA) approaches. Our results show a convergence of mean efficiency scores between not-for-profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. We also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates. PMID:16929498

  16. Distinguishing grass from ground using LiDAR: Techniques and applications

    NASA Astrophysics Data System (ADS)

    Pelletier, J. D.; Swetnam, T.; Papuga, S. A.; Nelson, K.; Brooks, P. D.; Harpold, A. A.; Chorover, J.

    2011-12-01

    Standard protocols exist for extracting bare-earth Digital Elevation Models (DEMs) from LiDAR point clouds that include trees and other large woody vegetation. Grasses and other herbaceous plants can also obscure the ground surface, yet methods for optimally distinguishing grass from ground to generate accurate LiDAR-based raster products for geomorphic and ecological applications are still under development. Developing such methods is important because LiDAR-based difference products (e.g. snow thickness) require accurate representations of the ground surface and because raster data for grass height and density have important applications in ecology. In this study, we developed and tested methods for constructing optimal bare-earth and grass height raster layers from LiDAR point clouds and compared the results to high-quality field-based measurements of grass height, density, and species type for nearly 1000 precisely geo-referenced locations collected during the acquisition of a >200 km^2 airborne LiDAR flight of the Valles Caldera National Preserve (New Mexico). In cases of partially bare ground (where the skewness of return heights above a plane fit to the lowest first returns is sufficiently large), a planar fit to the lowest first returns provides a good method of producing an accurate bare-earth DEM and the statistics of the first returns above that planar fit provide good estimates of the mean and variance of grass height. In areas of relatively thick grass cover, however, a fit to the lowest first returns yields a bare-earth DEM that may be a meter or more above the actual ground surface. Here we propose a method to solve this problem using field-measured correlations among the mean, variance, and skewness of grass heights. In this method, the variance and skewness of the differences between LiDAR first returns and a 10m^2 planar fit to the lowest first returns is used, together with field-based correlations of grass height statistics, to estimate the mean

  17. National survey on cholecystectomy related bile duct injury--public health and financial aspects in Belgian hospitals--1997.

    PubMed

    Van de Sande, St; Bossens, M; Parmentier, Y; Gigot, J F

    2003-04-01

    Public health and financial aspects of cholecystectomy related bile duct injury (BDI) are highlighted in a National Cholecystectomy Survey carried out through 'datamining' the Federal State Medical Records Summaries and Financial Summaries of all Belgian hospitals in 1997. All cancer diagnoses, children < or = 10 years, cholecystectomies performed as an abdominal co-procedure or patients having undergone other non-related surgery were excluded from the study. 10.595 laparoscopic (LC) and 1.033 open cholecystectomies (OC) as well as 137 secondary BDI treatments (LC/OC) were included in the survey (total 11.765). Both LC and OC groups turned out to be significantly different as to distribution of patient's age and APR-DRG severity classes. Composite criteria in terms of ICD-9-CM and billing codes were elaborated to classify: 1) primary, intra-operatively detected and treated BDI (N = 30), 2) primary delayed BDI treatments (N = 38), 3) secondary BDI treatments (N = 137), 4) non-BDI abdomino-surgical complications (N = 119), 4) uneventful laparoscopic (N = 7.476) and 5) uneventful open cholecystectomy (N = 681). Complication rates, community costs of LC and OC groups, incidence of preoperative ERCP and/or intra-operative cholangiography as well as interventions for complications were studied. Incidence of cholecystectomy related BDI was 0.37% in LC, 2.81% in OC and 0.58% overall. Average costs amounted to [symbol: see text] 1.721 for uneventful LC, [symbol: see text] 2.924 for uneventful OC, [symbol: see text] 7.250 for primary, intra-operatively detected and immediately treated BDI [symbol: see text] 9.258 for primary delayed BDI treatments, [symbol: see text] 6.076 for secondary BDI treatments and [symbol: see text] 10.363 for non-BDI abdomino-surgical complications. In conclusion BDI with cholecystectomy reveals to be a serious complication increasing the overall average cost factor ninefold if not detected intra-operatively, in which case the raise is only fourfold

  18. Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

    PubMed Central

    Mumghamba, Elifuraha GS; Manji, Karim P

    2007-01-01

    Background The study examined the relationship between oral health status (periodontal disease and carious pulpal exposure (CPE)) and preterm low-birth-weight (PTLBW) infant deliveries among Tanzanian-African mothers at Muhimbili National Hospital (MNH), Tanzania. Methods A retrospective case-control study was conducted, involving 373 postpartum mothers aged 14–44 years (PTLBW – 150 cases) and at term normal-birth-weight (TNBW) – 223 controls), using structured questionnaire and full-mouth examination for periodontal and dentition status. Results The mean number of sites with gingival bleeding was higher in PTLBW than in TNBW (P = 0.026). No significant differences were observed for sites with plaque, calculus, teeth with decay, missing, filling (DMFT) between PTLBW and TNBW. Controlling for known risk factors in all post-partum (n = 373), and primiparaous (n = 206) mothers, no significant differences were found regarding periodontal disease diagnosis threshold (PDT) (four sites or more that had probing periodontal pocket depth 4+mm and gingival bleeding ≥ 30% sites), and CPE between cases and controls. Significant risk factors for PTLBW among primi- and multiparous mothers together were age ≤ 19 years (adjusted Odds Ratio (aOR) = 2.09, 95% Confidence interval (95% CI): 1.18 – 3.67, P = 0.011), hypertension (aOR = 2.44, (95% CI): 1.20 – 4.93, P = 0.013) and being un-married (aOR = 1.59, (95% CI): 1.00 – 2.53, P = 0.049). For primiparous mothers significant risk factors for PTLBW were age ≤ 19 years (aOR = 2.07, 95% CI: 1.13 – 3.81, P = 0.019), and being un-married (aOR = 2.58, 95% CI: 1.42 – 4.67, P = 0.002). Conclusions These clinical findings show no evidence for periodontal disease or carious pulpal exposure being significant risk factors in PTLBW infant delivery among Tanzanian-Africans mothers at MNH, except for young age, hypertension, and being unmarried. Further research incorporating periodontal pathogens is recommended. PMID:17594498

  19. In‐Hospital Mortality Among Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From the National Inpatient Sample, 2000–2010

    PubMed Central

    Ahmed, Bina; Davis, Herbert T.; Laskey, Warren K.

    2014-01-01

    Background Case‐fatality rates in acute myocardial infarction (AMI) have significantly decreased; however, the prevalence of diabetes mellitus (DM), a risk factor for AMI, has increased. The purposes of the present study were to assess the prevalence and clinical impact of DM among patients hospitalized with AMI and to estimate the impact of important clinical characteristics associated with in‐hospital mortality in patients with AMI and DM. Methods and Results We used the National Inpatient Sample to estimate trends in DM prevalence and in‐hospital mortality among 1.5 million patients with AMI from 2000 to 2010, using survey data‐analysis methods. Clinical characteristics associated with in‐hospital mortality were identified using multivariable logistic regression. There was a significant increase in DM prevalence among AMI patients (year 2000, 22.2%; year 2010, 29.6%, Ptrend<0.0001). AMI patients with DM tended to be older and female and to have more cardiovascular risk factors. However, age‐standardized mortality decreased significantly from 2000 (8.48%) to 2010 (4.95%) (Ptrend<0.0001). DM remained independently associated with mortality (adjusted odds ratio 1.069, 95% CI 1.051 to 1.087; P<0.0001). The adverse impact of DM on in‐hospital mortality was unchanged over time. Decreased death risk over time was greatest among women and elderly patients. Among younger patients of both sexes, there was a leveling off of this decrease in more recent years. Conclusions Despite increasing DM prevalence and disease burden among AMI patients, in‐hospital mortality declined significantly from 2000 to 2010. The adverse impact of DM on mortality remained unchanged overall over time but was age and sex dependent. PMID:25158866

  20. Creating a “culture of research” in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program

    PubMed Central

    St. Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

    2015-01-01

    Background The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute’s Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. Methods To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. Limitations The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important

  1. Impact of tobacco control policies in hospitals: Evaluation of a national smoke-free campus ban in Spain

    PubMed Central

    Sureda, Xisca; Ballbè, Montse; Martínez, Cristina; Fu, Marcela; Carabasa, Esther; Saltó, Esteve; Martínez-Sánchez, Jose M.; Fernández, Esteve

    2014-01-01

    Introduction On January 2, 2011, the Spanish government passed a new smoking law that banned smoking in hospital campuses. The objective of this study was to evaluate the implementation of smoke-free campuses in the hospitals of Catalonia based on both airborne particulate matter and observational data. Methods This cross-sectional study included the hospitals registered in the Catalan Network of Smoke-free Hospitals. We measured the concentration of particulate matter < 2.5 µm in μg/m3 at different locations, both indoors and outdoors before (2009) and after (2011) the implementation of the tobacco law. During 2011, we also assessed smoke-free zone signage and indications of smoking in the outdoor areas of hospital campuses. Results The overall median particulate matter < 2.5 µm concentration fell from 12.22 μg/m3 (7.80–19.76 μg/m3) in 2009 to 7.80 μg/m3 (4.68–11.96 μg/m3) in 2011. The smoke-free zone signage within the campus was moderately implemented after the legislation in most hospitals, and 55% of hospitals exhibited no indications of tobacco consumption around the grounds. Conclusions After the law, particulate matter < 2.5 µm concentrations were much below the values obtained before the law and below the annual guideline value recommended by the World Health Organization for outdoor settings (10 μg/m3). Our data showed the feasibility of implementing a smoke-free campus ban and its positive effects. PMID:26844041

  2. Rural and Urban Hospitals' Role in Providing Inpatient Care, 2010

    MedlinePlus

    ... CDC/NCHS, National Hospital Discharge Survey, 2010. How did rural hospital inpatients differ from urban hospital inpatients ... CDC/NCHS, National Hospital Discharge Survey, 2010. How did patients' first-listed diagnoses differ in rural and ...

  3. Hospitals, finance, and health system reform in Britain and the United States, c. 1910-1950: historical revisionism and cross-national comparison.

    PubMed

    Gorsky, Martin

    2012-06-01

    Comparative histories of health system development have been variously influenced by the theoretical approaches of historical institutionalism, political pluralism, and labor mobilization. Britain and the United States have figured significantly in this literature because of their very different trajectories. This article explores the implications of recent research on hospital history in the two countries for existing historiographies, particularly the coming of the National Health Service in Britain. It argues that the two hospital systems initially developed in broadly similar ways, despite the very different outcomes in the 1940s. Thus, applying the conceptual tools used to explain the U.S. trajectory can deepen appreciation of events in Britain. Attention focuses particularly on working-class hospital contributory schemes and their implications for finance, governance, and participation; these are then compared with Blue Cross and U.S. hospital prepayment. While acknowledging the importance of path dependence in shaping attitudes of British bureaucrats toward these schemes, analysis emphasizes their failure in pressure group politics, in contrast to the United States. In both countries labor was also crucial, in the United States sustaining employment-based prepayment and in Britain broadly supporting system reform. PMID:22323233

  4. Establishing an Anaesthesia and Intensive Care partnership and aiming for national impact in Tanzania.

    PubMed

    Ulisubisya, Mpoki; Jörnvall, Henrik; Irestedt, Lars; Baker, Tim

    2016-01-01

    Anaesthesia and Intensive Care is a neglected specialty in low-income countries. There is an acute shortage of health workers - several low-income countries have less than 1 anaesthesia provider per 100,000 population. Only 1.5% of hospitals in Africa have the intensive care resources needed for managing patients with sepsis. Health partnerships between institutions in high and low-income countries have been proposed as an effective way to strengthen health systems. The aim of this article is to describe the origin and conduct of a health partnership in Anaesthesia and Intensive Care between institutions in Tanzania and Sweden and how the partnership has expanded to have an impact at regional and national levels.The Muhimbili-Karolinska Anaesthesia and Intensive Care Collaboration was initiated in 2008 on the request of the Executive Director of Muhimbili National Hospital in Dar es Salaam. The partnership has conducted training courses, exchanges, research projects and introduced new equipment, routines and guidelines. The partnership has expanded to include all hospitals in Dar es Salaam. Through the newly formed Life Support Foundation, the partnership has had a national impact assisting the reanimation of the Society of Anaesthesiologists of Tanzania and has seen a marked increase of the number of young doctors choosing a residency in Anaesthesia and Intensive Care. PMID:26993790

  5. Lava flow texture LiDAR signatures

    NASA Astrophysics Data System (ADS)

    Whelley, P.; Garry, W. B.; Scheidt, S. P.; Irwin, R. P., III; Fox, J.; Bleacher, J. E.; Hamilton, C. W.

    2014-12-01

    High-resolution point clouds and digital elevation models (DEMs) are used to investigate lava textures on the Big Island of Hawaii. An experienced geologist can distinguish fresh or degraded lava textures (e.g., blocky, a'a and pahoehoe) visually in the field. Lava texture depends significantly on eruption conditions, and it is therefore instructive, if accurately determined. In places where field investigations are prohibitive (e.g., Mercury, Venus, the Moon, Mars, Io and remote regions on Earth) lava texture must be assessed from remote sensing data. A reliable method for differentiating lava textures in remote sensing data remains elusive. We present preliminary results comparing properties of lava textures observed in airborne and terrestrial Light Detection and Ranging (LiDAR) data. Airborne data, in this study, were collected in 2011 by Airborne 1 Corporation and have a ~1m point spacing. The authors collected the terrestrial data during a May 2014 field season. The terrestrial scans have a heterogeneous point density. Points close to the scanner are 1 mm apart while 200 m in the distance points are 10 cm apart. Both platforms offer advantages and disadvantages beyond the differences in scale. Terrestrial scans are a quantitative representation of what a geologist sees "on the ground". Airborne scans are a point of view routinely imaged by other remote sensing tools, and can therefore be quickly compared to complimentary data sets (e.g., spectral scans or image data). Preliminary results indicate that LiDAR-derived surface roughness, from both platforms, is useful for differentiating lava textures, but at different spatial scales. As all lava types are quite rough, it is not simply roughness that is the most advantageous parameter; rather patterns in surface roughness can be used to differentiate lava surfaces of varied textures. This work will lead to faster and more reliable volcanic mapping efforts for planetary exploration as well as terrestrial

  6. US hospitals violate WHO policy on the distribution of formula sample packs: results of a national survey.

    PubMed

    Merewood, Anne; Grossman, Xena; Cook, John; Sadacharan, Radha; Singleton, Marcella; Peters, Karen; Navidi, Tina

    2010-11-01

    The World Health Organization's International Code of Marketing of Breast-Milk Substitutes, as well as most major medical authorities, opposes hospital-based distribution of free infant formula at discharge. The goal of this cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007, was to determine the extent of this practice. It was found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant (P < .001). It was concluded that most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of organizations including the US Government Accountability Office, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention. PMID:20871089

  7. Establishing a National Maternal Morbidity Outcome Indicator in England: A Population-Based Study Using Routine Hospital Data

    PubMed Central

    Nair, Manisha; Kurinczuk, Jennnifer J.; Knight, Marian

    2016-01-01

    Introduction As maternal deaths become rarer, monitoring near-miss or severe maternal morbidity becomes important as a tool to measure changes in care quality. Many calls have been made to use routinely available hospital administration data to monitor the quality of maternity care. We investigated 1) the feasibility of developing an English Maternal Morbidity Outcome Indicator (EMMOI) by reproducing an Australian indicator using routinely available hospital data, 2) the impact of modifications to the indicator to address potential data quality issues, 3) the reliability of the indicator. Methods We used data from 6,389,066 women giving birth in England from April 2003 to March 2013 available in the Hospital Episode Statistics (HES) database of the Health and Social care Information centre (HSCIC). A composite indicator, EMMOI, was generated from the diagnoses and procedure codes. Rates of individual morbid events included in the EMMOI were compared with the rates in the UK reported by population-based studies. Results EMMOI included 26 morbid events (17 diagnosis and 9 procedures). Selection of the individual morbid events was guided by the Australian indicator and published literature for conditions associated with maternal morbidity and mortality in the UK, but was mainly driven by the quality of the routine hospital data. Comparing the rates of individual morbid events of the indicator with figures from population-based studies showed that the possibility of false positive and false negative cases cannot be ruled out. Conclusion While routine English hospital data can be used to generate a composite indicator to monitor trends in maternal morbidity during childbirth, the quality and reliability of this monitoring indicator depends on the quality of the hospital data, which is currently inadequate. PMID:27054761

  8. Processing LiDAR Data to Predict Natural Hazards

    NASA Technical Reports Server (NTRS)

    Fairweather, Ian; Crabtree, Robert; Hager, Stacey

    2008-01-01

    ELF-Base and ELF-Hazards (wherein 'ELF' signifies 'Extract LiDAR Features' and 'LiDAR' signifies 'light detection and ranging') are developmental software modules for processing remote-sensing LiDAR data to identify past natural hazards (principally, landslides) and predict future ones. ELF-Base processes raw LiDAR data, including LiDAR intensity data that are often ignored in other software, to create digital terrain models (DTMs) and digital feature models (DFMs) with sub-meter accuracy. ELF-Hazards fuses raw LiDAR data, data from multispectral and hyperspectral optical images, and DTMs and DFMs generated by ELF-Base to generate hazard risk maps. Advanced algorithms in these software modules include line-enhancement and edge-detection algorithms, surface-characterization algorithms, and algorithms that implement innovative data-fusion techniques. The line-extraction and edge-detection algorithms enable users to locate such features as faults and landslide headwall scarps. Also implemented in this software are improved methodologies for identification and mapping of past landslide events by use of (1) accurate, ELF-derived surface characterizations and (2) three LiDAR/optical-data-fusion techniques: post-classification data fusion, maximum-likelihood estimation modeling, and hierarchical within-class discrimination. This software is expected to enable faster, more accurate forecasting of natural hazards than has previously been possible.

  9. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China.

    PubMed

    Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping

    2015-11-01

    This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p < 0.05), remuneration of prescribers was positively associated with higher performance in the rational use of medicines (p < 0.05), and drug sales were negatively associated with higher levels of drug expenditure (p < 0.01). In conclusion, irrational use of medicines remains a serious issue, although the financial barriers for gaining access to essential medicines may be less for prescribers and consumers. Limited public finance from local governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income

  10. Quality of acute stroke care improvement framework for the Paul Coverdell National Acute Stroke Registry: facilitating policy and system change at the hospital level.

    PubMed

    LaBresh, Kenneth A

    2006-12-01

    The Paul Coverdell National Acute Stroke Registry prototypes baseline data collection demonstrated a significant gap in the use of evidenced-based interventions. Barriers to the use of these interventions can be characterized as relating to lack of knowledge, attitudes, and ineffective behaviors and systems. Quality improvement programs can address these issues by providing didactic presentations to disseminate the science and peer interactions to address the lack of belief in the evidence, guidelines, and likelihood of improved patient outcomes. Even with knowledge and intention to provide evidenced-based care, the absence of effective systems is a significant behavioral barrier. A program for quality improvement that includes multidisciplinary teams of clinical and quality improvement professionals has been successfully used to carry out redesign of stroke care delivery systems. Teams are given a methodology to set goals, test ideas for system redesign, and implement those changes that can be successfully adapted to the hospital's environment. Bringing teams from several hospitals together substantially accelerates the process by sharing examples of successful change and by providing strategies to support the behavior change necessary for the adoption of new systems. The participation of many hospitals also creates momentum for the adoption of change by demonstrating observable and successful improvement. Data collection and feedback are useful to demonstrate the need for change and evaluate the impact of system change, but improvement occurs very slowly without a quality improvement program. This quality improvement framework provides hospitals with the capacity and support to redesign systems, and has been shown to improve stroke care considerably, when coupled with an Internet-based decision support registry, and at a much more rapid pace than when hospitals use only the support registry. PMID:17178313

  11. Comparison of Evidence-Based Practice between Physicians and Nurses: A National Survey of Regional Hospitals in Taiwan

    ERIC Educational Resources Information Center

    Chiu, Ya-Wen; Weng, Yi-Hao; Lo, Heng-Lien; Hsu, Chih-Cheng; Shih, Ya-Hui; Kuo, Ken N.

    2010-01-01

    Introduction: Although evidence-based practice (EBP) has been widely investigated, few studies compare physicians and nurses on performance. Methods: A structured questionnaire survey was used to investigate EBP among physicians and nurses in 61 regional hospitals of Taiwan. Valid postal questionnaires were collected from 605 physicians and 551…

  12. Harnessing a Nation's Linguistic Competence: Identifying and Addressing Needs for LOTE in the Tourism and Hospitality Industry.

    ERIC Educational Resources Information Center

    O'Neill, Shirley; Hatoss, Aniko

    2003-01-01

    Reports research that aimed to identify the foreign language and cross-cultural skill needs of workers in the tourism and hospitality industry in Australia and to develop foreign language competencies for use in industry training packages. Provides evidence for the need for foreign language skills in the industry and gives an account of the…

  13. Utilization and Expenditure of Hospital Admission in Patients with Autism Spectrum Disorder: National Health Insurance Claims Database Analysis

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Hung, Wen-Jiu; Lin, Lan-Ping; Lai, Chia-Im

    2011-01-01

    There were not many studies to provide information on health access and health utilization of people with autism spectrum disorders (ASD). The present study describes a general profile of hospital admission and the medical cost among people with ASD, and to analyze the determinants of medical cost. A retrospective study was employed to analyze…

  14. Tensor Modeling Based for Airborne LiDAR Data Classification

    NASA Astrophysics Data System (ADS)

    Li, N.; Liu, C.; Pfeifer, N.; Yin, J. F.; Liao, Z. Y.; Zhou, Y.

    2016-06-01

    Feature selection and description is a key factor in classification of Earth observation data. In this paper a classification method based on tensor decomposition is proposed. First, multiple features are extracted from raw LiDAR point cloud, and raster LiDAR images are derived by accumulating features or the "raw" data attributes. Then, the feature rasters of LiDAR data are stored as a tensor, and tensor decomposition is used to select component features. This tensor representation could keep the initial spatial structure and insure the consideration of the neighborhood. Based on a small number of component features a k nearest neighborhood classification is applied.

  15. National Trends in Pulmonary Embolism Hospitalization Rates and Outcomes for Adults Aged ≥65 Years in the United States (1999 to 2010).

    PubMed

    Minges, Karl E; Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Curtis, Jeptha P; Desai, Mayur M; Krumholz, Harlan M

    2015-11-01

    Little is known about national trends of pulmonary embolism (PE) hospitalizations and outcomes in older adults in the context of recent diagnostic and therapeutic advances. Therefore, we conducted a retrospective cohort study of 100% Medicare fee-for-service beneficiaries hospitalized from 1999 to 2010 with a principal discharge diagnosis code for PE. The adjusted PE hospitalization rate increased from 129/100,000 person-years in 1999 to 302/100,000 person-years in 2010, a relative increase of 134% (p <0.001). Black patients had the highest rate of increase (174 to 548/100,000 person-years) among all age, gender, and race categories. The mean (standard deviation) length of hospital stay decreased from 7.6 (5.7) days in 1999 to 5.8 (4.4) days in 2010, and the proportion of patients discharged to home decreased from 51.1% (95% confidence interval [CI] 50.5 to 51.6) to 44.1% (95% CI 43.7 to 44.6), whereas more patients were discharged with home health care and to skilled nursing facilities. The in-hospital mortality rate decreased from 8.3% (95% CI 8.0 to 8.6) in 1999 to 4.4% (95% CI 4.2 to 4.5) in 2010, as did adjusted 30-day (from 12.3% [95% CI 11.9 to 12.6] to 9.1% [95% CI 8.5 to 9.7]) and 6-month mortality rates (from 23.0% [95% CI 22.5 to 23.4] to 19.6% [95% CI 18.8 to 20.5]). There were no significant racial differences in mortality rates by 2010. There was no change in the adjusted 30-day all-cause readmission rate from 1999 to 2010. In conclusion, PE hospitalization rates increased substantially from 1999 to 2010, with a higher rate for black patients. All mortality rates decreased but remained high. The increase in hospitalization rates and continued high mortality and readmission rates confirm the significant burden of PE for older adults. PMID:26409636

  16. Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012)

    PubMed Central

    de Miguel-Yanes, José Ma; Esteban-Hernández, Jesús; Jiménez-Trujillo, Isabel; Alvaro-Meca, Alejandro; Carrasco-Garrido, Pilar; de Miguel-Díez, Javier

    2015-01-01

    Background Type 2 Diabetes (T2DM) is the most rapidly increasing risk factor for ischemic stroke. We aimed to compare trends in outcomes for ischemic stroke in people with or without diabetes in Spain between 2003 and 2012. Methods We selected all patients hospitalized for ischemic stroke using national hospital discharge data. We evaluated annual incident rates stratified by T2DM status. We analyzed trends in the use of diagnostic and therapeutic procedures, patient comorbidities, and in-hospital outcomes. We calculated in-hospital mortality (IHM), length of hospital stay (LOHS) and readmission rate in one month after discharge. Time trend on the incidence of hospitalization was estimated fitting Poisson regression models by sex and diabetes variables. In-hospital mortality was analyzed using logistic regression models separate for men and women. LOHS were compared with ANOVA or Kruskal-Wallis when necessary. Results We identified a total of 423,475 discharges of patients (221,418 men and 202,057 women) admitted with ischemic stroke as primary diagnosis. Patients with T2DM accounted for 30.9% of total. The estimated incidence rates of discharges increased significantly in all groups. The incidence of hospitalization due to stroke (with ICD9 codes for stroke as main diagnosis at discharge) was higher among those with than those without diabetes in all the years studied. T2DM was positively associated with ischemic stroke with an adjusted incidence rate ratio (IRR) of 2.27 (95% CI 2.24–2.29) for men and 2.15 (95%CI 2.13–2.17) for women. Over the 10 year period LOHS decreased significantly in men and women with and without diabetes. Readmission rate remained stable in diabetic and non diabetic men (around 5%) while slightly increased in women with and without diabetes. We observed a significant increase in the use of fibrinolysis from 2002–2013. IHM was positively associated with older age in all groups, with Charlson Comorbidity Index > 3 and atrial

  17. Analyzing Hydro-Geomorphic Responses in Post-Fire Stream Channels with Terrestrial LiDAR

    NASA Astrophysics Data System (ADS)

    Nourbakhshbeidokhti, S.; Kinoshita, A. M.; Chin, A.

    2015-12-01

    Wildfires have potential to significantly alter soil properties and vegetation within watersheds. These alterations often contribute to accelerated erosion, runoff, and sediment transport in stream channels and hillslopes. This research applies repeated Terrestrial Laser Scanning (TLS) Light Detection and Ranging (LiDAR) to stream reaches within the Pike National Forest in Colorado following the 2012 Waldo Canyon Fire. These scans allow investigation of the relationship between sediment delivery and environmental characteristics such as precipitation, soil burn severity, and vegetation. Post-fire LiDAR images provide high resolution information of stream channel changes in eight reaches for three years (2012-2014). All images are processed with RiSCAN PRO to remove vegetation and triangulated and smoothed to create a Digital Elevation Model (DEM) with 0.1 m resolution. Study reaches with two or more successive DEM images are compared using a differencing method to estimate the volume of sediment erosion and deposition. Preliminary analysis of four channel reaches within Williams Canyon and Camp Creek yielded erosion estimates between 0.035 and 0.618 m3 per unit area. Deposition was estimated as 0.365 to 1.67 m3 per unit area. Reaches that experienced higher soil burn severity or larger rainfall events produced the greatest geomorphic changes. Results from LiDAR analyses can be incorporated into post-fire hydrologic models to improve estimates of runoff and sediment yield. These models will, in turn, provide guidance for water resources management and downstream hazards mitigation.

  18. Impact of Safety Net Hospitals in the Care of the Hand-Injured Patient: A National Perspective.

    PubMed

    Yuan, Frank; Chung, Kevin C

    2016-08-01

    A clear disparity in the pattern and provision of surgical care exists, particularly for patients with vulnerable socioeconomic backgrounds. For hand-injured patients in particular, this discrepancy has been frequently shown in their receiving appropriate care. With the advent of the Affordable Care Act and with Medicaid expansion on the horizon, more patients will be requiring access to care. Safety net programs have been shown to provide equivalent levels of care for patients compared with non-safety net providers, and the survival of these hospitals for the disadvantaged is essential to providing quality care for this growing patient population. In this article, the authors review the factors that affect the barriers to care, the importance of safety net hospitals, the epidemiology of the hand-injured patient, and how the Affordable Care Act will impact these safety net programs. PMID:27465165

  19. Age differences in alcohol drinking patterns among Norwegian and German hospital doctors – a study based on national samples

    PubMed Central

    Rosta, Judith; Aasland, Olaf G.

    2010-01-01

    Aims: To describe and discuss the alcohol drinking patterns of the younger generation of hospital doctors in Norway and Germany – respectively the abstainers, frequent drinkers, episodic heavy drinkers and hazardous drinkers. Methods: Data were collected in nationwide postal surveys among doctors in Norway (2000) and Germany (2006). A representative sample of 1898 German and 602 Norwegian hospital doctors aged 27–65 years were included in the analyses (N=2500). Alcohol drinking patterns were measured using the first three items of AUDIT in Norway and the AUDIT-C in Germany, scores of ≥5 (ranking from 0 to 12) indicating hazardous drinking. Episodic heavy drinking was defined by the intake of ≥60g of ethanol, on one occasion, at least once a week. Frequent drinkers were who drank alcoholic beverages at least twice a week. Abstainers were persons who drank no alcohol. The analyses were performed separately for age groups (27–44 years versus 45–65 years) and genders. Results: Compared to the age groups 45 to 65 years in the Norwegian and German samples, the younger age groups (27–44 years) tend to have higher rates of abstainers, higher rates of infrequent drinking of moderate amount of alcoholic drinks, lower rates of episodic heavy drinking and lower rates of hazardous drinking. Conclusion: The younger generation of hospital doctors in Norway and Germany showed tendencies to healthier drinking habits. Changes in professional life, and in the attitude towards alcohol consumption, may go some way towards explaining these findings. PMID:20200658

  20. Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative.

    PubMed

    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

    2015-12-01

    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 study was to understand the determinants of nurses' hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses' hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence. PMID:26590244

  1. [Longer working hours of pharmacists in the ward resulted in lower medication-related errors--survey of national university hospitals in Japan].

    PubMed

    Matsubara, Kazuo; Toyama, Akira; Satoh, Hiroshi; Suzuki, Hiroshi; Awaya, Toshio; Tasaki, Yoshikazu; Yasuoka, Toshiaki; Horiuchi, Ryuya

    2011-04-01

    It is obvious that pharmacists play a critical role as risk managers in the healthcare system, especially in medication treatment. Hitherto, there is not a single multicenter-survey report describing the effectiveness of clinical pharmacists in preventing medical errors from occurring in the wards in Japan. Thus, we conducted a 1-month survey to elucidate the relationship between the number of errors and working hours of pharmacists in the ward, and verified whether the assignment of clinical pharmacists to the ward would prevent medical errors between October 1-31, 2009. Questionnaire items for the pharmacists at 42 national university hospitals and a medical institute included the total and the respective numbers of medication-related errors, beds and working hours of pharmacist in 2 internal medicine and 2 surgical departments in each hospital. Regardless of severity, errors were consecutively reported to the Medical Security and Safety Management Section in each hospital. The analysis of errors revealed that longer working hours of pharmacists in the ward resulted in less medication-related errors; this was especially significant in the internal medicine ward (where a variety of drugs were used) compared with the surgical ward. However, the nurse assignment mode (nurse/inpatients ratio: 1 : 7-10) did not influence the error frequency. The results of this survey strongly indicate that assignment of clinical pharmacists to the ward is critically essential in promoting medication safety and efficacy. PMID:21467804

  2. Shipborne LiDAR system for coastal change monitoring

    NASA Astrophysics Data System (ADS)

    Kim, chang hwan; Park, chang hong; Kim, hyun wook; hyuck Kim, won; Lee, myoung hoon; Park, hyeon yeong

    2016-04-01

    Coastal areas, used as human utilization areas like leisure space, medical care, ports and power plants, etc., are regions that are continuously changing and interconnected with oceans and land and the sea level has risen by about 8cm (1.9mm / yr) due to global warming from 1964 year to 2006 year in Korea. Coastal erosion due to sea-level rise has caused the problem of marine ecosystems and loss of tourism resources, etc. Regular monitoring of coastal erosion is essential at key locations with such volatility. But the survey method of land mobile LiDAR (light detection and ranging) system has much time consuming and many restrictions. For effective monitoring beach erosion, KIOST (Korea Institute of Ocean Science & Technology) has constructed a shipborne mobile LiDAR system. The shipborne mobile LiDAR system comprised a land mobile LiDAR (RIEGL LMS-420i), an INS (inertial navigation system, MAGUS Inertial+), a RTKGPS (LEICA GS15 GS25), and a fixed platform. The shipborne mobile LiDAR system is much more effective than a land mobile LiDAR system in the measuring of fore shore areas without shadow zone. Because the vessel with the shipborne mobile LiDAR system is continuously moved along the shoreline, it is possible to efficiently survey a large area in a relatively short time. Effective monitoring of the changes using the constructed shipborne mobile LiDAR system for seriously eroded coastal areas will be able to contribute to coastal erosion management and response.

  3. Modelling rating curves using remotely sensed LiDAR data

    USGS Publications Warehouse

    Nathanson, Marcus; Kean, Jason W.; Grabs, Thomas J.; Seibert, Jan; Laudon, Hjalmar; Lyon, Steve W.

    2012-01-01

    Accurate stream discharge measurements are important for many hydrological studies. In remote locations, however, it is often difficult to obtain stream flow information because of the difficulty in making the discharge measurements necessary to define stage-discharge relationships (rating curves). This study investigates the feasibility of defining rating curves by using a fluid mechanics-based model constrained with topographic data from an airborne LiDAR scanning. The study was carried out for an 8m-wide channel in the boreal landscape of northern Sweden. LiDAR data were used to define channel geometry above a low flow water surface along the 90-m surveyed reach. The channel topography below the water surface was estimated using the simple assumption of a flat streambed. The roughness for the modelled reach was back calculated from a single measurment of discharge. The topographic and roughness information was then used to model a rating curve. To isolate the potential influence of the flat bed assumption, a 'hybrid model' rating curve was developed on the basis of data combined from the LiDAR scan and a detailed ground survey. Whereas this hybrid model rating curve was in agreement with the direct measurements of discharge, the LiDAR model rating curve was equally in agreement with the medium and high flow measurements based on confidence intervals calculated from the direct measurements. The discrepancy between the LiDAR model rating curve and the low flow measurements was likely due to reduced roughness associated with unresolved submerged bed topography. Scanning during periods of low flow can help minimize this deficiency. These results suggest that combined ground surveys and LiDAR scans or multifrequency LiDAR scans that see 'below' the water surface (bathymetric LiDAR) could be useful in generating data needed to run such a fluid mechanics-based model. This opens a realm of possibility to remotely sense and monitor stream flows in channels in remote

  4. Georeferenced LiDAR 3D Vine Plantation Map Generation

    PubMed Central

    Llorens, Jordi; Gil, Emilio; Llop, Jordi; Queraltó, Meritxell

    2011-01-01

    The use of electronic devices for canopy characterization has recently been widely discussed. Among such devices, LiDAR sensors appear to be the most accurate and precise. Information obtained with LiDAR sensors during reading while driving a tractor along a crop row can be managed and transformed into canopy density maps by evaluating the frequency of LiDAR returns. This paper describes a proposed methodology to obtain a georeferenced canopy map by combining the information obtained with LiDAR with that generated using a GPS receiver installed on top of a tractor. Data regarding the velocity of LiDAR measurements and UTM coordinates of each measured point on the canopy were obtained by applying the proposed transformation process. The process allows overlap of the canopy density map generated with the image of the intended measured area using Google Earth®, providing accurate information about the canopy distribution and/or location of damage along the rows. This methodology was applied and tested on different vine varieties and crop stages in two important vine production areas in Spain. The results indicate that the georeferenced information obtained with LiDAR sensors appears to be an interesting tool with the potential to improve crop management processes. PMID:22163952

  5. Georeferenced LiDAR 3D vine plantation map generation.

    PubMed

    Llorens, Jordi; Gil, Emilio; Llop, Jordi; Queraltó, Meritxell

    2011-01-01

    The use of electronic devices for canopy characterization has recently been widely discussed. Among such devices, LiDAR sensors appear to be the most accurate and precise. Information obtained with LiDAR sensors during reading while driving a tractor along a crop row can be managed and transformed into canopy density maps by evaluating the frequency of LiDAR returns. This paper describes a proposed methodology to obtain a georeferenced canopy map by combining the information obtained with LiDAR with that generated using a GPS receiver installed on top of a tractor. Data regarding the velocity of LiDAR measurements and UTM coordinates of each measured point on the canopy were obtained by applying the proposed transformation process. The process allows overlap of the canopy density map generated with the image of the intended measured area using Google Earth(®), providing accurate information about the canopy distribution and/or location of damage along the rows. This methodology was applied and tested on different vine varieties and crop stages in two important vine production areas in Spain. The results indicate that the georeferenced information obtained with LiDAR sensors appears to be an interesting tool with the potential to improve crop management processes. PMID:22163952

  6. Atherosclerotic Risk Factors and Their Association With Hospital Mortality Among Patients With First Myocardial Infarction (from the National Registry of Myocardial Infarction)

    PubMed Central

    Canto, John G.; Kiefe, Catarina I.; Rogers, William J.; Peterson, Eric D.; Frederick, Paul D.; French, William J.; Gibson, C. Michael; Pollack, Charles V.; Ornato, Joseph P.; Zalenski, Robert J.; Penney, Jan; Tiefenbrunn, Alan J.; Greenland, Philip

    2013-01-01

    Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.3%) was most common, followed by smoking (31.3%). The least common risk factor was diabetes (22.4%). Crude mortality was highest in patients with MI with diabetes (11.9%) and hypertension (9.8%) and lowest in those with smoking histories (5.4%) and dyslipidemia (4.6%). The inclusion of 5 atherosclerotic risk factors in a stepwise multivariate model contributed little toward predicting hospital mortality over age alone (C-statistic = 0.73 and 0.71, respectively). After extensive multivariate adjustments for clinical and sociodemographic factors, patients with MI with diabetes had higher odds of dying (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.20 to 1.26) than those without diabetes and similarly for hypertension (OR 1.08, 95% CI 1.06 to 1.11). Conversely, family history (OR 0.71, 95% CI 0.69 to 0.73), dyslipidemia (OR 0.62, 95% CI 0.60 to 0.64), and smoking (OR 0.85, 95% CI 0.83 to 0.88) were associated with decreased mortality (C-statistic = 0.82 for the full model). In conclusion, in the setting of acute MI, histories of diabetes and hypertension are associated with higher hospital mortality, but the inclusion of atherosclerotic risk factors in models of hospital mortality does not improve predictive ability beyond other major clinical and sociodemographic characteristics. PMID:22840346

  7. Atherosclerotic risk factors and their association with hospital mortality among patients with first myocardial infarction (from the National Registry of Myocardial Infarction).

    PubMed

    Canto, John G; Kiefe, Catarina I; Rogers, William J; Peterson, Eric D; Frederick, Paul D; French, William J; Gibson, C Michael; Pollack, Charles V; Ornato, Joseph P; Zalenski, Robert J; Penney, Jan; Tiefenbrunn, Alan J; Greenland, Philip

    2012-11-01

    Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.3%) was most common, followed by smoking (31.3%). The least common risk factor was diabetes (22.4%). Crude mortality was highest in patients with MI with diabetes (11.9%) and hypertension (9.8%) and lowest in those with smoking histories (5.4%) and dyslipidemia (4.6%). The inclusion of 5 atherosclerotic risk factors in a stepwise multivariate model contributed little toward predicting hospital mortality over age alone (C-statistic = 0.73 and 0.71, respectively). After extensive multivariate adjustments for clinical and sociodemographic factors, patients with MI with diabetes had higher odds of dying (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.20 to 1.26) than those without diabetes and similarly for hypertension (OR 1.08, 95% CI 1.06 to 1.11). Conversely, family history (OR 0.71, 95% CI 0.69 to 0.73), dyslipidemia (OR 0.62, 95% CI 0.60 to 0.64), and smoking (OR 0.85, 95% CI 0.83 to 0.88) were associated with decreased mortality (C-statistic = 0.82 for the full model). In conclusion, in the setting of acute MI, histories of diabetes and hypertension are associated with higher hospital mortality, but the inclusion of atherosclerotic risk factors in models of hospital mortality does not improve predictive ability beyond other major clinical and sociodemographic characteristics. PMID:22840346

  8. Time trends in coronary revascularization procedures among people with COPD: analysis of the Spanish national hospital discharge data (2001–2011)

    PubMed Central

    de Miguel-Díez, Javier; Jiménez-García, Rodrigo; Hernández-Barrera, Valentín; Carrasco-Garrido, Pilar; Bueno, Héctor; Puente-Maestu, Luis; Jimenez-Trujillo, Isabel; Alvaro-Meca, Alejandro; Esteban-Hernandez, Jesús; de Andrés, Ana López

    2015-01-01

    Background People with COPD suffering from coronary artery disease are frequently treated with revascularization procedures. We aim to compare trends in the use and outcomes of these procedures in COPD and non-COPD patients in Spain between 2001 and 2011. Methods We identified all patients who had undergone percutaneous coronary interventions (PCIs) and coronary artery bypass graft (CABG) surgeries, using national hospital discharge data. Discharges were grouped into: COPD and no COPD. Results From 2001 to 2011, 428,516 PCIs and 79,619 CABGs were performed. The sex and age-adjusted use of PCI increased by 21.27% per year from 2001 to 2004 and by 5.47% per year from 2004 to 2011 in patients with COPD. In-hospital mortality (IHM) among patients with COPD who underwent a PCI increased significantly from 2001 to 2011 (odds ratio 1.11; 95% confidence interval 1.03–1.20). Among patients with COPD who underwent a CABG, the sex and age-adjusted CABG incidence rate increased by 9.77% per year from 2001 to 2003, and then decreased by 3.15% through 2011. The probability of dying during hospitalization in patients who underwent a CABG did not change significantly in patients with and without COPD (odds ratio, 1.06; 95% confidence interval 0.96–1.17). Conclusion The annual percent change in PCI procedures increased in COPD and non-COPD patients. We found a decrease in the use of CABG procedures in both groups. IHM was higher in patients with COPD who underwent a PCI than in those without COPD. However, COPD did not increase the probability of dying during hospitalization in patients who underwent a CABG. PMID:26543361

  9. National trends in the morbidity and mortality of asthma in the US. Prevalence, hospitalization and death from asthma over two decades: 1965-1984.

    PubMed

    Evans, R; Mullally, D I; Wilson, R W; Gergen, P J; Rosenberg, H M; Grauman, J S; Chevarley, F M; Feinleib, M

    1987-06-01

    National population-based data systems of the National Center for Health Statistics (NCHS) were used to study the epidemiology of asthma in the United States over the last 20 years. Asthma is more prevalent among males, those living below the poverty level, persons living in the South and West, and blacks; however, this difference did not attain statistical significance. Death rates from asthma among the older age groups probably increased between 1968 and 1982, with a substantial increase since 1979. For children, the evidence is less clear, but the death rate has increased for children over five years of age during the period from 1979 to 1982. Between 1964 and 1980, asthma has become more prevalent in children under 17 years of age, but this does not reflect an increase in the severity of asthma over this same time period. Hospitalization rates for asthma between 1965 and 1983 increased by 50 percent in adults and by over 200 percent in children. Rates for black patients are 50 percent higher in adults and 150 percent greater in children. It is concluded that there has been a marked increase in hospitalization rates for asthma, a moderate increase in death rates from asthma and a smaller increase in overall prevalence of the disease in the United States. PMID:3581966

  10. Measuring Hospital Productivity

    PubMed Central

    Ruchlin, Hirsch S.; Leveson, Irving

    1974-01-01

    This study presents a comprehensive method for quantifying hospital output and estimating hospital productivity. A number of less comprehensive productivity measures that can be quantified from data available from regional third-party payers and from the American Hospital Association are also developed and evaluated as proxies for the comprehensive measure, which is based on local area data. Methods are discussed for estimating the necessary variables on a regional or national level. PMID:4461703

  11. Free Medicines Thanks to Retirement: Impact of Coinsurance Exemption on Pharmaceutical Expenditures and Hospitalization Offsets in a national health service.

    PubMed

    Puig-Junoy, Jaume; García-Gómez, Pilar; Casado-Marín, David

    2016-06-01

    This paper examines the impact of coinsurance exemption for prescription medicines applied to elderly individuals in Spain after retirement. We use a rich administrative dataset that links pharmaceutical consumption and hospital discharge records for the full population aged 58 to 65 years in January 2004 covered by the public insurer in a Spanish region, and we follow them until December 2006. We use a difference-in-differences strategy and exploit the eligibility age for Social Security to control for the endogeneity of the retirement decision. Our results show that this uniform exemption increases the consumption of prescription medicines on average by 17.5%, total pharmaceutical expenditure by 25% and the costs borne by the insurer by 60.4%, without evidence of any offset effect in the form of lower short term probability of hospitalization. The impact is concentrated among consumers of medicines for acute and other non-chronic diseases whose previous coinsurance rate was 30% to 40%. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26082341

  12. LiDAR Vegetation Investigation and Signature Analysis System (LVISA)

    NASA Astrophysics Data System (ADS)

    Höfle, Bernhard; Koenig, Kristina; Griesbaum, Luisa; Kiefer, Andreas; Hämmerle, Martin; Eitel, Jan; Koma, Zsófia

    2015-04-01

    Our physical environment undergoes constant changes in space and time with strongly varying triggers, frequencies, and magnitudes. Monitoring these environmental changes is crucial to improve our scientific understanding of complex human-environmental interactions and helps us to respond to environmental change by adaptation or mitigation. The three-dimensional (3D) description of the Earth surface features and the detailed monitoring of surface processes using 3D spatial data have gained increasing attention within the last decades, such as in climate change research (e.g., glacier retreat), carbon sequestration (e.g., forest biomass monitoring), precision agriculture and natural hazard management. In all those areas, 3D data have helped to improve our process understanding by allowing quantifying the structural properties of earth surface features and their changes over time. This advancement has been fostered by technological developments and increased availability of 3D sensing systems. In particular, LiDAR (light detection and ranging) technology, also referred to as laser scanning, has made significant progress and has evolved into an operational tool in environmental research and geosciences. The main result of LiDAR measurements is a highly spatially resolved 3D point cloud. Each point within the LiDAR point cloud has a XYZ coordinate associated with it and often additional information such as the strength of the returned backscatter. The point cloud provided by LiDAR contains rich geospatial, structural, and potentially biochemical information about the surveyed objects. To deal with the inherently unorganized datasets and the large data volume (frequently millions of XYZ coordinates) of LiDAR datasets, a multitude of algorithms for automatic 3D object detection (e.g., of single trees) and physical surface description (e.g., biomass) have been developed. However, so far the exchange of datasets and approaches (i.e., extraction algorithms) among LiDAR users

  13. Uas Topographic Mapping with Velodyne LiDAR Sensor

    NASA Astrophysics Data System (ADS)

    Jozkow, G.; Toth, C.; Grejner-Brzezinska, D.

    2016-06-01

    Unmanned Aerial System (UAS) technology is nowadays willingly used in small area topographic mapping due to low costs and good quality of derived products. Since cameras typically used with UAS have some limitations, e.g. cannot penetrate the vegetation, LiDAR sensors are increasingly getting attention in UAS mapping. Sensor developments reached the point when their costs and size suit the UAS platform, though, LiDAR UAS is still an emerging technology. One issue related to using LiDAR sensors on UAS is the limited performance of the navigation sensors used on UAS platforms. Therefore, various hardware and software solutions are investigated to increase the quality of UAS LiDAR point clouds. This work analyses several aspects of the UAS LiDAR point cloud generation performance based on UAS flights conducted with the Velodyne laser scanner and cameras. The attention was primarily paid to the trajectory reconstruction performance that is essential for accurate point cloud georeferencing. Since the navigation sensors, especially Inertial Measurement Units (IMUs), may not be of sufficient performance, the estimated camera poses could allow to increase the robustness of the estimated trajectory, and subsequently, the accuracy of the point cloud. The accuracy of the final UAS LiDAR point cloud was evaluated on the basis of the generated DSM, including comparison with point clouds obtained from dense image matching. The results showed the need for more investigation on MEMS IMU sensors used for UAS trajectory reconstruction. The accuracy of the UAS LiDAR point cloud, though lower than for point cloud obtained from images, may be still sufficient for certain mapping applications where the optical imagery is not useful.

  14. Seagrass Identification Using High-Resolution 532nm Bathymetric LiDAR and Hyperspectral Imagery

    NASA Astrophysics Data System (ADS)

    Pan, Z.; Prasad, S.; Starek, M. J.; Fernandez Diaz, J. C.; Glennie, C. L.; Carter, W. E.; Shrestha, R. L.; Singhania, A.; Gibeaut, J. C.

    2013-12-01

    Seagrass provides vital habitat for marine fisheries and is a key indicator species of coastal ecosystem vitality. Monitoring seagrass is therefore an important environmental initiative, but measuring details of seagrass distribution over large areas via remote sensing has proved challenging. Developments in airborne bathymetric light detection and ranging (LiDAR) provide great potential in this regard. Traditional bathymetric LiDAR systems have been limited in their ability to map within the shallow water zone (< 1 m) where seagrass is typically present due to limitations in receiver response and laser pulse length. Emergent short-pulse width bathymetric LiDAR sensors and waveform processing algorithms enable depth measurements in shallow water environments previously inaccessible. This 3D information of the benthic layer can be applied to detect seagrass and characterize its distribution. Researchers with the National Center for Airborne Laser Mapping (NCALM) at the University of Houston (UH) and the Coastal and Marine Geospatial Sciences Lab (CMGL) of the Harte Research Institute at Texas A&M University-Corpus Christi conducted a coordinated airborne and boat-based survey of the Redfish Bay State Scientific Area as part of a collaborative study to investigate the capabilities of bathymetric LiDAR and hyperspectral imaging for seagrass mapping. Redfish Bay, located along the middle Texas coast of the Gulf of Mexico, is a state scientific area designated for the purpose of protecting and studying native seagrasses. Redfish Bay is part of the broader Coastal Bend Bays estuary system recognized by the US Environmental Protection Agency (EPA) as a national estuary of significance. For this survey, UH acquired high-resolution discrete-return and full-waveform bathymetric data using their Optech Aquarius 532 nm green LiDAR. In a separate flight, UH collected 2 sets of hyperspectral imaging data (1.2-m pixel resolution and 72 bands, and 0.6m pixel resolution and 36

  15. Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital

    PubMed Central

    Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

    2013-01-01

    Introduction The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin®) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. Methods An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital’s emergency and general surgical wards were included. Randomisation was to Gastrografin® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. Results All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance (P = 0.67). Average time to relief of obstruction was shorter in the Gastrografin® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference (P = 0.023). The average length of hospital stay was shorter in the Gastrografin® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference (P = 0.04). Conclusion The use of Gastrografin® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and

  16. An in-depth, exploratory assessment of the implementation of the National Health Information System at a district level hospital in Tanzania

    PubMed Central

    2014-01-01

    Background A well functioning Health Information System (HIS) is crucial for effective and efficient health service delivery. In Tanzania there is a national HIS called Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA). It comprises a guideline/manual, a series of registers for primary data collection and secondary data books where information from the registers is totalled or used for calculations. Methods A mix of qualitative methods were used. These included key informant interviews; staff interviews; participant observations; and a retrospective analysis of the hospital’s 2010 MTUHA reporting documents and the hospital’s development plan. Results All staff members acknowledged data collection as part of their job responsibilities. However, all had concerns about the accuracy of MTUHA data. Access to training was limited, mathematical capabilities often low, dissemination of MTUHA knowledge within the hospital poor, and a broad understanding of the HIS’s full capabilities lacking. Whilst data collection for routine services functioned reasonably well, filling of the secondary data tools was unsatisfactory. Internal inconsistencies between the different types of data tools were found. These included duplications, and the collection of data that was not further used. Sixteen of the total 72 forms (22.2%) that make up one of the key secondary data books (Hospital data/MTUHA book 2) could not be completed with the information collected in the primary data books. Moreover, the hospital made no use of any of the secondary data. The hospital’s main planning document was its development plan. Only 3 of the 22 indicators in this plan were the same as indicators in MTUHA, the information for 9 more was collected by the MTUHA system but figures had to be extracted and recalculated to fit, while for the remaining 10 indicators no use could be made of MTUHA at all. Conclusion The HIS in Tanzania is very extensive and it could be advisable to simplify it to the

  17. The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

    PubMed Central

    2013-01-01

    Background Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. Methods We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. Results The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Conclusion Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human

  18. Emerging Infectious Diseases in Free-Ranging Wildlife–Australian Zoo Based Wildlife Hospitals Contribute to National Surveillance

    PubMed Central

    Cox-Witton, Keren; Reiss, Andrea; Woods, Rupert; Grillo, Victoria; Baker, Rupert T.; Blyde, David J.; Boardman, Wayne; Cutter, Stephen; Lacasse, Claude; McCracken, Helen; Pyne, Michael; Smith, Ian; Vitali, Simone; Vogelnest, Larry; Wedd, Dion; Phillips, Martin; Bunn, Chris; Post, Lyndel

    2014-01-01

    Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases. PMID:24787430

  19. Preparing its first national brand, Columbia seeds an identity among its local hospitals. Columbia/HCA, Nashville, Tennessee.

    PubMed

    1996-01-01

    Columbia/HCA, the industry's 800-pound gorilla, is at last building a national brand. In the process, it has created one of the largest-circulation in-house magazines in the U.S. and found a way to build an enviable direct mail database at the same time. PMID:10161965

  20. Wet Channel Network Extraction based on LiDAR Data

    NASA Astrophysics Data System (ADS)

    Hooshyar, M.; Kim, S.; Wang, D.; Medeiros, S. C.

    2015-12-01

    The temporal dynamics of stream network is vitally important for understanding hydrologic processes including groundwater interactions and hydrograph recessions. However, observations are limited on flowing channel heads, which are usually located in headwater catchments and under canopy. Near infrared LiDAR data provides an opportunity to map the flowing channel network owing to the fine spatial resolution, canopy penetration, and strong absorption of the light energy by the water surface. A systematic method is developed herein to map flowing channel networks based on the signal intensity of ground LiDAR return, which is lower on water surfaces than on dry surfaces. Based on the selected sample sites where the wetness conditions are known, the signal intensities of ground returns are extracted from the LiDAR point data. The frequency distributions of wet surface and dry surface returns are constructed. With the aid of LiDAR-based ground elevation, the signal intensity thresholds are identified for mapping flowing channels. The developed method is applied to Lake Tahoe area based on eight LiDAR snapshots during recession periods in five watersheds. A power-law relationship between streamflow and flowing channel length during the recession period is derived based on the result.

  1. Biomass Estimation for Individual Trees using Waveform LiDAR

    NASA Astrophysics Data System (ADS)

    Wang, K.; Kumar, P.; Dutta, D.

    2015-12-01

    Vegetation biomass information is important for many ecological models that include terrestrial vegetation in their simulations. Biomass has strong influences on carbon, water, and nutrient cycles. Traditionally biomass estimation requires intensive, and often destructive, field measurements. However, with advances in technology, airborne LiDAR has become a convenient tool for acquiring such information on a large scale. In this study, we use infrared full waveform LiDAR to estimate biomass information for individual trees in the Sangamon River basin in Illinois, USA. During this process, we also develop automated geolocation calibration algorithms for raw waveform LiDAR data. In the summer of 2014, discrete and waveform LiDAR data were collected over the Sangamon River basin. Field measurements commonly used in biomass equations such as diameter at breast height and total tree height were also taken for four sites across the basin. Using discrete LiDAR data, individual trees are delineated. For each tree, a voxelization methods is applied to all waveforms associated with the tree to result in a pseudo-waveform. By relating biomass extrapolated using field measurements from a training set of trees to waveform metrics for each corresponding tree, we are able to estimate biomass on an individual tree basis. The results can be especially useful as current models increase in resolution.

  2. The virgin land of quality management: a first measure of patient safety climate at the National Hospital of the Faroe Islands

    PubMed Central

    Kristensen, Solvejg; Túgvustein, Naina; Zachariassen, Hjørdis; Sabroe, Svend; Bartels, Paul; Mainz, Jan

    2016-01-01

    Purpose The Faroe Islands are formally part of the Kingdom of Denmark, but the islands enjoy extensive autonomy as home ruled. In Denmark, extensive quality management initiatives have been implemented throughout hospitals, this was not the case in the Faroese Islands in 2013. The purpose of this study is to investigate the patient safety culture in the National Hospital of the Faroe Islands prior to implementation of quality management initiatives. Methods The Danish version of the Safety Attitudes Questionnaire (SAQ-DK) was distributed electronically to 557 staff members from five medical centers of the hospital, and one administrative unit. SAQ-DK has six cultural dimensions. The proportion of respondents with positive attitudes and mean scale scores were described, and comparison between medical specialties, and between clinical leaders and frontline staff was made using analysis of variance and chi-square test, respectively. Results The response rate was 65.8% (N=367). Job satisfaction was rated most favorable, and the perceived culture of the top management least favorable. Safety climate was the dimension with the greatest variability across the 28 units. The diagnostic center had the most favorable culture of all centers. More leaders than frontline staff had positive attitudes toward teamwork and safety climate, and working conditions, respectively. Also, the leaders perceived these dimensions more positive than the frontline staff, P<0.05. Among three management levels, the unit management was perceived most favorable and the top management least favorable. Conclusion The management group is recommended to raise awareness of their role in supporting a safe and caring environment for patients and staff, moreover the leaders should ensure that every day work achieves its objectives; keeping the patients safe. Furthermore, following the development in patient safety culture over time is recommended. PMID:27217800

  3. Comparison of Precision of Biomass Estimates in Regional Field Sample Surveys and Airborne LiDAR-Assisted Surveys in Hedmark County, Norway

    NASA Technical Reports Server (NTRS)

    Naesset, Erik; Gobakken, Terje; Bollandsas, Ole Martin; Gregoire, Timothy G.; Nelson, Ross; Stahl, Goeran

    2013-01-01

    Airborne scanning LiDAR (Light Detection and Ranging) has emerged as a promising tool to provide auxiliary data for sample surveys aiming at estimation of above-ground tree biomass (AGB), with potential applications in REDD forest monitoring. For larger geographical regions such as counties, states or nations, it is not feasible to collect airborne LiDAR data continuously ("wall-to-wall") over the entire area of interest. Two-stage cluster survey designs have therefore been demonstrated by which LiDAR data are collected along selected individual flight-lines treated as clusters and with ground plots sampled along these LiDAR swaths. Recently, analytical AGB estimators and associated variance estimators that quantify the sampling variability have been proposed. Empirical studies employing these estimators have shown a seemingly equal or even larger uncertainty of the AGB estimates obtained with extensive use of LiDAR data to support the estimation as compared to pure field-based estimates employing estimators appropriate under simple random sampling (SRS). However, comparison of uncertainty estimates under SRS and sophisticated two-stage designs is complicated by large differences in the designs and assumptions. In this study, probability-based principles to estimation and inference were followed. We assumed designs of a field sample and a LiDAR-assisted survey of Hedmark County (HC) (27,390 km2), Norway, considered to be more comparable than those assumed in previous studies. The field sample consisted of 659 systematically distributed National Forest Inventory (NFI) plots and the airborne scanning LiDAR data were collected along 53 parallel flight-lines flown over the NFI plots. We compared AGB estimates based on the field survey only assuming SRS against corresponding estimates assuming two-phase (double) sampling with LiDAR and employing model-assisted estimators. We also compared AGB estimates based on the field survey only assuming two-stage sampling (the NFI

  4. LiDAR Individual Tree Detection for Assessing Structurally Diverse Forest Landscapes

    NASA Astrophysics Data System (ADS)

    Jeronimo, Sean

    Contemporary forest management on public land incorporates a focus on restoration and maintenance of ecological functions through silvicultural manipulation of forest structure on a landscape scale. Incorporating reference conditions into restoration treatment planning and monitoring can improve treatment efficacy, but the typical ground-based methods of quantifying reference condition data---and comparing it to pre- and post-treatment stands---are expensive, time-consuming, and limited in scale. Airborne LiDAR may be part of the solution to this problem, since LiDAR acquisitions have both broad coverage and high resolution. I evaluated the ability of LiDAR Individual Tree Detection (ITD) to describe forest structure across a structurally variable landscape in support of large-scale forest restoration. I installed nineteen 0.25 ha stem map plots across a range of structural conditions in potential reference areas (Yosemite National Park) and potential restoration treatment areas (Sierra National Forest) in the Sierra Nevada of California. I used the plots to evaluate a common ITD algorithm, the watershed transform, compare it to past uses of ITD, and determine which aspects of forest structure contributed to errors in ITD. I found that ITD across this structurally diverse landscape was generally less accurate than across the smaller and less diverse areas over which it has previously been studied. However, the pattern of tree recognition is consistent: regardless of forest structure, canopy dominants are almost always detected and relatively shorter trees are almost never detected. Correspondingly, metrics dominated by large trees, such as biomass, basal area, and spatial heterogeneity, can be measured using ITD, while metrics dominated by smaller trees, such as stand density, cannot. Bearing these limitations in mind, ITD can be a powerful tool for describing forest structure across heterogeneous landscape restoration project areas.

  5. Automated Probabilistic LiDAR Swath Registration

    NASA Astrophysics Data System (ADS)

    Jalobeanu, A.; Gonçalves, G. R.

    2014-12-01

    We recently developed a new point cloud registration algorithm. Compared to Iterated Closest Point (ICP) techniques, it is robust to noise and outliers, and easier to use, as it is less sensitive to initial conditions. It minimizes the entropy of the joint point cloud (including intensity attributes to help register areas with poor relief), uses a voxel space and B-Spline interpolation to accelerate computation. A natural application of registration is swath alignment in airborne light detection and ranging (LiDAR). Indeed, due to uncertainty in the inertial navigation system (INS), attitude angles are subject to time-dependent errors. Such errors can be understood as a sum of three terms: 1) a global term, or boresight error, which can be addressed using several existing techniques; 2) a low-frequency term, which is modeled as a constant attitude error for regions several hundred meters along-track; 3) a high-frequency term, responsible for corduroy artifacts (not addressed here). We propose to use the new registration algorithm to correct the low-frequency attitude variations. Relative geometric errors are significantly reduced, as pairs of swaths are registered onto each other local corrections. Absolute geometric errors are reduced during a second step, by applying all the corrections together to the entire dataset. We used a test area of 200 km2 in Portugal, with a density of 3-4 pts/m2. The point clouds were derived from waveform data, and include predictive range uncertainties estimated within a Bayesian framework. The data collection was supported by FCT and FEDER as part of the AutoProbaDTM research project (2009-2012). Modeling and reducing geometric error helps build consistent uncertainty maps. After correction, residual errors are taken into account in the final 3D error budget. For gridded elevation models a vertical uncertainty map is computed. Finally, it is possible to use the inter-swath registration parameters to estimate the distribution of

  6. The evolution of epilepsy theory and practice at the National Hospital for the Relief and Cure of Epilepsy, Queen Square between 1860 and 1910.

    PubMed

    Shorvon, Simon

    2014-02-01

    In the years between 1860 and 1910, a revolution in epilepsy theory and practice occurred. The National Hospital for the Relief and Cure of the Paralysed and the Epileptic at Queen Square in London was at the center of this revolution. A series of remarkable physicians and surgeons were appointed to the staff. The four greatest were John Hughlings Jackson, Sir David Ferrier, Sir Victor Horsley, and Sir William Gowers. Their lasting contribution to epilepsy is discussed. Other physicians who made notable contributions to epilepsy were Jabez Spence Ramskill, Charles Eduard Brown-Séquard, Charles Bland Radcliffe, Sir John Russell Reynolds, Sir Edward Henry Sieveking, Walter Stacy Colman, and William Aldren Turner. At the hospital in this period, amongst the lasting contributions to epilepsy were the following: the development of a new conceptual basis of epilepsy, the development of a theory of the physiological structure of the nervous system in relation to epilepsy, the demonstration and investigation of cortical localization of epileptic activity, the establishment of the principle of focal epilepsy and the description of focal seizure types, the discovery of the first effective drug treatment for epilepsy (bromide therapy, indeed one of the first effective drug treatments in the whole of neurology), and the performance of the first surgical operation for epilepsy. This paper is based on the 2013 Gowers Memorial Lecture, delivered in May 2013. PMID:24239432

  7. Role of National Accreditation Board of Hospitals and Healthcare Providers (NABH) core indicators monitoring in quality and safety of blood transfusion

    PubMed Central

    Gupta, Anshu; Gupta, Chhavi

    2016-01-01

    Context: Certain quality indicators are mandatory in the maintenance and improvement of quality in blood transfusion. Monitoring of such indicators should be done regularly and deficiencies are to be corrected for effective blood transfusion services. Aims: To study the usefulness of monitoring of the National Accreditation Board for Hospitals and Healthcare Providers (NABH) core indicators in blood transfusion and in the maintenance of hemovigilance. Settings and Design: Hemovigilance is a quality process to improve quality and increase the safety of blood transfusion. It covers and surveys all activities of the blood transfusion chain from donors to recipients. Core indicators’ monitoring is a part of the hemovigilance process. Materials and Methods: A 2-year retrospective study was conducted in a blood storage unit of a NABH accredited tertiary care hospital of a metropolitan city. Four NABH core indicators in blood transfusion were observed and monitored by the clinical and blood storage unit staff of different levels. Results: It was observed that there was an improvement in quality by core indicators monitoring with decreased wastage of blood and blood components, decreased average turnaround time for issue of blood and blood components, and lesser number of transfusion reactions. Conclusion: This study demonstrated that monitoring of NABH core indicators results in the enhancement of quality and safety in blood transfusion services, reducing the incidence of transfusion reactions. PMID:27011668

  8. [The seroprevalence of human immunodeficiency virus infection (HIV) in patients with tuberculosis at the National Hospital of Niamey, Niger (1990-1991)].

    PubMed

    Ousseini, H; Kim, D S; Adamou, A

    1995-01-01

    This study has been planned in order to determinate the frequency of the infection by VIH among the 394 new tuberculous, for a period extended from July 1990 to July 1991 at the section of pneumophtisiology in the National Hospital of Niamey. The number of seropositives is 7.6%. The two types of viruses, i.e. VIH1 and VIH2, and the double infection by VIH1 + VIH2 types exist in the tuberculous patients. The VIH1 is most frequently found in the subjects of age group 20-39 years, who are almost emigrants. Inspite of the actual weak sero-prevalency among the tuberculous patients, the authors claim that a sero-epidemiological sequential survey of tuberculosis in Niamey can be a relatively easy method for measuring the variations of sero-prevalency of AIDS in Niger. PMID:8555766

  9. [Use and perceptions of information and communication technologies in patients with hypertension, dyslipidemia or diabetes in a national hospital in Lima, Peru].

    PubMed

    Rivas-Nieto, Andrea C; Málaga, Germán; Ruiz-Grosso, Paulo; Huayanay-Espinoza, Carlos A; Curioso, Walter H

    2015-01-01

    This study aimed to determine the use and perceptions towards information and communication technologies (ICT) in 206 patients with arterial hypertension, dyslipidemia and diabetes, recruited from the outpatient clinic in a national hospital in Lima, Peru. 54.4% were older adults and 70.4% were women. The use of daily phone calls was 44.7%. Most had never used a computer (78.2%), email (84%) or the Internet (84%). Many have never sent (80.6%) or received (69.9%) a text message. 70% had at some time forgotten to take their medicine. 72.8% would like to be reminded to take their medication and 67.9% had a family member who could help them with access to ICT. Despite the low use of ICT in this population, there is willingness and expectation from the patients to participate in programs that implement them. PMID:26338388

  10. A Geoinformatics Approach to LiDAR / ALSM Data Distribution, Interpolation, and Analysis

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Conner, J.; Frank, E.; Arrowsmith, J. R.; Memon, A.; Nandigam, V.; Wurman, G.; Baru, C.

    2005-12-01

    choose to download their results in ESRI or ascii grid formats as well as geo tiff. Additionally, our workflow feeds into GEON web services in development that will allow visualization of Lservice outputs in either a web browser window or in 3D through Fledermaus' free viewer iView3D (or our own OpenGL-based tools). This geoinformatics-based system will allow GEON to host LiDAR point cloud data for the greater geoscience community, including data collected by the National Center for Airborne Laser Mapping (NCALM). In addition, most of the functions within this workflow are not limited to LiDAR data and may be used for distributing, interpolating and visualizing any computationally intensive point dataset (such as gravity). By utilizing the computational infrastructure developed by GEON, this system can democratize LiDAR data access for the geoscience community.

  11. Is Survival After Out-of-Hospital Cardiac Arrests Worse During Days of National Academic Meetings in Japan? A Population-Based Study

    PubMed Central

    Kitamura, Tetsuhisa; Kiyohara, Kosuke; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Shimamoto, Tomonari; Izawa, Junichi; Nishiyama, Chika; Iwami, Taku

    2016-01-01

    Background Outcomes after out-of-hospital cardiac arrests (OHCAs) might be worse during academic meetings because many medical professionals attend them. Methods This nationwide population-based observation of all consecutively enrolled Japanese adult OHCA patients with resuscitation attempts from 2005 to 2012. The primary outcome was 1-month survival with a neurologically favorable outcome. Calendar days at three national meetings (Japanese Society of Intensive Care Medicine, Japanese Association for Acute Medicine, and Japanese Circulation Society) were obtained for each year during the study period, because medical professionals who belong to these academic societies play an important role in treating OHCA patients after hospital admission, and we identified two groups: the exposure group included OHCAs that occurred on meeting days, and the control group included OHCAs that occurred on the same days of the week 1 week before and after meetings. Multiple logistic regression analysis was used to adjust for confounding variables. Results A total of 20 143 OHCAs that occurred during meeting days and 38 860 OHCAs that occurred during non-meeting days were eligible for our analyses. The proportion of patients with favorable neurologic outcomes after whole arrests did not differ during meeting and non-meeting days (1.6% [324/20 143] vs 1.5% [596/38 855]; adjusted odds ratio 1.02; 95% confidence interval, 0.88–1.19). Regarding bystander-witnessed ventricular fibrillation arrests of cardiac origin, the proportion of patients with favorable neurologic outcomes also did not differ between the groups. Conclusions In this population, there were no significant differences in outcomes after OHCAs that occurred during national meetings of professional organizations related to OHCA care and those that occurred during non-meeting days. PMID:26639754

  12. National Institute of Allergy and Infectious Disease (NIAID) Funding for Studies of Hospital-Associated Bacterial Pathogens: Are Funds Proportionate to Burden of Disease?

    PubMed Central

    2012-01-01

    Background Hospital-associated infections (HAIs) are associated with a considerable burden of disease and direct costs greater than $17 billion. The pathogens that cause the majority of serious HAIs are Enterococcus faecium, Staphylococcus aureus, Clostridium difficile, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species, referred as ESCKAPE. We aimed to determine the amount of funding the National Institute of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) allocates to research on antimicrobial resistant pathogens, particularly ESCKAPE pathogens. Methods The NIH Research Portfolio Online Reporting Tools (RePORT) database was used to identify NIAID antimicrobial resistance research grants funded in 2007-2009 using the terms "antibiotic resistance," "antimicrobial resistance," and "hospital-associated infection." Results Funding for antimicrobial resistance grants has increased from 2007-2009. Antimicrobial resistance funding for bacterial pathogens has seen a smaller increase than non-bacterial pathogens. The total funding for all ESKCAPE pathogens was $ 22,005,943 in 2007, $ 30,810,153 in 2008 and $ 49,801,227 in 2009. S. aureus grants received $ 29,193,264 in FY2009, the highest funding amount of all the ESCKAPE pathogens. Based on 2009 funding data, approximately $1,565 of research money was spent per S. aureus related death and $750 of was spent per C. difficile related death. Conclusions Although the funding for ESCKAPE pathogens has increased from 2007 to 2009, funding levels for antimicrobial resistant bacteria-related grants is still lower than funding for antimicrobial resistant non-bacterial pathogens. Efforts may be needed to improve research funding for resistant-bacterial pathogens, particularly as their clinical burden increases. PMID:22958856

  13. Ecosystem Mapping Approaches Based on Vegetation Structure Using NEON Prototype Airborne LiDAR and Field Data

    NASA Astrophysics Data System (ADS)

    Krause, K.; Emery, W. J.; Barnett, D.; Petroy, S. B.; Meier, C. L.; Wessman, C. A.

    2014-12-01

    Remote sensing is a powerful tool for measuring the current state of vegetation and monitoring changes over time with repeated data collections. Airborne Light Detection and Ranging (LiDAR) data is especially well suited for mapping 3D vegetation structure. In 2010, the National Ecological Observatory Network (NEON) contracted LiDAR and hyperspectral airborne data collections over the Ordway-Swisher Biological Station (OSBS). Ground truth campaigns were also conducted in 2010, 2011, and 2014 including structural measurements and generation of species lists for a set of ground validation plots. The vegetation communities at OSBS can be characterized by the Florida Natural Areas Inventory (FNAI) classification system, with a large area of the property belonging to the Sandhill community. For this study, classification algorithm training locations are hand selected for each FNAI community type using photo-interpretation. A series of LiDAR metrics are calculated on the discrete return point clouds and derived digital elevation (DEM) and canopy height models (CHM). A decision tree classification algorithm is run using R package "rpart". A main goal of the project is to relate the LiDAR metrics used by the decision tree to direct canopy structural quantities. For instance, the canopy 75th minus the 50th percentile height in the LiDAR point clouds are related to the uniformity and light penetration in the upper canopy. A prototype of the decision tree achieved a classification accuracy of 89% on the training data itself, suggesting that some locations in different FNAI vegetation communities have similar structure and could not be distinguished in the LiDAR metrics used. An improved decision tree is currently under development which will include more training locations and more LiDAR metrics as input features. Results from this improved model will be presenting using the NEON ground truth locations as an independent and quantitative validation measure of the decision tree

  14. Application of High-resolution Aerial LiDAR Data in Calibration of a Two-dimensional Urban Flood Simulation

    NASA Astrophysics Data System (ADS)

    Piotrowski, J.; Goska, R.; Chen, B.; Krajewski, W. F.; Young, N.; Weber, L.

    2009-12-01

    In June 2008, the state of Iowa experienced an unprecedented flood event which resulted in an economic loss of approximately $2.88 billion. Flooding in the Iowa River corridor, which exceeded the previous flood of record by 3 feet, devastated several communities, including Coralville and Iowa City, home to the University of Iowa. Recognizing an opportunity to capture a unique dataset detailing the impacts of the historic flood, the investigators contacted the National Center for Airborne Laser Mapping (NCALM), which performed an aerial Light Detection and Ranging (LiDAR) survey along the Iowa River. The survey, conducted immediately following the flood peak, provided coverage of a 60-mile reach. The goal of the present research is to develop a process by which flood extents and water surface elevations can be accurately extracted from the LiDAR data set and to evaluate the benefit of such data in calibrating one- and two-dimensional hydraulic models. Whereas data typically available for model calibration include sparsely distributed point observations and high water marks, the LiDAR data used in the present study provide broad-scale, detailed, and continuous information describing the spatial extent and depth of flooding. Initial efforts were focused on a 10-mile, primarily urban reach of the Iowa River extending from Coralville Reservoir, a United States Army Corps of Engineers flood control project, downstream through the Coralville and Iowa City. Spatial extent and depth of flooding were estimated from the LiDAR data. At a given cross-sectional location, river channel and floodplain measurements were compared. When differences between floodplain and river channel measurements were less than a standard deviation of the vertical uncertainty in the LiDAR survey, floodplain measurements were classified as flooded. A flood water surface DEM was created using measurements classified as flooded. A two-dimensional, depth-averaged numerical model of a 10-mile reach of

  15. Cholera in pregnant women: the 2012 epidemic at the reference center at the Donka National Hospital in Conakry.

    PubMed

    Sako, F B; Traoré, F A; Camara, M K; Sylla, M; Bangoura, E F; Baldé, O

    2016-05-01

    Cholera is an epidemic diarrheal disease transmitted through the digestive tract; it can cause obstetric complications in pregnant women. The objective of this study was to describe the epidemiological, clinical, and therapeutic aspects of cholera in pregnant women, as well as its course, during the 2012 epidemic in Conakry. This retrospective, descriptive studied examined the records of this epidemic over a 7-month period (from May 15 to December 15, 2012). Of 2,808 cholera patients at our hospital, 80 were pregnant, that is, 2.85%. Their mean age was 30 years [range: 15-45 years], 94% were from Conakry (94%), and 69% were in the third trimester of pregnancy. Choleriform diarrhea and vomiting were the main signs, found respectively in 100% and 95% of the women; dehydration was mild for 16%, moderate for 45%, and severe for 39%. Support consisted of rehydration, by plans A (16%), B (45%) or C (39%) and antibiotic treatment based on erythromycin (85%), doxycycline (14%), or azithromycin (1%). Other drugs that were used included phloroglucinol-trimethylphloroglucinol (Spasfon(®)) for 45%, acetaminophen for 65%, and iron/folic acid for 1% of cases. The major obstetric complications were 4 intrauterine deaths (5%), 2 cases of threatened abortion (2%), 1 preterm delivery (1%), and 1 maternal death. The cholera outbreak in 2012 affected a large number of pregnant women in Conakry, most during their third trimester. The classic clinical manifestations were associated with obstetric complications and maternal-fetal risks. PMID:27412979

  16. Application of LiDAR's multiple attributes for wetland classification

    NASA Astrophysics Data System (ADS)

    Ding, Qiong; Ji, Shengyue; Chen, Wu

    2016-03-01

    Wetlands have received intensive interdisciplinary attention as a unique ecosystem and valuable resources. As a new technology, the airborne LiDAR system has been applied in wetland research these years. However, most of the studies used only one or two LiDAR observations to extract either terrain or vegetation in wetlands. This research aims at integrating LiDAR's multiple attributes (DSM, DTM, off-ground features, Slop map, multiple pulse returns, and normalized intensity) to improve mapping and classification of wetlands based on a multi-level object-oriented classification method. By using this method, we are able to classify the Yellow River Delta wetland into eight classes with overall classification accuracy of 92.5%

  17. Norovirus - hospital

    MedlinePlus

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  18. Integrating LiDAR Data into Earth Science Education

    NASA Astrophysics Data System (ADS)

    Robinson, S. E.; Arrowsmith, R.; de Groot, R. M.; Crosby, C. J.; Whitesides, A. S.; Colunga, J.

    2010-12-01

    The use of high-resolution topography derived from Light Detection and Ranging (LiDAR) in the study of active tectonics is widespread and has become an indispensable tool to better understand earthquake hazards. For this reason and the spectacular representation of the phenomena the data provide, it is appropriate to integrate these data into the Earth science education curriculum. A collaboration between Arizona State University, the OpenTopography Facility, and the Southern California Earthquake Center are developing, three earth science education products to inform students and other audiences about LiDAR and its application to active tectonics research. First, a 10-minute introductory video titled LiDAR: Illuminating Earthquakes was produced and is freely available online through the OpenTopography portal and SCEC. The second product is an update and enhancement of the Wallace Creek Interpretive Trail website (www.scec.org/wallacecreek). LiDAR topography data products have been added along with the development of a virtual tour of the offset channels at Wallace Creek using the B4 LiDAR data within the Google Earth environment. The virtual tour to Wallace Creek is designed as a lab activity for introductory undergraduate geology courses to increase understanding of earthquake hazards through exploration of the dramatic offset created by the San Andreas Fault (SAF) at Wallace Creek and Global Positioning System-derived displacements spanning the SAF at Wallace Creek . This activity is currently being tested in courses at Arizona State University. The goal of the assessment is to measure student understanding of plate tectonics and earthquakes after completing the activity. Including high-resolution topography LiDAR data into the earth science education curriculum promotes understanding of plate tectonics, faults, and other topics related to earthquake hazards.

  19. Modeling loblolly pine dominant height using airborne LiDAR

    NASA Astrophysics Data System (ADS)

    Maceyka, Andy

    The dominant height of 73 georeferenced field sample plots were modeled from various canopy height metrics derived by means of a small-footprint laser scanning technology, known as light detection and ranging (or just LiDAR), over young and mature forest stands using regression analysis. LiDAR plot metrics were regressed against field measured dominant height using Best Subsets Regression to reduce the number of models. From those models, regression assumptions were evaluated to determine which model was actually the best. The best model included the 1st and 90th height percentiles as predictors and explained 95% of the variance in average dominant height.

  20. [Clinical and therapeutic issues in children and adolescents with liver hidatidosis at the Hipolito Unanue National Hospital].

    PubMed

    Reto Valiente, Luz Victoria; Pichilingue Reto, Catherina; Pichilingue Reto, Patricia; Angulo, Galindo; Agusto, Carlos; Pichilingue Prieto, Oscar Alfredo

    2012-01-01

    The aim of this study is to evaluate the clinical diagnosis and treatment of pediatrics patients with hepatic hydatid disease hospitalized in the pediatric ward of HNHU in the last ten years. The study is a descriptive, cross-sectional and retrospective observational of patients undergoing surgery for liver hydatidosis. We studied 42 confirmed cases of hepatic hydatidosis, the ages ranged from 1 to 17 years and most were adolescents 13 to 17 years (20 cases 47.62%), the gender distribution is equal and the source of patients is mainly from the Central Andes of Peru (24 cases 57.14%) followed by Lima city (10 cases 23.81%). The most common presenting symptom was abdåominal pain (29 cases 69.05%) followed by fever (19 cases 45.24%). Ultrasound is the most common diagnostic method and only not done in a patient carrying a prior CT scan. Serology (indirect immunofluorescence) was positive in only 19 of 27 patients who had the test (70%).Most were single hepatic cysts (22 cases 52.38%) with size from 3 to 20 cm but most commonly they were 5 to 10 cm sized. The location was predominant on the right lobe (26 cases 61.98%) followed on both lobes (10 cases 23.81%). Apart from the liver there were cysts on the lungs (18 cases 42.86%).The surgical procedure performed was radical cystectomy with or without drainage in 36 cases (85.71%). And conservative surgery in only 6 cases (14.28). The important complications were: 15 cases of fever (35.71), nosocomial respiratory infection in 9 cases (21.43%), biliary fistula in 5 cases (11.90%) and residual abscess in 3 cases (7.14%). Although morbidity was high, mortality of the cases studied was zero. PMID:23128950

  1. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  2. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  3. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  4. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  5. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  6. DArT marker development and applications in oat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Progress of genomic research in oat has been limited by a lack of common markers and consensus maps that would provide integration platforms for structural genomic analysis. Diversity Array Technology (DArT) is a strategy that provides a high density of molecular markers that can be tested in par...

  7. Modeling low-height vegetation with airborne LiDAR

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Low-height vegetation, common in semiarid regions, is difficult to characterize with LiDAR (Light Detection and Ranging) due to similarities, in time and space, of the point returns of vegetation and ground. Other complications may occur due to the low-height vegetation structural characteristics a...

  8. National Assessment of Statin Therapy in Patients Hospitalized with Acute Myocardial Infarction: Insight from China PEACE-Retrospective AMI Study, 2001, 2006, 2011

    PubMed Central

    Zhang, Lihua; Li, Jing; Li, Xi; Nasir, Khurram; Zhang, Haibo; Wu, Yongjian; Hu, Shuang; Wang, Qing; Downing, Nicholas S.; Desai, Nihar R.; Masoudi, Frederick A.; Spertus, John A.; Krumholz, Harlan M.; Jiang, Lixin

    2016-01-01

    Background Statin therapy is among the most effective treatments to improve short- and long-term mortality after acute myocardial infarction. The use of statin, and the intensity of their use, has not been described in acute myocardial infarction patients in China, a country with a rapidly growing burden of cardiovascular disease. Methods and Results Using a nationally representative sample of patients with acute myocardial infarction admitted to 162 Chinese hospitals in 2001, 2006 and 2011, we identified 14,958 patients eligible for statin therapy to determine rates of statin use and the intensity of statin therapy, defined as those statin regimens with expected low-density lipoprotein cholesterol lowering of at least 40%, to identify factors associated with the use of statin therapy. Statin use among hospitalized patients with acute myocardial infarction increased from 27.9% in 2001 to 72.5% in 2006, and 88.8% in 2011 (P<0.001 for trend). Regional variation in statin use correspondingly decreased over time. Among treated patients, those receiving intensive statin therapy increased from 1.0% in 2001 to 24.2% in 2006 to 57.2% in 2011(P<0.001 for trend). Patients without low-density lipoprotein cholesterol measured were less likely to be treated with statin or to receive intensive therapy. Conclusions The use of statin therapy has dramatically increased over the past decade in Chinese patients with acute myocardial infarction. However, half of patients still did not receive intensive statin therapy in 2011.Given that guidelines strongly endorse intensive statin therapy for acute myocardial infarction patients, initiatives promoting the use of statin therapy, with attention to treatment intensity, would support further improvements in practice. PMID:27058862

  9. Landslide displacement vectors derived from multi-temporal topographic LiDAR data

    NASA Astrophysics Data System (ADS)

    Fey, Christine; Rutzinger, Martin; Bremer, Magnus; Prager, Christoph; Zangerl, Christian

    2014-05-01

    Information about slope geometry and kinematics of landslides is essential for hazard assessment, monitoring and planning of protection and mitigation measures. Especially for remote and inaccessible slopes, subsurface data (e.g. boreholes, tunnels, investigation adits) are often not available and thus the deformation characteristics must be derived from surface displacement data. In recent years, multi-temporal topographic LiDAR (Light Detection and Ranging) data became an increasingly improved tool for detecting topographic surface deformations. In this context, LiDAR-based change detection is commonly applied for quantifying surface elevation changes. Advanced change detection methods derive displacement vectors with direction and velocities of slope movements. To extract displacement vectors from LiDAR raster data (i) an approach based on feature tracking by image correlation and (ii) an approach based on feature tracking by vectors breaklines are investigated. The image correlation method is based on the IMCORR software (National Snow and Ice Data Center, University of Colorado, Boulder), implemented in a SAGA GIS module. The image correlation algorithm is based on a normalized cross-covariance method. The algorithm searches tie points in two feature rasters derived from a digital surface model acquired at different time stamps. The method assesses automatically the displacement rates and directions of distinct terrain features e.g. displaced mountain ridges or striking boulders. In contrast the vector-based breakline methods require manual selection of tie points. The breaklines are the product of vectorized curvature raster images and extracting the "upper terrain edges" (topographic ridges) and "lower terrain edges" (topographic depressions). Both methods were tested on simulated terrain with determined displacement rates in order to quantify i) the accuracy ii) the minimum detectable movement rates iii) the influence of terrain characteristics iv) the

  10. GeoEarthScope Airborne LiDAR and Satellite InSAR Imagery

    NASA Astrophysics Data System (ADS)

    Phillips, D. A.; Jackson, M. E.; Meertens, C.

    2008-12-01

    UNAVCO has successfully acquired a significant volume of aerial and satellite geodetic imagery as part of GeoEarthScope, a component of the EarthScope Facility project funded by the National Science Foundation. All GeoEarthScope acquisition activities are now complete. Airborne LiDAR data acquisitions took place in 2007 and 2008 and cover a total area of more than 5000 square kilometers. The primary LiDAR survey regions cover features in Northern California, Southern/Eastern California, the Pacific Northwest, the Intermountain Seismic Belt (including the Wasatch and Teton faults and Yellowstone), and Alaska. We have ordered and archived more than 28,000 scenes (more than 81,000 frames) of synthetic aperture radar (SAR) data suitable for interferometric analyses covering most of the western U.S. and parts of Alaska and Hawaii from several satellite platforms, including ERS-1/2, ENVISAT and RADARSAT. In addition to ordering data from existing archives, we also tasked the ESA ENVISAT satellite to acquire new SAR data in 2007 and 2008. GeoEarthScope activities were led by UNAVCO, guided by the community and conducted in partnership with the USGS and NASA. Processed imagery products, in addition to formats intended for use in standard research software, can also be viewed using general purpose tools such as Google Earth. We present a summary of these vast geodetic imagery datasets, totaling tens of terabytes, which are freely available to the community.

  11. Contrasting Patterns of Damage and Recovery in Logged Amazon Forests From Small Footprint LiDAR Data

    NASA Technical Reports Server (NTRS)

    Morton, D. C.; Keller, M.; Cook, B. D.; Hunter, Maria; Sales, Marcio; Spinelli, L.; Victoria, D.; Andersen, H.-E.; Saleska, S.

    2012-01-01

    Tropical forests ecosystems respond dynamically to climate variability and disturbances on time scales of minutes to millennia. To date, our knowledge of disturbance and recovery processes in tropical forests is derived almost exclusively from networks of forest inventory plots. These plots typically sample small areas (less than or equal to 1 ha) in conservation units that are protected from logging and fire. Amazon forests with frequent disturbances from human activity remain under-studied. Ongoing negotiations on REDD+ (Reducing Emissions from Deforestation and Forest Degradation plus enhancing forest carbon stocks) have placed additional emphasis on identifying degraded forests and quantifying changing carbon stocks in both degraded and intact tropical forests. We evaluated patterns of forest disturbance and recovery at four -1000 ha sites in the Brazilian Amazon using small footprint LiDAR data and coincident field measurements. Large area coverage with airborne LiDAR data in 2011-2012 included logged and unmanaged areas in Cotriguacu (Mato Grosso), Fiona do Jamari (Rondonia), and Floresta Estadual do Antimary (Acre), and unmanaged forest within Reserva Ducke (Amazonas). Logging infrastructure (skid trails, log decks, and roads) was identified using LiDAR returns from understory vegetation and validated based on field data. At each logged site, canopy gaps from logging activity and LiDAR metrics of canopy heights were used to quantify differences in forest structure between logged and unlogged areas. Contrasting patterns of harvesting operations and canopy damages at the three logged sites reflect different levels of pre-harvest planning (i.e., informal logging compared to state or national logging concessions), harvest intensity, and site conditions. Finally, we used multi-temporal LiDAR data from two sites, Reserva Ducke (2009, 2012) and Antimary (2010, 2011), to evaluate gap phase dynamics in unmanaged forest areas. The rates and patterns of canopy gap

  12. [A clinical study on tuberculosis among young adults in Japan: analysis on patients admitted to national hospitals in Kanto- and Kinki-areas in the year 2000].

    PubMed

    Yotsumoto, Hideki; Yonemaru, Makoto; Suzuki, Katsuhiro; Kawabe, Yoshiko; Sasaki, Yuka; Toyoda, Emiko; Yamagishi, Fumio; Kudoh, Koichiro; Kurasawa, Takuya; Ito, Masami; Kawashiro, Takeo; Sakatani, Mitsunori; Mori, Masashi

    2003-08-01

    Considering the high social activity, the trend of tuberculosis among young adults appears to be one of the key factors that influence the future morbidity rate of tuberculosis in Japan. To investigate its current characteristics, we analyzed new cases of tuberculosis aged 20 to 29 who were admitted to 7 national hospitals in Kanto- and Kinki-areas during the period of January 1st to December 31st, 2000. Data on the following items were compiled: sex, age, body height and weight, nationality; background factors such as life style, complications; course of the disease before the diagnosis; result of PPD skin test; severity of the disease estimated by the amount of M. tuberculosis in sputum and the grade of chest X-ray findings; therapeutic regimens and the response rate. Data were collected from 234 patients (129 males and 105 females) and the results were as follows: 1) about 80% of the patients were symptomatic and in 50% of patients who presented with cough, more than one month was needed before establishing the diagnosis as TB, 2) the disease was found in advanced stage in more than half of the patients, 3) foreigner patients, most of them were from Kanto-area, accounted for 11%, and were in advanced stage, some with drug-resistant tuberculosis, 4) INH resistance was noted in 7.7%, 5) pyrazinamide was included in the therapeutic regimens in 84.0% of the smear positive patients, 6) the admission period was within 90 days in 63.7% of the patients, however, the duration of treatment was 6 months in only 48.0% of patients who were treated with regimens containing pyrazinamide. More efforts for early detection of patients is needed to prevent the transmission of the disease, and more extensive use of directly observed therapy is essential for the prevention of dropout. We also argued about the shortening of the admission and duration of treatment in these patients. PMID:14509224

  13. Frequent Users of Hospital Emergency Departments in Korea Characterized by Claims Data from the National Health Insurance: A Cross Sectional Study.

    PubMed

    Woo, Jung Hoon; Grinspan, Zachary; Shapiro, Jason; Rhee, Sang Youl

    2016-01-01

    The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED) users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year) using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1%) were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p < 0.001 for each). Moreover, frequent ED users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED. PMID:26809051

  14. Hydrography change detection: the usefulness of surface channels derived From LiDAR DEMs for updating mapped hydrography

    USGS Publications Warehouse

    Poppenga, Sandra K.; Gesch, Dean B.; Worstell, Bruce B.

    2013-01-01

    The 1:24,000-scale high-resolution National Hydrography Dataset (NHD) mapped hydrography flow lines require regular updating because land surface conditions that affect surface channel drainage change over time. Historically, NHD flow lines were created by digitizing surface water information from aerial photography and paper maps. Using these same methods to update nationwide NHD flow lines is costly and inefficient; furthermore, these methods result in hydrography that lacks the horizontal and vertical accuracy needed for fully integrated datasets useful for mapping and scientific investigations. Effective methods for improving mapped hydrography employ change detection analysis of surface channels derived from light detection and ranging (LiDAR) digital elevation models (DEMs) and NHD flow lines. In this article, we describe the usefulness of surface channels derived from LiDAR DEMs for hydrography change detection to derive spatially accurate and time-relevant mapped hydrography. The methods employ analyses of horizontal and vertical differences between LiDAR-derived surface channels and NHD flow lines to define candidate locations of hydrography change. These methods alleviate the need to analyze and update the nationwide NHD for time relevant hydrography, and provide an avenue for updating the dataset where change has occurred.

  15. Intergration of LiDAR Data with Aerial Imagery for Estimating Rooftop Solar Photovoltaic Potentials in City of Cape Town

    NASA Astrophysics Data System (ADS)

    Adeleke, A. K.; Smit, J. L.

    2016-06-01

    Apart from the drive to reduce carbon dioxide emissions by carbon-intensive economies like South Africa, the recent spate of electricity load shedding across most part of the country, including Cape Town has left electricity consumers scampering for alternatives, so as to rely less on the national grid. Solar energy, which is adequately available in most part of Africa and regarded as a clean and renewable source of energy, makes it possible to generate electricity by using photovoltaics technology. However, before time and financial resources are invested into rooftop solar photovoltaic systems in urban areas, it is important to evaluate the potential of the building rooftop, intended to be used in harvesting the solar energy. This paper presents methodologies making use of LiDAR data and other ancillary data, such as high-resolution aerial imagery, to automatically extract building rooftops in City of Cape Town and evaluate their potentials for solar photovoltaics systems. Two main processes were involved: (1) automatic extraction of building roofs using the integration of LiDAR data and aerial imagery in order to derive its' outline and areal coverage; and (2) estimating the global solar radiation incidence on each roof surface using an elevation model derived from the LiDAR data, in order to evaluate its solar photovoltaic potential. This resulted in a geodatabase, which can be queried to retrieve salient information about the viability of a particular building roof for solar photovoltaic installation.

  16. High-intensity cyclotron for the IsoDAR experiment

    NASA Astrophysics Data System (ADS)

    Campo, D.; IsoDAR Collaboration

    2015-03-01

    The IsoDAR experiment is the MIT proposal to investigate about several neutrino properties, in order to explain some anomalies experimentally observed. It requires 10mA of proton beam at the energy of 60MeV to produce a high-intensity electron antineutrino flux from the production and the decay of 8Li: it is an ambitious goal for the accelerator design, due also to the fact that the machine has to be placed near a neutrino detector, like KAMLAND or WATCHMAN, located in underground sites. A compact cyclotron able to accelerate H2+ molecule beam up to energy of 60MeV/amu is under study. The critical issues of this machine concern the beam injection due to the effects of space charge, the efficiency of the beam extraction and the technical solutions needed to the machine assembly. Here, the innovative solutions and the preliminary results achieved by the IsoDAR team are discussed.

  17. Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals

    PubMed Central

    2012-01-01

    Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the

  18. Volume component analysis for classification of LiDAR data

    NASA Astrophysics Data System (ADS)

    Varney, Nina M.; Asari, Vijayan K.

    2015-03-01

    One of the most difficult challenges of working with LiDAR data is the large amount of data points that are produced. Analysing these large data sets is an extremely time consuming process. For this reason, automatic perception of LiDAR scenes is a growing area of research. Currently, most LiDAR feature extraction relies on geometrical features specific to the point cloud of interest. These geometrical features are scene-specific, and often rely on the scale and orientation of the object for classification. This paper proposes a robust method for reduced dimensionality feature extraction of 3D objects using a volume component analysis (VCA) approach.1 This VCA approach is based on principal component analysis (PCA). PCA is a method of reduced feature extraction that computes a covariance matrix from the original input vector. The eigenvectors corresponding to the largest eigenvalues of the covariance matrix are used to describe an image. Block-based PCA is an adapted method for feature extraction in facial images because PCA, when performed in local areas of the image, can extract more significant features than can be extracted when the entire image is considered. The image space is split into several of these blocks, and PCA is computed individually for each block. This VCA proposes that a LiDAR point cloud can be represented as a series of voxels whose values correspond to the point density within that relative location. From this voxelized space, block-based PCA is used to analyze sections of the space where the sections, when combined, will represent features of the entire 3-D object. These features are then used as the input to a support vector machine which is trained to identify four classes of objects, vegetation, vehicles, buildings and barriers with an overall accuracy of 93.8%

  19. Compact Adaptable Mobile LiDAR System Deployment

    NASA Astrophysics Data System (ADS)

    Glennie, C. L.; Brooks, B. A.; Ericksen, T. L.; Hudnut, K. W.; Foster, J. H.; Hauser, D.; Avery, J.

    2012-12-01

    Airborne LiDAR (LIght Detection And Ranging) systems have become a standard mechanism for acquiring dense high-precision topography, making it possible to perform large scale documentation (100's of km2) per day at spatial scales as fine as a few decimeters horizontally and a few centimeters vertically. However, current airborne and terrestrial LiDAR systems suffer from a number of drawbacks. They are expensive, bulky, require significant power supplies, and are often optimized for use in only one type of mobility platform. It would therefore be advantageous to design a lightweight, compact and relatively inexpensive multipurpose LiDAR and imagery system that could be used from a variety of mobility platforms - both terrestrial and airborne. The system should be quick and easy to deploy, and require a minimum amount of existing infrastructure for operational support. With these goals in mind, our research teams have developed a prototype field deployable compact dynamic laser scanning system that is configured for use on a variety of mobility platforms, including backpack wearable, as well as unmanned aerial vehicles (e.g. balloons & helicopters) and small off-road vehicles such as ATV's. The system is small, self-contained, relatively inexpensive, and easy to deploy. The first version of this multipurpose LiDAR system has been successfully tested in both backpack configuration and on a tethered flight attached to a helium balloon. We will present system design and development details, along with field experiences and a detailed accuracy analysis of the acquired point clouds which show that accuracy of 3-5 cm (1 sigma) vertical can be achieved in both backpack and balloon modalities.

  20. LiDAR observation of the flow structure in typhoons

    NASA Astrophysics Data System (ADS)

    Wu, Yu-Ting; Hsuan, Chung-Yao; Lin, Ta-Hui

    2015-04-01

    Taiwan is subject to 3.4 landfall typhoons each year in average, generally occurring in the third quarter of every year (July-September). Understanding of boundary-layer turbulence characteristics of a typhoon is needed to ensure the safety of both onshore and offshore wind turbines used for power generation. In this study, a floating LiDAR (Light Detection and Ranging) was deployed in a harbor to collect data of wind turbulence, atmospheric pressure, and temperature in three typhoon events (Matmo typhoon, Soulik typhoon, Trami typhoon). Data collected from the floating LiDAR and from meteorological stations located at Taipei, Taichung and Kaohsiung are adopted to analyse the wind turbulence characteristics in the three typhoon events. The measurement results show that the maximum 10-min average wind speed measured with the floating LiDAR is up to 24 m/s at a height of 200 m. Compared with other normal days, the turbulence intensity is lower in the three typhoon events where the wind speed has a rapid increase. Changes of wind direction take place clearly as the typhoons cross Taiwan from East to West. Within the crossing intervals, the vertical momentum flux is observed to have a significant pattern with both upward and downward propagating waves which are relevant to the flow structure of the typhoons.

  1. Rapid topographic and bathymetric reconnaissance using airborne LiDAR

    NASA Astrophysics Data System (ADS)

    Axelsson, Andreas

    2010-10-01

    Today airborne LiDAR (Light Detection And Ranging) systems has gained acceptance as a powerful tool to rapidly collect invaluable information to assess the impact from either natural disasters, such as hurricanes, earthquakes and flooding, or human inflicted disasters such as terrorist/enemy activities. Where satellite based imagery provides an excellent tool to remotely detect changes in the environment, the LiDAR systems, being active remote sensors, provide an unsurpassed method to quantify these changes. The strength of the active laser based systems is especially evident in areas covered by occluding vegetation or in the shallow coastal zone as the laser can penetrate the vegetation or water body to unveil what is below. The purpose of this paper is to address the task to survey complex areas with help of the state-of-the-art airborne LiDAR systems and also discuss scenarios where the method is used today and where it may be used tomorrow. Regardless if it is a post-hurricane survey or a preparation stage for a landing operation in unchartered waters, it is today possible to collect, process and present a dense 3D model of the area of interest within just a few hours from deployment. By utilizing the advancement in processing power and wireless network capabilities real-time presentation would be feasible.

  2. Rockfall hazard analysis using LiDAR and spatial modeling

    NASA Astrophysics Data System (ADS)

    Lan, Hengxing; Martin, C. Derek; Zhou, Chenghu; Lim, Chang Ho

    2010-05-01

    Rockfalls have been significant geohazards along the Canadian Class 1 Railways (CN Rail and CP Rail) since their construction in the late 1800s. These rockfalls cause damage to infrastructure, interruption of business, and environmental impacts, and their occurrence varies both spatially and temporally. The proactive management of these rockfall hazards requires enabling technologies. This paper discusses a hazard assessment strategy for rockfalls along a section of a Canadian railway using LiDAR and spatial modeling. LiDAR provides accurate topographical information of the source area of rockfalls and along their paths. Spatial modeling was conducted using Rockfall Analyst, a three dimensional extension to GIS, to determine the characteristics of the rockfalls in terms of travel distance, velocity and energy. Historical rockfall records were used to calibrate the physical characteristics of the rockfall processes. The results based on a high-resolution digital elevation model from a LiDAR dataset were compared with those based on a coarse digital elevation model. A comprehensive methodology for rockfall hazard assessment is proposed which takes into account the characteristics of source areas, the physical processes of rockfalls and the spatial attribution of their frequency and energy.

  3. Increasing the Efficiency of LiDAR Based Forest Inventories: A Novel Approach for Integrating Variable Radius Inventory Plots with LiDAR Data.

    NASA Astrophysics Data System (ADS)

    Falkowski, M. J.; Fekety, P.; Silva, C. A.; Hudak, A. T.

    2015-12-01

    LiDAR data are increasingly applied to support forest inventory and assessment across a variety of spatial scales. Typically this is achieved by integrating LiDAR data with forest inventory collected at fixed radius forest inventory plots. A well-designed forest inventory, one that covers the full range of structural and compositional variation across the forest of interest, is costly especially when collecting fixed radius plot data. Variable radius plots offer an alternative inventory protocol that is more efficient in terms of both time and money. However, integrating variable radius plot data with LiDAR data is problematic because the plots have unknown sizes that vary with variation in tree size. This leads to a spatial mismatch between LiDAR metrics (e.g., mean height, canopy cover, density, etc.) and plot data, which ultimately translates into errors in LiDAR derived forest inventory predictions. We propose and evaluate and novel approach for integrating variable radius plot data into a LiDAR based forest inventories in two different forest systems, one in the inland northwest and another in the northern lakes states of the USA. The novel approach calculates LiDAR metrics by weighting the point cloud proportional to return height, mimicking the way in which variable radius plot data weights tree measurements by tree size. This could increase inventory sampling efficiency, allowing for the collection of a greater number of inventory plots, and ultimately improve the performance of LiDAR based inventories.

  4. Mapping tropical forest biomass with radar and spaceborne LiDAR: overcoming problems of high biomass and persistent cloud

    NASA Astrophysics Data System (ADS)

    Mitchard, E. T. A.; Saatchi, S. S.; White, L. J. T.; Abernethy, K. A.; Jeffery, K. J.; Lewis, S. L.; Collins, M.; Lefsky, M. A.; Leal, M. E.; Woodhouse, I. H.; Meir, P.

    2011-08-01

    Spatially-explicit maps of aboveground biomass are essential for calculating the losses and gains in forest carbon at a regional to national level. The production of such maps across wide areas will become increasingly necessary as international efforts to protect primary forests, such as the REDD+ (Reducing Emissions from Deforestation and forest Degradation) mechanism, come into effect, alongside their use for management and research more generally. However, mapping biomass over high-biomass tropical forest is challenging as (1) direct regressions with optical and radar data saturate, (2) much of the tropics is persistently cloud-covered, reducing the availability of optical data, (3) many regions include steep topography, making the use of radar data complex, (4) while LiDAR data does not suffer from saturation, expensive aircraft-derived data are necessary for complete coverage. We present a solution to the problems, using a combination of terrain-corrected L-band radar data (ALOS PALSAR), spaceborne LiDAR data (ICESat GLAS) and ground-based data. We map Gabon's Lopé National Park (5000 km2) because it includes a range of vegetation types from savanna to closed-canopy tropical forest, is topographically complex, has no recent cloud-free high-resolution optical data, and the dense forest is above the saturation point for radar. Our 100 m resolution biomass map is derived from fusing spaceborne LiDAR (7142 ICESat GLAS footprints), 96 ground-based plots (average size 0.8 ha) and an unsupervised classification of terrain-corrected ALOS PALSAR radar data, from which we derive the aboveground biomass stocks of the park to be 78 Tg C (173 Mg C ha-1). This value is consistent with our field data average of 181 Mg C ha-1, from the field plots measured in 2009 covering a total of 78 ha, and which are independent as they were not used for the GLAS-biomass estimation. We estimate an uncertainty of ± 25 % on our carbon stock value for the park. This error term includes

  5. Tropical Airborne LiDAR for Landslide Assessment in Malaysia: a technical perspective

    NASA Astrophysics Data System (ADS)

    Abd Manap, Mohamad; Azhari Razak, Khamarrul; Mohamad, Zakaria; Ahmad, Azhari; Ahmad, Ferdaus; Mohamad Zin, Mazlan; A'zad Rosle, Qalam

    2015-04-01

    Malaysia has faced a substantial number of landslide events every year. Cameron Highlands, Pahang is one of the badly areas affected by slope failures characterized by extreme climate, rugged topographic and weathered geological structures in a tropical environment. A high frequency of landslide occurrence in the hilly areas is predominantly due to the geological materials, tropical monsoon seasons and uncontrolled agricultural activities. Therefore the Government of Malaysia through the Prime Minister Department has allocated a special budget to conduct national level hazard and risk mapping project through Minerals and Geoscience Department Malaysia, the Ministry of Natural Resources and Environment. The primary aim of this project is to provide slope hazard risk information for a better slope management in Malaysia. In addition this project will establish national infrastructure for geospatial information on the geological terrain and slope by emphasizing the disaster risk throughout the country. The areas of interest are located in the three different selected areas i.e. Cameron Highlands (275 square kilometers), Ipoh (200 square kilometers) and Cheras Kajang -- Batang kali (650 square kilometers). These areas are selected based on National Slope Master Plan (2009 -- 2023) that endorsed by Malaysia Government Cabinet. The national hazard and risk mapping project includes six parts of major tasks: (1) desk study and mobilization, (2) airborne LiDAR data acquisition and analysis, (3) field data acquisition and verification, (4) hazard and risk for natural terrain, (5) hazard and risk analysis for man-made slope and (6) Man-made slope mitigation/preventive measures. The project was authorized in September, 2014 and will be ended in March, 2016. In this paper, the main focus is to evaluate the suitability of integrated capability of airborne- and terrestrial LiDAR data acquisition and analysis, and also digital photography for regional landslide assessment. The

  6. Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi.

    PubMed

    Yator, Obadia; Mathai, Muthoni; Vander Stoep, Ann; Rao, Deepa; Kumar, Manasi

    2016-07-01

    Mothers with HIV are at high risk of a range of psychosocial issues that may impact HIV disease progression for themselves and their children. Stigma has also become a substantial barrier to accessing HIV/AIDS care and prevention services. The study objective was to determine the prevalence and severity of postpartum depression (PPD) among women living with HIV and to further understand the impact of stigma and other psychosocial factors in 123 women living with HIV attending prevention of mother-to-child transmission (PMTCT) clinic at Kenyatta National Hospital located in Nairobi, Kenya. We used the Edinburgh Postnatal Depression Scale and HIV/AIDS Stigma Instrument - PLWHA (HASI - P). Forty-eight percent (N = 59) of women screened positive for elevated depressive symptoms. Eleven (9%) of the participants reported high levels of stigma. Multivariate analyses showed that lower education (OR = 0.14, 95% CI [0.04-0.46], p = .001) and lack of family support (OR = 2.49, 95% CI [1.14-5.42], p = .02) were associated with the presence of elevated depressive symptoms. The presence of stigma implied more than ninefold risk of development of PPD (OR = 9.44, 95% CI [1.132-78.79], p = .04). Stigma was positively correlated with an increase in PPD. PMTCT is an ideal context to reach out to women to address mental health problems especially depression screening and offering psychosocial treatments bolstering quality of life of the mother-baby dyad. PMID:27045273

  7. Prevalence of human papillomavirus infection in Argentinean women attending two different hospitals prior to the implementation of the National vaccination program

    PubMed Central

    Chouhy, Diego; D’Andrea, Rubén Mamprín; Iglesias, Mercedes; Messina, Analía; Ivancovich, Juan J.; Cerda, Belen; Galimberti, Diana; Bottai, Hebe; Giri, Adriana A.

    2012-01-01

    Cervarix vaccine was included in the National Immunization Program of Argentina in 2011 but data about the local distribution of human papillomavirus (HPV) infection in women exposed to the virus are scarce. This cross-sectional study determined the prevalence and type distribution of HPV infection in unvaccinated women attending routine gynaecological screening in two public hospitals located in Buenos Aires and Santa Fe, Argentina. Socio-demographic, sexual behaviour and co-factors information was obtained from all participants (Buenos Aires, n=429; Santa Fe, n=433). Cervicovaginal swabs were tested with an MY11/09 primer-based assay and with the CUT primer system targeting mucosal/cutaneous HPVs. Participants from Buenos Aires showed significantly higher rates of HPV infection (52.4% vs. 40.6%), of multiple infections (24.2% vs. 16.4%), and of low-risk (20.3% vs. 13.9%) and high-risk types (44.1% vs. 33.3%) than those from Santa Fe. HPV-66 (Buenos Aires: 17%) and HPV-16 (Santa Fe: 8.5%) were the most prevalent types. Novel HPV-66 putative subtype and variants were identified. Vaccine types 16 and 18 were frequent (Buenos Aires: 13.5%; Santa Fe F: 10.2%) but few participants had co-infections with both (Buenos Aires: 1.4%; Santa Fe: 0.2%). A common risk factor for HPV infection was having a new sexual partner in the last year (Buenos Aires: OR 2.53, p<0.001; Santa Fe: OR 1.85, p=0.04). This study provides valuable baseline data for future assessment of the impact of massive vaccination in Argentina and it underlines the use of additional HPV testing strategies, such as the CUT system, for surveillance and vaccinology. PMID:23296573

  8. A nationwide study of patients hospitalised for poisoning in Korea based on Korea National Hospital Discharge In-Depth Injury Survey data from 2005 to 2009

    PubMed Central

    Kim, Kyunghee; Choi, Jae Wook; Park, Miso; Kim, Min Soo; Lee, Eun Sun

    2015-01-01

    Objectives In light of the need to develop an integrated database on poisoning incidents in Korea, this study seeks to determine the characteristics of poisoning incidents in Korea by age, gender, location of incident, causative substance and patient prognosis. Data sources The Korea National Hospital Discharge In-Depth Injury Survey results (2005–2009) from the Korea Centers for Disease Control and Prevention were used. Participants 3826 participants in the survey who had been hospitalised for poisoning incidents. Results The poisoning hospitalisation rate per 100 000 population was higher in women (1.735) than in men (1.372) and increased with age: the rate was 0.458 among individuals aged ≤9 years, 0.481 among those aged 10–19 years, 1.584 among those aged 20–64 years and 4.053 among those aged ≥65 years. The intentional poisoning hospitalisation rate differed by gender and age group. Women aged ≤19 years and 20–64 years showed a higher hospitalisation rate than men, while men aged ≥65 years showed a higher hospitalisation rate than women in the same age group. The most common poisoning substance was pesticides (33.6%), while antiepileptic, sedative-hypnotic and antiparkinsonism drugs and psychotropic drugs, not elsewhere classified were also very common. Poisoning in those aged ≤9 years usually involved other drugs, while pesticides were the most common substances in those aged 20–64 years and ≥65 years. Conclusions This study analysed poisoning incidents in Korea from 2005 to 2009, by age and gender, causative substance, and characteristics. The results of this study may serve as evidence for new strategies in Korea to prevent poisoning. PMID:26553832

  9. Management of snakebite cases by national treatment protocol at Jalpaiguri District Hospital in West Bengal in the year 2010--a retrospective study.

    PubMed

    Ghosh, Manab Kumar

    2011-08-01

    Snakebite remains a public health problem in India, occurring most frequently in the summer and rainy seasons. Bites are maximal in lower limbs. Victims are typically male and between 17 and 27 years of age. Children and the elderly have higher mortality. The worst affected states are Kerala, Maharashtra, Tamil Nadu, Orissa, Assam and West Bengal. There was no uniform guideline for treatment of snakebite cases. The five common venomous Indian snakes biting humans are common cobra, krait, Russell's viper, saw scaled viper and the hump nose pit viper. Seventy per cent of all snakebites are non-venomous. Even in bites by venomous snakes, envenomation occurs in only 50% of cases. Immobilisation is much more important than tight ligature, which may cause gangrene. Only a minority need antivenom, which is expensive, short in supply and may cause severe reaction. Antivenom treatment is recommended on the basis of local and systemic signs and symptoms and 20 minutes whole blood clotting test (20WBCT). Delay in starting AVS treatment is the main cause of mortality and morbidity. Skin test is of no value. But antivenom should not be used unless specifically indicated. The "Do it RIGHT" approach of national treatment protocol indicates the initial steps to be taken before reaching a hospital or primary healthcare facility. And it resulted in a 66% decline in the amount of ASV administration and an absolute reduction of mortality by 24%. However first aid treatment of the bitten limb/area with broad-spectrum antibiotics, injection tetanus antitoxin and Supportive treatment with blood transfusion, ventilatory support, anticholinesterase and peritoneal dialysis may also be required. PMID:22315862

  10. Coastal and tidal landform detection from high resolution topobathymetric LiDAR data

    NASA Astrophysics Data System (ADS)

    Skovgaard Andersen, Mikkel; Al-Hamdani, Zyad; Steinbacher, Frank; Rolighed Larsen, Laurids; Brandbyge Ernstsen, Verner

    2016-04-01

    Coastal and tidal environments are valuable ecosystems, which, however, are under pressure in many areas around the world due to globalisation and/or climate change. Detailed mapping of these environments is required in order to manage the coastal zone in a sustainable way. However, historically these transition zones between land and water are difficult or even impossible to map and investigate in high spatial resolution due to the challenging environmental conditions. The new generation of airborne topobathymetric light detection and ranging (LiDAR) potentially enables full-coverage and high-resolution mapping of these land-water transition zones. We have carried out topobathymetric LiDAR surveys in the Knudedyb tidal inlet system, a coastal environment in the Danish Wadden Sea which is part of the Wadden Sea National Park and UNESCO World Heritage. Detailed digital elevation models (DEMs) with a grid cell size of 0.5 m x 0.5 m were generated from the LiDAR point cloud with a mean point density in the order of 20 points/m2. The DEM was analysed morphometrically using a modification of the tool Benthic Terrain Modeler (BTM) developed by Wright et al. (2005). Initially, stage (the elevation in relation to tidal range) was used to divide the area of investigation into the different tidal zones, i.e. subtidal, intertidal and supratidal. Subsequently, morphometric units were identified and characterised by a combination of statistical neighbourhood analysis with varying window sizes (using the Bathymetric Positioning Index (BPI) from the BTM, moving average and standard deviation), slope parameters and area/perimeter ratios. Finally, these morphometric units were classified into six different types of landforms based on their stage and morphometric characteristics, i.e. either subtidal channel, intertidal flat, intertidal creek, linear bar, swash bar or beach dune. We hereby demonstrate the potential of using airborne topobathymetric LiDAR for seamless mapping of land

  11. Development of DArT Marker Platforms and Genetic Diversity Assessment of the U.S. Collection of the New Oilseed Crop Lesquerella and Related Species

    PubMed Central

    Cruz, Von Mark V.; Kilian, Andrzej; Dierig, David A.

    2013-01-01

    The advantages of using molecular markers in modern genebanks are well documented. They are commonly used to understand the distribution of genetic diversity in populations and among species which is crucial for efficient management and effective utilization of germplasm collections. We describe the development of two types of DArT molecular marker platforms for the new oilseed crop lesquerella (Physaria spp.), a member of the Brassicaceae family, to characterize a collection in the National Plant Germplasm System (NPGS) with relatively little known in regards to the genetic diversity and traits. The two types of platforms were developed using a subset of the germplasm conserved ex situ consisting of 87 Physaria and 2 Paysonia accessions. The microarray DArT revealed a total of 2,833 polymorphic markers with an average genotype call rate of 98.4% and a scoring reproducibility of 99.7%. On the other hand, the DArTseq platform developed for SNP and DArT markers from short sequence reads showed a total of 27,748 high quality markers. Cluster analysis and principal coordinate analysis indicated that the different accessions were successfully classified by both systems based on species, by geographical source, and breeding status. In the germplasm set analyzed, which represented more than 80% of the P. fendleri collection, we observed that a substantial amount of variation exists in the species collection. These markers will be valuable in germplasm management studies and lesquerella breeding, and augment the microsatellite markers previously developed on the taxa. PMID:23724020

  12. Method for Assigning Priority Levels in Acute Care (MAPLe-AC) predicts outcomes of acute hospital care of older persons - a cross-national validation

    PubMed Central

    2011-01-01

    Background Although numerous risk factors for adverse outcomes for older persons after an acute hospital stay have been identified, a decision making tool combining all available information in a clinically meaningful way would be helpful for daily hospital practice. The purpose of this study was to evaluate the ability of the Method for Assigning Priority Levels for Acute Care (MAPLe-AC) to predict adverse outcomes in acute care for older people and to assess its usability as a decision making tool for discharge planning. Methods Data from a prospective multicenter study in five Nordic acute care hospitals with information from admission to a one year follow-up of older acute care patients were compared with a prospective study of acute care patients from admission to discharge in eight hospitals in Canada. The interRAI Acute Care assessment instrument (v1.1) was used for data collection. Data were collected during the first 24 hours in hospital, including pre-morbid and admission information, and at day 7 or at discharge, whichever came first. Based on this information a crosswalk was developed from the original MAPLe algorithm for home care settings to acute care (MAPLe-AC). The sample included persons 75 years or older who were admitted to acute internal medical services in one hospital in each of the five Nordic countries (n = 763) or to acute hospital care either internal medical or combined medical-surgical services in eight hospitals in Ontario, Canada (n = 393). The outcome measures considered were discharge to home, discharge to institution or death. Outcomes in a 1-year follow-up in the Nordic hospitals were: living at home, living in an institution or death, and survival. Logistic regression with ROC curves and Cox regression analyses were used in the analyses. Results Low and mild priority levels of MAPLe-AC predicted discharge home and high and very high priority levels predicted adverse outcome at discharge both in the Nordic and Canadian data sets

  13. Peptic ulcer in hospital

    PubMed Central

    Johnson, H. Daintree

    1962-01-01

    This study corresponds to an estimated 142,250 admissions for peptic ulcer to the wards of National Health Service hospitals in England and Wales during the two years 1956 and 1957. It presents a picture of the incidence and mortality of complications and surgical treatment throughout England and Wales. PMID:14036965

  14. Segmenting tree crowns from terrestrial and mobile LiDAR data by exploring ecological theories

    NASA Astrophysics Data System (ADS)

    Tao, Shengli; Wu, Fangfang; Guo, Qinghua; Wang, Yongcai; Li, Wenkai; Xue, Baolin; Hu, Xueyang; Li, Peng; Tian, Di; Li, Chao; Yao, Hui; Li, Yumei; Xu, Guangcai; Fang, Jingyun

    2015-12-01

    The rapid development of light detection and ranging (LiDAR) techniques is advancing ecological and forest research. During the last decade, numerous single tree segmentation techniques have been developed using airborne LiDAR data. However, accurate crown segmentation using terrestrial or mobile LiDAR data, which is an essential prerequisite for extracting branch level forest characteristics, is still challenging mainly because of the difficulties posed by tree crown intersection and irregular crown shape. In the current work, we developed a comparative shortest-path algorithm (CSP) for segmenting tree crowns scanned using terrestrial (T)-LiDAR and mobile LiDAR. The algorithm consists of two steps, namely trunk detection and subsequent crown segmentation, with the latter inspired by the well-proved metabolic ecology theory and the ecological fact that vascular plants tend to minimize the transferring distance to the root. We tested the algorithm on mobile-LiDAR-scanned roadside trees and T-LiDAR-scanned broadleaved and coniferous forests in China. Point-level quantitative assessments of the segmentation results showed that for mobile-LiDAR-scanned roadside trees, all the points were classified to their corresponding trees correctly, and for T-LiDAR-scanned broadleaved and coniferous forests, kappa coefficients ranging from 0.83 to 0.93 were obtained. We believe that our algorithm will make a contribution to solving the problem of crown segmentation in T-LiDAR scanned-forests, and might be of interest to researchers in LiDAR data processing and to forest ecologists. In addition, our research highlights the advantages of using ecological theories as guidelines for processing LiDAR data.

  15. Using LiDAR to Estimate Surface Erosion Volumes within the Post-storm 2012 Bagley Fire

    NASA Astrophysics Data System (ADS)

    Mikulovsky, R. P.; De La Fuente, J. A.; Mondry, Z. J.

    2014-12-01

    The total post-storm 2012 Bagley fire sediment budget of the Squaw Creek watershed in the Shasta-Trinity National Forest was estimated using many methods. A portion of the budget was quantitatively estimated using LiDAR. Simple workflows were designed to estimate the eroded volume's of debris slides, fill failures, gullies, altered channels and streams. LiDAR was also used to estimate depositional volumes. Thorough manual mapping of large erosional features using the ArcGIS 10.1 Geographic Information System was required as these mapped features determined the eroded volume boundaries in 3D space. The 3D pre-erosional surface for each mapped feature was interpolated based on the boundary elevations. A surface difference calculation was run using the estimated pre-erosional surfaces and LiDAR surfaces to determine volume of sediment potentially delivered into the stream system. In addition, cross sections of altered channels and streams were taken using stratified random selection based on channel gradient and stream order respectively. The original pre-storm surfaces of channel features were estimated using the cross sections and erosion depth criteria. Open source software Inkscape was used to estimate cross sectional areas for randomly selected channel features and then averaged for each channel gradient and stream order classes. The average areas were then multiplied by the length of each class to estimate total eroded altered channel and stream volume. Finally, reservoir and in-channel depositional volumes were estimated by mapping channel forms and generating specific reservoir elevation zones associated with depositional events. The in-channel areas and zones within the reservoir were multiplied by estimated and field observed sediment thicknesses to attain a best guess sediment volume. In channel estimates included re-occupying stream channel cross sections established before the fire. Once volumes were calculated, other erosion processes of the Bagley

  16. Nursing Home Residents at Risk of Hospitalization and the Characteristics of Their Hospital Stays.

    ERIC Educational Resources Information Center

    Murtaugh, Christopher M.; Freiman, Marc P.

    1995-01-01

    Analysis of national medical data identified elderly nursing home residents with an elevated risk of hospitalization and the characteristics of their hospital stays. Findings indicate an elevated risk of hospitalization for residents diagnosed with one of several different primary diagnoses. Infections accounted for over 25% of hospital stays.…

  17. “Can’t you initiate me here?”: Challenges to timely initiation on antiretroviral therapy among methadone clients in Dar es Salaam, Tanzania

    PubMed Central

    Saleem, Haneefa T.; Mushi, Dorothy; Hassan, Saria; Bruce, R. Douglas; Cooke, Alexis; Mbwambo, Jessie; Lambdin, Barrot H.

    2016-01-01

    Background Despite dramatic improvement in antiretroviral therapy (ART) access globally, people living with HIV who inject drugs continue to face barriers that limit their access to treatment. This paper explores barriers and facilitators to ART initiation among clients attending a methadone clinic in Dar es Salaam, Tanzania. Methods We interviewed 12 providers and 20 clients living with HIV at the Muhimbili National Hospital methadone clinic between January and February 2015. We purposively sampled clients based on sex and ART status and providers based on job function. To analyze interview transcripts, we adopted a content analysis approach. Results Participants identified several factors that hindered timely ART initiation for clients at the methadone clinic. These included delays in CD4 testing and receiving CD4 test results; off-site HIV clinics; stigma operating at the individual, social and institutional levels; insufficient knowledge of the benefits of early ART initiation among clients; treatment breakdown at the clinic level possibly due to limited staff; and initiating ART only once one feels physically ill. Participants perceived social support as a buffer against stigma and facilitator of HIV treatment. Some clients also reported that persistent monitoring and follow-up on their HIV care and treatment by methadone clinic providers led them to initiate ART. Conclusion Health system factors, stigma and limited social support pose challenges for methadone clients living with HIV to initiate ART. Our findings suggest that on-site point-of-care CD4 testing, a peer support system, and trained HIV treatment specialists who are able to counsel HIV-positive clients and initiate them on ART at the methadone clinic could help reduce barriers to timely ART initiation for methadone clients. PMID:26831364

  18. Hospitality Management Education and Training.

    ERIC Educational Resources Information Center

    Brotherton, Bob, Ed.; And Others

    1995-01-01

    Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

  19. Synergy Between LiDAR and Image Data in Context of Building Extraction

    NASA Astrophysics Data System (ADS)

    Dal Poz, A. P.

    2014-11-01

    This paper compares the paradigms of LiDAR and aerophotogrammetry in the context of building extraction and briefly discusses a photogrammetric strategy for refining building roof polyhedrons previously extracted from LiDAR data. In general, empirical and theoretical studies have confirmed that LiDAR-based methodologies are more suitable in extracting planar roof faces and ridges of the roof, whereas the aerophotogrammetry are more suitable in extracting building roof outlines. In order to exemplify how to explore these properties, it is presented a photogrammetric method for refining 3D building roof contours extracted from airborne LiDAR data. Examples of application are provided for this refining approach.

  20. How integrating 3D LiDAR data in the dike surveillance protocol: The French case

    NASA Astrophysics Data System (ADS)

    Bretar, F.; Mériaux, P.; Fauchard, C.

    2012-04-01

    carried out. A LiDAR system is able to acquire data on a dike structure of up to 80 km per day, which makes the use of this technique also valuable in case of emergency situations. It provides additional valuable products like precious information on dike slopes and crest or their near environment (river banks, etc.). Moreover, in case of vegetation, LiDAR data makes possible to study hidden structures or defaults from images like the erosion of riverbanks under forestry vegetation. The possibility of studying the vegetation is also of high importance: the development of woody vegetation near or onto the dike is a major risk factor. Surface singularities are often signs of disorder or suspected disorder in the dike itself: for example a subsidence or a sinkhole on a ridge may result from internal erosion collapse. Finally, high resolution topographic data contribute to build specific geomechanical model of the dike that, after incorporating data provided by geophysical and geotechnical surveys, are integrated in the calculations of the structure stability. Integrating the regular use of LiDAR data in the dike surveillance protocol is not yet operational in France. However, the high number of French stakeholders at the national level (on average, there is one stakeholder for only 8-9km of dike !) and the real added value of LiDAR data makes a spatial data infrastructure valuable (webservices for processing the data, consulting and filling the database on the field when performing the local diagnosis)

  1. [The ANMCO (National Association of Hospital Cardiologists) in a changing health care system. Consensus development of the Organizing Symposium of the XXXI National Congress of Cardiology--ANMCO; Florence, May 21, 2000].

    PubMed

    2000-12-01

    This year's symposium, while following the 30-year-old tradition of Organizational Symposia which have become a trademark of the National Association of Hospital Cardiologists (ANMCO) annual meetings, is characterized by a novel approach in terms of method and content. Prompted by the profound changes affecting the socio-cultural, organizational and economic context in which the Health Service operates, the Board of the Association decided to invite the community of hospital-based cardiologists to reflect on and make proposals concerning a number of leading topics not strictly related to the organization of hospital-based cardiology, but of a wider relevance pertaining to the whole issue of the relationship between a Scientific Society and the other components of the Health Service: national and regional institutions, other doctors, the lay public and the pharmaceutical industry, etc. The main aim of this exercise was to stimulate the Society to adapt to a changing environment and so render it more capable of effectively fulfilling its duties. Naturally the larger the consensus regarding the strategies to adopt the greater this efficacy will be. Out of the many possible subjects, four were chosen as preeminent: 1. ANMCO and research: what fields of research should be prioritized, and with what kind of internal organization, and external relations? 2. ANMCO and professional training: what should be the professional standards governing the cardiologist in a changing society, what strategies for continuing education and institutional accreditation? 3. ANMCO and the community-based Health Service: the need to establish clear and efficient organizational relations with community-based cardiology and especially with general practitioners, in order to ensure that the health service is in tune with the real world, guarantee real continuity of care and reduce unnecessary hospital admissions; 4. ANMCO and the general population: how to support the citizen-user in the

  2. Assessing and Adapting LiDAR-Derived Pit-Free Canopy Height Model Algorithm for Sites with Varying Vegetation Structure

    NASA Astrophysics Data System (ADS)

    Scholl, V.; Hulslander, D.; Goulden, T.; Wasser, L. A.

    2015-12-01

    Spatial and temporal monitoring of vegetation structure is important to the ecological community. Airborne Light Detection and Ranging (LiDAR) systems are used to efficiently survey large forested areas. From LiDAR data, three-dimensional models of forests called canopy height models (CHMs) are generated and used to estimate tree height. A common problem associated with CHMs is data pits, where LiDAR pulses penetrate the top of the canopy, leading to an underestimation of vegetation height. The National Ecological Observatory Network (NEON) currently implements an algorithm to reduce data pit frequency, which requires two height threshold parameters, increment size and range ceiling. CHMs are produced at a series of height increments up to a height range ceiling and combined to produce a CHM with reduced pits (referred to as a "pit-free" CHM). The current implementation uses static values for the height increment and ceiling (5 and 15 meters, respectively). To facilitate the generation of accurate pit-free CHMs across diverse NEON sites with varying vegetation structure, the impacts of adjusting the height threshold parameters were investigated through development of an algorithm which dynamically selects the height increment and ceiling. A series of pit-free CHMs were generated using three height range ceilings and four height increment values for three ecologically different sites. Height threshold parameters were found to change CHM-derived tree heights up to 36% compared to original CHMs. The extent of the parameters' influence on modelled tree heights was greater than expected, which will be considered during future CHM data product development at NEON. (A) Aerial image of Harvard National Forest, (B) standard CHM containing pits, appearing as black speckles, (C) a pit-free CHM created with the static algorithm implementation, and (D) a pit-free CHM created through varying the height threshold ceiling up to 82 m and the increment to 1 m.

  3. Trends in Respiratory Syncytial Virus and Bronchiolitis Hospitalization Rates in High-Risk Infants in a United States Nationally Representative Database, 1997–2012

    PubMed Central

    Doucette, Abigail; Jiang, Xiaohui; Fryzek, Jon; Coalson, Jenna; McLaurin, Kimmie; Ambrose, Christopher S.

    2016-01-01

    Background Respiratory syncytial virus (RSV) causes significant pediatric morbidity and is the most common cause of bronchiolitis. Bronchiolitis hospitalizations declined among US infants from 2000‒2009; however, rates in infants at high risk for RSV have not been described. This study examined RSV and unspecified bronchiolitis (UB) hospitalization rates from 1997‒2012 among US high-risk infants. Methods The Kids’ Inpatient Database (KID) infant annual RSV (ICD-9 079.6, 466.11, 480.1) and UB (ICD-9 466.19, 466.1) hospitalization rates were estimated using weighted counts. Denominators were based on birth hospitalizations with conditions associated with high-risk for RSV: chronic perinatal respiratory disease (chronic lung disease [CLD]); congenital airway anomalies (CAA); congenital heart disease (CHD); Down syndrome (DS); and other genetic, metabolic, musculoskeletal, and immunodeficiency conditions. Preterm infants could not be identified. Hospitalizations were characterized by mechanical ventilation, inpatient mortality, length of stay, and total cost (2015$). Poisson and linear regression were used to test statistical significance of trends. Results RSV and UB hospitalization rates were substantially elevated for infants with higher-risk CHD, CLD, CAA and DS without CHD compared with all infants. RSV rates declined by 47.0% in CLD and 49.7% in higher-risk CHD infants; no other declines in high-risk groups were observed. UB rates increased in all high-risk groups except for a 22.5% decrease among higher-risk CHD. Among high-risk infants, mechanical ventilation increased through 2012 to 20.4% and 13.5% of RSV and UB hospitalizations; geometric mean cost increased to $31,742 and $25,962, respectively, and RSV mortality declined to 0.9%. Conclusions Among high-risk infants between 1997 and 2012, RSV hospitalization rates declined among CLD and higher-risk CHD infants, coincident with widespread RSV immunoprophylaxis use in these populations. UB

  4. Terrestrial LiDAR monitoring of rock slope-channel coupling

    NASA Astrophysics Data System (ADS)

    Bell, R.; Blöthe, J. H.; Meyer, N. K.; Hoffmann, T.; Hoffert, H.; Kreiner, D.; Elverfeldt, K. V.

    2009-04-01

    In steep terrain, various types of landslides (e.g. rock falls, debris flows and slides) are important erosional processes which often have a major impact on fluvial systems. On the one hand, they may divert river channels to opposite slopes or even block entire river channels, leading to the formation of landslide-dammed lakes. On the other hand, rivers prepare or even trigger landslides by undercutting slopes, which again will have an impact on the river channel. Our focus is on two study areas. One of them, the Schlichem Valley, is located in the Swabian Alb (SW-Germany), a lower mountain range consisting of Jurassic sedimentary rocks forming a cuesta landscape. There, the focus is on a larger landslide complex which blocked the river Schlichem three times during the 18th century and which is still active. Recent activity, especially at the location where the landslide enters the fluvial system, is investigated using Terrestrial LiDAR monitoring. The second study area is located in the Gesaeuse National Park in the Austrian Alps. There, various geomorphic environments are investigated by Terrestrial LiDAR including a vertical rock face in Dachstein limestone, which talus slope is directly coupled to the river Enns. The talus slope is built up by rock fall deposits, eroded mainly through smaller debris flow events. Furthermore, the talus slope is undercut by flood events of the river Enns. In this study a concept and first results are presented. They suggest how rock slope processes and their interactions with river channels can be monitored.

  5. Using LiDAR, RADAR, and Optical data to improve a NFMS in Kalimantan, Indonesia

    NASA Astrophysics Data System (ADS)

    Hagen, S. C.; Saatchi, S. S.; Braswell, B. H., Jr.; Palace, M. W.; Salas, W.; Walker, S.; Hoekman, D.; Ipsan, C.; Brown, S.; Sullivan, F.

    2014-12-01

    Around the world, governments are establishing national forest monitoring systems (NFMS) that use a combination of remote sensing and ground-based forest carbon inventory approaches to estimate anthropogenic forest-related greenhouse gas emissions and removals. The NFMS forms the link between historical assessments and current/future assessments of forests, enabling consistency in the data and information to support the implementation of REDD+ activities. The creation of a reliable, transparent, and comprehensive NFMS is currently limited by a dearth of relevant data that are accurate, low-cost, and spatially resolved at subnational scales. With funding from a 3-year NASA Carbon Monitoring System project beginning in September 2013, we are developing, evaluating, and validating several critical components of an NFMS in Kalimantan, Indonesia, focusing on the use of LiDAR and radar imagery for improved carbon stock and forest degradation information. Here, we present results from an initial analysis of a spatially extensive set of LiDAR data collected across the Indonesian provinces on the island of Borneo together with RADAR and optical data. Our objectives are to evaluate sensor and platform tradeoffs systematically against in situ investments, as well as provide detailed tracking and characterization of uncertainty in a cost-benefit framework. Kalimantan is an ideal area to evaluate the use of remote sensing methods because measuring forest carbon stocks and their human caused changes with a high degree of certainty on the ground can be difficult. While our work focuses at the subnational scale for Kalimantan, we are targeting these methods for applicability across broader geographies and for implementation at various scales.

  6. Data Archiving and Distribution of LiDAR and Derived Datasets in the Philippines

    NASA Astrophysics Data System (ADS)

    Tupas, M. E. A.; Lat, S. C.; Magturo, R. A.

    2016-06-01

    LiDAR programs in the Philippines have been generating valuable resource and hazard information for most of the country at a substantial rate since 2012. Significant progress have been made due to the programs design of engaging 16 Universities and research institutions spatially distributed across the country. Because of this, data has been accumulating at a brisk rate which poses significant technical and logistic issues. While a central node, the University of the Philippines, Diliman, handles data acquisition, pre-processing, and quality checking, processing and ground validation are devolved to the various nodes. For this setup to be successful, an efficient data access and distribution system should be in place. In this paper, we discuss the spatial data infrastructure and data access protocols implemented by the program. At the center of the data access and distribution operations is LiPAD or our LiDAR portal for archiving and distribution. LiPAD is built on open source technologies, established web standards, and protocols. At its back-end a central data archive has been established using state of the art Object Storage technology to store both raw, processed Lidar and derived data sets. Catalog of available data sets ranging from data acquisition foot prints, to DEM coverages, to derived products such as flood hazard, and crop suitability are viewable and accessible on the main site based on the popular GeoNode application. Data exchange is performed using varying protocols to address various logistical problems. Given the various challenges the program is successful in distributing data sets not just to partner processing nodes but to other stakeholders where main requesters include national agencies and general research and academic institutions.

  7. Financing hospital disaster preparedness.

    PubMed

    De Lorenzo, Robert A

    2007-01-01

    Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. Under current policy, virtually the entire funding stream for hospital preparedness comes from general tax revenues. Medical payers (e.g., Medicare, Medicaid, and private insurance) directly fund little, if any, of the current bill. Funding options to improve preparedness include increasing the current federal grants allocated to hospitals, using payer fees or a tax to subsidize preparedness, and financing other forms of expansion capability, such as mobile hospitals. Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk. PMID:18087914

  8. Mother-baby friendly hospital.

    PubMed

    Aragon-choudhury, P

    1996-01-01

    In Manila, the Philippines, the Dr. Jose Fabella Memorial Hospital has been a maternity hospital for 75 years. It averages 90 deliveries a day. Its fees are P200-P500 for a normal delivery and P800-P2000 for a cesarean section. Patients pay what they can and pay the balance when they can. The hospital provides a safe motherhood package that encompasses teaching responsible parenthood, prenatal care, labor, delivery, postpartum care, breast feeding, family planning, and child survival. In 1986, the hospital introduced innovative policies and procedures that promote, protect, and support breast feeding. It has a rooming-in policy that has saved the hospital P6.5 million so far. In the prenatal stage, hospital staff inform pregnant women that colostrum protects the newborn against infections, that suckling stimulates milk production, and that there is no basis to the claim of having insufficient breast milk. Sales representatives of milk substitutes are banned from the hospital. Staff confiscate milk bottles or formula. A lactation management team demonstrates breast feeding procedures. Mothers also receive support on the correct way of breast feeding from hospital staff, volunteers from the Catholic Women's League, consumer groups, and women lawyers. The hospital's policy is no breast milk, no discharge. This encourages mothers to motivate each other to express milk immediately after birth. The hospital has received numerous awards for its breast feeding promotion efforts. UNICEF has designated Fabella Hospital as a model of the Baby-Friendly Hospital Initiative. The hospital serves as the National Lactation Management Education Training Center. People from other developing countries have received training in lactation management here. The First Lady of the Philippines, the First Lady of the US, and the Queen of Spain have all visited the hospital. The hospital has also integrated its existing services into a women's health care center. PMID:12347466

  9. The Daily Activity Report (DAR) a Novel Measure of Functional Outcome for Serious Mental Illness.

    PubMed

    Velligan, Dawn I; Mintz, Jim; Sierra, Cynthia; Martin, Mona L; Fredrick, Megan; Maglinte, Gregory A; Corey-Lisle, Patricia K

    2016-05-01

    The assessment of real-world functional outcomes in clinical trials for medications targeting negative symptoms and cognitive impairment is extremely important. We tested the psychometric properties of the Daily Activity Report (DAR), a novel assessment of productive daily activity. We administered the DAR and additional assessments of functional outcome, functional capacity, cognition and symptomatology to 50 individuals with schizophrenia at 2 time points, 1 month apart and to 25 healthy controls. The DAR records a person's daily activity for 7 consecutive days based upon phone calls made 3 times a day. A total score and scores in 3 domains; instrumental activities (ie, independent living), social and work or school related activities are generated for the DAR. Inter-item consistency was high 0.89-0.94 for each domain and 0.88 overall. Test-retest reliability across 1 month for the total DAR score was 0.67,P< .0001. The total DAR score as well as scores for social activity and nondomestic work/school differed significantly between control and patient participants (P< .0001). DAR domain scores were associated with negative symptoms and functional outcomes, but the primary score related to these measures was the work/school dimension of the DAR. DAR scores were only weakly and nonsignificantly related to positive symptoms. This study provides preliminary support for the reliability and validity of the DAR using interviewer administration. The development of a patient reported version of the DAR using smart phone technology with automatic scoring is the next step. PMID:26712856

  10. The Daily Activity Report (DAR) a Novel Measure of Functional Outcome for Serious Mental Illness

    PubMed Central

    Velligan, Dawn I.; Mintz, Jim; Sierra, Cynthia; Martin, Mona L.; Fredrick, Megan; Maglinte, Gregory A.; Corey-Lisle, Patricia K.

    2016-01-01

    The assessment of real-world functional outcomes in clinical trials for medications targeting negative symptoms and cognitive impairment is extremely important. We tested the psychometric properties of the Daily Activity Report (DAR), a novel assessment of productive daily activity. We administered the DAR and additional assessments of functional outcome, functional capacity, cognition and symptomatology to 50 individuals with schizophrenia at 2 time points, 1 month apart and to 25 healthy controls. The DAR records a person’s daily activity for 7 consecutive days based upon phone calls made 3 times a day. A total score and scores in 3 domains; instrumental activities (ie, independent living), social and work or school related activities are generated for the DAR. Inter-item consistency was high 0.89–0.94 for each domain and 0.88 overall. Test–retest reliability across 1 month for the total DAR score was 0.67, P < .0001. The total DAR score as well as scores for social activity and nondomestic work/school differed significantly between control and patient participants (P < .0001). DAR domain scores were associated with negative symptoms and functional outcomes, but the primary score related to these measures was the work/school dimension of the DAR. DAR scores were only weakly and nonsignificantly related to positive symptoms. This study provides preliminary support for the reliability and validity of the DAR using interviewer administration. The development of a patient reported version of the DAR using smart phone technology with automatic scoring is the next step. PMID:26712856

  11. Hospital fundamentals.

    PubMed

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID

  12. Assessment of drainage network extractions in a low-relief area of the Cuvelai Basin (Namibia) from multiple sources: LiDAR, topographic maps, and digital aerial orthophotographs

    NASA Astrophysics Data System (ADS)

    Persendt, F. C.; Gomez, C.

    2016-05-01

    Accurate delineation of drainage networks (DNs) is crucial for hydrological or hydraulic modelling, and the comprehension of fluvial processes. This task presents challenging aspects in complex lowland terrains with subtle relief and particularly for data poor-areas like the Cuvelai river basin (CRB), Namibia, where the present study takes place. In the CRB standard methods of drainage network extraction from low resolution gridded digital elevation models (DEMs) are unsuitable, hence airborne Light Detection and Ranging (LiDAR) solutions have been utilized. However, LiDAR also presents challenges to large areal applications, especially with a surface roughness exceeding the capacity of numerous algorithms. Indeed, LiDAR-based DEMs (2 and 50 m resolutions) need to be hydrologically corrected and smoothed to enable the extraction of scale-relevant geomorphologic features such as DNs. In the present contribution, channels from topographic maps (blue lines) were compared to those from hydrologically corrected and uncorrected LiDAR DEMs, heads-up digitized channels from high-resolution digital aerial orthophotographs, field-mapped channels and auxiliary data. The 'maximum gradient deterministic eight (D8)' GIS algorithm was applied to the corrected and uncorrected LiDAR DEMs using two network extraction methods: area threshold support and curvature/drop analysis. Different progressive flow accumulation threshold values (12) were used to delineate channels with these methods. Validation was performed between the field-mapped channels, the modelled channels and those derived from multiple sources. Additionally, spatial and quantitative analyses were performed on geomorphologic parameters and indices. The results have shown that hydrologically corrected LiDAR DEMs offer useful details for identifying low order stream segments in headwaters, while blue lines derived from the national hydrography datasets for watersheds, located in elevated and low-lying areas of the study

  13. Performance testing of LiDAR exploitation software

    NASA Astrophysics Data System (ADS)

    Varela-González, M.; González-Jorge, H.; Riveiro, B.; Arias, P.

    2013-04-01

    Mobile LiDAR systems are being used widely in recent years for many applications in the field of geoscience. One of most important limitations of this technology is the large computational requirements involved in data processing. Several software solutions for data processing are available in the market, but users are often unknown about the methodologies to verify their performance accurately. In this work a methodology for LiDAR software performance testing is presented and six different suites are studied: QT Modeler, AutoCAD Civil 3D, Mars 7, Fledermaus, Carlson and TopoDOT (all of them in x64). Results depict as QTModeler, TopoDOT and AutoCAD Civil 3D allow the loading of large datasets, while Fledermaus, Mars7 and Carlson do not achieve these powerful performance. AutoCAD Civil 3D needs large loading time in comparison with the most powerful softwares such as QTModeler and TopoDOT. Carlson suite depicts the poorest results among all the softwares under study, where point clouds larger than 5 million points cannot be loaded and loading time is very large in comparison with the other suites even for the smaller datasets. AutoCAD Civil 3D, Carlson and TopoDOT show more threads than other softwares like QTModeler, Mars7 and Fledermaus.

  14. Identifying Colluvial Slopes by Airborne LiDAR Analysis

    NASA Astrophysics Data System (ADS)

    Kasai, M.; Marutani, T.; Yoshida, H.

    2015-12-01

    Colluvial slopes are one of major sources of landslides. Identifying the locations of the slopes will help reduce the risk of disasters, by avoiding building infrastructure and properties nearby, or if they are already there, by applying appropriate counter measures before it suddenly moves. In this study, airborne LiDAR data was analyzed to find their geomorphic characteristics to use for extracting their locations. The study site was set in the suburb of Sapporo City, Hokkaido in Japan. The area is underlain by Andesite and Tuff and prone to landslides. Slope angle and surface roughness were calculated from 5 m resolution DEM. These filters were chosen because colluvial materials deposit at around the angle of repose and accumulation of loose materials was considered to form a peculiar surface texture differentiable from other slope types. Field survey conducted together suggested that colluvial slopes could be identified by the filters with a probability of 80 percent. Repeat LiDAR monitoring of the site by an unmanned helicopter indicated that those slopes detected as colluviums appeared to be moving at a slow rate. In comparison with a similar study from the crushed zone in Japan, the range of slope angle indicative of colluviums agreed with the Sapporo site, while the texture was rougher due to larger debris composing the slopes.

  15. Patient-reported outcomes at hospital discharge from Heart Centres, a national cross-sectional survey with a register-based follow-up: the DenHeart study protocol

    PubMed Central

    Berg, Selina Kikkenborg; Svanholm, Jette; Lauberg, Astrid; Borregaard, Britt; Herning, Margrethe; Mygind, Anna; Christensen, Anne Vinggaard; Christensen, Anne Illemann; Ekholm, Ola; Juel, Knud; Thrysøe, Lars

    2014-01-01

    Introduction Patient reported health status, which includes symptom burden, functional status and quality of life, is an important measure of health. Differences in health status between diagnostic groups within cardiology have only been sparsely investigated. These outcomes may predict morbidity, mortality, labour market affiliation and healthcare utilisation in various diagnostic groups. A national survey aiming to include all cardiac diagnostic groups from a total Heart Centre population has been designed as the DenHeart survey. Methods and analysis DenHeart is designed as a cross-sectional survey with a register-based follow-up. All diagnostic groups at the five national Heart Centres are included during 1 year (15 April 2013 to 15 April 2014) and asked to fill out a questionnaire at hospital discharge. The total eligible population, both responders and non-responders, will be followed in national registers. The following instruments are used: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire (B-IPQ), HeartQoL and Edmonton Symptom Assessment Scale. The following variables are collected from national registers: action diagnosis, procedures, comorbidity, length of hospital stay, type of hospitalisation, visits to general practitioners and other agents in primary healthcare, dispensed prescription medication, vital status and cause of death. Labour market affiliation, sick leave, early retirement pension, educational degree and income will be collected from registers. Frequency distributions and multiple logistic regression analyses will be used to describe and assess differences in patient reported outcomes at hospital discharge between diagnostic groups and in-hospital predicting factors. Cox proportional hazards regression models with age as the time scale will be used to investigate associations between patient reported outcomes at baseline and morbidity/mortality, labour market affiliation and healthcare utilisation

  16. Hospital Hints

    MedlinePlus

    ... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... have to spend the night in the hospital. Learning more about what to expect and about people ...

  17. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

    It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise. PMID:23614267

  18. Remote sensing of Sonoran Desert vegetation structure and phenology with ground-based LiDAR

    USGS Publications Warehouse

    Sankey, Joel B.; Munson, Seth M.; Webb, Robert H.; Wallace, Cynthia S.A.; Duran, Cesar M.

    2015-01-01

    Long-term vegetation monitoring efforts have become increasingly important for understanding ecosystem response to global change. Many traditional methods for monitoring can be infrequent and limited in scope. Ground-based LiDAR is one remote sensing method that offers a clear advancement to monitor vegetation dynamics at high spatial and temporal resolution. We determined the effectiveness of LiDAR to detect intra-annual variability in vegetation structure at a long-term Sonoran Desert monitoring plot dominated by cacti, deciduous and evergreen shrubs. Monthly repeat LiDAR scans of perennial plant canopies over the course of one year had high precision. LiDAR measurements of canopy height and area were accurate with respect to total station survey measurements of individual plants. We found an increase in the number of LiDAR vegetation returns following the wet North American Monsoon season. This intra-annual variability in vegetation structure detected by LiDAR was attributable to a drought deciduous shrub Ambrosia deltoidea, whereas the evergreen shrub Larrea tridentata and cactus Opuntia engelmannii had low variability. Benefits of using LiDAR over traditional methods to census desert plants are more rapid, consistent, and cost-effective data acquisition in a high-resolution, 3-dimensional context. We conclude that repeat LiDAR measurements can be an effective method for documenting ecosystem response to desert climatology and drought over short time intervals and at detailed-local spatial scale.

  19. LiDAR, a great tool for archaeologists, but how do you interpret it?

    NASA Astrophysics Data System (ADS)

    Leisz, S.; Fisher, C.

    2013-05-01

    This paper focuses on the use of airborne LiDAR to identify archaeological features below forest canopies in Mesoamerica and the challenges faced in interpreting the data. To illustrate the issues involved in interpreting LiDAR point clouds and derived data sets for archaeological purposes, the case study of the use of airborne LiDAR at the archaeological site of Angamuco in West-Central Mexico is discussed. The case study details the reason LiDAR was collected, the challenges in interpreting it, methods and techniques that the authors are investigating to improve the interpretation of the LiDAR, and discoveries that have so far been made through the use of LiDAR. A key point discussed is the need to analyze the LiDAR point cloud in conjunction with products developed from the point cloud. Analyzing the various data sets jointly allows the user to better identify archaeological features of interest. New ways of utilizing hillshades of DEMs, such as creating 360 degree hillshades of the derived DEMs, are also presented. Last the authors discuss their experience in using object-based classification of the products derived from the LiDAR point cloud as an example of one possible technique for automating the delineation and classification of archaeological features.

  20. Dia de Dar Gracias. Modulo Nivel Primario. (Day to Give Thanks. Module Primary Level.)

    ERIC Educational Resources Information Center

    Espinoza, Delia; Lopez, Santiago, III

    Dia de Dar Gracias (Thanksgiving) is the subject of this primary level unit. The unit objectives are to: (1) know about El Dia de Dar Gracias as it is celebrated in the United States; (2) know how the Mayas celebrated it; (3) understand the context of the stories in the unit; (4) know about the main food used, the turkey; (5) distinguish other…

  1. 4D Terrestrial LiDAR Data Collection: Geomorphic and Hydraulic Applications (Invited)

    NASA Astrophysics Data System (ADS)

    Minear, J. T.; Wright, S. A.; Kinzel, P. J.; Draut, A. E.; Logan, J.

    2013-12-01

    Terrestrial LiDAR, also known as T-LiDAR, ground-based LiDAR, or Terrestrial Laser Scanning, can provide great insights into some types of geomorphic and hydraulic studies, particularly when collected repeatedly over time. Because T-LiDAR collects a large amount of data on a set grid, oftentimes processes are inadvertently captured that are not part of the initial research question but can be important factors in their own right. In addition, though T-LiDAR is most often used at relatively small sites for high-precision scanning, it also can be used for relatively rapid meso-scale site measurements, albeit typically with less precision. Using examples from the Elwha River dam removals, WA, a canal experiment in NE, and several small river restoration sites in CA, we highlight several important and innovative uses of T-LiDAR measurements, including quick temporal scale changes in water surface features and larger temporal- and spatial-scale changes in reservoir deltaic deposits and longitudinal profile features. Also discussed will be some considerations for improving T-LiDAR error estimation and a comparison to other data collection techniques, including aerial LiDAR, structure-from-motion photogrammetry, and UAV- and plane-captured photogrammetry.

  2. Wetland inundation mapping and change monitoring using landsat and airborne LiDAR data

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper presents a new approach for mapping wetland inundation change using Landsat and LiDAR intensity data. In this approach, LiDAR data were used to derive highly accurate reference subpixel inundation percentage (SIP) maps at the 30-m resolution. The reference SIP maps were then used to est...

  3. Applicability of Aerial Green LiDAR to a Large River in the Western United States

    NASA Astrophysics Data System (ADS)

    Conner, J. T.; Welcker, C. W.; Cooper, C.; Faux, R.; Butler, M.; Nayegandhi, A.

    2013-12-01

    In October 2012, aerial green LiDAR data were collected in the Snake River (within Idaho and Oregon) to test this emerging technology in a large river with poor water clarity. Six study areas (total of 30 river miles spread out over 250 river miles) were chosen to represent a variety of depths, channel types, and surface conditions to test the accuracy, depth penetration, data density of aerial green LiDAR. These characteristics along with cost and speed of acquisition were compared to other bathymetric survey techniques including rod surveys (total station and RTK-GPS), single-beam sonar, and multibeam echosounder (MBES). The green LiDAR system typically measured returns from the riverbed through 1-2 meters of water, which was less than one Secchi depth. However, in areas with steep banks or aquatic macrophytes, LiDAR returns from the riverbed were less frequent or non-existent. In areas of good return density, depths measured from green LiDAR data corresponded well with previously collected data sets from traditional bathymetric survey techniques. In such areas, the green LiDAR point density was much higher than both rod and single beam sonar surveys, yet lower than MBES. The green LiDAR survey was also collected more efficiently than all other methods. In the Snake River, green LiDAR does not provide a method to map the entire riverbed as it only receives bottom returns in shallow water, typically at the channel margins. However, green LiDAR does provide survey data that is an excellent complement to MBES, which is more effective at surveying the deeper portions of the channel. In some cases, the green LiDAR was able to provide data in areas that the MBES could not, often due to issues with navigating the survey boat in shallow water. Even where both MBES and green LiDAR mapped the river bottom, green LiDAR often provides more accurate data through a better angle of incidence and less shadowing than the MBES survey. For one MBES survey in 2013, the green LiDAR

  4. The risks of getting hospital discharge wrong.

    PubMed

    2016-08-01

    Hospital discharge remains a hot topic for all of us who work with older people. As the recent National Audit Office (NAO) 2016 report on discharging older patients from hospital rather bluntly put it: 'There are currently far too many older people in hospitals who do not need to be there.' PMID:27573940

  5. Multipath estimation in urban environments from joint GNSS receivers and LiDAR sensors.

    PubMed

    Ali, Khurram; Chen, Xin; Dovis, Fabio; De Castro, David; Fernández, Antonio J

    2012-01-01

    In this paper, multipath error on Global Navigation Satellite System (GNSS) signals in urban environments is characterized with the help of Light Detection and Ranging (LiDAR) measurements. For this purpose, LiDAR equipment and Global Positioning System (GPS) receiver implementing a multipath estimating architecture were used to collect data in an urban environment. This paper demonstrates how GPS and LiDAR measurements can be jointly used to model the environment and obtain robust receivers. Multipath amplitude and delay are estimated by means of LiDAR feature extraction and multipath mitigation architecture. The results show the feasibility of integrating the information provided by LiDAR sensors and GNSS receivers for multipath mitigation. PMID:23202177

  6. Using a multiwavelength LiDAR for improved remote sensing of natural waters.

    PubMed

    Gray, Deric J; Anderson, John; Nelson, Jean; Edwards, Jarrod

    2015-11-01

    This paper describes research to characterize the benefits of a multiwavelength oceanographic LiDAR for various water types. Field measurements were conducted to establish endmembers representative of both typical and extremely challenging natural conditions. Laboratory tests were performed using a prototype multiwavelength LiDAR in water tanks with optical conditions simulating both sediment-laden and biologically rich water types. LiDAR models were used to simulate the LiDAR signal from both field and laboratory experiments. Our measurements and models show that using a laser wavelength of 470-490 nm in the open ocean leads to an improvement factor of 1.50-1.75 compared to a 532 nm system. In more turbid areas using a laser wavelength of 560-580 nm leads to an improvement factor of 1.25. We conclude by demonstrating how using multiple LiDAR wavelengths can help detect and characterize constituents in the water column. PMID:26560612

  7. Multipath Estimation in Urban Environments from Joint GNSS Receivers and LiDAR Sensors

    PubMed Central

    Ali, Khurram; Chen, Xin; Dovis, Fabio; De Castro, David; Fernández, Antonio J.

    2012-01-01

    In this paper, multipath error on Global Navigation Satellite System (GNSS) signals in urban environments is characterized with the help of Light Detection and Ranging (LiDAR) measurements. For this purpose, LiDAR equipment and Global Positioning System (GPS) receiver implementing a multipath estimating architecture were used to collect data in an urban environment. This paper demonstrates how GPS and LiDAR measurements can be jointly used to model the environment and obtain robust receivers. Multipath amplitude and delay are estimated by means of LiDAR feature extraction and multipath mitigation architecture. The results show the feasibility of integrating the information provided by LiDAR sensors and GNSS receivers for multipath mitigation. PMID:23202177

  8. Who is less likely to die in association with improved National Emergency Access Target (NEAT) compliance for emergency admissions in a tertiary referral hospital?

    PubMed

    Sullivan, Clair; Staib, Andrew; Eley, Rob; Griffin, Bronwyn; Cattell, Rohan; Flores, Judy; Scott, Ian

    2016-04-01

    Objective The aim of the present study was to identify patient and non-patient factors associated with reduced mortality among patients admitted from the emergency department (ED) to in-patient wards in a major tertiary hospital that had previously reported a near halving in mortality in association with a doubling in National Emergency Access Target (NEAT) compliance over a 2-year period from 2012 to 2014. Methods We retrospectively analysed routinely collected data from the Emergency Department Information System (EDIS) and hospital discharge abstracts on all emergency admissions during calendar years 2011 (pre-NEAT interventions) and 2013 (post-NEAT interventions). Patients admitted to short-stay wards and then discharged home, as well as patients dying in the ED, were excluded. Patients included in the study were categorised according to age, time and day of arrival to the ED, mode of transport to the ED, emergency triage category, type of clinical presentation and major diagnostic codes. Results The in-patient mortality rate for emergency admissions decreased from 1.9% (320/17022) in 2011 to 1.2% (202/17162) in 2013 (P<0.001). There was no change from 2011 to 2013 in the percentage of deaths in the ED (0.19% vs 0.17%) or those coded as in-patient palliative care (17.9% vs 22.2%). Although deaths were not associated with age by itself, the mortality rate of older patients admitted to medical wards decreased significantly from 3.5% to 1.7% (P=0.011). A higher mortality rate was seen among patients presenting to ED triage between midnight and 12 noon than at other times in 2011 (2.5% vs 1.5%; P<0.001), but this difference disappeared by 2013 (1.3% vs 1.1%; P=0.150). A similar pattern was seen among patients presenting on weekends versus weekdays: 2.2% versus 1.7% (P=0.038) in 2011 and 1.3% versus 1.1% (P=0.150) in 2013. Fewer deaths were noted among patients with acute cardiovascular or respiratory disease in 2013 than in 2011 (1.7% vs 3.6% and 1.5% vs 3

  9. Modelling Sensor and Target effects on LiDAR Waveforms

    NASA Astrophysics Data System (ADS)

    Rosette, J.; North, P. R.; Rubio, J.; Cook, B. D.; Suárez, J.

    2010-12-01

    The aim of this research is to explore the influence of sensor characteristics and interactions with vegetation and terrain properties on the estimation of vegetation parameters from LiDAR waveforms. This is carried out using waveform simulations produced by the FLIGHT radiative transfer model which is based on Monte Carlo simulation of photon transport (North, 1996; North et al., 2010). The opportunities for vegetation analysis that are offered by LiDAR modelling are also demonstrated by other authors e.g. Sun and Ranson, 2000; Ni-Meister et al., 2001. Simulations from the FLIGHT model were driven using reflectance and transmittance properties collected from the Howland Research Forest, Maine, USA in 2003 together with a tree list for a 200m x 150m area. This was generated using field measurements of location, species and diameter at breast height. Tree height and crown dimensions of individual trees were calculated using relationships established with a competition index determined for this site. Waveforms obtained by the Laser Vegetation Imaging Sensor (LVIS) were used as validation of simulations. This provided a base from which factors such as slope, laser incidence angle and pulse width could be varied. This has enabled the effect of instrument design and laser interactions with different surface characteristics to be tested. As such, waveform simulation is relevant for the development of future satellite LiDAR sensors, such as NASA’s forthcoming DESDynI mission (NASA, 2010), which aim to improve capabilities of vegetation parameter estimation. ACKNOWLEDGMENTS We would like to thank scientists at the Biospheric Sciences Branch of NASA Goddard Space Flight Center, in particular to Jon Ranson and Bryan Blair. This work forms part of research funded by the NASA DESDynI project and the UK Natural Environment Research Council (NE/F021437/1). REFERENCES NASA, 2010, DESDynI: Deformation, Ecosystem Structure and Dynamics of Ice. http

  10. LiDAR Analysis of Hector Mine Fault Scarp Degradation

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Hudnut, K. W.; Glennie, C. L.; Sousa, F.; Stock, J. M.; Akciz, S. O.

    2014-12-01

    The Mw 7.1 right-lateral strike-slip Hector Mine earthquake occurred on 10/16/1999 and generated an approximately 48 km long surface rupture. The Lavic Lake fault and the central section of the Bullion fault and several lesser faults ruptured, characterized by maximum strike slip of 5.25 ±0.85 m [Treiman, 2002]. As a very remote and un-populated area of the Mojave Desert, southern California, the study area is highly favorable for fault degradation studies with essentially no influence from vegetation or human activity. Airborne LiDAR (light detection and ranging) data and terrestrial laser scanning (TLS) are used to evaluate the form and rate of degradation of scarps along the Hector Mine fault rupture, California, USA. Airborne LiDAR data were acquired in 2000 and 2012 and these data were differenced using a newly developed algorithm for point cloud matching, which is improved over prior methods by accounting for scan geometry error sources. Using the bi-temporal data (scrutinizing profiles from 2000 & 2012), parameters for a fault scarp diffusion model are estimated and then a simulation result is generated to predict the evolved landform shape at the time of the 2014 TLS data set. Results are checked against TLS 2014 data collected at five key sites within the maximum slip field study area. In the past, scarp degradation has been mostly investigated using traditional survey methods (e.g., measuring elevations of points in a line perpendicular to the scarp) that require time-consuming field work and tend to introduce bias and variance due to data limitations. Airborne, mobile and terrestrial LiDAR data offer great potential to precisely document and rigorously determine morphologic degradation of fault scarps [Hilley et al., 2010]. In the present study, a unique set of data have been acquired at three points in time across several classic types of fault scarps and offset fault zone features. This allows progress in assessing the fitting of functions and

  11. Canopy wake measurements using multiple scanning wind LiDARs

    NASA Astrophysics Data System (ADS)

    Markfort, Corey D.; Carbajo Fuertes, Fernando; Valerio Iungo, Giacomo; Stefan, Heinz; Porté-Agel, Fernando

    2014-05-01

    Canopy wakes have been shown, in controlled wind tunnel experiments, to significantly affect the fluxes of momentum, heat and other scalars at the land and water surface over distances of ~O(1 km), see Markfort et al. (EFM, 2013). However, there are currently no measurements of the velocity field downwind of a full-scale forest canopy. Point-based anemometer measurements of wake turbulence provide limited insight into the extent and details of the wake structure, whereas scanning Doppler wind LiDARs can provide information on how the wake evolves in space and varies over time. For the first time, we present measurements of the velocity field in the wake of a tall patch of forest canopy. The patch consists of two uniform rows of 35-meter tall deciduous, plane trees, which border either side of the Allée de Dorigny, near the EPFL campus. The canopy is approximately 250 m long, and it is 35 m wide, along the direction of the wind. A challenge faced while making field measurements is that the wind rarely intersects a canopy normal to the edge. The resulting wake flow may be deflected relative to the mean inflow. Using multiple LiDARs, we measure the evolution of the wake due to an oblique wind blowing over the canopy. One LiDAR is positioned directly downwind of the canopy to measure the flow along the mean wind direction and the other is positioned near the canopy to evaluate the transversal component of the wind and how it varies with downwind distance from the canopy. Preliminary results show that the open trunk space near the base of the canopy results in a surface jet that can be detected just downwind of the canopy and farther downwind dissipates as it mixes with the wake flow above. A time-varying recirculation zone can be detected by the periodic reversal of the velocity vector near the surface, downwind of the canopy. The implications of canopy wakes for measurement and modeling of surface fluxes will be discussed.

  12. Canopy wake measurements using multiple scanning wind LiDARs

    NASA Astrophysics Data System (ADS)

    Markfort, C. D.; Carbajo Fuertes, F.; Iungo, V.; Stefan, H. G.; Porte-Agel, F.

    2014-12-01

    Canopy wakes have been shown, in controlled wind tunnel experiments, to significantly affect the fluxes of momentum, heat and other scalars at the land and water surface over distances of ˜O(1 km), see Markfort et al. (EFM, 2013). However, there are currently no measurements of the velocity field downwind of a full-scale forest canopy. Point-based anemometer measurements of wake turbulence provide limited insight into the extent and details of the wake structure, whereas scanning Doppler wind LiDARs can provide information on how the wake evolves in space and varies over time. For the first time, we present measurements of the velocity field in the wake of a tall patch of forest canopy. The patch consists of two uniform rows of 40-meter tall deciduous, plane trees, which border either side of the Allée de Dorigny, near the EPFL campus. The canopy is approximately 250 m long, and it is approximately 40 m wide, along the direction of the wind. A challenge faced while making field measurements is that the wind rarely intersects a canopy normal to the edge. The resulting wake flow may be deflected relative to the mean inflow. Using multiple LiDARs, we measure the evolution of the wake due to an oblique wind blowing over the canopy. One LiDAR is positioned directly downwind of the canopy to measure the flow along the mean wind direction and the other is positioned near the canopy to evaluate the transversal component of the wind and how it varies with downwind distance from the canopy. Preliminary results show that the open trunk space near the base of the canopy results in a surface jet that can be detected just downwind of the canopy and farther downwind dissipates as it mixes with the wake flow above. A time-varying recirculation zone can be detected by the periodic reversal of the velocity near the surface, downwind of the canopy. The implications of canopy wakes for measurement and modeling of surface fluxes will be discussed.

  13. Needlestick/sharps injuries and HIV exposure among health care workers. National estimates based on a survey of U.S. hospitals.

    PubMed

    Henry, K; Campbell, S

    1995-11-01

    Exposure to HIV in the workplace is a major concern for health care workers. The greatest risk for bloodborne pathogen transmission is associated with percutaneous injuries involving hollow-bore needles contaminated with patient blood. Limited data are available about how many sharps injuries (SIs) and needlesticks (NSs) occur in the United States, with estimates ranging from 100,000 to 1 million injuries per year. We conducted a survey of 100 infection control practitioners located at randomly selected U.S. hospitals to assess the number of SIs or NSs occurring during 1990; 65 (65%) responded. The mean number of NS/SIs reported was 45, with a mean of 1.1 known HIV-related NS/SIs. The underreporting rate was estimated to be 18.5%. Assuming that the hospitals provided exact numbers of injuries and were representative of the approximately 5,100 U.S. hospitals, then about 252,000 NS/SIs were reported in U.S. hospitals in 1990 (95% CI = 193,000-312,000). If the under-reporting rate was 33% to 66%, then the point estimate for the total number of NS/SIs ranges from 378,000 to 756,000. Similar extrapolation involving the reported number of NS/SIs contaminated with blood from an HIV-infected patient yields an estimate of 5,610 exposures in 1990 (95% CI = 1,300-8,300). The number of U.S. hospital workers sustaining NS/SIs with potential exposure to HIV appears to be considerable. Efforts to reduce the risk of bloodborne pathogen transmission from NS/SIs are warranted. PMID:8531904

  14. An automated algorithm for extracting road edges from terrestrial mobile LiDAR data

    NASA Astrophysics Data System (ADS)

    Kumar, Pankaj; McElhinney, Conor P.; Lewis, Paul; McCarthy, Timothy

    2013-11-01

    Terrestrial mobile laser scanning systems provide rapid and cost effective 3D point cloud data which can be used for extracting features such as the road edge along a route corridor. This information can assist road authorities in carrying out safety risk assessment studies along road networks. The knowledge of the road edge is also a prerequisite for the automatic estimation of most other road features. In this paper, we present an algorithm which has been developed for extracting left and right road edges from terrestrial mobile LiDAR data. The algorithm is based on a novel combination of two modified versions of the parametric active contour or snake model. The parameters involved in the algorithm are selected empirically and are fixed for all the road sections. We have developed a novel way of initialising the snake model based on the navigation information obtained from the mobile mapping vehicle. We tested our algorithm on different types of road sections representing rural, urban and national primary road sections. The successful extraction of road edges from these multiple road section environments validates our algorithm. These findings and knowledge provide valuable insights as well as a prototype road edge extraction tool-set, for both national road authorities and survey companies.

  15. Hospital pharmacy in Canada.

    PubMed

    Bachynsky, J A

    1980-04-01

    The status of Canadian hospital pharmacy and the impact of national hospital insurance on its development are discussed. The provision of health care services for Canadians is shared by the federal and provincial governments. The federal government enacts protective and regulatory legislation, compiles health statistics, promotes research, and provides direct health care for those citizens for whom it is directly responsible. Each province is responsible for hospitals, the education and training of health care professionals, public health, and the financing and administration of health insurance for all its citizens. Largely because of line-item budget allocations and a bureaucratic tendency to equalize services for the whole population, funds for existing pharmaceutical services have been assured but the introduction of upgraded or innovative programs has been difficult to achieve. The result has been an even quality of health care services, including pharmacy, throughout the country and a deficiency in clinical pharmacy programs and the trained personnel to run them. The last decade has brought advances, however, as allocation methods have changed and both hospital and insurance administrators have recognized the patient benefits and cost effectiveness of many of the newer pharmacy programs. The main challenges facing Canadian hospital pharmacy are to upgrade clinical services and education and to improve managerial and bureaucratic competence among department directors. PMID:7377213

  16. [Laennec Hospital].

    PubMed

    Dauphin, A; Mazin-Deslandes, C

    2000-01-01

    When the Laennec Hospital of Paris closed, after 366 years of activities for the patients, the articles about the circumstances of the foundation and the main stapes of the institution which became an very famous university hospital it present the available information of the history of the apothecaries, of the "gagnants-maitrise", pharmacists and the pharmacy's interns who succeeded themselves to create and dispense the medicaments necessary to the patients hospitalized or welcomed in ambulatory. It describes the evolution of the places, of the material, of forms, of the organization, of the medicaments and of the missions of what became the Pharmacy department after the recent individualization of the biological analysis in the biochemistry. PMID:11625687

  17. Dynamic LiDAR-NDVI classification of fluvial landscape units

    NASA Astrophysics Data System (ADS)

    Ramírez-Núñez, Carolina; Parrot, Jean-François

    2015-04-01

    The lower basin of the Coatzacoalcos River is a wide floodplain in which, during the wet season, local and major flooding are distinguished. Both types of floods, intermittent and regional, are important in terms of resources; the regional flood sediments enrich the soils of the plains and intermittent floods allow obtaining aquatic resources for subsistence during the heatwave. In the floodplain different abandoned meanders and intermittent streams are quickly colonized by aquatic vegetation. However, from the 1990s, the Coatzacoalcos River floodplain has important topographic changes due to mining, road and bridges construction; erosion and sedimentation requires continuous parcel boundaries along with the increasing demand of channel reparation, embankments, levees and bridges associated to tributaries. NDVI data, LiDAR point cloud and various types of flood simulations taking into account the DTM are used to classify the dynamic landscape units. These units are associated to floods in relation with water resources, agriculture and livestock. In the study area, the first returns of the point cloud allow extracting vegetation strata. The last returns correspond to the bare earth surface, especially in this area with few human settlements. The surface that is not covered by trees or by aquatic vegetation, correspond to crops, pastures and bare soils. The classification is obtained by using the NDVI index coupled with vegetation strata and water bodies. The result shows that 47.96% of the area does not present active vegetation and it includes 31.53% of bare soils. Concerning the active vegetation, pastures, bushes and trees represent respectively 25.59%, 11.14% and 13.25%. The remaining 1.25% is distributed between water bodies with aquatic vegetation, trees and shrubs. Dynamic landscape units' classification represents a tool for monitoring water resources in a fluvial plain. This approach can be also applied to forest management, environmental services and

  18. Urban agriculture and Anopheles habitats in Dar es Salaam, Tanzania.

    PubMed

    Dongus, Stefan; Nyika, Dickson; Kannady, Khadija; Mtasiwa, Deo; Mshinda, Hassan; Gosoniu, Laura; Drescher, Axel W; Fillinger, Ulrike; Tanner, Marcel; Killeen, Gerry F; Castro, Marcia C

    2009-05-01

    A cross-sectional survey of agricultural areas, combined with routinely monitored mosquito larval information, was conducted in urban Dar es Salaam, Tanzania, to investigate how agricultural and geographical features may influence the presence of Anopheles larvae. Data were integrated into a geographical information systems framework, and predictors of the presence of Anopheles larvae in farming areas were assessed using multivariate logistic regression with independent random effects. It was found that more than 5% of the study area (total size 16.8 km2) was used for farming in backyard gardens and larger open spaces. The proportion of habitats containing Anopheles larvae was 1.7 times higher in agricultural areas compared to other areas (95% confidence interval = 1.56-1.92). Significant geographic predictors of the presence of Anopheles larvae in gardens included location in lowland areas, proximity to river, and relatively impermeable soils. Agriculture-related predictors comprised specific seedbed types, mid-sized gardens, irrigation by wells, as well as cultivation of sugar cane or leafy vegetables. Negative predictors included small garden size, irrigation by tap water, rainfed production and cultivation of leguminous crops or fruit trees. Although there was an increased chance of finding Anopheles larvae in agricultural sites, it was found that breeding sites originated by urban agriculture account for less than a fifth of all breeding sites of malaria vectors in Dar es Salaam. It is suggested that strategies comprising an integrated malaria control effort in malaria-endemic African cities include participatory involvement of farmers by planting shade trees near larval habitats. PMID:19440962

  19. S-DARS broadcast from inclined, elliptical orbits

    NASA Astrophysics Data System (ADS)

    Briskman, Robert D.; Prevaux, Robert J.

    2004-04-01

    The first Sirius spacecraft was launched on July 1, 2000. Exactly 5 months later, on December 1, the third spacecraft was launched, completing the three satellite S-DARS (Satellite Digital Audio Radio Service) constellation. The three satellites are deployed in inclined, elliptical, geosynchronous orbits, which allow seamless broadcast coverage to mobile users in the contiguous US. Terrestrial broadcast repeaters provide service in urban cores. The system is in operation, providing the first ever S-DARS service. The constellation design results in satellite ground tracks over North America with two satellites always above the equator. High elevation look angles from the mobile ground terminals to the satellites minimize performance degradation due to blockage, foliage attenuation and multi-path. The spacecraft were built by Space Systems/Loral using the 1300 bus modified for operation in high inclination orbits. Each spacecraft was launched using a dedicated Russian Proton booster. The satellite payload is a bent pipe repeater using 7.1 GHz for the uplink and 2.3 GHz for the broadcast transmission. The repeater high-power amplification stage consists of 32 Traveling Wave Tube Amplifiers phase combined to yield a total radio frequency output power of nearly 4 kW at saturated operation. The satellite antennas are mechanically steered to maintain the transmit beam centered on the Contiguous United States and the receive beam centered on the uplink earth station located in Vernon Valley, New Jersey. The satellite payload design and performance are described. The principal spacecraft bus systems are described with emphasis on improvements made for operation in the inclined, elliptical geosynchronous orbits.

  20. Hospital utilization and expenditures in a Medicaid population

    PubMed Central

    Buczko, William

    1989-01-01

    Determinants of hospital utilization and expenditures are analyzed for Medicaid enrollees in the State Medicaid household sample portion of the National Medical Care Utilization and Expenditure Survey who were continuously enrolled throughout 1980. Health status measures were the best predictors of both the probability of hospitalization and total hospitalizations. Children covered by Aid to Families with Dependent Children were the Medicaid enrollees least likely to be hospitalized. Number of hospital days, surgery, and California residence directly increased hospital expenditures. Conditions responsible for hospitalization increased hospital expenditures indirectly by increasing the number of hospital days and the probability of surgery. PMID:10313353

  1. Mapping and quantifying geodiversity in land-water transition zones using MBES and topobathymetric LiDAR

    NASA Astrophysics Data System (ADS)

    Brandbyge Ernstsen, Verner; Skovgaard Andersen, Mikkel; Gergely, Aron; Schulze Tenberge, Yvonne; Al-Hamdani, Zyad; Steinbacher, Frank; Rolighed Larsen, Laurids; Winter, Christian; Bartholomä, Alexander

    2016-04-01

    Land-water transition zones, like e.g. coastal and fluvial environments, are valuable ecosystems which are often characterised by high biodiversity and geodiversity. However, often these land-water transition zones are difficult or even impossible to map and investigate in high spatial resolution due to the challenging environmental conditions. Combining vessel borne shallow water multibeam echosounder (MBES) surveys ,to cover the subtidal coastal areas and the river channel areas, with airborne topobathymetric light detection and ranging (LiDAR) surveys, to cover the intertidal and supratidal coastal areas and the river floodplain areas, potentially enables full-coverage and high-resolution mapping in these challenging environments. We have carried out MBES and topobathymetric LiDAR surveys in the Knudedyb tidal inlet system, a coastal environment in the Danish Wadden Sea which is part of the Wadden Sea National Park and UNESCO World Heritage, and in the Ribe Vesterå, a fluvial environment in the Ribe Å river catchment discharging into the Knudedyb tidal basin. Detailed digital elevation models (DEMs) with a grid cell size of 0.5 m x 0.5 m were generated from the MBES and the LiDAR point clouds, which both have point densities in the order of 20 points/m2. Morphometric analyses of the DEMs enabled the identification and mapping of the different landforms within the coastal and fluvial environments. Hereby, we demonstrate that vessel borne MBES and airborne topobathymetric LiDAR, here in combination, are promising tools for seamless mapping across land-water transition zones as well as for the quantification of a range of landforms at landscape scale in different land-water transition zone environments. Hence, we demonstrate the potential for mapping and quantifying geomorphological diversity, which is one of the main components of geodiversity and a prerequisite for assessing geoheritage. Acknowledgements This work was funded by the Danish Council for

  2. Trends of hospitalized acute stroke care in Germany from clinical trials to bedside. Comparison of nation-wide administrative data 2008-2012.

    PubMed

    Krogias, Christos; Bartig, Dirk; Kitzrow, Martin; Weber, Ralph; Eyding, Jens

    2014-10-15

    Promising advances in stroke medicine have been reported recently regarding specialized stroke unit (SU) care, expansion of the time window of iv thrombolysis (IVT), mechanical thrombectomy (MT), and decompressive hemicraniectomy (DHC) for malignant brain infarction. It remains unclear to what extent new evidence of therapeutic procedures is transferred to the "real-world" of everyday hospital care. We analyzed epidemiologic and procedural therapeutic trends of hospitalized acute stroke patients in Germany by the comparison of administrative hospital data of the years 2008 (n=219,359) and 2012 (n=239,394). Proportion of specialized SU care rose from 43.4% to 56.9%. Even in age-matched analysis women were less likely to obtain this procedure. Rate of IVT increased from 5.6% to 10.2%. 32% of IVT therapies in 2012 were performed in patients over 80 years. Number of MT increased exponentially from 298 to 3906 procedures. Number of DHC did not increase significantly (2008=636; 2011=796). A strong momentum in transferring scientific insights to the "real-world" stroke care in Germany was documented. Increase of IVT therapy is largely due to the increase of off-label treatment. Almost every 46 th patient <80 years was treated by MT in 2012. Despite proven benefits in selected patients, utilization of DHC remained almost stable. PMID:25109534

  3. Advances in animal ecology from 3D ecosystem mapping with LiDAR

    NASA Astrophysics Data System (ADS)

    Davies, A.; Asner, G. P.

    2015-12-01

    The advent and recent advances of Light Detection and Ranging (LiDAR) have enabled accurate measurement of 3D ecosystem structure. Although the use of LiDAR data is widespread in vegetation science, it has only recently (< 14 years) been applied to animal ecology. Despite such recent application, LiDAR has enabled new insights in the field and revealed the fundamental importance of 3D ecosystem structure for animals. We reviewed the studies to date that have used LiDAR in animal ecology, synthesising the insights gained. Structural heterogeneity is most conducive to increased animal richness and abundance, and increased complexity of vertical vegetation structure is more positively influential than traditionally measured canopy cover, which produces mixed results. However, different taxonomic groups interact with a variety of 3D canopy traits and some groups with 3D topography. LiDAR technology can be applied to animal ecology studies in a wide variety of environments to answer an impressive array of questions. Drawing on case studies from vastly different groups, termites and lions, we further demonstrate the applicability of LiDAR and highlight new understanding, ranging from habitat preference to predator-prey interactions, that would not have been possible from studies restricted to field based methods. We conclude with discussion of how future studies will benefit by using LiDAR to consider 3D habitat effects in a wider variety of ecosystems and with more taxa to develop a better understanding of animal dynamics.

  4. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  5. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  6. Applications of High-Resolution LiDAR Data for the Christina River Basin CZO

    NASA Astrophysics Data System (ADS)

    Hicks, N. S.; Aufdenkampe, A. K.; Hicks, S. D.

    2011-12-01

    High-resolution LiDAR data allows for fine scale geomorphic assessment over relatively large spatial extents. Previously available DEMs with a resolution of ten meters or more did not provide adequate resolution for geomorphic characterization of small streams and watersheds or the identification of changes in stream morphology over time. High-resolution LiDAR data for a portion of the Christina River Basin Critical Zone Observatory (CRB-CZO) was obtained during both leaf-off and leaf-on time periods in 2010. Topographic data from these flights is being analyzed with the intent of geomorphic applications such as stream morphology, sediment transport studies, and the evaluation of alluvial deposits. These data and resultant products will also be used in hydrologic and biogeochemical modeling and in biologic and biogeochemical studies of these streams, which are long-term study sites. The LiDAR data also facilitate informed instrument placement and will be used for vegetation studies. The LiDAR data for the CRB-CZO has been used to create a variety of LiDAR based topographic data products including TINs and 0.5-m DEMs. LiDAR derived slope and elevation products were combined with LiDAR intensity images to identify stream channel boundaries and stream centerlines for third through first-order streams. High-resolution slope data also aided in floodplain characterization of these small streams. These high precision stream channel and floodplain characterizations would not have been otherwise possible without extensive field surveying. Future LiDAR flights will allow for the identification of changes in channel morphology over time in low order basins. These characterizations are of particular interest in comparisons between forested and meadow reaches, and in studying the effects of changes in land-use on channel morphology. High-resolution LiDAR data allow for the generation of surface characterizations of importance to a wide range of interdisciplinary researchers.

  7. Automatic registration of UAV-borne sequent images and LiDAR data

    NASA Astrophysics Data System (ADS)

    Yang, Bisheng; Chen, Chi

    2015-03-01

    Use of direct geo-referencing data leads to registration failure between sequent images and LiDAR data captured by mini-UAV platforms because of low-cost sensors. This paper therefore proposes a novel automatic registration method for sequent images and LiDAR data captured by mini-UAVs. First, the proposed method extracts building outlines from LiDAR data and images and estimates the exterior orientation parameters (EoPs) of the images with building objects in the LiDAR data coordinate framework based on corresponding corner points derived indirectly by using linear features. Second, the EoPs of the sequent images in the image coordinate framework are recovered using a structure from motion (SfM) technique, and the transformation matrices between the LiDAR coordinate and image coordinate frameworks are calculated using corresponding EoPs, resulting in a coarse registration between the images and the LiDAR data. Finally, 3D points are generated from sequent images by multi-view stereo (MVS) algorithms. Then the EoPs of the sequent images are further refined by registering the LiDAR data and the 3D points using an iterative closest-point (ICP) algorithm with the initial results from coarse registration, resulting in a fine registration between sequent images and LiDAR data. Experiments were performed to check the validity and effectiveness of the proposed method. The results show that the proposed method achieves high-precision robust co-registration of sequent images and LiDAR data captured by mini-UAVs.

  8. 4D Near Real-Time Environmental Monitoring Using Highly Temporal LiDAR

    NASA Astrophysics Data System (ADS)

    Höfle, Bernhard; Canli, Ekrem; Schmitz, Evelyn; Crommelinck, Sophie; Hoffmeister, Dirk; Glade, Thomas

    2016-04-01

    The last decade has witnessed extensive applications of 3D environmental monitoring with the LiDAR technology, also referred to as laser scanning. Although several automatic methods were developed to extract environmental parameters from LiDAR point clouds, only little research has focused on highly multitemporal near real-time LiDAR (4D-LiDAR) for environmental monitoring. Large potential of applying 4D-LiDAR is given for landscape objects with high and varying rates of change (e.g. plant growth) and also for phenomena with sudden unpredictable changes (e.g. geomorphological processes). In this presentation we will report on the most recent findings of the research projects 4DEMON (http://uni-heidelberg.de/4demon) and NoeSLIDE (https://geomorph.univie.ac.at/forschung/projekte/aktuell/noeslide/). The method development in both projects is based on two real-world use cases: i) Surface parameter derivation of agricultural crops (e.g. crop height) and ii) change detection of landslides. Both projects exploit the "full history" contained in the LiDAR point cloud time series. One crucial initial step of 4D-LiDAR analysis is the co-registration over time, 3D-georeferencing and time-dependent quality assessment of the LiDAR point cloud time series. Due to the high amount of datasets (e.g. one full LiDAR scan per day), the procedure needs to be performed fully automatically. Furthermore, the online near real-time 4D monitoring system requires to set triggers that can detect removal or moving of tie reflectors (used for co-registration) or the scanner itself. This guarantees long-term data acquisition with high quality. We will present results from a georeferencing experiment for 4D-LiDAR monitoring, which performs benchmarking of co-registration, 3D-georeferencing and also fully automatic detection of events (e.g. removal/moving of reflectors or scanner). Secondly, we will show our empirical findings of an ongoing permanent LiDAR observation of a landslide (Gresten

  9. Frontiers in Using LiDAR to Analyze Urban Landscape Heterogeneity

    NASA Astrophysics Data System (ADS)

    Singh, Kunwar Krishna Veer

    Light Detection and Ranging (LiDAR) technology has facilitated extraordinary advances in our ability to remotely sense precise details of both built and natural environments. The inherent complexity of urban landscapes and the massive data volumes produced by LiDAR require unique methodological considerations for big data remote sensing over large metropolitan regions. The heterogeneous landscapes of the rapidly urbanizing Charlotte Metropolitan Region of North Carolina provided an ideal testing ground for developing methods of analysis for urban ecosystems over large regional extents, including: (1) fusion of LiDAR digital surface models (DSMs) with Landsat TM imagery to balance spatial resolution, data volume, and mapping accuracy of urban land covers, (2) comparison of LiDAR-derived metrics to fine grain optical imagery -- and their integration -- for detecting forest understory plant invaders, and (3) data reduction techniques for computationally efficient estimation of aboveground woody biomass in urban forests. In Chapter 1, I examined tradeoffs between potential gains in mapping accuracy and computational costs by integrating DSMs (structural and intensity) extracted from LiDAR with TM imagery and evaluating the degree to which TM, LiDAR, and LiDAR-TM fusion data discriminated land covers. I used Maximum Likelihood and Classification Tree algorithms to classify TM data, LiDAR data, and LiDAR-TM fusions. I assessed the relative contributions of LiDAR DSMs to map classification accuracy and identified an optimal spatial resolution of LiDAR DSMs for large area assessments of urban land cover. In Chapter 2, I analyzed combinations of datasets developed from categorized LiDAR-derived variables (Overstory, Understory, Topography, and Overall Vegetation Characteristics) and IKONOS imagery ( Optical) to detect and map the understory plant invader, Ligustrum sinense, using Random Forest (RF) and logistic regression (LR) algorithms, and I assessed the relative

  10. Comparison of Inhospital Outcomes of Surgical Aortic Valve Replacement in Hospitals With and Without Availability of a Transcatheter Aortic Valve Implantation Program (from a Nationally Representative Database).

    PubMed

    Singh, Vikas; Badheka, Apurva O; Patel, Samir V; Patel, Nileshkumar J; Thakkar, Badal; Patel, Nilay; Arora, Shilpkumar; Patel, Nish; Patel, Achint; Savani, Chirag; Ghatak, Abhijit; Panaich, Sidakpal S; Jhamnani, Sunny; Deshmukh, Abhishek; Chothani, Ankit; Sonani, Rajesh; Patel, Aashay; Bhatt, Parth; Dave, Abhishek; Bhimani, Ronak; Mohamad, Tamam; Grines, Cindy; Cleman, Michael; Forrest, John K; Mangi, Abeel

    2015-10-15

    We hypothesized that the availability of a transcatheter aortic valve implantation (TAVI) program in hospitals impacts the overall management of patients with aortic valve disease and hence may also improve postprocedural outcomes of conventional surgical aortic valve replacement (SAVR). The aim of the present study was to compare the inhospital outcomes of SAVR in centers with versus without availability of a TAVI program in an unrestricted large nationwide patient population >50 years of age. SAVRs performed on patients aged >50 years were identified from the Nationwide Inpatient Sample (NIS) for the years 2011 and 2012 using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. SAVR cases were divided into 2 categories: those performed at hospitals with a TAVI program (SAVR-TAVI) and those without (SAVR-non-TAVI). A total of 9,674 SAVR procedures were identified: 4,526 (46.79%) in the SAVR-TAVI group and 5,148 (53.21%) in SAVR-non-TAVI group. The mean age of the study population was 70.2 ± 0.1 years with majority (53%) of the patients aged >70 years. The mean Charlson's co-morbidity score for patients in SAVR-TAVI group was greater (greater percentage of patients were aged >80 years, had hypertension, congestive heart failure, renal failure, and peripheral arterial disease) than that of patients in SAVR-non-TAVI group (1.6 vs 1.4, p <0.001). The propensity score matching analysis showed a statistically significant lower inhospital mortality (1.25% vs 1.72%, p = 0.001) and complications rate (35.6% vs 37.3%, p = 0.004) in SAVR-TAVI group compared to SAVR-non-TAVI group. The mean length of hospital stay was similar in the 2 groups the cost of hospitalization was higher in the SAVR-TAVI group ($43,894 ± 483 vs $41,032 ± 473, p <0.0001). Having a TAVI program was a significant predictor of reduced mortality and complications rate after SAVR in multivariate analysis. In conclusion, this largest direct

  11. Energy audits at 48 hospitals

    NASA Astrophysics Data System (ADS)

    Hirst, E.

    1981-11-01

    Staff at the Oak Ridge Associated Universities (ORAU) conducted energy audits at 48 hospitals in four states (New York, Pennsylvania, Virginia, Tennessee) between 1978 and 1980. Staff at the Oak Ridge National Laboratory (ORNL) and ORAU developed and organized a computerized data base containing information from these audits. This paper describes the ORAU audit process; summarizes the data collected from these audits on hospital characteristics annual energy use, and the audit recommendations; and analyzes the audit data in terms of cost effectiveness, type of recommendations, and the relationship between potential energy saving and characteristics of the individual hospital.

  12. Patients of immigrant origin in inpatient psychiatric facilities. A representative national survey by the Psychiatry and Migration Working Group of the German Federal Conference of Psychiatric Hospital Directors.

    PubMed

    Schouler-Ocak, M; Bretz, H J; Penka, S; Koch, E; Hartkamp, N; Siefen, R G; Schepker, R; Ozek, M; Hauth, I; Heinz, A

    2008-01-01

    In a representative nationwide survey, the Psychiatry and Migration Working Group of the German Federal Conference of Psychiatric Hospital Directors (Bundesdirektorenkonferenz) examined the use of inpatient psychiatric and psychotherapeutic services in Germany by patients of immigrant origin. Questionnaires were sent to a total of 350 general hospital psychiatric clinics throughout Germany, and 131 clinics responded. As shown by the 2005 Microcensus [22], almost one-fifth (18.6%) of the German population is of immigrant origin. In our study, persons of immigrant origin comprised 17% of patients in the responding facilities. This indicates that the percentage of inpatient psychiatric services used by patients of immigrant origin is almost proportionate to these patients' percentage of the general population. The largest group of immigrant patients in our study were those of Russian heritage, followed by patients of Turkish, Arabic, or other origin. Almost two-thirds of the immigrant patients were born in Germany, and a considerably larger percentage were German citizens (74%). Sixty-two per cent of all patients of immigrant origin spoke a language other than German (e.g. Russian, Turkish, Polish) at home. Patients of immigrant origin were significantly more likely to receive an ICD-10 F2 diagnosis, and it was precisely patients with this diagnosis who were observed to experience difficulties in communication with caregivers. PMID:18371576

  13. Rational dispensing and use of artemether-lumefantrine during pregnancy in Dar es Salaam, Tanzania.

    PubMed

    Kamuhabwa, Appolinary R; Mnyusiwalla, Fatema

    2011-04-01

    Artemether-Lumefantrine (ALu) is widely used for uncomplicated malaria during the second and third trimester of pregnancy. Because of the suspected teratogenic effects of artemether during the first trimester, quinine is used in early pregnancy unless the risks outweigh the benefits. The aim of this study was to assess dispensing practice of ALu in private pharmacies and knowledge of pregnant women regarding the use of ALu. This was a prospective-descriptive study involving visits to 200 private retail pharmacies (using a mystery shopper) and interviewing pregnant women at the municipal public hospitals in Dar es Salaam, Tanzania. Among the drug dispensers, 60 (30%) were pharmacists, 71(35.5%) nurse assistants, 34 (17%) pharmaceutical technicians and 35 (17.5%) sales persons with no formal education on drug dispensing. Among the dispensers, 14.5% had high knowledge, 38.0% had medium knowledge and 47.5% had low knowledge on the use of ALu during pregnancy. About thirty three percent of the drug dispensers were willing to dispense ALu during the first trimester of pregnancy. Sixty two percent of the drug dispensers indicated that ALu is the drug of choice for uncomplicated malaria after the first trimester of pregnancy. However, 36% indicated that ALu could not be used during pregnancy. A total of 200 pregnant women were interviewed. Among them, 16.5% were aware that ALu should not be taken during the first trimester of pregnancy. Only 17% of pregnant women were given information on the importance of taking food when using ALu, but none of them was given information on the importance of fatty meals when using ALu. In conclusion, the results show that most drug dispensers have inadequate knowledge about good dispensing practice of ALu in pregnancy. There is therefore a need for continuing training of drug dispensers regarding antimalarial drugs use in pregnancy. PMID:25566607

  14. A Bayesian functional data model for predicting forest variables using high-dimensional waveform LiDAR over large geographic domains

    NASA Astrophysics Data System (ADS)

    Finley, A. O.; Banerjee, S.; Cook, B. D.

    2010-12-01

    Recent advances in remote sensing, specifically waveform Light Detection and Ranging (LiDAR) sensors, provide the data needed to quantify forest variables at a fine spatial resolution over large domains. Of particular interest is LiDAR data from NASA's Laser Vegetation Imaging Sensor (LVIS), upcoming Deformation, Ecosystem Structure, and Dynamics of Ice (DESDynI) missions, and NSF's National Ecological Observatory Network planned Airborne Observation Platform. A central challenge to using these data is to couple field measurements of forest variables (e.g., species, indices of structural complexity, light competition, or drought stress) with the high-dimensional LiDAR signal through a model, which allows prediction of the tree-level variables at locations where only the remotely sensed data area are available. It is common to model the high-dimensional signal vector as a mixture of a relatively small number of Gaussian distributions. The parameters from these Gaussian distributions, or indices derived from the parameters, can then be used as regressors in a regression model. These approaches retain only a small amount of information contained in the signal. Further, it is not known a priori which features of the signal explain the most variability in the response variables. It is possible to fully exploit the information in the signal by treating it as an object, thus, we define a framework to couple a spatial latent factor model with forest variables using a fully Bayesian functional spatial data analysis. Our proposed modeling framework explicitly: 1) reduces the dimensionality of signals in an optimal way (i.e., preserves the information that describes the maximum variability in response variable); 2) propagates uncertainty in data and parameters through to prediction, and; 3) acknowledges and leverages spatial dependence among the regressors and model residuals to meet statistical assumptions and improve prediction. The proposed modeling framework is

  15. Surface characteristics modeling and performance evaluation of urban building materials using LiDAR data.

    PubMed

    Li, Xiaolu; Liang, Yu

    2015-05-20

    Analysis of light detection and ranging (LiDAR) intensity data to extract surface features is of great interest in remote sensing research. One potential application of LiDAR intensity data is target classification. A new bidirectional reflectance distribution function (BRDF) model is derived for target characterization of rough and smooth surfaces. Based on the geometry of our coaxial full-waveform LiDAR system, the integration method is improved through coordinate transformation to establish the relationship between the BRDF model and intensity data of LiDAR. A series of experiments using typical urban building materials are implemented to validate the proposed BRDF model and integration method. The fitting results show that three parameters extracted from the proposed BRDF model can distinguish the urban building materials from perspectives of roughness, specular reflectance, and diffuse reflectance. A comprehensive analysis of these parameters will help characterize surface features in a physically rigorous manner. PMID:26192511

  16. Regional Hospital Input Price Indexes

    PubMed Central

    Freeland, Mark S.; Schendler, Carol Ellen; Anderson, Gerard

    1981-01-01

    This paper describes the development of regional hospital input price indexes that is consistent with the general methodology used for the National Hospital Input Price Index. The feasibility of developing regional indexes was investigated because individuals inquired whether different regions experienced different rates of increase in hospital input prices. The regional indexes incorporate variations in cost-share weights (the amount an expense category contributes to total spending) associated with hospital type and location, and variations in the rate of input price increases for various regions. We found that between 1972 and 1979 none of the regional price indexes increased at average annual rates significantly different from the national rate. For the more recent period 1977 through 1979, the increase in one Census Region was significantly below the national rate. Further analyses indicated that variations in cost-share weights for various types of hospitals produced no substantial variations in the regional price indexes relative to the national index. We consider these findings preliminary because of limitations in the availability of current, relevant, and reliable data, especially for local area wage rate increases. PMID:10309557

  17. Synergy of VSWIR and LiDAR for Ecosystem Structure, Biomass, and Canopy Diversity

    NASA Technical Reports Server (NTRS)

    Cook, Bruce D.; Asner, Gregory P.

    2010-01-01

    This slide presentation reviews the use of Visible ShortWave InfraRed (VSWIR) Imaging Spectrometer and LiDAR to study ecosystem structure, biomass and canopy diversity. It is shown that the biophysical data from LiDAR and biochemical information from hyperspectral remote sensing provides complementary data for: (1) describing spatial patterns of vegetation and biodiversity, (2) characterizing relationships between ecosystem form and function, and (3) detecting natural and human induced change that affects the biogeochemical cycles.

  18. Modeling marbled murrelet (Brachyramphus marmoratus) habitat using LiDAR-derived canopy data

    USGS Publications Warehouse

    Hagar, Joan C.; Eskelson, Bianca N.I.; Haggerty, Patricia K.; Nelson, S. Kim; Vesely, David G.

    2014-01-01

    LiDAR (Light Detection And Ranging) is an emerging remote-sensing tool that can provide fine-scale data describing vertical complexity of vegetation relevant to species that are responsive to forest structure. We used LiDAR data to estimate occupancy probability for the federally threatened marbled murrelet (Brachyramphus marmoratus) in the Oregon Coast Range of the United States. Our goal was to address the need identified in the Recovery Plan for a more accurate estimate of the availability of nesting habitat by developing occupancy maps based on refined measures of nest-strand structure. We used murrelet occupancy data collected by the Bureau of Land Management Coos Bay District, and canopy metrics calculated from discrete return airborne LiDAR data, to fit a logistic regression model predicting the probability of occupancy. Our final model for stand-level occupancy included distance to coast, and 5 LiDAR-derived variables describing canopy structure. With an area under the curve value (AUC) of 0.74, this model had acceptable discrimination and fair agreement (Cohen's κ = 0.24), especially considering that all sites in our sample were regarded by managers as potential habitat. The LiDAR model provided better discrimination between occupied and unoccupied sites than did a model using variables derived from Gradient Nearest Neighbor maps that were previously reported as important predictors of murrelet occupancy (AUC = 0.64, κ = 0.12). We also evaluated LiDAR metrics at 11 known murrelet nest sites. Two LiDAR-derived variables accurately discriminated nest sites from random sites (average AUC = 0.91). LiDAR provided a means of quantifying 3-dimensional canopy structure with variables that are ecologically relevant to murrelet nesting habitat, and have not been as accurately quantified by other mensuration methods.

  19. The Krüppel-Like Factor Dar1 Determines Multipolar Neuron Morphology

    PubMed Central

    Wang, Xin; Zhang, Macy W.; Kim, Jung Hwan; Macara, Ann Marie; Sterne, Gabriella; Yang, Tao

    2015-01-01

    Neurons typically assume multipolar, bipolar, or unipolar morphologies. Little is known about the mechanisms underlying the development of these basic morphological types. Here, we show that the Krüppel-like transcription factor Dar1 determines the multipolar morphology of postmitotic neurons in Drosophila. Dar1 is specifically expressed in multipolar neurons and loss of dar1 gradually converts multipolar neurons into the bipolar or unipolar morphology without changing neuronal identity. Conversely, misexpression of Dar1 or its mammalian homolog in unipolar and bipolar neurons causes them to assume multipolar morphologies. Dar1 regulates the expression of several dynein genes and nuclear distribution protein C (nudC), which is an essential component of a specialized dynein complex that positions the nucleus in a cell. We further show that these genes are required for Dar1-induced multipolar neuron morphology. Dar1 likely functions as a terminal selector gene for the basic layout of neuron morphology by regulating both dendrite extension and the dendrite–nucleus coupling. SIGNIFICANCE STATEMENT The three basic morphological types of neurons—unipolar, bipolar, and multipolar—are important for information processing and wiring of neural circuits. Little progress has been made toward understanding the molecular and cellular programs that generate these types since their discovery over a century ago. It is generally assumed that basic morphological types of neurons are determined by the number of dendrites growing out from the cell body. Here, we show that this model alone is insufficient. We introduce the positioning of nucleus as a critical factor in this process and report that the transcription factor Dar1 determines multipolar neuron morphology in postmitotic neurons by regulating genes involved in nuclear positioning. PMID:26490864

  20. Detecting understory plant invasion in urban forests using LiDAR

    NASA Astrophysics Data System (ADS)

    Singh, Kunwar K.; Davis, Amy J.; Meentemeyer, Ross K.

    2015-06-01

    Light detection and ranging (LiDAR) data are increasingly used to measure structural characteristics of urban forests but are rarely used to detect the growing problem of exotic understory plant invaders. We explored the merits of using LiDAR-derived metrics alone and through integration with spectral data to detect the spatial distribution of the exotic understory plant Ligustrum sinense, a rapidly spreading invader in the urbanizing region of Charlotte, North Carolina, USA. We analyzed regional-scale L. sinense occurrence data collected over the course of three years with LiDAR-derived metrics of forest structure that were categorized into the following groups: overstory, understory, topography, and overall vegetation characteristics, and IKONOS spectral features - optical. Using random forest (RF) and logistic regression (LR) classifiers, we assessed the relative contributions of LiDAR and IKONOS derived variables to the detection of L. sinense. We compared the top performing models developed for a smaller, nested experimental extent using RF and LR classifiers, and used the best overall model to produce a predictive map of the spatial distribution of L. sinense across our country-wide study extent. RF classification of LiDAR-derived topography metrics produced the highest mapping accuracy estimates, outperforming IKONOS data by 17.5% and the integration of LiDAR and IKONOS data by 5.3%. The top performing model from the RF classifier produced the highest kappa of 64.8%, improving on the parsimonious LR model kappa by 31.1% with a moderate gain of 6.2% over the county extent model. Our results demonstrate the superiority of LiDAR-derived metrics over spectral data and fusion of LiDAR and spectral data for accurately mapping the spatial distribution of the forest understory invader L. sinense.

  1. Hospital staffing adjustments under global budgeting.

    PubMed

    Lehner, L A; Burgess, J F; Stefos, T

    1995-01-01

    The U.S. Department of Veterans Affairs operates a hospital system that distributes a national global budget to 159 hospital units. Over recent years, cost containment and downward budgetary pressures have affected hospital performance and the quality of care delivered in unknown ways. This article examines hospital staffing levels as potential performance measures. We first develop a regression model to estimate the number and types of clinical staff required to meet current inpatient workloads at VA medical centers. We are able to improve on previous analyses by employing better data on physicians and by evaluating the behavior of hospitals in consecutive years. Our findings provide managers of hospital systems with promising new approaches for comparing hospital production processes and more information on the effects of global budgeting on individual hospital staffing within systems. PMID:10153372

  2. Determinants of Outcome in Hospitalized Patients With Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: Results From National Surveillance in Canada, 2008-2012.

    PubMed

    Simor, Andrew E; Pelude, Linda; Golding, George; Fernandes, Rachel; Bryce, Elizabeth; Frenette, Charles; Gravel, Denise; Katz, Kevin; McGeer, Allison; Mulvey, Michael R; Smith, Stephanie; Weiss, Karl

    2016-04-01

    BACKGROUND Bloodstream infection (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with considerable morbidity and mortality. OBJECTIVE To determine the incidence of MRSA BSI in Canadian hospitals and to identify variables associated with increased mortality. METHODS Prospective surveillance for MRSA BSI conducted in 53 Canadian hospitals from January 1, 2008, through December 31, 2012. Thirty-day all-cause mortality was determined, and logistic regression analysis was used to identify variables associated with mortality. RESULTS A total of 1,753 patients with MRSA BSI were identified (incidence, 0.45 per 1,000 admissions). The most common sites presumed to be the source of infection were skin/soft tissue (26.6%) and an intravascular catheter (22.0%). The most common spa types causing MRSA BSI were t002 (USA100/800; 55%) and t008 (USA300; 29%). Thirty-day all-cause mortality was 23.8%. Mortality was associated with increasing age (odds ratio, 1.03 per year [95% CI, 1.02-1.04]), the presence of pleuropulmonary infection (2.3 [1.4-3.7]), transfer to an intensive care unit (3.2 [2.1-5.0]), and failure to receive appropriate antimicrobial therapy within 24 hours of MRSA identification (3.2 [2.1-5.0]); a skin/soft-tissue source of BSI was associated with decreased mortality (0.5 [0.3-0.9]). MRSA genotype and reduced susceptibility to vancomycin were not associated with risk of death. CONCLUSIONS This study provides additional insight into the relative impact of various host and microbial factors associated with mortality in patients with MRSA BSI. The results emphasize the importance of ensuring timely receipt of appropriate antimicrobial agents to reduce the risk of an adverse outcome. PMID:26782274

  3. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments. PMID:19545081

  4. Classification of LiDAR Data with Point Based Classification Methods

    NASA Astrophysics Data System (ADS)

    Yastikli, N.; Cetin, Z.

    2016-06-01

    LiDAR is one of the most effective systems for 3 dimensional (3D) data collection in wide areas. Nowadays, airborne LiDAR data is used frequently in various applications such as object extraction, 3D modelling, change detection and revision of maps with increasing point density and accuracy. The classification of the LiDAR points is the first step of LiDAR data processing chain and should be handled in proper way since the 3D city modelling, building extraction, DEM generation, etc. applications directly use the classified point clouds. The different classification methods can be seen in recent researches and most of researches work with the gridded LiDAR point cloud. In grid based data processing of the LiDAR data, the characteristic point loss in the LiDAR point cloud especially vegetation and buildings or losing height accuracy during the interpolation stage are inevitable. In this case, the possible solution is the use of the raw point cloud data for classification to avoid data and accuracy loss in gridding process. In this study, the point based classification possibilities of the LiDAR point cloud is investigated to obtain more accurate classes. The automatic point based approaches, which are based on hierarchical rules, have been proposed to achieve ground, building and vegetation classes using the raw LiDAR point cloud data. In proposed approaches, every single LiDAR point is analyzed according to their features such as height, multi-return, etc. then automatically assigned to the class which they belong to. The use of un-gridded point cloud in proposed point based classification process helped the determination of more realistic rule sets. The detailed parameter analyses have been performed to obtain the most appropriate parameters in the rule sets to achieve accurate classes. The hierarchical rule sets were created for proposed Approach 1 (using selected spatial-based and echo-based features) and Approach 2 (using only selected spatial-based features

  5. Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales

    PubMed Central

    Fone, David; Gartner, Andrea; Bellis, Mark A

    2016-01-01

    Objectives To investigate the risk of emergency hospital admissions for violence (EHAV) associated with demographic and socioeconomic factors in Wales between 2007/2008 and 2013/2014, and to describe the site of injury causing admission. Design Database analysis of 7 years’ hospital admissions using the Patient Episode Database for Wales (PEDW). Setting and participants Wales, UK, successive annual populations ∼2.8 million aged 0–74 years. Primary outcome The first emergency admission for violence in each year of the study, defined by the International Classification of Diseases V.10 (ICD-10) codes for assaults (X85-X99, Y00-Y09) in any coding position. Results A total of 11 033 admissions for assault. The majority of admissions resulted from head injuries. The overall crude admission rate declined over the study period, from 69.9 per 100 000 to 43.2 per 100 000, with the largest decrease in the most deprived quintile of deprivation. A generalised linear count model with a negative binomial log link, adjusted for year, age group, gender, deprivation quintile and settlement type, showed the relative risk was highest in age group 18–19 years (RR=6.75, 95% CI 5.88 to 7.75) compared with the reference category aged 10–14 years. The risk decreased with age after 25 years. Risk of admission was substantially higher in males (RR=4.55, 95% CI 4.31 to 4.81), for residents of the most deprived areas of Wales (RR=3.60, 95% CI 3.32 to 3.90) compared with the least deprived, and higher in cities (RR=1.37, 95% CI 1.27 to 1.49) and towns (RR=1.32, 95% CI 1.21 to 1.45) compared with villages. Conclusions Despite identifying a narrowing in the gap between prevalence of violence in richer and poorer communities, violence remains strongly associated with young men living in areas of socioeconomic deprivation. There is potential for a greater reduction, given that violence is mostly preventable. Recommendations for reducing inequalities in the risk of

  6. United Kingdom National Ophthalmology Database Study: Diabetic Retinopathy; Report 1: prevalence of centre-involving diabetic macular oedema and other grades of maculopathy and retinopathy in hospital eye services

    PubMed Central

    Keenan, T D L; Johnston, R L; Donachie, P H J; Sparrow, J M; Stratton, I M; Scanlon, P

    2013-01-01

    Aims To report estimates of the prevalence of diabetic retinopathy (DR) and maculopathy grades for a large cohort of patients managed by the UK hospital eye service (HES). Methods Anonymised data were extracted from 30 UK NHS hospital trusts using a single ophthalmic electronic medical record (EMR) for the period from April 2000 to November 2010 to create the National Ophthalmology Database (NOD). From 2007, the EMR facilitated capture of a nationally agreed-upon standardised data set (DR Structured Assessment) relating to the presence or absence of clinical signs of DR and maculopathy. An algorithm in the software automatically calculated the Early Treatment of Diabetic Retinopathy Study grades of retinopathy and maculopathy. Results Between 2007 and 2010, 307 538 patients had data on the NOD, with 76 127 (24.8%) patients having been recorded as having diabetes. The proportion of patients with diabetes who had a structured assessment increased from 50.7% (2007) to 86.8% (2010). In each NHS year, 12.6–20.6% of eyes with structured assessments had no DR; 59.6–67.3% had non-proliferative DR; and 18.3–20.9% had active or regressed proliferative DR. Clinically significant macular oedema was present in 15.8–18.1% of eyes, and in 8.7–10.0% of eyes, this involved the central macula. Conclusion This study provides contemporary estimates of the prevalence of retinopathy and maculopathy grades in a large cohort of patients with diabetes managed by the UK HES. Centre-involving diabetic macular oedema, potentially amenable to anti-VEGF therapy, is present in the eyes of almost 10% of these patients. This information is useful for clinicians, health-care economists, and commissioners involved in planning and delivering diabetic eye services. PMID:24051410

  7. A study and comparative analysis of managerial and leadership effectiveness in the National Health Service: an empirical factor analytic study within an NHS Trust hospital.

    PubMed

    Hamlin, R G

    2002-11-01

    The research described in this article was concerned primarily with identifying the criteria of managerial/leadership effectiveness applying at the middle and front line levels of management within an NHS Trust Hospital using critical incident technique and factor analysis methods. The findings suggest that the self-perceptions of managers and the perceptions of superiors and subordinates are very similar, and only differ on a limited number of criteria. This challenges the 'perspective-specific' models of managerial effectiveness advocated by some researchers. The results are compared against those from a near identical study carried out by the author within one part of the British Civil Service, and the results from a different but comparable factor analytic study carried out by other researchers elsewhere in the NHS. The results suggest the existence of generalized criteria of managerial effectiveness, which lend considerable support to the notion of the 'universally effective manager'. This challenges the 'contingent models' of managerial effectiveness advocated by various expert commentators. In addition, the research supports the new model of transformational leadership offered by Alimo-Metcalfe and Alban-Metcalfe for application within both the NHS and local government, and adds to the empirical base supporting the current drive towards evidence-based practice in management within the healthcare sector. PMID:12396550

  8. Estimating FPAR of maize canopy using airborne discrete-return LiDAR data.

    PubMed

    Luo, Shezhou; Wang, Cheng; Xi, Xiaohuan; Pan, Feifei

    2014-03-10

    The fraction of absorbed photosynthetically active radiation (FPAR) is a key parameter for ecosystem modeling, crop growth monitoring and yield prediction. Ground-based FPAR measurements are time consuming and labor intensive. Remote sensing provides an alternative method to obtain repeated, rapid and inexpensive estimates of FPAR over large areas. LiDAR is an active remote sensing technology and can be used to extract accurate canopy structure parameters. A method to estimating FPAR of maize from airborne discrete-return LiDAR data was developed and tested in this study. The raw LiDAR point clouds were processed to separate ground returns from vegetation returns using a filter method over a maize field in the Heihe River Basin, northwest China. The fractional cover (fCover) of maize canopy was computed using the ratio of canopy return counts or intensity sums to the total of returns or intensities. FPAR estimation models were established based on linear regression analysis between the LiDAR-derived fCover and the field-measured FPAR (R(2) = 0.90, RMSE = 0.032, p < 0.001). The reliability of the constructed regression model was assessed using the leave-one-out cross-validation procedure and results show that the regression model is not overfitting the data and has a good generalization capability. Finally, 15 independent field-measured FPARs were used to evaluate accuracy of the LiDAR-predicted FPARs and results show that the LiDAR-predicted FPAR has a high accuracy (R(2) = 0.89, RMSE = 0.034). In summary, this study suggests that the airborne discrete-return LiDAR data could be adopted to accurately estimate FPAR of maize. PMID:24663850

  9. Estimation of effective plant area index for South Korean forests using LiDAR system.

    PubMed

    Kwak, Doo-Ahn; Lee, Woo-Kyun; Kafatos, Menas; Son, Yowhan; Cho, Hyun-Kook; Lee, Seung-Ho

    2010-07-01

    Light Detection and Ranging (LiDAR) systems can be used to estimate both vertical and horizontal forest structure. Woody components, the leaves of trees and the understory can be described with high precision, using geo-registered 3D-points. Based on this concept, the Effective Plant Area Indices (PAI(e)) for areas of Korean Pine (Pinus koraiensis), Japanese Larch (Larix leptolepis) and Oak (Quercus spp.) were estimated by calculating the ratio of intercepted and incident LIDAR laser rays for the canopies of the three forest types. Initially, the canopy gap fraction (G ( LiDAR )) was generated by extracting the LiDAR data reflected from the canopy surface, or inner canopy area, using k-means statistics. The LiDAR-derived PAI(e) was then estimated by using G ( LIDAR ) with the Beer-Lambert law. A comparison of the LiDAR-derived and field-derived PAI(e) revealed the coefficients of determination for Korean Pine, Japanese Larch and Oak to be 0.82, 0.64 and 0.59, respectively. These differences between field-based and LIDAR-based PAI(e) for the different forest types were attributed to the amount of leaves and branches in the forest stands. The absence of leaves, in the case of both Larch and Oak, meant that the LiDAR pulses were only reflected from branches. The probability that the LiDAR pulses are reflected from bare branches is low as compared to the reflection from branches with a high leaf density. This is because the size of the branch is smaller than the resolution across and along the 1 meter LIDAR laser track. Therefore, a better predictive accuracy would be expected for the model if the study would be repeated in late spring when the shoots and leaves of the deciduous trees begin to appear. PMID:20697878

  10. Effects of LiDAR point density and landscape context on estimates of urban forest biomass

    NASA Astrophysics Data System (ADS)

    Singh, Kunwar K.; Chen, Gang; McCarter, James B.; Meentemeyer, Ross K.

    2015-03-01

    Light Detection and Ranging (LiDAR) data is being increasingly used as an effective alternative to conventional optical remote sensing to accurately estimate aboveground forest biomass ranging from individual tree to stand levels. Recent advancements in LiDAR technology have resulted in higher point densities and improved data accuracies accompanied by challenges for procuring and processing voluminous LiDAR data for large-area assessments. Reducing point density lowers data acquisition costs and overcomes computational challenges for large-area forest assessments. However, how does lower point density impact the accuracy of biomass estimation in forests containing a great level of anthropogenic disturbance? We evaluate the effects of LiDAR point density on the biomass estimation of remnant forests in the rapidly urbanizing region of Charlotte, North Carolina, USA. We used multiple linear regression to establish a statistical relationship between field-measured biomass and predictor variables derived from LiDAR data with varying densities. We compared the estimation accuracies between a general Urban Forest type and three Forest Type models (evergreen, deciduous, and mixed) and quantified the degree to which landscape context influenced biomass estimation. The explained biomass variance of the Urban Forest model, using adjusted R2, was consistent across the reduced point densities, with the highest difference of 11.5% between the 100% and 1% point densities. The combined estimates of Forest Type biomass models outperformed the Urban Forest models at the representative point densities (100% and 40%). The Urban Forest biomass model with development density of 125 m radius produced the highest adjusted R2 (0.83 and 0.82 at 100% and 40% LiDAR point densities, respectively) and the lowest RMSE values, highlighting a distance impact of development on biomass estimation. Our evaluation suggests that reducing LiDAR point density is a viable solution to regional

  11. Improved estimates of forest vegetation structure and biomass with a LiDAR-optimized sampling design

    NASA Astrophysics Data System (ADS)

    Hawbaker, Todd J.; Keuler, Nicholas S.; Lesak, Adrian A.; Gobakken, Terje; Contrucci, Kirk; Radeloff, Volker C.

    2009-06-01

    LiDAR data are increasingly available from both airborne and spaceborne missions to map elevation and vegetation structure. Additionally, global coverage may soon become available with NASA's planned DESDynI sensor. However, substantial challenges remain to using the growing body of LiDAR data. First, the large volumes of data generated by LiDAR sensors require efficient processing methods. Second, efficient sampling methods are needed to collect the field data used to relate LiDAR data with vegetation structure. In this paper, we used low-density LiDAR data, summarized within pixels of a regular grid, to estimate forest structure and biomass across a 53,600 ha study area in northeastern Wisconsin. Additionally, we compared the predictive ability of models constructed from a random sample to a sample stratified using mean and standard deviation of LiDAR heights. Our models explained between 65 to 88% of the variability in DBH, basal area, tree height, and biomass. Prediction errors from models constructed using a random sample were up to 68% larger than those from the models built with a stratified sample. The stratified sample included a greater range of variability than the random sample. Thus, applying the random sample model to the entire population violated a tenet of regression analysis; namely, that models should not be used to extrapolate beyond the range of data from which they were constructed. Our results highlight that LiDAR data integrated with field data sampling designs can provide broad-scale assessments of vegetation structure and biomass, i.e., information crucial for carbon and biodiversity science.

  12. [The hospital ship Jutlandia].

    PubMed

    Winge, M

    1996-01-01

    The Danish contribution to the United Nations action during the Korean War (1950-52) was the hospital ship "Jutlandia". The motorvessel Jutlandia - 8.500 tons - was built by the Nakskov Shipyard in 1934, and was rebuilt in three months at the same shipyard to a modern hospital ship with 300 beds, 3 operating theatres, a dental clinic, an x-ray department etc. The crew and the hospital staff consisted approximately each of 100 persons. Jutlandia sailed for Korea on Jan. 23. 1951 and the expedition ended in Copenhagen on Oct. 16. 1953. On the first two cruises the ship was stationed at Pusan. During the first period mostly as an "evacuation sick-bay" and during the second period the ship was opened for Korean military and civil patients, and extensive help was given to the local population on shore. While in Denmark between the second and third cruise a helicopter deck was installed and the operating theatre for neuro-surgery was changed to an opthalmic clinic. This time the ship was stationed at the Bay of Ichon so close to the front, that the wounded could be admitted directly from the advanced dressing stations. On the return journeys to Europe patients were sailed to their home countries. Commodore Kai Hammerich was in charge of the expedition and captain Christen Kondrup was in charge of the ship, throughout the whole expedition. PMID:11625136

  13. Hospital union election activity, 1974-85

    PubMed Central

    Becker, Edmund R.; Rakich, Jonathon S.

    1988-01-01

    This study, using National Labor Relations Board data and American Hospital Association data, reports on the status of union election activity in the hospital industry for a 65-month period, January 1980-May 1985, and contrasts it with earlier data for a similar 65-month time period (1974-79). Together these data provide a comprehensive overview of union election activity in non-Federal, nongovernment hospitals since the passage of the 1974 Nonprofit Hospital Amendments to the Taft-Hartley Act. The study analyzes union, election, hospital, and environmental characteristics. Comparisons over the two time periods show that, while union victory rates in hospital elections have remained constant, the total number of elections has declined dramatically in the hospital industry. PMID:10312518

  14. Hospitals for sale.

    PubMed

    Costello, Michael M; West, Daniel J; Ramirez, Bernardo

    2011-01-01

    The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

  15. Geotechnical applications of LiDAR pertaining to geomechanical evaluation and hazard identification

    NASA Astrophysics Data System (ADS)

    Lato, Matthew J.

    Natural hazards related to ground movement that directly affect the safety of motorists and highway infrastructure include, but are not limited to, rockfalls, rockslides, debris flows, and landslides. This thesis specifically deals with the evaluation of rockfall hazards through the evaluation of LiDAR data. Light Detection And Ranging (LiDAR) is an imaging technology that can be used to delineate and evaluate geomechanically-controlled hazards. LiDAR has been adopted to conduct hazard evaluations pertaining to rockfall, rock-avalanches, debris flows, and landslides. Characteristics of LiDAR surveying, such as rapid data acquisition rates, mobile data collection, and high data densities, pose problems to traditional CAD or GIS-based mapping methods. New analyses methods, including tools specifically oriented to geomechanical analyses, are needed. The research completed in this thesis supports development of new methods, including improved survey techniques, innovative software workflows, and processing algorithms to aid in the detection and evaluation of geomechanically controlled rockfall hazards. The scientific research conducted between the years of 2006-2010, as presented in this thesis, are divided into five chapters, each of which has been published by or is under review by an international journal. The five research foci are: (i) geomechanical feature extraction and analysis using LiDAR data in active mining environments; (ii) engineered monitoring of rockfall hazards along transportation corridors: using mobile terrestrial LiDAR; (iii) optimization of LiDAR scanning and processing for automated structural evaluation of discontinuities in rockmasses; (iv) location orientation bias when using static LiDAR data for geomechanical analysis; and (v) evaluating roadside rockmasses for rockfall hazards from LiDAR data: optimizing data collection and processing protocols. The research conducted pertaining to this thesis has direct and significant implications with

  16. Implementing Patient Safety Initiatives in Rural Hospitals

    ERIC Educational Resources Information Center

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  17. Youth Employment in the Hospitality Sector.

    ERIC Educational Resources Information Center

    Schiller, Bradley R.

    A study used data from the National Longitudinal Surveys of Youth to analyze the long-term effects of hospitality industry employment on youth. The subsample extracted for the study included all youth who were aged 16-24 in 1980 and employed in the civilian sector for pay at any time in the year. Statistics indicated the hospitality sector was…

  18. Evolutionary feature selection to estimate forest stand variables using LiDAR

    NASA Astrophysics Data System (ADS)

    Garcia-Gutierrez, Jorge; Gonzalez-Ferreiro, Eduardo; Riquelme-Santos, Jose C.; Miranda, David; Dieguez-Aranda, Ulises; Navarro-Cerrillo, Rafael M.

    2014-02-01

    Light detection and ranging (LiDAR) has become an important tool in forestry. LiDAR-derived models are mostly developed by means of multiple linear regression (MLR) after stepwise selection of predictors. An increasing interest in machine learning and evolutionary computation has recently arisen to improve regression use in LiDAR data processing. Although evolutionary machine learning has already proven to be suitable for regression, evolutionary computation may also be applied to improve parametric models such as MLR. This paper provides a hybrid approach based on joint use of MLR and a novel genetic algorithm for the estimation of the main forest stand variables. We show a comparison between our genetic approach and other common methods of selecting predictors. The results obtained from several LiDAR datasets with different pulse densities in two areas of the Iberian Peninsula indicate that genetic algorithms perform better than the other methods statistically. Preliminary studies suggest that a lack of parametric conditions in field data and possible misuse of parametric tests may be the main reasons for the better performance of the genetic algorithm. This research confirms the findings of previous studies that outline the importance of evolutionary computation in the context of LiDAR analisys of forest data, especially when the size of fieldwork datatasets is reduced.

  19. Specular and diffuse object extraction from a LiDAR derived Digital Surface Model (DSM)

    NASA Astrophysics Data System (ADS)

    Saraf, N. M.; Hamid, J. R. A.; Kamaruddin, M. H.

    2014-02-01

    This paper intents to investigate the indifferent behaviour quantitatively of target objects of interest due to specular and diffuse reflectivity based on generated LiDAR DSM of the study site in Ampang, Kuala Lumpur. The LiDAR data to be used was initially checked for its reliability and accuracy. The point cloud LiDAR data was converted to raster to allow grid analysis of the next process of generating the DSM and DTM. Filtering and masking were made removing the features of interest (i.e. building and tree) and other unwanted above surface features. A normalised DSM and object segmentation approach were conducted on the trees and buildings separately. Error assessment and findings attained were highlighted and documented. The result of LiDAR verification certified that the data is reliable and useable. The RMSE obtained is within the tolerance value of horizontal and vertical accuracy (x, y, z) i.e. 0.159 m, 0.211 m 0.091 m respectively. Building extraction inclusive of roof top based on slope and contour analysis undertaken indicate the capability of the approach while single tree extraction through aspect analysis appears to preserve the accuracy of the extraction accordingly. The paper has evaluated the suitable methods of extracting non-ground features and the effective segmentation of the LiDAR data.

  20. Detection of fault structures with airborne LiDAR point-cloud data

    NASA Astrophysics Data System (ADS)

    Chen, Jie; Du, Lei

    2015-08-01

    The airborne LiDAR (Light Detection And Ranging) technology is a new type of aerial earth observation method which can be used to produce high-precision DEM (Digital Elevation Model) quickly and reflect ground surface information directly. Fault structure is one of the key forms of crustal movement, and its quantitative description is the key to the research of crustal movement. The airborne LiDAR point-cloud data is used to detect and extract fault structures automatically based on linear extension, elevation mutation and slope abnormal characteristics. Firstly, the LiDAR point-cloud data is processed to filter out buildings, vegetation and other non-surface information with the TIN (Triangulated Irregular Network) filtering method and Burman model calibration method. TIN and DEM are made from the processed data sequentially. Secondly, linear fault structures are extracted based on dual-threshold method. Finally, high-precision DOM (Digital Orthophoto Map) and other geological knowledge are used to check the accuracy of fault structure extraction. An experiment is carried out in Beiya Village of Yunnan Province, China. With LiDAR technology, results reveal that: the airborne LiDAR point-cloud data can be utilized to extract linear fault structures accurately and automatically, measure information such as height, width and slope of fault structures with high precision, and detect faults in areas with vegetation coverage effectively.

  1. Study of Ground Subsidence in North West Houston using GPS, LiDAR and InSAR techniques

    NASA Astrophysics Data System (ADS)

    Karacay, A.; Khan, S. D.

    2012-12-01

    Land subsidence can be caused by natural or human activities, such as carbonate dissolution, extraction of material from mines, soil compaction and fluid withdrawal. This phenomenon affects many cities around the world, such as Nagoya-Japan, Venice-Italy, San Joaquin Valley and Long Beach in California. Recent work by Engelkemeir et al, (2010), suggested that subsidence occurred as high as 5.6 cm/year in northwest Houston. The processes that may contribute to land subsidence in the Houston-Galveston area includes faulting, soil compaction, salt tectonic, water pumping and hydrocarbon extraction. This study aims to assess the possible role of water pumping on subsidence. Northwest Houston has two aquifer systems, the Evangeline and Chicot aquifers that dip in the southeast direction. The effect of water pumping on subsidence from these two aquifers was monitored using InSAR, GPS and LiDAR data. The data from eleven GPS stations were processed using Online Positioning User Service (OPUS) of National Geodetic Survey (NGS). Three of these GPS stations are Continuously Operating Reference Stations (CORS) and eight are Port-A-Measure (PAM) sites. All the GPS data were obtained from Harris-Galveston Subsidence District (HGSD). CORS sites were used as reference stations for processing GPS data from the PAM stations. GPS data show that subsidence rate in northwest Houston decreased to approximately 2 cm/year. In addition, the surface deformation is also estimated using Light Detection and Ranging (LiDAR) technique. For this purpose, raw LiDAR (LAS-Long ASCII Standart) files of 2001 and 2008 were processed. The subsidence rate near the Hockley Fault was calculated by applying zonal statistics method on LiDAR data which shows about 10 cm of subsidence in nine years. This result is supported by processed GPS data from PAM site 48 that show subsidence rate of 1.3 cm/yr. For the InSAR (Interferometric Synthetic Aperture Radar) technique, an image pair of PALSAR (The Phased Array

  2. Hospital prices and market structure in the hospital and insurance industries.

    PubMed

    Moriya, Asako S; Vogt, William B; Gaynor, Martin

    2010-10-01

    There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%. PMID:20478106

  3. Evaluation of an experimental LiDAR for surveying a shallow, braided, sand-bedded river

    USGS Publications Warehouse

    Kinzel, P.J.; Wright, C.W.; Nelson, J.M.; Burman, A.R.

    2007-01-01

    Reaches of a shallow (<1.0m), braided, sand-bedded river were surveyed in 2002 and 2005 with the National Aeronautics and Space Administration's Experimental Advanced Airborne Research LiDAR (EAARL) and concurrently with conventional survey-grade, real-time kinematic, global positioning system technology. The laser pulses transmitted by the EAARL instrument and the return backscatter waveforms from exposed sand and submerged sand targets in the river were completely digitized and stored for postflight processing. The vertical mapping accuracy of the EAARL was evaluated by comparing the ellipsoidal heights computed from ranging measurements made using an EAARL terrestrial algorithm to nearby (<0.5m apart) ground-truth ellipsoidal heights. After correcting for apparent systematic bias in the surveys, the root mean square error of these heights with the terrestrial algorithm in the 2002 survey was 0.11m for the 26 measurements taken on exposed sand and 0.18m for the 59 measurements taken on submerged sand. In the 2005 survey, the root mean square error was 0.18m for 92 measurements taken on exposed sand and 0.24m for 434 measurements on submerged sand. In submerged areas the waveforms were complicated by reflections from the surface, water column entrained turbidity, and potentially the riverbed. When applied to these waveforms, especially in depths greater than 0.4m, the terrestrial algorithm calculated the range above the riverbed. A bathymetric algorithm has been developed to approximate the position of the riverbed in these convolved waveforms and preliminary results are encouraging. ?? 2007 ASCE.

  4. Automatic extraction of building boundaries using aerial LiDAR data

    NASA Astrophysics Data System (ADS)

    Wang, Ruisheng; Hu, Yong; Wu, Huayi; Wang, Jian

    2016-01-01

    Building extraction is one of the main research topics of the photogrammetry community. This paper presents automatic algorithms for building boundary extractions from aerial LiDAR data. First, segmenting height information generated from LiDAR data, the outer boundaries of aboveground objects are expressed as closed chains of oriented edge pixels. Then, building boundaries are distinguished from nonbuilding ones by evaluating their shapes. The candidate building boundaries are reconstructed as rectangles or regular polygons by applying new algorithms, following the hypothesis verification paradigm. These algorithms include constrained searching in Hough space, enhanced Hough transformation, and the sequential linking technique. The experimental results show that the proposed algorithms successfully extract building boundaries at rates of 97%, 85%, and 92% for three LiDAR datasets with varying scene complexities.

  5. Using 3D visual tools with LiDAR for environmental outreach

    NASA Astrophysics Data System (ADS)

    Glenn, N. F.; Mannel, S.; Ehinger, S.; Moore, C.

    2009-12-01

    The project objective is to develop visualizations using light detection and ranging (LiDAR) data and other data sources to increase community understanding of remote sensing data for earth science. These data are visualized using Google Earth and other visualization methods. Final products are delivered to K-12, state, and federal agencies to share with their students and community constituents. Once our partner agencies were identified, we utilized a survey method to better understand their technological abilities and use of visualization products. The final multimedia products include a visualization of LiDAR and well data for water quality mapping in a southeastern Idaho watershed; a tour of hydrologic points of interest in southeastern Idaho visited by thousands of people each year, and post-earthquake features near Borah Peak, Idaho. In addition to the customized multimedia materials, we developed tutorials to encourage our partners to utilize these tools with their own LiDAR and other scientific data.

  6. [Analysis of an Air Pollution Process Using LiDAR in Nanjing, Spring of 2014].

    PubMed

    Bao, Qing; He, Jun-liang; Zha, Yong; Cheng, Feng; Li, Qian-nan

    2015-04-01

    Based on environmental monitoring data, meteorological data and the results of numerical simulation, a typical air pollution process in Nanjing, from 26th May to 1st June, 2014 was deeply analyzed combining aerosol extinction coefficient derived from LiDAR system. Experimental results showed that the entire pollution process was affected by both local pollution and exogenous inputs including dust and smoke. Meteorological factors played a significant role in the generation and elimination of pollutants. Low pressure and temperature inversion also hindered the diffusion of pollutants, while strong rainfall terminated the pollution process. During the pollution, the height of atmospheric boundary layer was lower than normal situation and changed little during the pollution period, which provided a poor diffusion condition for pollutants. LiDAR could accurately detect aerosol vertical structure which was able to capture the temporal and spatial variation of pollutant distributions. Therefore, LiDAR can be of great significance for the atmospheric pollution monitoring. PMID:26164889

  7. Octree-based segmentation for terrestrial LiDAR point cloud data in industrial applications

    NASA Astrophysics Data System (ADS)

    Su, Yun-Ting; Bethel, James; Hu, Shuowen

    2016-03-01

    Automated and efficient algorithms to perform segmentation of terrestrial LiDAR data is critical for exploitation of 3D point clouds, where the ultimate goal is CAD modeling of the segmented data. In this work, a novel segmentation technique is proposed, starting with octree decomposition to recursively divide the scene into octants or voxels, followed by a novel split and merge framework that uses graph theory and a series of connectivity analyses to intelligently merge components into larger connected components. The connectivity analysis, based on a combination of proximity, orientation, and curvature connectivity criteria, is designed for the segmentation of pipes, vessels, and walls from terrestrial LiDAR data of piping systems at industrial sites, such as oil refineries, chemical plants, and steel mills. The proposed segmentation method is exercised on two terrestrial LiDAR datasets of a steel mill and a chemical plant, demonstrating its ability to correctly reassemble and segregate features of interest.

  8. Prevalence and risk factors for Giardia spp. infection in a large national sample of pet dogs visiting veterinary hospitals in the United States (2003-2009).

    PubMed

    Mohamed, Ahmed S; Glickman, Larry T; Camp, Joseph W; Lund, Elizabeth; Moore, George E

    2013-07-01

    Estimates of the prevalence of intestinal infection of dogs with Giardia spp. in the United States vary widely. Risk factors for infection in a large sample of dogs over an extended period of time have not been well characterized. A national, electronic database of medical records was used to estimate the prevalence and identify risk factors for Giardia spp. infection among dogs visiting Banfield Pet Hospital™ located in 43 states in the United States. The overall prevalence of Giardia spp. Infection was 0.44% (95% CI: 0.43-0.45%) in approximately 2.5 million owned dogs who had a fecal flotation test performed from January 2003 to December 2009. A steady decrease in annual prevalence was observed, from a high of 0.61% in 2003 to 0.27% in 2009. Seasonal increases in prevalence were noted during the winter and summer months. Giardia spp. prevalence was highest in the Mountain region, especially Colorado (2.63%; 95% CI: 2.53-2.73%), and in puppies ≤0.5 year of age (0.63%; 95% CI: 0.61-0.64%). It was lowest for dogs of mixed breeding compared with pure breeds. Infection risk was 25-30% greater in sexually intact dogs compared to spayed and neutered dogs. PMID:23337331

  9. National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

    PubMed Central

    2010-01-01

    Background Physicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals. Methods A cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables. Results Among the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men. Conclusion Some physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms. PMID:20222990

  10. Can hospitals compete on quality? Hospital competition.

    PubMed

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples. PMID:25711185

  11. Estimating stem volume and biomass of Pinus koraiensis using LiDAR data.

    PubMed

    Kwak, Doo-Ahn; Lee, Woo-Kyun; Cho, Hyun-Kook; Lee, Seung-Ho; Son, Yowhan; Kafatos, Menas; Kim, So-Ra

    2010-07-01

    The objective of this study was to estimate the stem volume and biomass of individual trees using the crown geometric volume (CGV), which was extracted from small-footprint light detection and ranging (LiDAR) data. Attempts were made to analyze the stem volume and biomass of Korean Pine stands (Pinus koraiensis Sieb. et Zucc.) for three classes of tree density: low (240 N/ha), medium (370 N/ha), and high (1,340 N/ha). To delineate individual trees, extended maxima transformation and watershed segmentation of image processing methods were applied, as in one of our previous studies. As the next step, the crown base height (CBH) of individual trees has to be determined; information for this was found in the LiDAR point cloud data using k-means clustering. The LiDAR-derived CGV and stem volume can be estimated on the basis of the proportional relationship between the CGV and stem volume. As a result, low tree-density plots had the best performance for LiDAR-derived CBH, CGV, and stem volume (R (2) = 0.67, 0.57, and 0.68, respectively) and accuracy was lowest for high tree-density plots (R (2) = 0.48, 0.36, and 0.44, respectively). In the case of medium tree-density plots accuracy was R (2) = 0.51, 0.52, and 0.62, respectively. The LiDAR-derived stem biomass can be predicted from the stem volume using the wood basic density of coniferous trees (0.48 g/cm(3)), and the LiDAR-derived above-ground biomass can then be estimated from the stem volume using the biomass conversion and expansion factors (BCEF, 1.29) proposed by the Korea Forest Research Institute (KFRI). PMID:20182905

  12. LiDAR data and SAR imagery acquired by an unmanned helicopter for rapid landslide investigation

    NASA Astrophysics Data System (ADS)

    Kasai, M.; Tanaka, Y.; Yamazaki, T.

    2012-12-01

    When earthquakes or heavy rainfall hits a landslide prone area, initial actions require estimation of the size of damage to people and infrastructure. This includes identifying the number and size of newly collapsed or expanded landslides, and appraising subsequent risks from remobilization of landslides and debris materials. In inapproachable areas, the UAV (Unmanned Aerial Vehicles) is likely to be of greatest use. In addition, repeat monitoring of sites after the event is a way of utilizing UAVs, particularly in terms of cost and convenience. In this study, LiDAR (SkEyesBox MP-1) data and SAR (Nano SAR) imagery, acquired over 0.5 km2 landslide prone area, are presented to assess the practicability of using unmanned helicopters (in this case a 10 year old YAMAHA RMAX G1) in these situations. LiDAR data was taken in July 2012, when tree foliage covered the ground surface. However, imagery was of sufficient quality to identify and measure landslide features. Nevertheless, LiDAR data obtained by a manned helicopter in the same area in August 2008 was more detailed, reflecting the function of the LiDAR scanner. On the other hand, 2 m resolution Nano SAR imagery produced reasonable results to elucidate hillslope condition. A quick method for data processing without loss of image quality was also investigated. In conclusion, the LiDAR scanner and UAV employed here could be used to plan immediate remedial activity of the area, before LiDAR measurement with a manned helicopter can be organized. SAR imagery from UAV is also available for this initial activity, and can be further applied to long term monitoring.

  13. Reconstruction and analysis of a deciduous sapling using digital photographs or terrestrial-LiDAR technology

    PubMed Central

    Delagrange, Sylvain; Rochon, Pascal

    2011-01-01

    Background and Aims To meet the increasing need for rapid and non-destructive extraction of canopy traits, two methods were used and compared with regard to their accuracy in estimatating 2-D and 3-D parameters of a hybrid poplar sapling. Methods The first method consisted of the analysis of high definition photographs in Tree Analyser (TA) software (PIAF-INRA/Kasetsart University). TA allowed the extraction of individual traits using a space carving approach. The second method utilized 3-D point clouds acquired from terrestrial light detection and ranging (T-LiDAR) scans. T-LiDAR scans were performed on trees without leaves to reconstruct the lignified structure of the sapling. From this skeleton, foliage was added using simple modelling rules extrapolated from field measurements. Validation of the estimated dimension and the accuracy of reconstruction was then achieved by comparison with an empirical data set. Key Results TA was found to be slightly less precise than T-LiDAR for estimating tree height, canopy height and mean canopy diameter, but for 2-D traits both methods were, however, fully satisfactory. TA tended to over-estimate total leaf area (error up to 50 %), but better estimates were obtained by reducing the size of the voxels used for calculations. In contrast, T-LiDAR estimated total leaf area with an error of <6 %. Finally, both methods led to an over-estimation of canopy volume. With respect to this trait, T-LiDAR (14·5 % deviation) greatly surpassed the accuracy of TA (up to 50 % deviation), even if the voxels used were reduced in size. Conclusions Taking into account their magnitude of data acquisition and analysis and their accuracy in trait estimations, both methods showed contrasting potential future uses. Specifically, T-LiDAR is a particularly promising tool for investigating the development of large perennial plants, by itself or in association with plant modelling. PMID:21515607

  14. Detailed Hydrographic Feature Extraction from High-Resolution LiDAR Data

    SciTech Connect

    Danny L. Anderson

    2012-05-01

    Detailed hydrographic feature extraction from high-resolution light detection and ranging (LiDAR) data is investigated. Methods for quantitatively evaluating and comparing such extractions are presented, including the use of sinuosity and longitudinal root-mean-square-error (LRMSE). These metrics are then used to quantitatively compare stream networks in two studies. The first study examines the effect of raster cell size on watershed boundaries and stream networks delineated from LiDAR-derived digital elevation models (DEMs). The study confirmed that, with the greatly increased resolution of LiDAR data, smaller cell sizes generally yielded better stream network delineations, based on sinuosity and LRMSE. The second study demonstrates a new method of delineating a stream directly from LiDAR point clouds, without the intermediate step of deriving a DEM. Direct use of LiDAR point clouds could improve efficiency and accuracy of hydrographic feature extractions. The direct delineation method developed herein and termed “mDn”, is an extension of the D8 method that has been used for several decades with gridded raster data. The method divides the region around a starting point into sectors, using the LiDAR data points within each sector to determine an average slope, and selecting the sector with the greatest downward slope to determine the direction of flow. An mDn delineation was compared with a traditional grid-based delineation, using TauDEM, and other readily available, common stream data sets. Although, the TauDEM delineation yielded a sinuosity that more closely matches the reference, the mDn delineation yielded a sinuosity that was higher than either the TauDEM method or the existing published stream delineations. Furthermore, stream delineation using the mDn method yielded the smallest LRMSE.

  15. LiDAR remote sensing observations for forest assessment and recovery responses following disturbance

    NASA Astrophysics Data System (ADS)

    Rosette, J.; Suárez, J.; Fonweben, J.; North, P.

    2013-12-01

    LiDAR data covering 400 km2 in the Cowal and Trossacs Forest District, Scotland, U.K., were used to provide a low cost solution to update the database of public forests and to produce multi-scale cartographic products for supporting management decisions in the event of forest disturbance such as infestation or wind damage. All parameter estimates were directly obtained from the LiDAR data without the necessity of field calibration. This was achieved using a hybrid approach integrating current stand models for Sitka spruce (Picea sitchensis bong. Carr) and LiDAR analysis. More conventional field methods offer percentage sampling, permitting only a proportion of stands to be surveyed each year and aiming to represent stand-level conditions. The use of LiDAR is advantageous in allowing a complete observation-based assessment throughout the forest and greatly-improved spatial representation of important forest parameters. Time-series analysis was performed using LiDAR data collected in the past 10 years. This analysis allowed us to establish growth trajectories in the forest stands, automatically discriminating areas of growth, those whose growth had been affected by disease and the occurrence of windthrow gaps. The results were compared to the cartography produced by the Forest District after a severe wind storm that affected the area in 2012. This analysis showed the ability of LiDAR to create a more precise location and extent of catastrophic damage and windthrow gaps. In addition, once windthrow has occurred, progression of further damage in existing canopy gaps can be observed. This approach additionally allows the impact of disease on forest growth and subsequent recovery response to be monitored.

  16. Hospital-acquired pneumonia

    MedlinePlus

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  17. Pediatric Inpatient Hospital Resource Use for Congenital Heart Defects

    PubMed Central

    Simeone, Regina M.; Oster, Matthew E.; Cassell, Cynthia H.; Armour, Brian S.; Gray, Darryl T.; Honein, Margaret A.

    2015-01-01

    Background Congenital heart defects (CHDs) occur in approximately 8 per 1000 live births. Improvements in detection and treatment have increased survival. Few national estimates of the healthcare costs for infants, children and adolescents with CHDs are available. Methods We estimated hospital costs for hospitalizations using pediatric (0–20 years) hospital discharge data from the 2009 Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) for hospitalizations with CHD diagnoses. Estimates were up-weighted to be nationally representative. Mean costs were compared by demographic factors and presence of critical CHDs (CCHDs). Results Up-weighting of the KID generated an estimated 4,461,615 pediatric hospitalizations nationwide, excluding normal newborn births. The 163,980 (3.7%) pediatric hospitalizations with CHDs accounted for approximately $5.6 billion in hospital costs, representing 15.1% of costs for all pediatric hospitalizations in 2009. Approximately 17% of CHD hospitalizations had a CCHD, but it varied by age: approximately 14% of hospitalizations of infants, 30% of hospitalizations of patients aged 1 to 10 years, and 25% of hospitalizations of patients aged 11 to 20 years. Mean costs of CHD hospitalizations were higher in infancy ($36,601) than at older ages and were higher for hospitalizations with a CCHD diagnosis ($52,899). Hospitalizations with CCHDs accounted for 26.7% of all costs for CHD hospitalizations, with hypoplastic left heart syndrome, coarctation of the aorta, and tetralogy of Fallot having the highest total costs. Conclusion Hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with CCHD diagnoses accounted for 27% of CHD hospital costs. PMID:24975483

  18. Drug-to-antibody ratio (DAR) and drug load distribution by LC-ESI-MS.

    PubMed

    Basa, Louisette

    2013-01-01

    This chapter describes an LC-ESI-MS method for the DAR and drug load distribution analysis that is suitable for lysine-linked ADCs. The ADC sample is desalted using a reversed-phase LC column with an acetonitrile gradient prior to online MS analysis. The MS spectrum is processed (deconvoluted) and converted to a series of zero charge state masses that corresponds to the increasing number of drugs in the ADC. Integration of the mass peak area allows the calculation of the DAR and drug load distribution of ADCs. PMID:23913155

  19. Direct injection into the IsoDAR Cyclotron using a RFQ

    NASA Astrophysics Data System (ADS)

    Axani, Spencer; IsoDAR Collaboration

    2015-04-01

    Beginning in the 1970s, the use of Radio Frequency Quadrupoles (RFQs) has been pervasive in linear accelerators in order to accelerate, bunch, and separate ion species. Current research suggests this may be an ideal way to inject a low energy H2+ beam axially into a cyclotron. The IsoDAR (Isotope Decay At Rest) experiment aims to implement this injection system in order to achieve higher Low Energy Beam Transport (LEBT) efficiencies and ultimately construct a novel compact neutrino factory to test the hypothesis of sterile neutrinos. This talk will focus on the research and development needed to implement a RFQ into the IsoDAR experiment.

  20. Parenteral nutrition in hospital pharmacies.

    PubMed

    Katoue, Maram Gamal; Al-Taweel, Dalal; Matar, Kamal Mohamed; Kombian, Samuel B

    2016-07-11

    Purpose - The purpose of this paper is to explore parenteral nutrition (PN) practices in hospital pharmacies of Kuwait and identify potential avenues for quality improvement in this service. Design/methodology/approach - A descriptive, qualitative study about PN practices was conducted from June 2012 to February 2013 in Kuwait. Data were collected via in-depth semi-structured interviews with the head total parenteral nutrition (TPN) pharmacists at seven hospitals using a developed questionnaire. The questionnaire obtained information about the PN service at each hospital including the existence of nutritional support teams (NSTs), PN preparation practices, quality controls and guidelines/protocols. The interviews were audio-recorded, transcribed verbatim and analyzed for content. Findings - Seven hospitals in Kuwait provided PN preparation service through TPN units within hospital pharmacies. Functional NSTs did not exist in any of these hospitals. All TPN units used paper-based standard PN order forms for requesting PN. The content of PN order forms and PN formulas labeling information were inconsistent across hospitals. Most of the prepared PN formulas were tailor-made and packed in single compartment bags. Quality controls used included gravimetric analysis and visual inspection of PN formulations, and less consistently reported periodic evaluation of the aseptic techniques. Six TPN units independently developed PN guidelines/protocols. Originality/value - This study revealed variations in many aspects of PN practices among the hospitals in Kuwait and provided recommendations to improve this service. Standardization of PN practices would enhance the quality of care provided to patients receiving PN and facilitate national monitoring. This can be accomplished through the involvement of healthcare professionals with expertise in nutrition support working within proactive NSTs. PMID:27298063

  1. LiDAR DTMs and anthropogenic feature extraction: testing the feasibility of geomorphometric parameters in floodplains

    NASA Astrophysics Data System (ADS)

    Sofia, G.; Tarolli, P.; Dalla Fontana, G.

    2012-04-01

    In floodplains, massive investments in land reclamation have always played an important role in the past for flood protection. In these contexts, human alteration is reflected by artificial features ('Anthropogenic features'), such as banks, levees or road scarps, that constantly increase and change, in response to the rapid growth of human populations. For these areas, various existing and emerging applications require up-to-date, accurate and sufficiently attributed digital data, but such information is usually lacking, especially when dealing with large-scale applications. More recently, National or Local Mapping Agencies, in Europe, are moving towards the generation of digital topographic information that conforms to reality and are highly reliable and up to date. LiDAR Digital Terrain Models (DTMs) covering large areas are readily available for public authorities, and there is a greater and more widespread interest in the application of such information by agencies responsible for land management for the development of automated methods aimed at solving geomorphological and hydrological problems. Automatic feature recognition based upon DTMs can offer, for large-scale applications, a quick and accurate method that can help in improving topographic databases, and that can overcome some of the problems associated with traditional, field-based, geomorphological mapping, such as restrictions on access, and constraints of time or costs. Although anthropogenic features as levees and road scarps are artificial structures that actually do not belong to what is usually defined as the bare ground surface, they are implicitly embedded in digital terrain models (DTMs). Automatic feature recognition based upon DTMs, therefore, can offer a quick and accurate method that does not require additional data, and that can help in improving flood defense asset information, flood modeling or other applications. In natural contexts, morphological indicators derived from high

  2. KML-Based Access and Visualization of High Resolution LiDAR Topography

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Blair, J. L.; Nandigam, V.; Memon, A.; Baru, C.; Arrowsmith, J. R.

    2008-12-01

    Over the past decade, there has been dramatic growth in the acquisition of LiDAR (Light Detection And Ranging) high-resolution topographic data for earth science studies. Capable of providing digital elevation models (DEMs) more than an order of magnitude higher resolution than those currently available, LiDAR data allow earth scientists to study the processes that contribute to landscape evolution at resolutions not previously possible yet essential for their appropriate representation. These datasets also have significant implications for earth science education and outreach because they provide an accurate representation of landforms and geologic hazards. Unfortunately, the massive volume of data produced by LiDAR mapping technology can be a barrier to their use. To make these data available to a larger user community, we have been exploring the use of Keyhole Markup Language (KML) and Google Earth to provide access to LiDAR data products and visualizations. LiDAR digital elevation models are typically delivered in a tiled format that lends itself well to a KML-based distribution system. For LiDAR datasets hosted in the GEON OpenTopography Portal (www.opentopography.org) we have developed KML files that show the extent of available LiDAR DEMs and provide direct access to the data products. Users interact with these KML files to explore the extent of the available data and are able to select DEMs that correspond to their area of interest. Selection of a tile loads a download that the user can then save locally for analysis in their software of choice. The GEON topography system also has tools available that allow users to generate custom DEMs from LiDAR point cloud data. This system is powerful because it enables users to access massive volumes of raw LiDAR data and to produce DEM products that are optimized to their science applications. We have developed a web service that converts the custom DEM models produced by the system to a hillshade that is delivered to

  3. Epidemiology of Abusive Abdominal Trauma Hospitalizations in United States Children

    ERIC Educational Resources Information Center

    Lane, Wendy Gwirtzman; Dubowitz, Howard; Langenberg, Patricia; Dischinger, Patricia

    2012-01-01

    Objectives: (1) To estimate the incidence of abusive abdominal trauma (AAT) hospitalizations among US children age 0-9 years. (2) To identify demographic characteristics of children at highest risk for AAT. Design: Secondary data analysis of a cross-sectional, national hospitalization database. Setting: Hospitalization data from the 2003 and 2006…

  4. Hospitalization for Congestive Heart Failure: United States, 2000-2010

    MedlinePlus

    ... care, health care utilization, National Hospital Discharge Survey Did the number and age distribution of patients hospitalized ... those aged 65–74 and 75–84 decreased. Did the rate of hospitalization for CHF change from ...

  5. Investigation of knickpoint propagation in tributaries to the South Fork Eel River, northern California, using 10-m and LiDAR-derived digital elevation models

    NASA Astrophysics Data System (ADS)

    Foster, M. A.; Kelsey, H. M.

    2009-12-01

    Base-level lowering is expressed in the long-profile of the South Fork Eel River, northern California by a knickpoint/knickzone ~135 km upstream from its mouth. Numerous knickpoints and knickzones in tributaries of the South Fork Eel River indicate that knickpoint propagation may be the dominant process of Quaternary base-level lowering throughout the basin. We study two tributary basins downstream from the mainstem South Fork Eel River knickzone, Bear Pen and Standley Creeks, for evidence of base-level lowering via knickpoint propagation. Results from the 10-m digital elevation models (DEM) indicate that these two tributaries, and their sub-tributaries, deviate from a typical concave-up long profile, and display a convexity in profile shape toward the stream mouths. When scaled against drainage area, tributary basins within the study area are steeper in the lower reaches of the basins. Steepness indices (ksn) normalized to a reference concavity (θ) of 0.45, are ~40-60 toward the mouth of the tributary basins, whereas in the upper watersheds ksn values are typically 10-40. Knickzones are identified along several of the sub-tributaries using the 10 m DEM data base. In addition, many field-identified knickpoints are not detected on 10m DEMs. Under the auspices of the National Center for Airborne Laser Mapping high-resolution LiDAR data recently (Sept. 2009) have been collected for the study area. We anticipate additional knickpoints and more subtle knickzones will be identified with high-quality LiDAR data. If knickpoint propagation has occurred in these two tributaries, we expect not only a steepening in lower reaches of these watersheds, but an increase in valley wall slopes. LiDAR data will allow precise measurement of valley walls and channel morphometrics, and more subtle indications of knickpoint propagation may be detected.

  6. Deciphering the Precision of Stereo IKONOS Canopy Height Models for U.S. Forests with G-LiHT Airborne LiDAR

    NASA Technical Reports Server (NTRS)

    Rudasill-Neigh, Christopher S.; Masek, Jeffrey G.; Bourget, Paul; Cook, Bruce; Huang, Chengquan; Rishmawi, Khaldoun; Zhao, Feng

    2014-01-01

    Few studies have evaluated the precision of IKONOS stereo data for measuring forest canopy height. The high cost of airborne light detection and ranging (LiDAR) data collection for large area studies and the present lack of a spaceborne instrument lead to the need to explore other low cost options. The US Government currently has access to a large archive of commercial high-resolution imagery, which could be quite valuable to forest structure studies. At 1 m resolution, we here compared canopy height models (CHMs) and height data derived from Goddard's airborne LiDAR Hyper-spectral and Thermal Imager (G-LiHT) with three types of IKONOS stereo derived digital surface models (DSMs) that estimate CHMs by subtracting National Elevation Data (NED) digital terrain models (DTMs). We found the following in three different forested regions of the US after excluding heterogeneous and disturbed forest samples: (1) G-LiHT DTMs were highly correlated with NED DTMs with R (sup 2) greater than 0.98 and root mean square errors (RMSEs) less than 2.96 m; (2) when using one visually identifiable ground control point (GCP) from NED, G-LiHT DSMs and IKONOS DSMs had R (sup 2) greater than 0.84 and RMSEs of 2.7 to 4.1 m; and (3) one GCP CHMs for two study sites had R (sup 2) greater than 0.7 and RMSEs of 2.6 to 3 m where data were collected less than four years apart. Our results suggest that IKONOS stereo data are a useful LiDAR alternative where high-quality DTMs are available.

  7. Validating LiDAR Derived Estimates of Canopy Height, Structure and Fractional Cover in Riparian Areas: A Comparison of Leaf-on and Leaf-off LiDAR Data

    NASA Astrophysics Data System (ADS)

    Wasser, L. A.; Chasmer, L. E.; Taylor, A.; Day, R.

    2010-12-01

    Characterization of riparian buffers is integral to understanding the landscape scale impacts of disturbance on wildlife and aquatic ecosystems. Riparian buffers may be characterized using in situ plot sampling or via high resolution remote sensing. Field measurements are time-consuming and may not cover a broad range of ecosystem types. Further, spectral remote sensing methods introduce a compromise between spatial resolution (grain) and area extent. Airborne LiDAR can be used to continuously map and characterize riparian vegetation structure and composition due to the three-dimensional reflectance of laser pulses within and below the canopy, understory and at the ground surface. The distance between reflections (or ‘returns’) allows for detection of narrow buffer corridors at the landscape scale. There is a need to compare leaf-off and leaf-on surveyed LiDAR data with in situ measurements to assess accuracy in landscape scale analysis. These comparisons are particularly important considering increased availability of leaf-off surveyed LiDAR datasets. And given this increased availability, differences between leaf-on and leaf-off derived LiDAR metrics are largely unknown for riparian vegetation of varying composition and structure. This study compares the effectiveness of leaf-on and leaf-off LiDAR in characterizing riparian buffers of varying structure and composition as compared to field measurements. Field measurements were used to validate LiDAR derived metrics. Vegetation height, canopy cover, density and overstory and understory species composition were recorded in 80 random plots of varying vegetation type, density and structure within a Pennsylvania watershed (-77.841, 40.818). Plot data were compared with LiDAR data collected during leaf on and leaf off conditions to determine 1) accuracy of LiDAR derived metrics compared to field measures and 2) differences between leaf-on and leaf-off LiDAR metrics. Results illustrate that differences exist between

  8. National Quality Assessment Evaluating Spironolactone Use During Hospitalization for Acute Myocardial Infarction (AMI) in China: China Patient-centered Evaluation Assessment of Cardiac Events (PEACE)-Retrospective AMI Study, 2001, 2006, and 2011

    PubMed Central

    Guan, Wenchi; Murugiah, Karthik; Downing, Nicholas; Li, Jing; Wang, Qing; Ross, Joseph S; Desai, Nihar R; Masoudi, Frederick A; Spertus, John A; Li, Xi; Krumholz, Harlan M; Jiang, Lixin

    2015-01-01

    Background Spironolactone, the only aldosterone antagonist available in China, improves outcomes in acute myocardial infarction (AMI) among patients with systolic dysfunction and either diabetes or heart failure (HF). However, national practice patterns in the use of spironolactone in China are unknown. Methods and Results From a nationally representative sample of AMI patients from in 2001, 2006, and 2011, we identified 6906 patients with either diabetes or HF and classified them into 1 of 4 groups according to their eligibility for spironolactone—“ideal”(left ventricular ejection fraction [LVEF] ≤40% and without contraindications), “contraindicated,” “not indicated” (neither ideal nor contraindicated), and “unknown indications” (LVEF unmeasured)—to determine how frequently patient eligibility for this drug is assessed in the hospital, how it is used in several groups, and to identify factors associated with the use in these groups. From 2001 to 2011, the proportion of patients whose eligibility for spironolactone was not assessed decreased (66.9% in 2001 to 32.8% in 2011). Spironolactone use significantly increased among ideal patients over this period (28.6% to 72.4%; P<0.001 for trend), but also in contraindicated patients (11.4% to 27.5%; P=0.002 for trend) and in other patients groups (not indicated: 27.5% to 38.3%; unknown indications: 21.3% to 35.1%; both P<0.01 for trend). In all 4 groups, patients presenting with HF on admission were more likely to receive spironolactone. Conclusions Although the appropriate use of spironolactone and assessment of eligibility increased in China over the past decade, there remains marked opportunities for improvement. Clinical Trial Registration URL: http://www.clinicaltrials.gov Unique identifier: NCT01624883. PMID:26071031

  9. Technical Efficiency of Hospitals in Tehran, Iran

    PubMed Central

    KAKEMAN, Edris; RAHIMI FORUSHANI, Abbas; DARGAHI, Hossein

    2016-01-01

    Background: Nowadays, restriction on access and optimum use of resources is the main challenge of development in all organizations. Therefore, the aim of this study was to determine the technical efficiency and its factors, influencing hospitals of Tehran. Methods: This research was a descriptive-analytical and retrospective study conducted in 2014–2015. Fifty two hospitals with public, private, and social security ownership type were selected for this study. The required data was collected by a researcher-made check list in 3 sections of background data, inputs and outputs. The data was analyzed by DEAP 1.0.2, and STATA-13 technique. Results: Seventeen (31/48) of hospitals had the efficiency score of 1 as the highest technical efficiency. The highest average score of efficiency was related to social security hospitals as 84.32, and then the public and private hospitals with the average of 84.29 and 79.64 respectively. Tobit regression results showed that the size, type of practice, and ownership of hospitals were effective on the degree of their technical efficiency. However, there was no significant correlation between teaching / non-teaching hospitals with technical efficiency. Conclusion: Establishment of competition system among hospitals, constitution of medium size hospitals and allocation of budget to hospitals based on national accreditation system are recommended. PMID:27252919

  10. Unsafe driving behaviors and hospitalization.

    PubMed

    Van Tuinen, M

    1994-04-01

    The medical costs associated with motor vehicle crashes are difficult to measure. Most attempts have used crash data and cost data that are only indirectly related to each other or have followed patients in a few hospitals or trauma centers. These studies produce localized estimates or rough national estimates of limited use to policy makers. The result has been a dependence on more readily available mortality data, such as the Fatal Accident Reporting System, to guide automotive safety efforts. The limitations of mortality data and the increasing sophistication of medical care data bases have resulted in a strong interest in obtaining crash-linked morbidity data. Hence, in 1993, the National Highway Traffic Safety Administration (NHTSA) awarded the Missouri Department of Health and six other applicants grants to link automotive crash records to statewide ambulance trip, outpatient care, hospitalization and mortality records. By identifying an individual across multiple data sets, states would be able to determine directly the relationship of driver behaviors and crash characteristics to hospitalization rates and other medical outcomes. Examination of hospital pay source information would expose the toll of automotive crashes on public tax dollars. Having recently completed the record linkage phase of this project, Missouri Department of Health staff are beginning to analyze the impact of automotive crashes on health care costs in Missouri. In this report, three unsafe driving behaviors, failure to use a safety device (seatbelts and motorcycle helmets), driving under the influence of alcohol, and speeding, are related to the risk of hospitalization or death, hospital costs, and expected pay source. PMID:8202067

  11. The Effect of Lava Texture on LiDAR Attributes and Full Waveform

    NASA Astrophysics Data System (ADS)

    Anderson, S. W.; Finnegan, D. C.; LeWinter, A.

    2013-12-01

    The distribution of glassy, vesicular, and crystalline textures on lava flow and dome surfaces provides insights regarding the physical and chemical processes occurring during emplacement. For silicic flows, these textures may reflect variations in the volatile content of lava upon eruption. To assess the efficacy of texture detection with our terrestrial full waveform LiDAR system capable of measuring ~125,000 topographic points/second, we analyzed attribute and full waveform data from a variety of lava textures displayed on recent rhyolitic obsidian flows of the Inyo Dome chain (California) and pahoehoe and aa flows at Kilauea volcano (Hawaii). We find that attributes such as intensity, amplitude and deviation of the returned 1550nm laser pulse fall into discrete ranges associated with glassy, pumiceous and crystalline textures on both the rhyolitic and basaltic surfaces. This enables detection of vesicularity at ranges in excess of 500 m, making LiDAR a useful tool for remotely determining lava texture. Scan times using our Riegl VZ1000 and VZ400 systems require only minutes, allowing for repeated scans over a short time period, and processing times are <1 hour. We have also analyzed the full digitized waveforms of LiDAR pulses returned from these surfaces, and find that they also have unique signatures related to texture. We therefore suggest that LiDAR can provide reliable information on lava texture during eruption, aiding in the interpretation of eruption hazards from increasing volatile contents.

  12. Geospatial revolution and remote sensing LiDAR in Mesoamerican archaeology

    PubMed Central

    Chase, Arlen F.; Fisher, Christopher T.; Leisz, Stephen J.; Weishampel, John F.

    2012-01-01

    The application of light detection and ranging (LiDAR), a laser-based remote-sensing technology that is capable of penetrating overlying vegetation and forest canopies, is generating a fundamental shift in Mesoamerican archaeology and has the potential to transform research in forested areas world-wide. Much as radiocarbon dating that half a century ago moved archaeology forward by grounding archaeological remains in time, LiDAR is proving to be a catalyst for an improved spatial understanding of the past. With LiDAR, ancient societies can be contextualized within a fully defined landscape. Interpretations about the scale and organization of densely forested sites no longer are constrained by sample size, as they were when mapping required laborious on-ground survey. The ability to articulate ancient landscapes fully permits a better understanding of the complexity of ancient Mesoamerican urbanism and also aids in modern conservation efforts. The importance of this geospatial innovation is demonstrated with newly acquired LiDAR data from the archaeological sites of Caracol, Cayo, Belize and Angamuco, Michoacán, Mexico. These data illustrate the potential of technology to act as a catalytic enabler of rapid transformational change in archaeological research and interpretation and also underscore the value of on-the-ground archaeological investigation in validating and contextualizing results. PMID:22802623

  13. Students' Experiences and Challenges of Blended Learning at the University of Dar Es Salaam, Tanzania

    ERIC Educational Resources Information Center

    Mtebe, Joel S.; Raphael, Christina

    2013-01-01

    Recent developments in Information and Communication Technologies (ICTs), especially eLearning, have heightened the need for University of Dar es Salaam (UDSM) to supplement on-campus face-to-face delivery as well as meeting increased students' enrolments through blended distance learning. Since 2008, the University has been offering three…

  14. High-throughput genotyping of hop (Humulus lupulus L.) utilising diversity arrays technology (DArT)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Implementation of molecular methods in hop breeding is dependent on the availability of sizeable numbers of polymorphic markers and a comprehensive understanding of genetic variation. Diversity Arrays Technology (DArT) is a high-throughput cost-effective method for the discovery of large numbers of...

  15. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014

    PubMed Central

    Mboera, Leonard E.G.; De Nardo, Pasquale; Oriyo, Ndekya M.; Meschi, Silvia; Rumisha, Susan F.; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N.; Ippolito, Giuseppe

    2016-01-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV. PMID:27088845

  16. Geospatial revolution and remote sensing LiDAR in Mesoamerican archaeology.

    PubMed

    Chase, Arlen F; Chase, Diane Z; Fisher, Christopher T; Leisz, Stephen J; Weishampel, John F

    2012-08-01

    The application of light detection and ranging (LiDAR), a laser-based remote-sensing technology that is capable of penetrating overlying vegetation and forest canopies, is generating a fundamental shift in Mesoamerican archaeology and has the potential to transform research in forested areas world-wide. Much as radiocarbon dating that half a century ago moved archaeology forward by grounding archaeological remains in time, LiDAR is proving to be a catalyst for an improved spatial understanding of the past. With LiDAR, ancient societies can be contextualized within a fully defined landscape. Interpretations about the scale and organization of densely forested sites no longer are constrained by sample size, as they were when mapping required laborious on-ground survey. The ability to articulate ancient landscapes fully permits a better understanding of the complexity of ancient Mesoamerican urbanism and also aids in modern conservation efforts. The importance of this geospatial innovation is demonstrated with newly acquired LiDAR data from the archaeological sites of Caracol, Cayo, Belize and Angamuco, Michoacán, Mexico. These data illustrate the potential of technology to act as a catalytic enabler of rapid transformational change in archaeological research and interpretation and also underscore the value of on-the-ground archaeological investigation in validating and contextualizing results. PMID:22802623

  17. Pit Latrine Emptying Behavior and Demand for Sanitation Services in Dar Es Salaam, Tanzania

    PubMed Central

    Jenkins, Marion W.; Cumming, Oliver; Cairncross, Sandy

    2015-01-01

    Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic latrine emptying service in unplanned communities in Dar Es Salaam (Dar), Tanzania, using data from a cross-sectional survey at 662 residential properties in 35 unplanned sub-wards across Dar, where 97% had pit latrines. A picture emerges of expensive and poor FSM service options for latrine owners, resulting in widespread fecal sludge exposure that is likely to increase unless addressed. Households delay emptying as long as possible, use full pits beyond what is safe, face high costs even for unhygienic emptying, and resort to unsafe practices like ‘flooding out’. We measured strong interest in and willingness to pay (WTP) for the new pit emptying service at 96% of residences; 57% were WTP ≥U.S. $17 to remove ≥200 L of sludge. Emerging policy recommendations for safe FSM in unplanned urban communities in Dar and elsewhere are discussed. PMID:25734790

  18. Engineering monitoring of rockfall hazards along transportation corridors: using mobile terrestrial LiDAR

    NASA Astrophysics Data System (ADS)

    Lato, M.; Hutchinson, J.; Diederichs, M.; Ball, D.; Harrap, R.

    2009-06-01

    Geotechnical hazards along linear transportation corridors are challenging to identify and often require constant monitoring. Inspecting corridors using traditional, manual methods requires the engineer to be unnecessarily exposed to the hazard. It also requires closure of the corridor to ensure safety of the worker from passing vehicles. This paper identifies the use of mobile terrestrial LiDAR data as a compliment to traditional field methods. Mobile terrestrial LiDAR is an emerging remote data collection technique capable of generating accurate fully three-dimensional virtual models while driving at speeds up to 100 km/h. Data is collected from a truck that causes no delays to active traffic nor does it impede corridor use. These resultant georeferenced data can be used for geomechanical structural feature identification and kinematic analysis, rockfall path identification and differential monitoring of rock movement or failure over time. Comparisons between mobile terrestrial and static LiDAR data collection and analysis are presented. As well, detailed discussions on workflow procedures for possible implementation are discussed. Future use of mobile terrestrial LiDAR data for corridor analysis will focus on repeated surveys and developing dynamic four-dimensional models, higher resolution data collection. As well, computationally advanced, spatially accurate, geomechanically controlled three-dimensional rockfall simulations should be investigated.

  19. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014.

    PubMed

    Vairo, Francesco; Mboera, Leonard E G; De Nardo, Pasquale; Oriyo, Ndekya M; Meschi, Silvia; Rumisha, Susan F; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N; Ippolito, Giuseppe

    2016-05-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV. PMID:27088845

  20. Registration of optical imagery and LiDAR data using an inherent geometrical constraint.

    PubMed

    Zhang, Wuming; Zhao, Jing; Chen, Mei; Chen, Yiming; Yan, Kai; Li, Linyuan; Qi, Jianbo; Wang, Xiaoyan; Luo, Jinghui; Chu, Qing

    2015-03-23

    A novel method for registering imagery with Light Detection And Ranging (LiDAR) data is proposed. It is based on the phenomenon that the back-projection of LiDAR point cloud of an object should be located within the object boundary in the image. Using this inherent geometrical constraint, the registration parameters computation of both data sets only requires LiDAR point clouds of several objects and their corresponding boundaries in the image. The proposed registration method comprises of four steps: point clouds extraction, boundary extraction, back-projection computation and registration parameters computation. There are not any limitations on the geometrical and spectral properties of the object. So it is suitable not only for structured scenes with man-made objects but also for natural scenes. Moreover, the proposed method based on the inherent geometrical constraint can register two data sets derived from different parts of an object. It can be used to co-register TLS (Terrestrial Laser Scanning) LiDAR point cloud and UAV (Unmanned aerial vehicle) image, which are obtaining more attention in the forest survey application. Using initial registration parameters comparable to POS (position and orientation system) accuracy, the performed experiments validated the feasibility of the proposed registration method. PMID:25837107

  1. Child Labour in Urban Agriculture: The Case of Dar es Salaam, Tanzania.

    ERIC Educational Resources Information Center

    Mlozi, Malongo R. S.

    1995-01-01

    Urban agriculture in Dar es Salaam was found to use child labor of both children with parents of higher and lower socioeconomic status (SES). Discusses policy implications and calls for the education of parents of lower SES not to expect an economic contribution from their children's labor, and the education of children about their rights. (LZ)

  2. a Data Driven Method for Building Reconstruction from LiDAR Point Clouds

    NASA Astrophysics Data System (ADS)

    Sajadian, M.; Arefi, H.

    2014-10-01

    Airborne laser scanning, commonly referred to as LiDAR, is a superior technology for three-dimensional data acquisition from Earth's surface with high speed and density. Building reconstruction is one of the main applications of LiDAR system which is considered in this study. For a 3D reconstruction of the buildings, the buildings points should be first separated from the other points such as; ground and vegetation. In this paper, a multi-agent strategy has been proposed for simultaneous extraction and segmentation of buildings from LiDAR point clouds. Height values, number of returned pulse, length of triangles, direction of normal vectors, and area are five criteria which have been utilized in this step. Next, the building edge points are detected using a new method named "Grid Erosion". A RANSAC based technique has been employed for edge line extraction. Regularization constraints are performed to achieve the final lines. Finally, by modelling of the roofs and walls, 3D building model is reconstructed. The results indicate that the proposed method could successfully extract the building from LiDAR data and generate the building models automatically. A qualitative and quantitative assessment of the proposed method is then provided.

  3. A comparison of two open source LiDAR surface classification algorithms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    With the progression of LiDAR (Light Detection and Ranging) towards a mainstream resource management tool, it has become necessary to understand how best to process and analyze the data. While most ground surface identification algorithms remain proprietary and have high purchase costs; a few are op...

  4. Mapping of post-event earthquake induced landslides in Sg. Mesilou using LiDAR

    NASA Astrophysics Data System (ADS)

    Hanan Mat Yusoff, Habibah; Azahari Razak, Khamarrul; Yuen, Florence; Harun, Afifi; Talib, Jasmi; Mohamad, Zakaria; Ramli, Zamri; Abd Razab, Razain

    2016-06-01

    Earthquake is a common natural disaster in active tectonic regions. The disaster can induce cascading disasters such as debris flow, mudflow and reactivated old landslides. M 6.0 Ranau earthquake dated on June 05, 2015 coupling with intense and prolonged rainfall caused several mass movements such as debris flow, deep-seated and shallow landslides in Mesilou, Sabah. This study aims at providing a better insight into the use of advanced LiDAR mapping technology for recognizing landslide induced by earthquakes particularly in a vegetated terrain, assessing post event hazard and analyzing its distribution for hazard zonation. We developed the landslide inventory using LiDAR-derived visual analysis method and validated in the field. A landslide inventory map improved with the support of LiDAR derivative data. Finally, landslide inventory was analysed by emphasizing its distribution and density in such a way that it provides clues of risky zone as a result of debris flow. We recommend that mitigation action and risk reduction should be taken place at a transport zone of the channel compared to other zones. This study indicates that modern airborne LiDAR can be a good complementary tool for improving landslide inventory in a complex environment, and an effective tool for rapid regional hazard and risk assessment in the tropics.

  5. Spatially-aware Processing of Large Raw LiDAR Data Sets

    NASA Astrophysics Data System (ADS)

    Strane, M. D.; Oskin, M.

    2004-12-01

    An ultimate goal of LiDAR (LIght Detection And Ranging) data acquisition is to produce a regularly sampled accurate topographic view of the surface of the Earth. Last-return and inverse-distance weighted sampling of raw LiDAR data do not take into account the non-random distribution of raw data points. While elevation data produced by these methods is of high accuracy, gradients are not well-resolved and aliasing artifacts are produced, especially on low gradient surfaces. Because of the volume of data involved, resampling schemes that take into account the spatial distribution of raw data have been cumbersome to implement. We have developed a resampling method that uses the free open-source PostgresSQL database to store the raw LiDAR data indexed spatially and as its original time series. This database permits rapid access to raw data points via spatial queries. A robust and expedient algorithm has been implemented to produce regularly gridded resampled data with a least squares plane fit regression. This algorithm reduces aliasing artifacts on low gradient surfaces. The algorithm is also a proof-of-concept to show that complex spatially-aware processing of large LiDAR data sets is feasible on a reasonable time scale, and will be the basis for further improvements such as vegetation removal.

  6. Pit latrine emptying behavior and demand for sanitation services in Dar Es Salaam, Tanzania.

    PubMed

    Jenkins, Marion W; Cumming, Oliver; Cairncross, Sandy

    2015-03-01

    Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic latrine emptying service in unplanned communities in Dar Es Salaam (Dar), Tanzania, using data from a cross-sectional survey at 662 residential properties in 35 unplanned sub-wards across Dar, where 97% had pit latrines. A picture emerges of expensive and poor FSM service options for latrine owners, resulting in widespread fecal sludge exposure that is likely to increase unless addressed. Households delay emptying as long as possible, use full pits beyond what is safe, face high costs even for unhygienic emptying, and resort to unsafe practices like 'flooding out'. We measured strong interest in and willingness to pay (WTP) for the new pit emptying service at 96% of residences; 57% were WTP≥U.S. $17 to remove ≥200 L of sludge. Emerging policy recommendations for safe FSM in unplanned urban communities in Dar and elsewhere are discussed. PMID:25734790

  7. Spatial Patterns of Trees from Airborne LiDAR Using a Simple Tree Segmentation Algorithm

    NASA Astrophysics Data System (ADS)

    Jeronimo, S.; Kane, V. R.; McGaughey, R. J.; Franklin, J. F.

    2015-12-01

    Objectives for management of forest ecosystems on public land incorporate a focus on maintenance and restoration of ecological functions through silvicultural manipulation of forest structure. The spatial pattern of residual trees - the horizontal element of structure - is a key component of ecological restoration prescriptions. We tested the ability of a simple LiDAR individual tree segmentation method - the watershed transform - to generate spatial pattern metrics similar to those obtained by the traditional method - ground-based stem mapping - on forested plots representing the structural diversity of a large wilderness area (Yosemite NP) and a large managed area (Sierra NF) in the Sierra Nevada, Calif. Most understory and intermediate-canopy trees were not detected by the LiDAR segmentation; however, LiDAR- and field-based assessments of spatial pattern in terms of tree clump size distributions largely agreed. This suggests that (1) even when individual tree segmentation is not effective for tree density estimates, it can provide a good measurement of tree spatial pattern, and (2) a simple segmentation method is adequate to measure spatial pattern of large areas with a diversity of structural characteristics. These results lay the groundwork for a LiDAR tool to assess clumping patterns across forest landscapes in support of restoration silviculture. This tool could describe spatial patterns of functionally intact reference ecosystems, measure departure from reference targets in treatment areas, and, with successive acquisitions, monitor treatment efficacy.

  8. Airborne hyperspectral and LiDAR data integration for weed detection

    NASA Astrophysics Data System (ADS)

    Tamás, János; Lehoczky, Éva; Fehér, János; Fórián, Tünde; Nagy, Attila; Bozsik, Éva; Gálya, Bernadett; Riczu, Péter

    2014-05-01

    Agriculture uses 70% of global available fresh water. However, ca. 50-70% of water used by cultivated plants, the rest of water transpirated by the weeds. Thus, to define the distribution of weeds is very important in precision agriculture and horticulture as well. To survey weeds on larger fields by traditional methods is often time consuming. Remote sensing instruments are useful to detect weeds in larger area. In our investigation a 3D airborne laser scanner (RIEGL LMS-Q680i) was used in agricultural field near Sopron to scouting weeds. Beside the airborne LiDAR, hyperspectral imaging system (AISA DUAL) and air photos helped to investigate weed coverage. The LiDAR survey was carried out at early April, 2012, before sprouting of cultivated plants. Thus, there could be detected emerging of weeds and direction of cultivation. However airborne LiDAR system was ideal to detect weeds, identification of weeds at species level was infeasible. Higher point density LiDAR - Terrestrial laser scanning - systems are appropriate to distinguish weed species. Based on the results, laser scanner is an effective tool to scouting of weeds. Appropriate weed detection and mapping systems could contribute to elaborate water and herbicide saving management technique. This publication was supported by the OTKA project K 105789.

  9. Biomass estimation of Douglas fir stands using airborne LiDAR data

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biomass is an important parameter not only for carbon cycle modeling, but also for supporting land management operations (e.g. land use policy, forest fire management). Various remote sensing data have been utilized for biomass estimation, especially in forested areas. LiDAR (Light Detection And Ran...

  10. Errors in LiDAR-derived shrub height and crown area on sloped terrain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study developed and tested four methodologies for determining shrub height measurements with LiDAR data in a semiarid shrub-steppe in southwestern Idaho, USA. Unique to this study was the focus of sagebrush height measurements on sloped terrain. The study also developed one of the first metho...

  11. Integrating ICT into Teaching and Learning at the University of Dar es Salaam

    ERIC Educational Resources Information Center

    Mtebe, Joel S.; Dachi, Hilary; Raphael, Christina

    2011-01-01

    Since 1985, Tanzania has been undergoing significant political and economic changes from a centralized to a more market-oriented and globally connected economy. The University of Dar es Salaam (UDSM) has responded to these changes by reviewing its legal status, vision, and functions, particularly those related to research, teaching, and public…

  12. High-throughput genotyping of hop (Humulus lupulus L.) utilising diversity arrays technology (DArT).

    PubMed

    Howard, E L; Whittock, S P; Jakše, J; Carling, J; Matthews, P D; Probasco, G; Henning, J A; Darby, P; Cerenak, A; Javornik, B; Kilian, A; Koutoulis, A

    2011-05-01

    Implementation of molecular methods in hop (Humulus lupulus L.) breeding is dependent on the availability of sizeable numbers of polymorphic markers and a comprehensive understanding of genetic variation. However, use of molecular marker technology is limited due to expense, time inefficiency, laborious methodology and dependence on DNA sequence information. Diversity arrays technology (DArT) is a high-throughput cost-effective method for the discovery of large numbers of quality polymorphic markers without reliance on DNA sequence information. This study is the first to utilise DArT for hop genotyping, identifying 730 polymorphic markers from 92 hop accessions. The marker quality was high and similar to the quality of DArT markers previously generated for other species; although percentage polymorphism and polymorphism information content (PIC) were lower than in previous studies deploying other marker systems in hop. Genetic relationships in hop illustrated by DArT in this study coincide with knowledge generated using alternate methods. Several statistical analyses separated the hop accessions into genetically differentiated North American and European groupings, with hybrids between the two groups clearly distinguishable. Levels of genetic diversity were similar in the North American and European groups, but higher in the hybrid group. The markers produced from this time and cost-efficient genotyping tool will be a valuable resource for numerous applications in hop breeding and genetics studies, such as mapping, marker-assisted selection, genetic identity testing, guidance in the maintenance of genetic diversity and the directed breeding of superior cultivars. PMID:21243330

  13. Diversity Arrays Technology (DArT) platform for genotyping and mapping in carrot (Daucus carota L.)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Carrot is one of the most important root vegetable crops grown worldwide on more than one million hectares. Its progenitor, wild Daucus carota, is a weed commonly occurring across continents in the temperate climatic zone. Diversity Array Technology (DArT) is a microarray-based molecular marker syst...

  14. Genetics and Human Agency: Comment on Dar-Nimrod and Heine (2011)

    ERIC Educational Resources Information Center

    Turkheimer, Eric

    2011-01-01

    Dar-Nimrod and Heine (2011) decried genetic essentialism without denying the importance of genetics in the genesis of human behavior, and although I agree on both counts, a deeper issue remains unaddressed: how should we adjust our cognitions about our own behavior in light of genetic influence, or is it perhaps not necessary to take genetics into…

  15. An Analysis of Student Reading as Measured on the Diagnostic Assessment of Reading (DAR)

    ERIC Educational Resources Information Center

    Baca, Jo-Ann M.; Shepperson, Barbara A.

    2006-01-01

    As part of the reporting of Delaware's State Improvement Grant (DelaSIG), the Delaware Education Research and Development Center (R&D Center) completed a study on the Diagnostic Assessment of Reading (DAR) scores of students whose teachers attended a professional development program designed to help focus teacher instruction of struggling readers…

  16. Genetic Essentialism, Neuroessentialism, and Stigma: Commentary on Dar-Nimrod and Heine (2011)

    ERIC Educational Resources Information Center

    Haslam, Nick

    2011-01-01

    Dar-Nimrod and Heine (2011) presented a masterfully broad review of the implications of genetic essentialism for understandings of human diversity. This commentary clarifies the reasons that essentialist thinking has problematic social consequences and links genetic forms of essentialism to those invoking neural essences. The mounting evidence…

  17. Design of paediatric hospitals.

    PubMed

    Lambert, Veronica

    2016-05-01

    The impact of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the impact of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children. PMID:27214414

  18. Hospital Library Administration.

    ERIC Educational Resources Information Center

    Cramer, Anne

    The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…

  19. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  20. Hospital marketing revisited.

    PubMed

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

  1. Effects of atmospheric stability on the evolution of wind turbine wakes: Volumetric LiDAR scans

    NASA Astrophysics Data System (ADS)

    Valerio Iungo, Giacomo; Porté-Agel, Fernando

    2014-05-01

    Aerodynamic optimization of wind farm layout is a fundamental task to reduce wake effects on downstream wind turbines, thus to maximize wind power harvesting. However, downstream evolution and recovery of wind turbine wakes are strongly affected by the characteristics of the incoming atmospheric boundary layer (ABL) flow, like the vertical profiles of the mean wind velocity and the turbulence intensity, which are in turn affected by the ABL stability regime. Therefore, the characterization of the variability of wind turbine wakes under different ABL stability regimes becomes fundamental to better predict wind power harvesting and improve wind farm efficiency. To this aim, wind velocity measurements of the wake produced by a 2 MW Enercon E-70 wind turbine were performed with three scanning Doppler wind Light Detection and Ranging (LiDAR) instruments. One LiDAR was typically devoted to the characterization of the incoming wind, in particular wind velocity, shear and turbulence intensity at the height of the rotor disc. The other two LiDARs performed scans in order to characterize the wake velocity field produced by the tested wind turbine. The main challenge in performing field measurements of wind turbine wakes is represented by the varying wind conditions, and by the consequent adjustments of the turbine yaw angle needed to maximize power production. Consequently, taking into account possible variations of the relative position between LiDAR measurement volume and wake location, different LiDAR measurement procedures were carried out in order to perform 2-D and 3-D characterizations of the mean wake velocity field. However, larger measurement volumes and higher spatial resolution require longer sampling periods; thus, to investigate wake turbulence tests were also performed by staring the LiDAR laser beam over fixed directions and with the maximum sampling frequency. Furthermore, volumetric scans of the wind turbine wake were performed under different wind

  2. Using Satellite and Airborne LiDAR to Model Woodpecker Habitat Occupancy at the Landscape Scale

    PubMed Central

    Vierling, Lee A.; Vierling, Kerri T.; Adam, Patrick; Hudak, Andrew T.

    2013-01-01

    Incorporating vertical vegetation structure into models of animal distributions can improve understanding of the patterns and processes governing habitat selection. LiDAR can provide such structural information, but these data are typically collected via aircraft and thus are limited in spatial extent. Our objective was to explore the utility of satellite-based LiDAR data from the Geoscience Laser Altimeter System (GLAS) relative to airborne-based LiDAR to model the north Idaho breeding distribution of a forest-dependent ecosystem engineer, the Red-naped sapsucker (Sphyrapicus nuchalis). GLAS data occurred within ca. 64 m diameter ellipses spaced a minimum of 172 m apart, and all occupancy analyses were confined to this grain scale. Using a hierarchical approach, we modeled Red-naped sapsucker occupancy as a function of LiDAR metrics derived from both platforms. Occupancy models based on satellite data were weak, possibly because the data within the GLAS ellipse did not fully represent habitat characteristics important for this species. The most important structural variables influencing Red-naped Sapsucker breeding site selection based on airborne LiDAR data included foliage height diversity, the distance between major strata in the canopy vertical profile, and the vegetation density near the ground. These characteristics are consistent with the diversity of foraging activities exhibited by this species. To our knowledge, this study represents the first to examine the utility of satellite-based LiDAR to model animal distributions. The large area of each GLAS ellipse and the non-contiguous nature of GLAS data may pose significant challenges for wildlife distribution modeling; nevertheless these data can provide useful information on ecosystem vertical structure, particularly in areas of gentle terrain. Additional work is thus warranted to utilize LiDAR datasets collected from both airborne and past and future satellite platforms (e.g. GLAS, and the planned IceSAT2

  3. Field and LiDAR observations of the Hector Mine California 1999 surface rupture

    NASA Astrophysics Data System (ADS)

    Sousa, F.; Akciz, S. O.; Harvey, J. C.; Hudnut, K. W.; Lynch, D. K.; Scharer, K. M.; Stock, J. M.; Witkosky, R.; Kendrick, K. J.; Wespestad, C.

    2014-12-01

    We report new field- and computer-based investigations of the surface rupture of the October 16, 1999 Hector Mine Earthquake. Since May 2012, in cooperation with the United States Marine Corps Air Ground Combat Center (MCAGCC) at Twentynine Palms, CA, our team has been allowed ground and aerial access to the entire surface rupture. We have focused our new field-based research and imagery analysis along the ~10 kilometer-long maximum slip zone (MSZ) which roughly corresponds to the zone of >4 meter dextral horizontal offset. New data include: 1) a 1 km wide aerial LiDAR survey along the entire surface rupture (@ 10 shots/m2, May 2012, www.opentopography.org); 2) terrestrial LiDAR surveys at 5 sites within the MSZ (@ >1000 shots/m2, April 2014); 3) low altitude aerial photography and ground based photography of the entire MSZ; 4) a ground-truthed database of 87 out of the 94 imagery-based offset measurements made within the MSZ; and 5) a database of 50 new field-based offset measurements made within the MSZ by our team on the ground, 31 of which have also been made on the computer (Ladicaoz) with both the 2000 LiDAR data (@ 0.5 m DEM resolution; Chen et al, in review) and 2012 LiDAR data (@ 35 cm DEM resolution; our team). New results to date include 1) significant variability (> 2 m) in horizontal offsets measured along short distances of the surface rupture (~100 m) within segments of the surface rupture that are localized to a single fault strand; 2) strong dependence of decadal scale fault scarp preservation on local lithology (bedrock vs. alluvial fan vs. fine sediment) and geomorphology (uphill vs. downhill facing scarp); 3) newly observed offset features which were never measured during the post-event field response; 4) newly observed offset features too small to be resolved in airborne LiDAR data (< 1 m); 5) nearly 25% of LiDAR imagery-based measurements that were later ground-truthed were judged by our team to warrant removal from the database due to

  4. Using satellite and airborne LiDAR to model woodpecker habitat occupancy at the landscape scale.

    PubMed

    Vierling, Lee A; Vierling, Kerri T; Adam, Patrick; Hudak, Andrew T

    2013-01-01

    Incorporating vertical vegetation structure into models of animal distributions can improve understanding of the patterns and processes governing habitat selection. LiDAR can provide such structural information, but these data are typically collected via aircraft and thus are limited in spatial extent. Our objective was to explore the utility of satellite-based LiDAR data from the Geoscience Laser Altimeter System (GLAS) relative to airborne-based LiDAR to model the north Idaho breeding distribution of a forest-dependent ecosystem engineer, the Red-naped sapsucker (Sphyrapicus nuchalis). GLAS data occurred within ca. 64 m diameter ellipses spaced a minimum of 172 m apart, and all occupancy analyses were confined to this grain scale. Using a hierarchical approach, we modeled Red-naped sapsucker occupancy as a function of LiDAR metrics derived from both platforms. Occupancy models based on satellite data were weak, possibly because the data within the GLAS ellipse did not fully represent habitat characteristics important for this species. The most important structural variables influencing Red-naped Sapsucker breeding site selection based on airborne LiDAR data included foliage height diversity, the distance between major strata in the canopy vertical profile, and the vegetation density near the ground. These characteristics are consistent with the diversity of foraging activities exhibited by this species. To our knowledge, this study represents the first to examine the utility of satellite-based LiDAR to model animal distributions. The large area of each GLAS ellipse and the non-contiguous nature of GLAS data may pose significant challenges for wildlife distribution modeling; nevertheless these data can provide useful information on ecosystem vertical structure, particularly in areas of gentle terrain. Additional work is thus warranted to utilize LiDAR datasets collected from both airborne and past and future satellite platforms (e.g. GLAS, and the planned IceSAT2

  5. Application of LiDAR to hydrologic flux estimation in Australian eucalypt forests (Invited)

    NASA Astrophysics Data System (ADS)

    Lane, P. N.; Mitchell, P. J.; Jaskierniak, D.; Hawthorne, S. N.; Griebel, A.

    2013-12-01

    The potential of LiDAR in ecohydrology is significant as characterising catchment vegetation is crucial to accurate estimation of evapotranspiration (ET). While this may be done at large scales for model parameterisation, stand-scale applications are equally appropriate where traditional methods of measurement of LAI or sapwood areas are time consuming and reliant on assumptions of representative sampling. This is particularly challenging in mountain forests where aspect, soil properties and energy budgets can vary significantly, reflected in the vegetation or where there are changes in the spatial distribution of structural attributes following disturbance. Recent research has investigated the spatial distribution of ET in a eucalypt forest in SE Australia using plot-scale sapflow, interception and forest floor ET measurements. LiDAR was used scale up these measurements. LiDAR (0.16 m scanner footprint) canopy indices were correlated via stepwise regression with 4 water use scalars: basal area (BA), sapwood area (SA), leaf area index (LAI) and canopy coverage (C), with Hmed, Hmean, H80, H95 the best predictors. Combining these indices with empirical relationships between SA and BA, and SA and transpiration (T), and inventory plot 'ground truthing' transpiration was estimated across the 1.3 km2 catchment. Interception was scaled via the Gash model with LiDAR derived inputs. The up-scaling showed a significant variability in the spatial distribution of ET, related to the distribution of SA. The use of LiDAR meant scaling could be achieved at an appropriate spatial scale (20 x 20 m) to the measurements. The second example is the use of airborne LiDAR in developing growth forest models for hydrologic modeling. LiDAR indices were used to stratify multilayered forests using mixed-effect models with a wide range of theoretical distribution functions. When combined with historical plot-scale inventory data we show demonstrated improved growth modeling over traditional

  6. Hospital Workers Disaster Management and Hospital Nonstructural: A Study in Bandar Abbas, Iran

    PubMed Central

    Lakbala, Parvin

    2016-01-01

    Introduction: A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions. Methods: The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital. Results: This study found that knowledge, awareness, and disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities. Conclusion: It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities. PMID:26573039

  7. Hospital board and management practices are strongly related to hospital performance on clinical quality metrics.

    PubMed

    Tsai, Thomas C; Jha, Ashish K; Gawande, Atul A; Huckman, Robert S; Bloom, Nicholas; Sadun, Raffaella

    2015-08-01

    National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of high-performing hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery. PMID:26240243

  8. A universal airborne LiDAR approach for tropical forest carbon mapping.

    PubMed

    Asner, Gregory P; Mascaro, Joseph; Muller-Landau, Helene C; Vieilledent, Ghislain; Vaudry, Romuald; Rasamoelina, Maminiaina; Hall, Jefferson S; van Breugel, Michiel

    2012-04-01

    Airborne light detection and ranging (LiDAR) is fast turning the corner from demonstration technology to a key tool for assessing carbon stocks in tropical forests. With its ability to penetrate tropical forest canopies and detect three-dimensional forest structure, LiDAR may prove to be a major component of international strategies to measure and account for carbon emissions from and uptake by tropical forests. To date, however, basic ecological information such as height-diameter allometry and stand-level wood density have not been mechanistically incorporated into methods for mapping forest carbon at regional and global scales. A better incorporation of these structural patterns in forests may reduce the considerable time needed to calibrate airborne data with ground-based forest inventory plots, which presently necessitate exhaustive measurements of tree diameters and heights, as well as tree identifications for wood density estimation. Here, we develop a new approach that can facilitate rapid LiDAR calibration with minimal field data. Throughout four tropical regions (Panama, Peru, Madagascar, and Hawaii), we were able to predict aboveground carbon density estimated in field inventory plots using a single universal LiDAR model (r ( 2 ) = 0.80, RMSE = 27.6 Mg C ha(-1)). This model is comparable in predictive power to locally calibrated models, but relies on limited inputs of basal area and wood density information for a given region, rather than on traditional plot inventories. With this approach, we propose to radically decrease the time required to calibrate airborne LiDAR data and thus increase the output of high-resolution carbon maps, supporting tropical forest conservation and climate mitigation policy. PMID:22033763

  9. Object-oriented identification of forested landslides with derivatives of single pulse LiDAR data

    NASA Astrophysics Data System (ADS)

    Van Den Eeckhaut, Miet; Kerle, Norman; Poesen, Jean; Hervás, Javier

    2012-11-01

    In contrast to the many studies that use expert-based analysis of LiDAR derivatives for landslide mapping in forested terrain, only few studies have attempted to develop (semi-)automatic methods for extracting landslides from LiDAR derivatives. While all these studies are pixel-based, it has not yet been tested whether object-oriented analysis (OOA) could be an alternative. This study investigates the potential of OOA using only single-pulse LiDAR derivatives, such as slope gradient, roughness and curvature to map landslides. More specifically, the focus is on both LiDAR data segmentation and classification of slow-moving landslides in densely vegetated areas, where spectral data do not allow accurate landslide identification. A multistage procedure has been developed and tested in the Flemish Ardennes (Belgium). The procedure consists of (1) image binarization and multiresolution segmentation, (2) classification of landslide parts (main scarps and landslide body segments) and non-landslide features (i.e. earth banks and cropland fields) with supervised support vector machines at the appropriate scale, (3) delineation of landslide flanks, (4) growing of a landslide body starting from its main scarp, and (5) final cleaning of the inventory map. The results obtained show that OOA using LiDAR derivatives allows recognition and characterization of profound morphologic properties of forested deep-seated landslides on soil-covered hillslopes, because more than 90% of the main scarps and 70% of the landslide bodies of an expert-based inventory were accurately identified with OOA. For mountainous areas with bedrock, on the other hand, creation of a transferable model is expected to be more difficult.

  10. LiDAR Segmentation using Suitable Seed Points for 3D Building Extraction

    NASA Astrophysics Data System (ADS)

    Abdullah, S. M.; Awrangjeb, M.; Lu, G.

    2014-08-01

    Effective building detection and roof reconstruction has an influential demand over the remote sensing research community. In this paper, we present a new automatic LiDAR point cloud segmentation method using suitable seed points for building detection and roof plane extraction. Firstly, the LiDAR point cloud is separated into "ground" and "non-ground" points based on the analysis of DEM with a height threshold. Each of the non-ground point is marked as coplanar or non-coplanar based on a coplanarity analysis. Commencing from the maximum LiDAR point height towards the minimum, all the LiDAR points on each height level are extracted and separated into several groups based on 2D distance. From each group, lines are extracted and a coplanar point which is the nearest to the midpoint of each line is considered as a seed point. This seed point and its neighbouring points are utilised to generate the plane equation. The plane is grown in a region growing fashion until no new points can be added. A robust rule-based tree removal method is applied subsequently to remove planar segments on trees. Four different rules are applied in this method. Finally, the boundary of each object is extracted from the segmented LiDAR point cloud. The method is evaluated with six different data sets consisting hilly and densely vegetated areas. The experimental results indicate that the proposed method offers a high building detection and roof plane extraction rates while compared to a recently proposed method.

  11. Building Damage Assessment after Earthquake Using Post-Event LiDAR Data

    NASA Astrophysics Data System (ADS)

    Rastiveis, H.; Eslamizade, F.; Hosseini-Zirdoo, E.

    2015-12-01

    After an earthquake, damage assessment plays an important role in leading rescue team to help people and decrease the number of mortality. Damage map is a map that demonstrates collapsed buildings with their degree of damage. With this map, finding destructive buildings can be quickly possible. In this paper, we propose an algorithm for automatic damage map generation after an earthquake using post-event LiDAR Data and pre-event vector map. The framework of the proposed approach has four main steps. To find the location of all buildings on LiDAR data, in the first step, LiDAR data and vector map are registered by using a few number of ground control points. Then, building layer, selected from vector map, are mapped on the LiDAR data and all pixels which belong to the buildings are extracted. After that, through a powerful classifier all the extracted pixels are classified into three classes of "debris", "intact building" and "unclassified". Since textural information make better difference between "debris" and "intact building" classes, different textural features are applied during the classification. After that, damage degree for each candidate building is estimated based on the relation between the numbers of pixels labelled as "debris" class to the whole building area. Calculating the damage degree for each candidate building, finally, building damage map is generated. To evaluate the ability proposed method in generating damage map, a data set from Port-au-Prince, Haiti's capital after the 2010 Haiti earthquake was used. In this case, after calculating of all buildings in the test area using the proposed method, the results were compared to the damage degree which estimated through visual interpretation of post-event satellite image. Obtained results were proved the reliability of the proposed method in damage map generation using LiDAR data.

  12. Water turbidity estimation from airborne hyperspectral imagery and full waveform bathymetric LiDAR

    NASA Astrophysics Data System (ADS)

    Pan, Z.; Glennie, C. L.; Fernandez-Diaz, J. C.

    2015-12-01

    The spatial and temporal variations in water turbidity are of great interest for the study of fluvial and coastal environments; and for predicting the performance of remote sensing systems that are used to map these. Conventional water turbidity estimates from remote sensing observations have normally been derived using near infrared reflectance. We have investigated the potential of determining water turbidity from additional remote sensing sources, namely airborne hyperspectral imagery and single wavelength bathymetric LiDAR (Light Detection and Ranging). The confluence area of the Blue and Colorado River, CO was utilized as a study area to investigate the capabilities of both airborne bathymetric LiDAR and hyperspectral imagery for water turbidity estimation. Discrete and full waveform bathymetric data were collected using Optech's Gemini (1064 nm) and Aquarius (532 nm) LiDAR sensors. Hyperspectral imagery (1.2 m pixel resolution and 72 spectral bands) was acquired using an ITRES CASI-1500 imaging system. As an independent reference, measurements of turbidity were collected concurrent with the airborne remote sensing acquisitions, using a WET Labs EcoTriplet deployed from a kayak and turbidity was then derived from the measured backscatter. The bathymetric full waveform dataset contains a discretized sample of the full backscatter of water column and benthic layer. Therefore, the full waveform records encapsulate the water column characteristics of turbidity. A nonparametric support vector regression method is utilized to estimate water turbidity from both hyperspectral imagery and voxelized full waveform LiDAR returns, both individually and as a fused dataset. Results of all the evaluations will be presented, showing an initial turbidity prediction accuracy of approximately 1.0 NTU. We will also discuss our future strategy for enhanced fusion of the full waveform LiDAR and hyperspectral imagery for improved turbidity estimation.

  13. Mapping the Risk of Forest Wind Damage Using Airborne Scanning LiDAR

    NASA Astrophysics Data System (ADS)

    Saarinen, N.; Vastaranta, M.; Honkavaara, E.; Wulder, M. A.; White, J. C.; Litkey, P.; Holopainen, M.; Hyyppä, J.

    2015-03-01

    Wind damage is known for causing threats to sustainable forest management and yield value in boreal forests. Information about wind damage risk can aid forest managers in understanding and possibly mitigating damage impacts. The objective of this research was to better understand and quantify drivers of wind damage, and to map the probability of wind damage. To accomplish this, we used open-access airborne scanning light detection and ranging (LiDAR) data. The probability of wind-induced forest damage (PDAM) in southern Finland (61°N, 23°E) was modelled for a 173 km2 study area of mainly managed boreal forests (dominated by Norway spruce and Scots pine) and agricultural fields. Wind damage occurred in the study area in December 2011. LiDAR data were acquired prior to the damage in 2008. High spatial resolution aerial imagery, acquired after the damage event (January, 2012) provided a source of model calibration via expert interpretation. A systematic grid (16 m x 16 m) was established and 430 sample grid cells were identified systematically and classified as damaged or undamaged based on visual interpretation using the aerial images. Potential drivers associated with PDAM were examined using a multivariate logistic regression model. Risk model predictors were extracted from the LiDAR-derived surface models. Geographic information systems (GIS) supported spatial mapping and identification of areas of high PDAM across the study area. The risk model based on LiDAR data provided good agreement with detected risk areas (73 % with kappa-value 0,47). The strongest predictors in the risk model were mean canopy height and mean elevation. Our results indicate that open-access LiDAR data sets can be used to map the probability of wind damage risk without field data, providing valuable information for forest management planning.

  14. Combined use of LiDAR data and multispectral earth observation imagery for wetland habitat mapping

    NASA Astrophysics Data System (ADS)

    Rapinel, Sébastien; Hubert-Moy, Laurence; Clément, Bernard

    2015-05-01

    Although wetlands play a key role in controlling flooding and nonpoint source pollution, sequestering carbon and providing an abundance of ecological services, the inventory and characterization of wetland habitats are most often limited to small areas. This explains why the understanding of their ecological functioning is still insufficient for a reliable functional assessment on areas larger than a few hectares. While LiDAR data and multispectral Earth Observation (EO) images are often used separately to map wetland habitats, their combined use is currently being assessed for different habitat types. The aim of this study is to evaluate the combination of multispectral and multiseasonal imagery and LiDAR data to precisely map the distribution of wetland habitats. The image classification was performed combining an object-based approach and decision-tree modeling. Four multispectral images with high (SPOT-5) and very high spatial resolution (Quickbird, KOMPSAT-2, aerial photographs) were classified separately. Another classification was then applied integrating summer and winter multispectral image data and three layers derived from LiDAR data: vegetation height, microtopography and intensity return. The comparison of classification results shows that some habitats are better identified on the winter image and others on the summer image (overall accuracies = 58.5 and 57.6%). They also point out that classification accuracy is highly improved (overall accuracy = 86.5%) when combining LiDAR data and multispectral images. Moreover, this study highlights the advantage of integrating vegetation height, microtopography and intensity parameters in the classification process. This article demonstrates that information provided by the synergetic use of multispectral images and LiDAR data can help in wetland functional assessment

  15. Applying a weighted random forests method to extract karst sinkholes from LiDAR data

    NASA Astrophysics Data System (ADS)

    Zhu, Junfeng; Pierskalla, William P.

    2016-02-01

    Detailed mapping of sinkholes provides critical information for mitigating sinkhole hazards and understanding groundwater and surface water interactions in karst terrains. LiDAR (Light Detection and Ranging) measures the earth's surface in high-resolution and high-density and has shown great potentials to drastically improve locating and delineating sinkholes. However, processing LiDAR data to extract sinkholes requires separating sinkholes from other depressions, which can be laborious because of the sheer number of the depressions commonly generated from LiDAR data. In this study, we applied the random forests, a machine learning method, to automatically separate sinkholes from other depressions in a karst region in central Kentucky. The sinkhole-extraction random forest was grown on a training dataset built from an area where LiDAR-derived depressions were manually classified through a visual inspection and field verification process. Based on the geometry of depressions, as well as natural and human factors related to sinkholes, 11 parameters were selected as predictive variables to form the dataset. Because the training dataset was imbalanced with the majority of depressions being non-sinkholes, a weighted random forests method was used to improve the accuracy of predicting sinkholes. The weighted random forest achieved an average accuracy of 89.95% for the training dataset, demonstrating that the random forest can be an effective sinkhole classifier. Testing of the random forest in another area, however, resulted in moderate success with an average accuracy rate of 73.96%. This study suggests that an automatic sinkhole extraction procedure like the random forest classifier can significantly reduce time and labor costs and makes its more tractable to map sinkholes using LiDAR data for large areas. However, the random forests method cannot totally replace manual procedures, such as visual inspection and field verification.

  16. Enhanced detection of 3D individual trees in forested areas using airborne full-waveform LiDAR data by combining normalized cuts with spatial density clustering

    NASA Astrophysics Data System (ADS)

    Yao, W.; Krzystek, P.; Heurich, M.

    2013-10-01

    A detailed understanding of the spatial distribution of forest understory is important but difficult. LiDAR remote sensing has been developing as a promising additional instrument to the conventional field work towards automated forest inventory. Unfortunately, understory (up to 50% of the top-tree height) in mixed and multilayered forests is often ignored due to a difficult observation scenario and limitation of the tree detection algorithm. Currently, the full-waveform (FWF) LiDAR with high penetration ability against overstory crowns can give us new hope to resolve the forest understory. Former approach based on 3D segmentation confirmed that the tree detection rates in both middle and lower forest layers are still low. Therefore, detecting sub-dominant and suppressed trees cannot be regarded as fully solved. In this work, we aim to improve the performance of the FWF laser scanner for the mapping of forest understory. The paper is to develop an enhanced methodology for detecting 3D individual trees by partitioning point clouds of airborne LiDAR. After extracting 3D coordinates of the laser beam echoes, the pulse intensity and width by waveform decomposition, the newly developed approach resolves 3D single trees are by an integrated approach, which delineates tree crowns by applying normalized cuts segmentation to the graph structure of local dense modes in point clouds constructed by mean shift clustering. In the context of our strategy, the mean shift clusters approximate primitives of (sub) single trees in LiDAR data and allow to define more significant features to reflect geometric and reflectional characteristics towards the single tree level. The developed methodology can be regarded as an object-based point cloud analysis approach for tree detection and is applied to datasets captured with the Riegl LMS-Q560 laser scanner at a point density of 25 points/m2 in the Bavarian Forest National Park, Germany, respectively under leaf-on and leaf-off conditions

  17. Health-related quality of life of people living with HIV followed up in hospitals in France: comparing trends and correlates between 2003 and 2011 (ANRS-VESPA and VESPA2 national surveys).

    PubMed

    Douab, Taoufiq; Marcellin, Fabienne; Vilotitch, Antoine; Protopopescu, Camelia; Préau, Marie; Suzan-Monti, Marie; Sagaon-Teyssier, Luis; Lert, France; Carrieri, Maria Patrizia; Dray-Spira, Rosemary; Spire, Bruno

    2014-01-01

    In recent years, France has witnessed both structural changes in the population of people living with HIV and a relative improvement in the social representation of HIV infection. However, potential changes in people's day-to-day experience with HIV have not been documented. We used data from the national surveys ANRS-VESPA (2003) and VESPA2 (2011) to compare the levels and patterns of correlates of health-related quality of life (HRQL) in adult HIV-infected patients followed up in French hospitals over a period of eight years. Mean physical and mental SF-12 scores were compared (VESPA, n = 2072; and VESPA2, n = 2267) using analysis of variance (ANOVA) F tests. Heckman regression models were then used to identify independent correlates of physical and mental quality of life in the two surveys, while accounting for possible bias due to missing score values. A common set of potential socio-demographic, clinical, behavioral, and psychosocial correlates was tested. Individuals reported a decrease in physical quality of life in VESPA2 compared with VESPA (mean score (standard error): 47.5 (0.2) versus 49.6 (0.2), p < .0001), and better mental HRQL (44.3 (0.3) versus 42.3 (0.3), p < 0.0001). In both surveys, financial difficulties and patient-perceived experience of rejection behaviors by medical staff were independently associated with impaired physical and mental quality of life. Older age and unemployment were independently associated with impaired physical quality of life. Immigrants from Sub-Saharan Africa reported better mental quality of life. Findings show that quality of life levels in adult HIV-infected patients followed up at hospital in France has significantly, yet modestly, changed in recent years. However, the pattern of quality of life correlates has remained relatively stable. The impact of patient-provider relationships on self-reported outcomes is confirmed. Further research is needed to identify potential differences in quality of life correlates in

  18. Information needs and seeking behaviour among health professionals working at public hospital and health centres in Bahir Dar, Ethiopia

    PubMed Central

    2013-01-01

    Background Universal access to information for health professionals is a need to achieve “health for all strategy.” A large proportion of the population including health professionals have limited access to health information in resource limited countries. The aim of this study is to assess information needs among Ethiopian health professionals. Methods A cross sectional quantitative study design complemented with qualitative method was conducted among 350 health care workers in Feburary26-June5/2012. Pretested self-administered questionnaire and observation checklist were used to collect data on different variables. Data entry and data analysis were done using Epi-Info version 3.5.1 and by SPSS version19, respectively. Descriptive statistics and multivariate regression analyses were applied to describe study objectives and identify the determinants of information seeking behaviours respectively. Odds ratio with 95% CI was used to assess the association between a factor and an outcome variable. Results The majority of the respondents acknowledged the need of health information to their routine activities. About 54.0% of respondents lacked access to health information. Only 42.8% of respondents have access to internet sources. Important barriers to access information were geographical, organizational, personal, economic, educational status and time. About 58.0% of the respondents accessed information by referring their hard copies and asking senior staff. Age, sex, income, computer literacy and access, patient size, work experience and working site were significantly associated with information needs and seeking behaviour. Conclusions The health information seeking behaviour of health professional was significant. The heaklth facilities had neither informationcenter such as library, nor internet facilities. Conducting training on managing health information, accessing computer and improving infrastructures are important interventions to facilitate evidence based descions. PMID:24373296

  19. Spatial accounting for errors in LiDAR-derived products: Snow volume and snow water equivalent estimation

    NASA Astrophysics Data System (ADS)

    Tinkham, W. T.; Hoffman, C. M.; Falkowski, M. J.; Smith, A. M.; Link, T. E.; Marshall, H.

    2011-12-01

    Light Detection and Ranging (LiDAR) has become one of the most effective and reliable means of characterizing surface topography and vegetation structure. Most LiDAR-derived estimates such as vegetation height, snow depth, and floodplain boundaries rely on the accurate creation of digital terrain models (DTM). As a result of the importance of an accurate DTM in using LiDAR data to estimate snow depth, it is necessary to understand the variables that influence the DTM accuracy in order to assess snow depth error. A series of 4 x 4 m plots that were surveyed at 0.5 m spacing in a semi-arid catchment were used for training the Random Forests algorithm along with a series of 35 variables in order to spatially predict vertical error within a LiDAR derived DTM. The final model was utilized to predict the combined error resulting from snow volume and snow water equivalent estimates derived from a snow-free LiDAR DTM and a snow-on LiDAR acquisition of the same site. The methodology allows for a statistical quantification of the spatially-distributed error patterns that are incorporated into the estimation of snow volume and snow water equivalents from LiDAR.

  20. Development and validation of the Dimensional Anhedonia Rating Scale (DARS) in a community sample and individuals with major depression.

    PubMed

    Rizvi, Sakina J; Quilty, Lena C; Sproule, Beth A; Cyriac, Anna; Michael Bagby, R; Kennedy, Sidney H

    2015-09-30

    Anhedonia, a core symptom of Major Depressive Disorder (MDD), is predictive of antidepressant non-response. In contrast to the definition of anhedonia as a "loss of pleasure", neuropsychological studies provide evidence for multiple facets of hedonic function. The aim of the current study was to develop and validate the Dimensional Anhedonia Rating Scale (DARS), a dynamic scale that measures desire, motivation, effort and consummatory pleasure across hedonic domains. Following item selection procedures and reliability testing using data from community participants (N=229) (Study 1), the 17-item scale was validated in an online study with community participants (N=150) (Study 2). The DARS was also validated in unipolar or bipolar depressed patients (n=52) and controls (n=50) (Study 3). Principal components analysis of the 17-item DARS revealed a 4-component structure mapping onto the domains of anhedonia: hobbies, food/drink, social activities, and sensory experience. Reliability of the DARS subscales was high across studies (Cronbach's α=0.75-0.92). The DARS also demonstrated good convergent and divergent validity. Hierarchical regression analysis revealed the DARS showed additional utility over the Snaith-Hamilton Pleasure Scale (SHAPS) in predicting reward function and distinguishing MDD subgroups. These studies provide support for the reliability and validity of the DARS. PMID:26250147

  1. Improving estimation of tree carbon stocks by harvesting aboveground woody biomass within airborne LiDAR flight areas

    NASA Astrophysics Data System (ADS)

    Colgan, M.; Asner, G. P.; Swemmer, A. M.

    2011-12-01

    The accurate estimation of carbon stored in a tree is essential to accounting for the carbon emissions due to deforestation and degradation. Airborne LiDAR (Light Detection and Ranging) has been successful in estimating aboveground carbon density (ACD) by correlating airborne metrics, such as canopy height, to field-estimated biomass. This latter step is reliant on field allometry which is applied to forest inventory quantities, such as stem diameter and height, to predict the biomass of a given tree stem. Constructing such allometry is expensive, time consuming, and requires destructive sampling. Consequently, the sample sizes used to construct such allometry are often small, and the largest tree sampled is often much smaller than the largest in the forest population. The uncertainty resulting from these sampling errors can lead to severe biases when the allometry is applied to stems larger than those harvested to construct the allometry, which is then subsequently propagated to airborne ACD estimates. The Kruger National Park (KNP) mission of maintaining biodiversity coincides with preserving ecosystem carbon stocks. However, one hurdle to accurately quantifying carbon density in savannas is that small stems are typically harvested to construct woody biomass allometry, yet they are not representative of Kruger's distribution of biomass. Consequently, these equations inadequately capture large tree variation in sapwood/hardwood composition, root/shoot/leaf allocation, branch fall, and stem rot. This study eliminates the "middleman" of field allometry by directly measuring, or harvesting, tree biomass within the extent of airborne LiDAR. This enables comparisons of field and airborne ACD estimates, and also enables creation of new airborne algorithms to estimate biomass at the scale of individual trees. A field campaign was conducted at Pompey Silica Mine 5km outside Kruger National Park, South Africa, in Mar-Aug 2010 to harvest and weigh tree mass. Since

  2. Demonstration of a conceptual model for using LiDAR to improve the estimation of floodwater mitigation potential of Prairie Pothole Region wetlands

    USGS Publications Warehouse

    Huang, S.; Young, Caitlin; Feng, M.; Heidemann, K.; Cushing, M.; Mushet, D.M.; Liu, S.

    2011-01-01

    Recent flood events in the Prairie Pothole Region of North America have stimulated interest in modeling water storage capacities of wetlands and their surrounding catchments to facilitate flood mitigation efforts. Accurate estimates of basin storage capacities have been hampered by a lack of high-resolution elevation data. In this paper, we developed a 0.5 m bare-earth model from Light Detection And Ranging (LiDAR) data and, in combination with National Wetlands Inventory data, delineated wetland catchments and their spilling points within a 196 km2 study area. We then calculated the maximum water storage capacity of individual basins and modeled the connectivity among these basins. When compared to field survey results, catchment and spilling point delineations from the LiDAR bare-earth model captured subtle landscape features very well. Of the 11 modeled spilling points, 10 matched field survey spilling points. The comparison between observed and modeled maximum water storage had an R2 of 0.87 with mean absolute error of 5564 m3. Since maximum water storage capacity of basins does not translate into floodwater regulation capability, we further developed a Basin Floodwater Regulation Index. Based upon this index, the absolute and relative water that could be held by wetlands over a landscape could be modeled. This conceptual model of floodwater downstream contribution was demonstrated with water level data from 17 May 2008.

  3. The politics of local hospital reform: a case study of hospital reorganization following the 2002 Norwegian hospital reform

    PubMed Central

    2009-01-01

    Background The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. Method The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT), which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. Results The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Conclusion Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate

  4. Financial management of hospitals.

    PubMed

    Speranzo, A J

    1984-05-01

    The effect of hospital reimbursement systems on the financial management of hospitals is briefly discussed, and the organization of hospital financial operations is reviewed. The implementation of Medicare prospective pricing will change the way in which hospital finances are managed. Health-care managers will be concerned with the profitability of product lines, or diagnosis-related groups, in future strategic planning efforts. The hospital's finance department consists of several traditional areas that exist in almost all financial organizations. The functions and interactions of these various areas are discussed in light of previous and current hospital reimbursement strategies. Staffing of the finance department and the duties of the hospital's chief financial officer are also described. The prospective pricing system of hospital reimbursement and increasing pressure from the business community to stem the rising costs of health care will produce changes in the medical and financial operations of the hospital industry over the next decade. PMID:6375357

  5. Multi-component wind measurements of wind turbine wakes performed with three LiDARs

    NASA Astrophysics Data System (ADS)

    Iungo, G. V.; Wu, Y.-T.; Porté-Agel, F.

    2012-04-01

    Field measurements of the wake flow produced from the interaction between atmospheric boundary layer and a wind turbine are performed with three wind LiDARs. The tested wind turbine is a 2 MW Enercon E-70 located in Collonges, Switzerland. First, accuracy of mean values and frequency resolution of the wind measurements are surveyed as a function of the number of laser rays emitted for each measurement. Indeed, measurements performed with one single ray allow maximizing sampling frequency, thus characterizing wake turbulence. On the other hand, if the number of emitted rays is increased accuracy of mean wind is increased due to the longer sampling period. Subsequently, two-dimensional measurements with a single LiDAR are carried out over vertical sections of the wind turbine wake and mean wake flow is obtained by averaging 2D measurements consecutively performed. The high spatial resolution of the used LiDAR allows characterizing in details velocity defect present in the central part of the wake and its downstream recovery. Single LiDAR measurements are also performed by staring the laser beam at fixed directions for a sampling period of about ten minutes and maximizing the sampling frequency in order to characterize wake turbulence. From these tests wind fluctuation peaks are detected in the wind turbine wake at blade top-tip height for different downstream locations. The magnitude of these turbulence peaks is generally reduced by moving downstream. This increased turbulence level at blade top-tip height observed for a real wind turbine has been already detected from previous wind tunnel tests and Large Eddy simulations, thus confirming the presence of a source of dangerous fatigue loads for following wind turbines within a wind farm. Furthermore, the proper characterization of wind fluctuations through LiDAR measurements is proved by the detection of the inertial subrange from spectral analysis of these velocity signals. Finally, simultaneous measurements with two

  6. Change detection of riverbed movements using river cross-sections and LiDAR data

    NASA Astrophysics Data System (ADS)

    Vetter, Michael; Höfle, Bernhard; Mandlburger, Gottfried; Rutzinger, Martin

    2010-05-01

    Today, Airborne LiDAR derived digital terrain models (DTMs) are used for several aspects in different scientific disciplines, such as hydrology, geomorphology or archaeology. In the field of river geomorphology, LiDAR data sets can provide information on the riverine vegetation, the level and boundary of the water body, the elevation of the riparian foreland and their roughness. The LiDAR systems in use for topographic data acquisition mainly operate with wavelengths of at least 1064nm and, thus, are not able to penetrate water. LiDAR sensors with two wavelengths are available (bathymetric LiDAR), but they can only provide elevation information of riverbeds or lakes, if the water is clear and the minimum water depth exceeds 1.5m. In small and shallow rivers it is impossible to collect information of the riverbed, regardless of the used LiDAR sensor. In this article, we present a method to derive a high-resolution DTM of the riverbed and to combine it with the LiDAR DTM resulting in a watercourse DTM (DTM-W) as a basis for calculating the changes in the riverbed during several years. To obtain such a DTM-W we use river cross-sections acquired by terrestrial survey or echo-sounding. First, a differentiation between water and land has to be done. A highly accurate water surface can be derived by using a water surface delineation algorithm, which incorporates the amplitude information of the LiDAR point cloud and additional geometrical features (e.g. local surface roughness). The second step is to calculate a thalweg line, which is the lowest flow path in the riverbed. This is achieved by extracting the lowest point of each river cross section and by fitting a B-spline curve through those points. In the next step, the centerline of the river is calculated by applying a shrinking algorithm of the water boundary polygon. By averaging the thalweg line and the centerline, a main flow path line can be computed. Subsequently, a dense array of 2D-profiles perpendicular to the

  7. Capabilities of the bathymetric Hawk Eye LiDAR for coastal habitat mapping: A case study within a Basque estuary

    NASA Astrophysics Data System (ADS)

    Chust, Guillem; Grande, Maitane; Galparsoro, Ibon; Uriarte, Adolfo; Borja, Ángel

    2010-10-01

    The bathymetric LiDAR system is an airborne laser that detects sea bottom at high vertical and horizontal resolutions in shallow coastal waters. This study assesses the capabilities of the airborne bathymetric LiDAR sensor (Hawk Eye system) for coastal habitat mapping in the Oka estuary (within the Biosphere Reserve of Urdaibai, SE Bay of Biscay, northern Spain), where water conditions are moderately turbid. Three specific objectives were addressed: 1) to assess the data quality of the Hawk Eye LiDAR, both for terrestrial and subtidal zones, in terms of height measurement density, coverage, and vertical accuracy; 2) to compare bathymetric LiDAR with a ship-borne multibeam echosounder (MBES) for different bottom types and depth ranges; and 3) to test the discrimination potential of LiDAR height and reflectance information, together with multi-spectral imagery (three visible and near infrared bands), for the classification of 22 salt marsh and rocky shore habitats, covering supralittoral, intertidal and subtidal zones. The bathymetric LiDAR Hawk Eye data enabled the generation of a digital elevation model (DEM) of the Oka estuary, at 2 m of horizontal spatial resolution in the terrestrial zone (with a vertical accuracy of 0.15 m) and at 4 m within the subtidal, extending a water depth of 21 m. Data gaps occurred in 14.4% of the area surveyed with the LiDAR (13.69 km 2). Comparison of the LiDAR system and the MBES showed no significant mean difference in depth. However, the Root Mean Square error of the former was high (0.84 m), especially concentrated upon rocky (0.55-1.77 m) rather than in sediment bottoms (0.38-0.62 m). The potential of LiDAR topographic variables and reflectance alone for discriminating 15 intertidal and submerged habitats was low (with overall classification accuracy between 52.4 and 65.4%). In particular, reflectance retrieved for this case study has been found to be not particularly useful for classification purposes. The combination of the LiDAR

  8. Hospital demand for physicians.

    PubMed

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  9. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    ERIC Educational Resources Information Center

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  10. Importance of High-Resolution LiDAR Data in Modeling Runoff Levels Over Impervious Surfaces

    NASA Astrophysics Data System (ADS)

    Melosh, C.; Rao, M.

    2013-12-01

    Directly connected impervious areas collect and deliver unfiltered runoff to modified and impacted waterways. Modeling water flow over the landscape is an effective method of observing drainage patterns and predicting pollutant and sediment loadings. Improved models applying high-resolution elevation data can identify key areas with high pollutant output. This is a crucial issue in the Lake Tahoe Basin where lakeshore urban development has increased and lake clarity has been declining for years. This study aims to evaluate an integrated LiDAR and GIS-based modeling approach that uses a fine-scaled ground surface and impervious surface connectivity to predict the pollutant load in the Lake Tahoe Basin This study produced a fine-scaled surface model of nine subset catchments in the South Tahoe basin, including areas of low (below 20%), medium (30% to 50%) and high (above 50%) impervious surface cover. Our method integrated LiDAR, multispectral imagery, and GIS data to develop accurate terrain models, hydrologic routing, and directly connected impervious area layers for the Lake Tahoe basin. The high-density ground and object elevation data collected using Light Detection and Ranging (LiDAR) creates an accurate picture of water flow over the land, and obstacles to the flow such as buildings. High-resolution LiDAR data was obtained from the Round 10 Lake Tahoe Southern Nevada Public Land Management capital program from the year 2010. This data was processed to create a digital elevation model of the ground surface. Land use classification used object height information from the LiDAR cloud, NAIP 4-band images with 1-meter resolution and a normalized difference vegetation index image derived from the NAIP imagery. The US Army Core of Engineers hydrologic modeling system (HEC-HMS) will be used to model runoff. Based on long-term simulations the effect of directly connected impervious area on rainfall-runoff characteristics for the South Lake Tahoe catchments will be

  11. Quantifying spatial distribution of snow depth errors from LiDAR using Random Forests

    NASA Astrophysics Data System (ADS)

    Tinkham, W.; Smith, A. M.; Marshall, H.; Link, T. E.; Falkowski, M. J.; Winstral, A. H.

    2013-12-01

    There is increasing need to characterize the distribution of snow in complex terrain using remote sensing approaches, especially in isolated mountainous regions that are often water-limited, the principal source of terrestrial freshwater, and sensitive to climatic shifts and variations. We apply intensive topographic surveys, multi-temporal LiDAR, and Random Forest modeling to quantify snow volume and characterize associated errors across seven land cover types in a semi-arid mountainous catchment at a 1 and 4 m spatial resolution. The LiDAR-based estimates of both snow-off surface topology and snow depths were validated against ground-based measurements across the catchment. Comparison of LiDAR-derived snow depths to manual snow depth surveys revealed that LiDAR based estimates were more accurate in areas of low lying vegetation such as shrubs (RMSE = 0.14 m) as compared to areas consisting of tree cover (RMSE = 0.20-0.35 m). The highest errors were found along the edge of conifer forests (RMSE = 0.35 m), however a second conifer transect outside the catchment had much lower errors (RMSE = 0.21 m). This difference is attributed to the wind exposure of the first site that led to highly variable snow depths at short spatial distances. The Random Forest modeled errors deviated from the field measured errors with a RMSE of 0.09-0.34 m across the different cover types. Results show that snow drifts, which are important for maintaining spring and summer stream flows and establishing and sustaining water-limited plant species, contained 30 × 5-6% of the snow volume while only occupying 10% of the catchment area similar to findings by prior physically-based modeling approaches. This study demonstrates the potential utility of combining multi-temporal LiDAR with Random Forest modeling to quantify the distribution of snow depth with a reasonable degree of accuracy. Future work could explore the utility of Terrestrial LiDAR Scanners to produce validation of snow-on surface

  12. Investigating the spatial distribution of water levels in the Mackenzie Delta using airborne LiDAR

    USGS Publications Warehouse

    Hopkinson, C.; Crasto, N.; Marsh, P.; Forbes, D.; Lesack, L.

    2011-01-01

    Airborne light detection and ranging (LiDAR) data were used to map water level (WL) and hydraulic gradients (??H/??x) in the Mackenzie Delta. The LiDAR WL data were validated against eight independent hydrometric gauge measurements and demonstrated mean offsets from - 0??22 to + 0??04 m (??< 0??11). LiDAR-based WL gradients could be estimated with confidence over channel lengths exceeding 5-10 km where the WL change exceeded local noise levels in the LiDAR data. For the entire Delta, the LiDAR sample coverage indicated a rate of change in longitudinal gradient (??2H/??x) of 5??5 ?? 10-10 m m-2; therefore offering a potential means to estimate average flood stage hydraulic gradient for areas of the Delta not sampled or monitored. In the Outer Delta, within-channel and terrain gradient measurements all returned a consistent estimate of - 1 ?? 10-5 m m-1, suggesting that this is a typical hydraulic gradient for the downstream end of the Delta. For short reaches (<10 km) of the Peel and Middle Channels in the middle of the Delta, significant and consistent hydraulic gradient estimates of - 5 ?? 10-5 m m-1 were observed. Evidence that hydraulic gradients can vary over short distances, however, was observed in the Peel Channel immediately upstream of Aklavik. A positive elevation anomaly (bulge) of > 0??1 m was observed at a channel constriction entering a meander bend, suggesting a localized modification of the channel hydraulics. Furthermore, water levels in the anabranch channels of the Peel River were almost 1 m higher than in Middle Channel of the Mackenzie River. This suggests: (i) the channels are elevated and have shallower bank heights in this part of the delta, leading to increased cross-delta and along-channel hydraulic gradients; and/or (ii) a proportion of the Peel River flow is lost to Middle Channel due to drainage across the delta through anastamosing channels. This study has demonstrated that airborne LiDAR data contain valuable information describing

  13. Potential of Airborne LiDAR in Geomorphology - A Technological Perspective

    NASA Astrophysics Data System (ADS)

    Höfle, B.; Mandlburger, G.; Pfeifer, N.; Rutzinger, M.; Bell, R.

    2009-04-01

    Airborne LiDAR, also referred to as Airborne Laser Scanning, is widely used for high-resolution topographic data acquisition, offering a planimetric (<50cm) and vertical accuracy (<20cm) suited for many applications (e.g. in natural hazard management, forestry). Due to the direct determination of elevation and the penetration capabilities of the laser beam through gaps in vegetation, the LiDAR technology exceeds other methods such as stereo-photogrammetry or interferometric SAR particularly in vegetated areas. This contribution gives a review of recent developments of LiDAR systems but also advances in data processing, resulting in a higher data density and quality for geomorphological applications. Besides the elevation information most systems additionally record the strength of the received backscatter or even the full temporal distribution of the received energy (i.e. full-waveform). This radiometric information is a valuable parameter for further classification of the scanned areas, in particular for objects being not distinguishable by their geometry. In geomorphology airborne LiDAR data can either be used directly in the form of digital elevation data (e.g. digital terrain and surface model, original point cloud) and therein detected surface discontinuities (e.g. breaklines, lineaments) and forms (e.g. fans, rock glaciers), or indirectly by classification of surface features (e.g. vegetation and water) relevant for geomorphological processes. Furthermore, these datasets can be used for visual interpretation and mapping by experts or for automatic derivation of land-surface parameters by means of geomorphometry. With the availability of multitemporal datasets the investigation and quantification of dynamic processes becomes possible. Recent studies show the advantages by using full-waveform LiDAR system, which enable an improved echo detection and radiometric calibration of the received backscatter. The availability of additional echo attributes (e

  14. Proficiency Program for Real-Time PCR Diagnosis of Bordetella pertussis Infections in French Hospital Laboratories and at the French National Reference Center for Whooping Cough and other Bordetelloses▿ †

    PubMed Central

    Caro, Valérie; Guiso, Nicole; Alberti, Corinne; Liguori, Sandrine; Burucoa, Christophe; Couetdic, Gérard; Doucet-Populaire, Florence; Ferroni, Agnès; Papin-Gibaud, Sophie; Grattard, Florence; Réglier-Poupet, Hélène; Raymond, Josette; Soler, Catherine; Bouchet, Sylvie; Charreau, Sandrine; Couzon, Brigitte; Leymarie, Isabelle; Tavares, Nicole; Choux, Mathilde; Bingen, Edouard; Bonacorsi, Stéphane

    2009-01-01

    With the support of a ministerial program for innovative and expensive technologies, dedicated to the economic evaluation of laboratory diagnosis of pertussis by real-time PCR, external quality assessment for real-time IS481 PCR was carried out. Coordinated by the National Centre of Reference of Pertussis and other Bordetelloses (NCR), this study aimed to harmonize and to assess the performances of eight participating microbiology hospital laboratories throughout the French territory. Between January 2006 and February 2007, 10 proficiency panels were sent by the NCR (ascending proficiency program), representing a total of 49 samples and including eight panels to analyze and evaluate the global sensitivity and specificity of real-time PCR, one to assess the limit of detection, and one to evaluate nucleic acid extraction methods. As part of the descending proficiency program, extracted DNA from clinical samples was sent by the eight participating laboratories in different panels and analyzed by the NCR. In the ascending proficiency analysis, the sensitivity and specificity of the real-time PCR methods were 92.2% and 94.3%, respectively. The limit of detection of the different methods ranged between 0.1 and 1 fg/μl (0.2 to 2 CFU/μl). The nucleic acid extraction methods showed similar performances. During the descending proficiency analysis, performed with 126 samples, the result of the NCR for 15 samples (11.9%) was discordant with the result obtained by the source laboratory. Despite several initial differences, harmonization was easy and performances were homogeneous. However, the risk of false-positive results remains quite high, and we strongly recommend establishment of uniform quality control procedures performed regularly. PMID:19692562

  15. Systemic treatment with capecitabine as maintenance therapy in patients with recurring or metastatic breast cancer: experience in the Oncology Hospital, National Medical Center Siglo XXI, Mexican Social Security Institute.

    PubMed

    Segura-González, Manuel; Quintana-Quintana, Miguel

    2015-04-01

    Metastatic breast cancer as initial onset represents between 20 and 30 % of cases and is considered an incurable disease. The goal of its treatment is palliative, looking for increasing the survival while reducing the symptoms. Maintenance chemotherapy studies for metastatic breast cancer have demonstrated to prolong the progression-free survival, with unclear results in terms of overall survival. The main objectives of our study were the progression-free survival and overall survival in patients with recurring or metastatic breast cancer treated with capecitabine in the maintenance chemotherapy setting compared with patients not receiving maintenance chemotherapy. As secondary objectives, the frequency of dose-limiting toxicities and response rate were determined. A non-probabilistic sampling was used, through expert selection of patients from the recurring/metastatic breast cancer survey cared within the period from January 1, 2007, to December 21, 2012. A total of 77 patients were included. Clinical data of advanced/recurrent breast cancer patients that were treated with capecitabine were recorded. The study achieved its primary objective, since the progression-free survival was prolonged for the maintenance therapy group: 6.6 versus 18.1 months, p < 0.001. The absolute benefit was 11.5 months. Likewise, there was a benefit in the overall survival of 21.03 versus 29 months, p = 0.015, with an absolute benefit of 7.97 months. The toxicity profile was favorable in the maintenance group. The maintenance chemotherapy with capecitabine in patients treated at the National Medical Center Siglo XXI Oncology Hospital extends the overall survival and progression-free survival with a good toxicity profile. PMID:25720523

  16. State hospital rate-setting revisited.

    PubMed

    Atkinson, Graham

    2009-10-01

    In an attempt to control rapid growth in hospital costs, beginning in the mid-1970s several states implemented rate-setting programs to regulate hospital payments. In seven states, rate-setting was in effect for a substantial period of time (14 years or more). While most of these programs were discontinued by the mid-1990s, two are still active. In five of the seven states, the rates of increase in hospital costs were lower than the corresponding national rates during the periods in which the regulation programs were in place. Four of the states--Maryland, Massachusetts, New York, and New Jersey--had some of the lowest rates of hospital cost increases among all the states. This indicates that hospital rate regulation may be a useful approach in managing a major component of health care spending. PMID:20614649

  17. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  18. Weekly LiDAR snow depth mapping for operational snow hydrology - the NASA JPL Airborne Snow Observatory (Invited)

    NASA Astrophysics Data System (ADS)

    Deems, J. S.; Painter, T. H.; McGurk, B. J.

    2013-12-01

    Operational hydrologic simulation and forecasting in snowmelt-dominated watersheds currently relies on indices of snow accumulation and melt from measurements at a small number of point locations or geographically-limited manual surveys. These data sources cannot adequately characterize the spatial distribution of snow depth/water equivalent, which is the primary determinant of snowpack volume and runoff rates. The NASA JPL Airborne Snow Observatory's airborne laser scanning system maps snow depth at high spatial and temporal resolutions, providing an unprecedented snowpack monitoring capability and enabling a new operational paradigm. In the Spring of 2013, the ASO mapped snow depth in the Tuolumne River Basin in California's Yosemite National Park on a nominally weekly basis, and provided fast-turnaround spatial snow depth and water equivalent maps to the operators of Hetch Hetchy Reservoir, the water supply for 2.5 million people on the San Francisco peninsula. These products enabled more accurate runoff simulation and optimal reservoir management in a year of very low snow accumulation. We present the initial results from this new application of multi-temporal LiDAR mapping in operational snow hydrology.

  19. Climate change induced heat wave hazard in eastern Africa: Dar Es Salaam (Tanzania) and Addis Ababa (Ethiopia) case study

    NASA Astrophysics Data System (ADS)

    Capuano, Paolo; Sellerino, Mariangela; Di Ruocco, Angela; Kombe, Wilbard; Yeshitela, Kumelachew

    2013-04-01

    Last decades, new records were set in the world for tornadoes, drought, wind, floods, wildfires and hot temperatures, testifying unusual weather and climate patterns with increasing frequency and intensity of extreme weather events. Extreme heat events are natural hazards affecting many regions in the world, nevertheless limited work has been done on the analysis and effects of extreme heat events in Africa, that is considered a continent particularly vulnerable to the effects of climate change. In fact, the increase of temperature expected in the African continent during the 21st century is larger than the global mean warming, being about 3° to 4° C, about 1.5 times the global temperature increase (Christensen et al., 2007; Gualdi et al., 2012), with the subtropical regions projected to warm more than the tropical regions. Observations and downscaled model simulations (RCP4.5 and RCP8.5 IPCC scenarios) are analyzed to describe heat wave characteristics in Dar es Salaam (Tanzania) and Addis Ababa (Ethiopia), spanning the last five decades as well as that projected for the 21st century. Observed data are daily maximum and minimum temperature collected in the period 1961-2011; downscaled model simulations span up to 2050. Heat waves are defined following a peak over threshold approach by statistical comparison to historical meteorological baselines (site dependent), using a fixed absolute threshold. Projected future warming in the Dar es Salaam and Addis Ababa shows a further increase in the heat waves parameters. Heat wave duration and hot days number are strictly correlated showing that the temperature rise could generate not only an increase of heat waves number but mainly a longer average duration, that can strongly affect the resilience capacity of the population, particularly the elder people. In fact, the impacts of heat waves on the society are determined also by temporal duration (Stephenson, 2008), in addition to their frequency, in fact the capacity of

  20. Exploring the spatial heterogeneity of terraced landscapes using LiDAR: the Slope Local Length of Auto-Correlation (SLLAC).

    NASA Astrophysics Data System (ADS)

    Sofia, Giulia; Marinello, Francesco; Tarolli, Paolo

    2014-05-01

    Terraces represent an outstanding example that displays centuries of a ubiquitous human-Earth interaction, in a very specific and productive way, and they are a significant part of numerous local economies. They, in fact, optimise the local resources for agricultural purposes, but also exploit marginal landscapes, expanding local populations. The ubiquity, variety, and importance of terraces have motivated studies designed to understand them better both as cultural and ecological features, but also as elements that can deeply influence runoff generation and propagation, contributing to local instabilities, and triggering or aggravating land degradation processes. Their vulnerability in the face of fast-growing urban settlements and the changes in agricultural practices is also well known, prompting protection measures strongly supported by local communities, but also by national and international projects. This work explores the spatial heterogeneity of terraced landscapes, identifying a proper indicator able to discriminate a terraced landscape respect to a more natural one. Recognizing and characterizing terraced areas can offer important multi-temporal insights into issues such as agricultural sustainability, indigenous knowledge systems, human-induced impact on soil degradation or erosive and landslide processes, geomorphological and pedologic processes that influence soil development, and climatic and biodiversity changes. More in detail, the present work introduces a new morphological indicator from LiDAR, effectively implementable for the automatic characterization of terraced landscapes. For the study, we tested the algorithm for environments that differ in term of natural morphology and terracing system. Starting from a LiDAR Digital Terrain Models (DTM), we considered the local auto-correlation (~local self-similarity) of the slope, calculating the correlation between a slope patch and its surrounding areas. We define the resulting map as the "Slope Local

  1. Hospital-acquired pneumonia

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000146.htm Hospital-acquired pneumonia To use the sharing features on this page, please enable JavaScript. Hospital-acquired pneumonia is an infection of the lungs ...

  2. Surviving Your Child's Hospitalization.

    ERIC Educational Resources Information Center

    Cohen, David A.

    1988-01-01

    The parent of a young child who required major open heart surgery shares his suggestions for coping with a young child's hospitalization including parent visitation, relating to the hospital staff, getting answers to questions, and utilizing available services. (DB)

  3. Understanding your hospital bill

    MedlinePlus

    ... getting the help you need, consider hiring a medical-billing advocate. Advocates charge an hourly fee or a ... American Hospital Association. Hospital Billing and Collection ... 15, 2015. Family Doctor.org. Understanding your Medical Bills. ...

  4. Hospitals as health educators

    MedlinePlus

    ... than your local hospital. From health videos to yoga classes, many hospitals offer information families need to ... care and breastfeeding Parenting Baby sign language Baby yoga or massage Babysitting courses for teens Exercise classes ...

  5. Market orientation in the hospital industry.

    PubMed

    Bhuian, S N; Abdul-Gader, A

    1997-01-01

    Using the more recent methodological developments in the assessment of the unidemensionality, reliability, and validity, the authors developed and examined a scale of market orientation for the hospital industry. The scale is based on a clear definition of the content of the construct of market orientation in the hospital industry. To this end, a national random sample of 237 hospital administrators was used. In addition to the support for the reliability and validity, the scale promises parsimony, pragmatism, and wide-ranging applicability. PMID:10177360

  6. Evaluation of the contribution of LiDAR data and postclassification procedures to object-based classification accuracy

    NASA Astrophysics Data System (ADS)

    Styers, Diane M.; Moskal, L. Monika; Richardson, Jeffrey J.; Halabisky, Meghan A.

    2014-01-01

    Object-based image analysis (OBIA) is becoming an increasingly common method for producing land use/land cover (LULC) classifications in urban areas. In order to produce the most accurate LULC map, LiDAR data and postclassification procedures are often employed, but their relative contributions to accuracy are unclear. We examined the contribution of LiDAR data and postclassification procedures to increase classification accuracies over using imagery alone and assessed sources of error along an ecologically complex urban-to-rural gradient in Olympia, Washington. Overall classification accuracy and user's and producer's accuracies for individual classes were evaluated. The addition of LiDAR data to the OBIA classification resulted in an 8.34% increase in overall accuracy, while manual postclassification to the imagery+LiDAR classification improved accuracy only an additional 1%. Sources of error in this classification were largely due to edge effects, from which multiple different types of errors result.

  7. Landslide investigation using LiDAR data acquired by an unmanned helicopter

    NASA Astrophysics Data System (ADS)

    Kasai, M.; Tanaka, Y.; Marutani, T.; Saito, Y.

    2013-12-01

    In this study, LiDAR data acquired over 0.5 km2 landslide prone area by an unmanned helicopter is presented. The data was taken in summer 2012 and 2013, when tree foliage covered the ground surface. Imagery was of sufficient quality to identify and measure landslide features. These data together with LiDAR data obtained by a manned helicopter in the same area in August 2008 were examined to find active slopes on landslides during the period from 2008 to 2013. Morphological characteristics of these slopes were also analyzed to utilize the notion to discover active but hiding landslides in the region. In inapproachable areas, the UAV (Unmanned Aerial Vehicles) is likely to be of greatest use. In addition, this study showed that repeat monitoring of sites is a way of utilizing UAVs, particularly in terms of cost and convenience.

  8. Characterization of the OPAL obscurant penetrating LiDAR in various degraded visual environments

    NASA Astrophysics Data System (ADS)

    Trickey, Evan; Church, Philip; Cao, Xiaoying

    2013-05-01

    The OPAL obscurant penetrating LiDAR was developed by Neptec and characterized in various degraded visual environments (DVE) over the past five years. Quantitative evaluations of obscurant penetration were performed using the Defence RD Canada - Valcartier (DRDC Valcartier) instrumented aerosol chamber for obscurants such as dust and fog. Experiments were done with the sensor both at a standoff distance and totally engulfed in the obscurants. Field trials were also done to characterize the sensor in snow conditions and in smoke. Finally, the OPAL was also mounted on a Bell 412 helicopter to characterize its dust penetration capabilities, in environment such as Yuma Proving Ground. The paper provides a summary of the results of the OPAL evaluations demonstrating it to be a true "see through" obscurant penetrating LiDAR and explores commercial applications of the technology.

  9. Quantifying post-wildfire erosion patterns using terrestrial LiDAR

    NASA Astrophysics Data System (ADS)

    Rengers, F.; Tucker, G. E.; Moody, J. A.

    2012-12-01

    Wildfires are becoming increasingly frequent in the western United States. In burned landscapes, geomorphic change can take place rapidly during rainstorms following a wildfire. Rainfall over a burned area tends to mobilize more sediment than in unburned basins because the wildfire changes soil properties, creating more overland flow. A dearth of ground debris allows for deeper and faster flow that can entrain sediment. We apply terrestrial LiDAR to post-wildfire geomorphic change analysis to determine the pattern and magnitude of erosion following rain storms. By differencing digital elevation models created from terrestrial LiDAR surveys, we can measure post-wildfire geomorphic change. Topographic analysis with LiDAR allows us to monitor landscape recovery and evolution following a wildfire. Traditional methods of post-wildfire erosion analysis have focused on measurements such as erosion pins and silt fences. These capture erosion or deposition at a point or cumulative deposition of the sediment from some unknown contributing area upstream of the silt fence. This requires researchers to integrate measurements over a large area to determine basin-wide erosion. By contrast, successive terrestrial LiDAR surveys allow us to map changes in topography over an entire basin or hillslope to determine the spatial distribution of erosion within a basin or on a hillslope and to correlate the erosion with the hydrologic processes between surveys. Our study site is a high-severity burn hillslope, burned by the 2010 Fourmile Canyon fire about 15 km west of Boulder, CO. The wildfire was contained on 16 September 2010 and the first LiDAR survey was on 7 October 2010 prior to any significant rain storms. Following this baseline survey, we have used terrestrial LiDAR to capture the landscape state before and after unique hydrologic events such as: low-intensity rain storms, winter snowmelt, and summer convective thunderstorms. Comparing the landscape topography before and after

  10. An automatic and overlap based method for LiDAR intensity correction

    NASA Astrophysics Data System (ADS)

    Ding, Qiong

    2016-03-01

    LiDAR provides intensity data that reflect the material characteristics of objects. However, intensity values need to be corrected before they can be reliably used for applications because of the error during data acquisition. This study proposed an automatic and overlap based method for intensity correction. Firstly, a radar equation based method was employed for removal of main errors. Then, nearest neighbor algorithm was used to find out homologous points of overlap regions and assumption was made that homologous points should have same intensity. Finally, an improved model was utilized to eliminate overlap discrepancies. This method can be considered as a potential aid to enhance the accuracy of LiDAR intensity data and improve the automation of data process.

  11. Characterization of Forest Ecosystems by combined Radiative Transfer Modeling for Imaging Spectrometer and LiDAR

    NASA Astrophysics Data System (ADS)

    Koetz, B.; Sun, G.; Morsdorf, F.; Rubio, J.; Kimes, D.; Ranson, J.

    2009-04-01

    This research was motivated by the increased information dimensionality provided by current Earth Observation systems measuring the complex and dynamic medium of the vegetated surface of the Earth. Advanced and reliable algorithms that fully exploit this enhanced Earth Observation information are needed to deliver consistent data sets of the Earth vegetation condition describing its spatial distribution and change over time. Spectral observation provided by imaging spectrometers and the waveform from large-footprint LiDAR are now available from space for forest ecosystem studies. The imaging spectrometer data contains information about the biochemical composition of the canopy foliage, and is widely used to estimate biophysical canopy parameters such as LAI and fractional cover. LiDAR responds to the vertical distribution of scatters and permits inferences about the plant structures required to supply water and mechanical support to those surfaces. Various canopy height indices derived from LiDAR waveform have been successfully used to infer forest above-ground biomass and the characterization of canopy structure. The structure parameters derived from LiDAR data can improve the accuracy and robustness of canopy parameter retrieval from imaging spectrometer by reducing uncertainties related to the canopy structure. The specific information content, inherent to the observations of imaging spectrometry and LIDAR, assesses thus different but complementary characteristics of the complex vegetation canopy. The combination of these two information dimensions offers a unique and reliable canopy characterization including information relevant to different aspects of the biochemical and biophysical properties and thus understanding of processes within forest ecosystems. A comprehensive canopy characterization of a forest ecosystem is derived from the combined remote sensing signal of imaging spectrometry and large footprint LIDAR. The inversion of two linked physically based

  12. Advances in animal ecology from 3D-LiDAR ecosystem mapping.

    PubMed

    Davies, Andrew B; Asner, Gregory P

    2014-12-01

    The advent and recent advances of Light Detection and Ranging (LiDAR) have enabled accurate measurement of 3D ecosystem structure. Here, we review insights gained through the application of LiDAR to animal ecology studies, revealing the fundamental importance of structure for animals. Structural heterogeneity is most conducive to increased animal richness and abundance, and increased complexity of vertical vegetation structure is more positively influential compared with traditionally measured canopy cover, which produces mixed results. However, different taxonomic groups interact with a variety of 3D canopy traits and some groups with 3D topography. To develop a better understanding of animal dynamics, future studies will benefit from considering 3D habitat effects in a wider variety of ecosystems and with more taxa. PMID:25457158

  13. Cosmogenic Records in 18 Ordinary Chondrites from the Dar Al Gani Region, Libya. 1; Noble Gases

    NASA Technical Reports Server (NTRS)

    Schultz, L.; Franke, L.; Welten, K. C.; Nishiizumi, K.; Jull, A. J. T.

    2003-01-01

    In the last decade thousands of meteorites have been recovered from hot deserts in the Sahara and Oman. One of the main meteorite concentration surfaces in the Sahara is the Dar al Gani plateau in Libya, which covers a total area of 8000 km2. More than 1000 meteorites have been reported from this area. The geological setting, meteorite pairings and the meteorite density of the Dar al Gani (DaG) field are described in more detail in [1]. In this work we report concentrations of the noble gas isotopes of He, Ne, Ar as well as 84Kr and 132Xe in 18 DaG meteorites. In a separate paper we will report the cosmogenic radionuclides [2]. We discuss the thermal history and cosmic-ray exposure (CRE) history of these meteorites, and evaluate the effects of the hot desert environment on the noble gas record.

  14. Remote sensing based detection of forested wetlands: An evaluation of LiDAR, aerial imagery, and their data fusion

    NASA Astrophysics Data System (ADS)

    Suiter, Ashley Elizabeth

    Multi-spectral imagery provides a robust and low-cost dataset for assessing wetland extent and quality over broad regions and is frequently used for wetland inventories. However in forested wetlands, hydrology is obscured by tree canopy making it difficult to detect with multi-spectral imagery alone. Because of this, classification of forested wetlands often includes greater errors than that of other wetlands types. Elevation and terrain derivatives have been shown to be useful for modelling wetland hydrology. But, few studies have addressed the use of LiDAR intensity data detecting hydrology in forested wetlands. Due the tendency of LiDAR signal to be attenuated by water, this research proposed the fusion of LiDAR intensity data with LiDAR elevation, terrain data, and aerial imagery, for the detection of forested wetland hydrology. We examined the utility of LiDAR intensity data and determined whether the fusion of Lidar derived data with multispectral imagery increased the accuracy of forested wetland classification compared with a classification performed with only multi-spectral image. Four classifications were performed: Classification A -- All Imagery, Classification B -- All LiDAR, Classification C -- LiDAR without Intensity, and Classification D -- Fusion of All Data. These classifications were performed using random forest and each resulted in a 3-foot resolution thematic raster of forested upland and forested wetland locations in Vermilion County, Illinois. The accuracies of these classifications were compared using Kappa Coefficient of Agreement. Importance statistics produced within the random forest classifier were evaluated in order to understand the contribution of individual datasets. Classification D, which used the fusion of LiDAR and multi-spectral imagery as input variables, had moderate to strong agreement between reference data and classification results. It was found that Classification A performed using all the LiDAR data and its derivatives

  15. Histoplasmosis-Associated Hospitalizations in the United States, 2001-2012.

    PubMed

    Benedict, Kaitlin; Derado, Gordana; Mody, Rajal K

    2016-01-01

    We examined trends in histoplasmosis-associated hospitalizations in the United States using the 2001-2012 National (Nationwide) Inpatient Sample. An estimated 50 778 hospitalizations occurred, with significant increases in hospitalizations overall and in the proportion of hospitalizations associated with transplant, diabetes, and autoimmune conditions often treated with biologic therapies; therefore, histoplasmosis remains an important opportunistic infection. PMID:26894201

  16. Histoplasmosis-Associated Hospitalizations in the United States, 2001–2012

    PubMed Central

    Benedict, Kaitlin; Derado, Gordana; Mody, Rajal K.

    2016-01-01

    We examined trends in histoplasmosis-associated hospitalizations in the United States using the 2001–2012 National (Nationwide) Inpatient Sample. An estimated 50 778 hospitalizations occurred, with significant increases in hospitalizations overall and in the proportion of hospitalizations associated with transplant, diabetes, and autoimmune conditions often treated with biologic therapies; therefore, histoplasmosis remains an important opportunistic infection. PMID:26894201

  17. The Japanese Hospital in Broome, 1910-1926. A harmony of contrasts.

    PubMed

    Stride, P; Louws, A

    2015-01-01

    The Japanese Hospital in Broome remains the only hospital in Australia's history predominantly staffed, controlled and funded by a linguistically, culturally and geographically alien nation. Initially the proposal, challenging prevailing attitudes, was bitterly opposed by the white community, but the hospital became respected thanks to Dr Tadashi Suzuki, the hospital's first doctor, and his successors' clinical skills and compassion. PMID:26181534

  18. Mapping and Monitoring Delmarva Fox Squirrel Habitat Using an Airborne LiDAR Profiler

    NASA Technical Reports Server (NTRS)

    Nelson, Ross; Ratnaswamy, Mary; Keller, Cherry

    2004-01-01

    Twenty five hundred thirty nine kilometers of airborne laser profiling and videography data were acquired over the state of Delaware during the summer of 2000. The laser ranging measurements and video from approximately one-half of that data set (1304 km) were analyzed to identify and locate forested sites that might potentially support populations of Delmarva fox squirrel (DFS, Sciurus niger cinereus). The DFS is an endangered species previously endemic to tall, dense, mature forests with open understories on the Eastern Shore of the Chesapeake Bay. The airborne LiDAR employed in this study can measure forest canopy height and canopy closure, but cannot measure or infer understory canopy conditions. Hence the LiDAR must be viewed as a tool to map potential, not actual, habitat. Fifty-three potentially suitable DFS sites were identified in the 1304 km of flight transect data. Each of the 53 sites met the following criteria according to the LiDAR and video record: (1 ) at least 120m of contiguous forest; (2) an average canopy height greater than 20m; (3) an average canopy closure of >80%; and (4) no roofs, impervious surface (e.g., asphalt, concrete), and/or open water anywhere along the 120m length of the laser segment. Thirty-two of the 53 sites were visited on the ground and measurements taken for a DFS habitat suitability model. Seventy eight percent of the sites (25 of 32) were judged by the model to be suited to supporting a DFS population. Twenty-eight of the 32 sites visited in the field were in forest cover types (hardwood, mixed wood, conifer, wetlands) according to a land cover GIS map. Of these, 23 (82%) were suited to support DFS. The remaining 4 sites were located in nonforest cover types - agricultural or residential areas. Two of the four, or 50% were suited to the DFS. All of the LiDAR flight data, 2539 km, were analyzed to

  19. Flying Under the LiDAR: Relating Forest Structure to Bat Community Diversity

    NASA Astrophysics Data System (ADS)

    Swanson, A. C.; Weishampel, J. F.

    2015-12-01

    Bats are important to many ecological processes such as pollination, insect (and by proxy, disease) control, and seed dispersal and can be used to monitor ecosystem health. However, they are facing unprecedented extinction risks from habitat degradation as well as pressures from pathogens (e.g., white-nose syndrome) and wind turbines. LiDAR allows ecologists to measure structural variables of forested landscapes with increased precision and accuracy at broader spatial scales than previously possible. This study used airborne LiDAR to classify forest habitat/canopy structure at the Ordway-Swisher Biological Station (OSBS) in north central Florida. LiDAR data were acquired by the NEON airborne observation platform in summer 2014. OSBS consists of open-canopy pine savannas, closed-canopy hardwood hammocks, and seasonally wet prairies. Multiple forest structural parameters (e.g., mean, maximum, and standard deviation of height returns) were derived from LiDAR point clouds using the USDA software program FUSION. K-means clustering was used to segregate each 5x5 m raster across the ~3765 ha OSBS area into six different clusters based on the derived canopy metrics. Cluster averages for maximum, mean, and standard deviation of return heights ranged from 0 to 19.4 m, 0 to 15.3 m, and 0 to 3.0 m, respectively. To determine the relationships among these landscape-canopy features and bat species diversity and abundances, AnaBat II bat detectors were deployed from May to September in 2015 stratified by these distinct clusters. Bat calls were recorded from sunset to sunrise during each sampling period. Species were identified using AnalookW. A statistical regression model selection approach was performed in order to evaluate how forest attributes such as understory clutter, open regions, open and closed canopy, etc. influence bat communities. This knowledge provides a deeper understanding of habitat-species interactions to better manage survival of these species.

  20. Topographic and Thermal Investigations of Active Pahoehoe Lava Flows Using Coupled LiDAR/FLIR Datasets

    NASA Astrophysics Data System (ADS)

    Crown, D. A.; Anderson, S. W.; Finnegan, D. C.; LeWinter, A. L.; Ramsey, M.

    2012-12-01

    Pahoehoe lava flows consist of multiple overlapping and interfingering lobes and exhibit morphologically diverse surfaces characterized by channels, smooth-surfaced sheets, and numerous, small networks of interconnected pahoehoe toes. In order to analyze the different pahoehoe emplacement regimes, we have acquired simultaneous high-resolution topographic and thermal measurements of advancing and inflating flow lobes at high temporal frequency. These datasets allow the creation of flow lobe maps at regular intervals during flow emplacement that document morphologic, thermal, and morphometric characteristics of individual pahoehoe elements (e.g., pahoehoe toes) as well as compound pahoehoe features (e.g., toe networks, channels with lateral levees). These datasets reveal patterns in flow behavior and provide quantitative documentation of flow emplacement processes. Field investigations were conducted in February and March, 2012 on tube-fed pahoehoe flows in the Puu Oo flow field, Kilauea Volcano, Hawaii. We utilized a ground-based, full-waveform scanning LiDAR and FLIR SC645 thermal infrared camera, supplemented by high-definition video and time-lapse photography. The LiDAR scanner is capable of acquiring rapid, successive scans with reproducible 5 mm resolution data at a rate of 300 kHz. The FLIR camera acquires calibrated thermal images in the 7.5 - 13 mm range; the object temperature range is -20°C to +2000°C, with a thermal sensitivity of <0.05°C at 30°C. An RTK GPS was used to acquire precise locations of scan positions and to georeference LiDAR point cloud data to real-world coordinates. The combined LiDAR/FLIR system provides rapid acquisition of high-resolution spatial and high-precision thermal datasets for advancing pahoehoe flows.

  1. NASA Goddards LiDAR, Hyperspectral and Thermal (G-LiHT) Airborne Imager

    NASA Technical Reports Server (NTRS)

    Cook, Bruce D.; Corp, Lawrence A.; Nelson, Ross F.; Middleton, Elizabeth M.; Morton, Douglas C.; McCorkel, Joel T.; Masek, Jeffrey G.; Ranson, Kenneth J.; Ly, Vuong; Montesano, Paul M.

    2013-01-01

    The combination of LiDAR and optical remotely sensed data provides unique information about ecosystem structure and function. Here, we describe the development, validation and application of a new airborne system that integrates commercial off the shelf LiDAR hyperspectral and thermal components in a compact, lightweight and portable system. Goddard's LiDAR, Hyperspectral and Thermal (G-LiHT) airborne imager is a unique system that permits simultaneous measurements of vegetation structure, foliar spectra and surface temperatures at very high spatial resolution (approximately 1 m) on a wide range of airborne platforms. The complementary nature of LiDAR, optical and thermal data provide an analytical framework for the development of new algorithms to map plant species composition, plant functional types, biodiversity, biomass and carbon stocks, and plant growth. In addition, G-LiHT data enhance our ability to validate data from existing satellite missions and support NASA Earth Science research. G-LiHT's data processing and distribution system is designed to give scientists open access to both low- and high-level data products (http://gliht.gsfc.nasa.gov), which will stimulate the community development of synergistic data fusion algorithms. G-LiHT has been used to collect more than 6,500 km2 of data for NASA-sponsored studies across a broad range of ecoregions in the USA and Mexico. In this paper, we document G-LiHT design considerations, physical specifications, instrument performance and calibration and acquisition parameters. In addition, we describe the data processing system and higher-level data products that are freely distributed under NASA's Data and Information policy.

  2. Reduction of training costs using active classification in fused hyperspectral and LiDAR data

    NASA Astrophysics Data System (ADS)

    Wuttke, Sebastian; Schilling, Hendrik; Middelmann, Wolfgang

    2012-11-01

    This paper presents a novel approach for the reduction of training costs in classification with co-registered hyperspectral (HS) and Light Detection and Ranging (LiDAR) data using an active classification framework. Fully automatic classification can be achieved by unsupervised learning, which is not suited for adjustment to specific classes. On the other hand, supervised classification with predefined classes needs a lot of training examples, which need to be labeled with the ground truth, usually at a significant cost. The concept of active classification alleviates these problems by the use of a selection strategy: only selected samples are ground truth labeled and used as training data. One common selection strategy is to incorporate in a first step the current state of the classification algorithm and choose only the examples for which the expected information gain is maximized. In the second step a conventional classification algorithm is trained using this data. By alternating between these two steps the algorithm reaches high classification accuracy results with less training samples and therefore lower training costs. The approach presented in this paper involves the user in the active selection strategy and the k-NN algorithm is chosen for classification. The results further benefit from fusing the heterogeneous information of HS and LiDAR data within the classification algorithm. For this purpose, several HS features, such as vegetation indices, and LiDAR features, such as relative height and roughness, are extracted. This increases the separability between different classes and reduces the dimensionality of the HS data. The practicability and performance of this framework is shown for the detection and separation of different kinds of vegetation, e.g. trees and grass in an urban area of Berlin. The HS data was obtained by the SPECIM AISA Eagle 2 sensor, LiDAR data by Riegl LMS Q560.

  3. Quantitative study of tectonic geomorphology along Haiyuan fault based on airborne LiDAR

    USGS Publications Warehouse

    Chen, Tao; Zhang, Pei Zhen; Liu, Jing; Li, Chuan You; Ren, Zhi Kun; Hudnut, Kenneth W.

    2014-01-01

    High-precision and high-resolution topography are the fundamental data for active fault research. Light detection and ranging (LiDAR) presents a new approach to build detailed digital elevation models effectively. We take the Haiyuan fault in Gansu Province as an example of how LiDAR data may be used to improve the study of active faults and the risk assessment of related hazards. In the eastern segment of the Haiyuan fault, the Shaomayin site has been comprehensively investigated in previous research because of its exemplary tectonic topographic features. Based on unprecedented LiDAR data, the horizontal and vertical coseismic offsets at the Shaomayin site are described. The measured horizontal value is about 8.6 m, and the vertical value is about 0.8 m. Using prior dating ages sampled from the same location, we estimate the horizontal slip rate as 4.0 ± 1.0 mm/a with high confidence and define that the lower bound of the vertical slip rate is 0.4 ± 0.1 mm/a since the Holocene. LiDAR data can repeat the measurements of field work on quantifying offsets of tectonic landform features quite well. The offset landforms are visualized on an office computer workstation easily, and specialized software may be used to obtain displacement quantitatively. By combining precious chronological results, the fundamental link between fault activity and large earthquakes is better recognized, as well as the potential risk for future earthquake hazards.

  4. Strategies for minimizing sample size for use in airborne LiDAR-based forest inventory

    USGS Publications Warehouse

    Junttila, Virpi; Finley, Andrew O.; Bradford, John B.; Kauranne, Tuomo

    2013-01-01

    Recently airborne Light Detection And Ranging (LiDAR) has emerged as a highly accurate remote sensing modality to be used in operational scale forest inventories. Inventories conducted with the help of LiDAR are most often model-based, i.e. they use variables derived from LiDAR point clouds as the predictive variables that are to be calibrated using field plots. The measurement of the necessary field plots is a time-consuming and statistically sensitive process. Because of this, current practice often presumes hundreds of plots to be collected. But since these plots are only used to calibrate regression models, it should be possible to minimize the number of plots needed by carefully selecting the plots to be measured. In the current study, we compare several systematic and random methods for calibration plot selection, with the specific aim that they be used in LiDAR based regression models for forest parameters,