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Sample records for acs ed visit

  1. ED Patients with Prolonged Complaints and Repeat ED Visits Have an Increased Risk of Depression

    PubMed Central

    Brickman, Kristopher R.; Bahl, Rajiv; Marcinkowski, Nathan F.; Ammons, Katelyn R.; Akpunonu, Peter

    2016-01-01

    Introduction The objective of this study was to explore associations between presenting chief complaints of prolonged symptomatology, patient usage of the emergency department (ED), and underlying depression so that emergency physicians may better target patients for depression screening. Methods A convenience sample of ED patients were administered the Beck Depression Inventory-II (BDI-II) to assess for depression. We correlated completed BDI-II surveys to patient information including demographics, pertinent history of present illness information, and past medical history. Results Out of 425 participants screened, we identified complaints of two weeks or longer in 92 patients (22%). Of these patients, mild to severe depression was recognized in over half of the population (47), yet only nine patients reported a prior depression diagnosis. These 92 patients also visited the ED three times as frequently as those patients with more acute complaints (p<0.001). Finally, our study showed that patients with mild to severe depression had three times as many ED visits compared to patients with minimal or no depression (p<0.001). Conclusion Patients with complaints of symptomatology two weeks or longer are more likely to have underlying depression when presenting to the ED. Patients with three or more ED visits within the past year also have a greater incidence of underlying depression. We found a strong correlation between complaints with symptomatology of two weeks or longer and multiple ED visits, in which underlying depression may have contributed to these patients’ ED visits. PMID:27625727

  2. Air pollution and ED visits for chest pain.

    PubMed

    Szyszkowicz, Mieczyslaw

    2009-02-01

    This was a study of 157,028 emergency department (ED)-diagnosed visits for chest pain (International Classification of Diseases, Ninth Revision [ICD-9]: 786) in 6 cities in Canada. The generalized linear mixed methods technique was applied to analyze the relations between daily counts of ED visits for chest pain on the levels of ambient air pollutants after adjusting for meteorological variables. The daily counts of visits were analyzed separately for the whole period (January-December), warm (April-September), and cold (October-March). The results are presented in the form of the excess risks associated with an increase in the mean values of the pollutant concentrations. The highest increase was obtained for nitrogen dioxide (NO2) exposure in the warm period as follows: 5.9% (95% confidence interval, 3.3-5.8) for mean value equals to 20.1 ppb. The associations of ED visits for chest pain with air pollution are very similar to the associations of ED visits related to cardiac problems. PMID:19371523

  3. Population-Based Burden of COPD-Related Visits in the ED

    PubMed Central

    Lippmann, Steven J.; Waller, Anna E.; Hassmiller Lich, Kristen; Travers, Debbie; Weinberger, Morris; Donohue, James F.

    2013-01-01

    Background: Little is known about the population-based burden of ED care for COPD. Methods: We analyzed statewide ED surveillance system data to quantify the frequency of COPD-related ED visits, hospital admissions, and comorbidities. Results: In 2008 to 2009 in North Carolina, 97,511 COPD-related ED visits were made by adults ≥ 45 years of age, at an annual rate of 13.8 ED visits/1,000 person-years. Among patients with COPD (n = 33,799), 7% and 28% had a COPD-related return ED visit within a 30- and 365-day period of their index visit, respectively. Compared with patients on private insurance, Medicare, Medicaid, and noninsured patients were more likely to have a COPD-related return visit within 30 and 365 days and have three or more COPD-related visits within 365 days. There were no differences in return visits by sex. Fifty-one percent of patients with COPD were admitted to the hospital from the index ED visit. Subsequent hospital admission risk in the cohort increased with age, peaking at 65 to 69 years (risk ratio [RR], 1.41; 95% CI, 1.26-1.57); there was no difference by sex. Patients with congestive heart failure (RR, 1.29; 95% CI, 1.22-1.37), substance-related disorders (RR, 1.35; 95% CI, 1.13-1.60), or respiratory failure/supplemental oxygen (RR, 1.25; 95% CI, 1.19-1.31) were more likely to have a subsequent hospital admission compared with patients without these comorbidities. Conclusions: The population-based burden of COPD-related care in the ED is significant. Further research is needed to understand variations in COPD-related ED visits and hospital admissions. PMID:23579283

  4. EdTrAc Teacher Education Program: First-Year Implementation Evaluation (2005-2006)

    ERIC Educational Resources Information Center

    Pittman, Brian; Shelton, Ellen

    2006-01-01

    The Educational Training Academy (EdTrAc) is an NSF-funded project of Normandale Community College to increase the number, diversity, and skills of students preparing to be elementary and middle school teachers with a specialty in math and science. Overall, this evaluation indicates that the EdTrAc implementation is on track after its first year…

  5. Trends in Hospital Admission and Surgical Procedures Following ED visits for Diverticulitis

    PubMed Central

    Greenwood-Ericksen, Margaret B.; Havens, Joaquim M.; Ma, Jiemin; Weissman, Joel S.; Schuur, Jeremiah D.

    2016-01-01

    Introduction Diverticulitis is a common diagnosis in the emergency department (ED). Outpatient management of diverticulitis is safe in selected patients, yet the rates of admission and surgical procedures following ED visits for diverticulitis are unknown, as are the predictive patient characteristics. Our goal is to describe trends in admission and surgical procedures following ED visits for diverticulitis, and to determine which patient characteristics predict admission. Methods : We performed a cross-sectional descriptive analysis using data on ED visits from 2006–2011 to determine change in admission and surgical patterns over time. The Nationwide Emergency Department Sample database, a nationally representative administrative claims dataset, was used to analyze ED visits for diverticulitis. We included patients with a principal diagnosis of diverticulitis (ICD-9 codes 562.11, 562.13). We analyzed the rate of admission and surgery in all admitted patients and in low-risk patients, defined as age <50 with no comorbidities (Elixhauser). We used hierarchical multivariate logistic regression to identify patient characteristics associated with admission for diverticulitis. Results Fryom 2006 to 2011 ED visits for diverticulitis increased by 21.3% from 238,248 to 302,612, while the admission rate decreased from 55.7% to 48.5% (−7.2%, 95% CI [−7.78 to −6.62]; p<0.001 for trend). The admission rate among low-risk patients decreased from 35.2% in 2006 to 26.8% in 2011 (−8.4%, 95% CI [−9.6 to −7.2]; p<0.001 for trend). Admission for diverticulitis was independently associated with male gender, comorbid illnesses, higher income and commercial health insurance. The surgical rate decreased from 6.5% in 2006 to 4.7% in 2011 (−1.8%, 95% CI [−2.1 to −1.5]; p<0.001 for trend), and among low-risk patients decreased from 4.0% to 2.2% (−1.8%, 95% CI [−4.5 to −1.7]; p<0.001 for trend). Conclusion From 2006 to 2011 ED visits for diverticulitis increased

  6. Exposure to Community Violence is Associated with Asthma Hospitalizations and ED Visits

    PubMed Central

    Apter, Andrea J.; Garcia, Laura A.; Boyd, Rhonda C.; Wang, Xingmei; Bogen, Daniel K.; Have, Thomas Ten

    2010-01-01

    Background Exposure to community violence (ECV) has been associated with asthma morbidity of children living in inner-city neighborhoods. Objective To examine with prospective longitudinal data whether ECV is independently associated with asthma-related health outcomes in adults. Methods Adults with moderate-severe asthma, recruited from clinics serving inner-city neighborhoods, completed questionnaires covering socio-demographics, asthma severity, and ECV and were followed for 26 weeks. Longitudinal models were employed to assess unadjusted and adjusted associations of subsequent asthma outcomes (emergency department (ED) visits, hospitalizations, FEV1, quality of life). Results 397 adults, 47±14 years, 73% female, 70% African American, 7% Latino, mean FEV1 66%±19%, 133 with hospitalizations and 222 with ED visits for asthma in the year before entry were evaluated. 91 reported ECV. Controlling for age, gender, race/ethnicity, and household income, those exposed to violence had 2.27 (95% CI: 1.32-3.90) times more asthma-related ED visits per month and 2.49 (95% CI: 1.11-5.60) times more asthma-related hospitalizations per month over the 26-week study period compared to those unexposed. Violence-exposed participants also had 1.71 (95% CI: 1.14-2.56) times more overall ED visits per month and 1.72 (95% CI: 0.95-3.11) times more overall hospitalizations per month from any cause. Asthma-related quality of life was lower in the violence-exposed participants (-0.40 (95%CI: -0.77-0.025), p=0.04). Effect modification by depressive symptoms was only statistically significant for the ECV association with overall ED visits and quality of life outcomes (p<.01). Conclusion In adults, ECV is associated with increased hospitalizations and emergency care for asthma or any condition and with asthma-related quality of life. PMID:20816190

  7. New levitation scheme with AC superconducting magnet for EDS MAGLEV system

    SciTech Connect

    Kim, D.H.; Lee, J.K.; Hahn, S.Y.; Cha, G.

    1996-09-01

    This paper proposes a new magnetic levitation scheme which is able to generate levitation force for all speeds including a standstill. Auxiliary wheels which are needed in EDS MAGLEV vehicle can be eliminated. This scheme uses AC superconducting magnets to generate levitation force. In this paper, magnetic fields, forces and power dissipations generated by AC magnets moving above a conducting slab are calculated analytically. Results of calculation show characteristics of EDS system with AC magnet, such as levitation force and loss, are superior to those of EDS system with DC magnets for all speeds.

  8. Emergency department visit volume variability

    PubMed Central

    Kang, Seung Woo; Park, Hyun Soo

    2015-01-01

    Objective One of the most important and basic variables in emergency department (ED) operations is patient visit volumes. This variable is usually predicted on the basis of the average ED patient visit volume over a certain period. However, ED patient visit variability is poorly understood. Therefore, we evaluated ED patient visit variability in order to determine if the average can be used to operate EDs. Methods Nationwide ED patient visit data were from the standard emergency patient data of the National Emergency Department Information System. The data are transferred automatically by 141 EDs nationwide. The hourly ED visit volumes over 365 days were determined, and the variability was analyzed to evaluate the representativeness of the average. Results A total of 4,672,275 patient visits were collected in 2013. The numbers of daily ED patient visits were widely dispersed and positively skewed rather than symmetric and narrow with a normal distribution. Conclusion The daily variability of ED visit is too large and it did not show normal distribution. The average visit volume does not adequately represent ED operation. PMID:27752589

  9. An Observational Study to Evaluate the Prevalence of Erectile Dysfunction (ED) and Prescribing Pattern of Drugs in Patients with ED Visiting an Andrology Specialty Clinic, Mumbai: 2012-14

    PubMed Central

    Kulkarni, Vijay R.; Bhagat, Sagar B.; Beldar, Amit S.; Patel, Sadiq B.

    2015-01-01

    Introduction: Erectile dysfunction (ED) is a common occurrence and its incidence is expected to increase significantly along with the increase in various lifestyle diseases. The drug utilization for ED is very low. Also, studies describing the prescription pattern in ED are lacking. Materials and Methods: We conducted a retrospective cross-sectional observational study, including a drug utilization analysis, of 606 prescriptions as per the standard guidelines (WHO and STROBE). Results: Out of 606, 249 (41%) were from the age group of 30-39 years. Addictions were present in 388 (64%). Out of 606, 186 had urological, 154 had cardiovascular and 102 had psychological co-morbid disorders. Out of 348, 201 were prescribed Tadalafil (low dose) on a once daily basis. Out of 172, 121 were prescribed Sildenafil (high dose) on an ‘as and when required’ basis. Nutritional/ herbal supplements were prescribed in 126/606. The ratio of ‘Prescribed Daily Dose’ to ‘Defined Daily Dose’ of Tadalafil, Sildenafil, and Dapoxetine were 1.1, 1.3 and 1.5 respectively. Conclusion: Measures for de-addiction play an important role in the overall management of ED. The most common co-morbid disorders were urological, like BPH, LUTS, etc, followed by cardiovascular, psychological and diabetes. Overall, rational pharmacotherapy was observed. Tadalafil was the most commonly prescribed drug for ED. The main factor in the selection of a particular PDE5 inhibitor was its pharmacokinetics and cost. Udenafil, being the costliest, was the least prescribed. Dapoxetine was used in a significant number of individuals primarily for PE with ED. The combination of Papaverine, Chlorpromazine ± Alprostadil was used as intracavernosal injection in patients not responding to oral drugs. PMID:26393163

  10. Emergency department visits and proximity to patients' residences, 2009-2010.

    PubMed

    Brown, Amy M; Decker, Sandra L; Selck, Frederic W

    2015-03-01

    The number of emergency department (ED) visits rose 44% from 1991 through 2010, even as the number of hospital EDs declined 10% over the same period. As a result, EDs have increasingly experienced overcrowding and longer waiting times. However, little is known about which ED patients visit, how often patients go to the ED closest to their home, and how differences in geography, patient demographics, and hospital characteristics are associated with ED selection patterns. PMID:25932892

  11. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    PubMed Central

    Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

    2016-01-01

    Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition. PMID:27625723

  12. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    PubMed Central

    Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

    2016-01-01

    Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition.

  13. Emergency Department Visits for Drug-Related Suicide Attempts Involving Antidepressants by Adolescents and Young Adults: 2004 to 2008. The DAWN Report

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2011

    2011-01-01

    In 2008, adolescents made 23,124 visits to the emergency department (ED) for drug-related suicide attempts, and young adults made 38,036 such visits; of these visits, 23.0 percent (5,312 visits) among adolescents and 17.6 percent (6,700 visits) among young adults involved antidepressants. Among ED visits for suicide attempts involving…

  14. Aftercare, Emergency Department Visits, and Readmission in Adolescents

    ERIC Educational Resources Information Center

    Carlisle, Corine E.; Mamdani, Muhammad; Schachar, Russell; To, Teresa

    2012-01-01

    Objective: U.S. and Canadian data demonstrate decreasing inpatient days, increasing nonurgent emergency department (ED) visits, and short supply of child psychiatrists. Our study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization. Method: We conducted a population-based…

  15. Visiting Professorships

    NASA Astrophysics Data System (ADS)

    Applications are now being accepted for the National Science Foundation (NSF) Visiting Professorships for Women Program. Under this program, women scientists and engineers from industry, government, and academia can be visiting professors at academic institutions in the United States.The program's objectives are to provide opportunities for women to advance their careers in the disciplines of science and engineering that are supported by NSF to provide greater visibility and wider opportunities for women scientists and engineers employed in industry, government, and academic institutions, and to provide encouragement for other women to pursue careers in science and engineering through the awardees' research, lecturing, counseling, and mentoring activities.

  16. Duration of patients’ visits to the hospital emergency department

    PubMed Central

    2012-01-01

    Background Length of stay is an important indicator of quality of care in Emergency Departments (ED). This study explores the duration of patients’ visits to the ED for which they are treated and released (T&R). Methods Retrospective data analysis and multivariate regression analysis were conducted to investigate the duration of T&R ED visits. Duration for each visit was computed by taking the difference between admission and discharge times. The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) for 2008 were used in the analysis. Results The mean duration of T&R ED visit was 195.7 minutes. The average duration of ED visits increased from 8 a.m. until noon, then decreased until midnight at which we observed an approximately 70-minute spike in average duration. We found a substantial difference in mean duration of ED visits (over 90 minutes) between Mondays and other weekdays during the transition time from the evening of the day before to the early morning hours. Black / African American patients had a 21.4-minute longer mean duration of visits compared to white patients. The mean duration of visits at teaching hospitals was substantially longer than at non-teaching hospitals (243.8 versus 175.6 minutes). Hospitals with large bed size were associated with longer duration of visits (222.2 minutes) when compared to hospitals with small bed size (172.4 minutes) or those with medium bed size (166.5 minutes). The risk-adjusted results show that mean duration of visits on Mondays are longer by about 4 and 9 percents when compared to mean duration of visits on non-Monday workdays and weekends, respectively. Conclusions The duration of T&R ED visits varied significantly by admission hour, day of the week, patient volume, patient characteristics, hospital characteristics and area characteristics. PMID:23126473

  17. The contribution of health anxiety to retrospectively-recalled emergency department visits within a sample of patients in residential substance abuse treatment.

    PubMed

    Fergus, Thomas A; Bardeen, Joseph R; Gratz, Kim L; Fulton, Jessica J; Tull, Matthew T

    2015-01-01

    With the burden of emergency department (ED) use increasing, research examining the factors associated with ED visits among individuals who use the ED most frequently is needed. Given that substance use is strongly linked to ED visits, this study sought to examine the factors associated with greater ED visits among patients with substance use disorders (SUD). More precisely, we examined whether health anxiety incrementally contributes to the prediction of ED visits for medical care among adult patients (N = 118) in a residential substance abuse disorder treatment facility. As predicted, health anxiety was significantly positively correlated with ED visits during the past year. Furthermore, health anxiety remained a significant predictor of ED visits after accounting for sociodemographic variables, frequency of substance use, and physical health status. These results suggest that health anxiety may contribute to increased ED visits for medical care among individuals with SUD.

  18. Visiting 'Voltaire'

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Annotated image of PIA04192 Sitting on 'Voltaire'

    Spirit's panoramic camera took this mosaic on martian day, or sol, 549 (July 20, 2005), as it approached a suite of layered rocks named 'Voltaire.' Seven to eight discrete layers can be seen in the bottom portion of the image, running from upper left to lower right. These rock layers are about 20 to 40 centimeters (8 to 16 inches) wide, and extend several meters in length. Spirit visited 'Haussmann' and several other rocks within the layered suite to perform close-up imaging, and to obtain measurements from its Moessbauer and alpha particle X-ray spectrometers.

  19. Visits to US Emergency Departments by 20 to 29 Year-olds with Chief Complaint of Toothache during 2001–2010

    PubMed Central

    McKinney, Christy M.; Lee, Helen H.; Melbye, Molly L.; Rue, Tessa C.

    2015-01-01

    Background Visits to emergency departments (EDs) for dental complaints are on the rise, yet reliance on EDs for dental care is far from ideal. ED toothache visits represent opportunities to improve access to professional dental care. Methods This research focuses on 20–29 year-olds, who account for more ED toothache visits than other age groups. We analyzed publicly available ED visits data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). We assessed trends in ED toothache visit rates compared with back pain and all-cause ED visits during the past decade. We used 2009–2010 NHAMCS to characterize the more recent magnitude, relative frequency, and independent risk factors for ED toothache visits. Statistical analyses accounted for the complex sampling design. Results The average annual increase in ED visit rates among 20–29 year-olds during 2001–2010 was 6.1% for toothache; 0.3% for back pain; and 0.8% for all-causes ED visits. In 2009–2010, 20–29 year-olds made an estimated 1.27 million ED visits for toothaches and accounted for 42% of all ED toothache visits. Toothache was the fifth most common reason for any ED visit and third most common for uninsured ED visits in 20–29 year-olds. Independent risk factors for ED toothache visits were being uninsured or Medicaid-insured. Conclusions Younger adults increasingly rely on EDs for toothaches—likely because of barriers to accessing professional dental care. Expanding dental coverage and access to affordable dental care could increase options for timely dental care and decrease ED use for dental complaints. PMID:25925521

  20. The association between office-based provider visits and emergency department utilization among Medicaid beneficiaries.

    PubMed

    Widmer, Andrew J; Basu, Rashmita; Hochhalter, Angela K

    2015-06-01

    The purpose of our study was to describe the relationship between office-based provider visits and emergency department (ED) utilization by adult Medicaid beneficiaries. Data were extracted from the publicly-available Medical Expenditure Panel Survey, a nationally representative sample of the civilian non-institutionalized population in the United States. The sample included 1,497 respondents who had full year Medicaid coverage in 2009. Study variables included insurance coverage type, usual source of care, chronic illnesses, and beneficiary demographics. Multivariate analyses were conducted to describe associations between individual characteristics and (a) likelihood of any ED utilization, and (b) number of ED visits by those who utilized the ED at least once in the study year. The analysis was adjusted for demographic characteristics and chronic health conditions. A greater number of office-based provider visits was associated with a higher likelihood of ED utilization. Among those with at least one ED visit, a greater number of office-based visits was associated with a higher number of ED visits. A respondent's age, history of hypertension or myocardial infarction, and Hispanic/Latino ethnicity were associated with having one or more ED visits; age and Hispanic/Latino ethnicity were associated with total number of ED visits among those with at least one. In this representative sample of adult Medicaid beneficiaries, there was no evidence that office-based provider visits reduced ED utilization. Office visits were associated with higher ED utilization, as were certain chronic conditions, older age, and Hispanic/Latino ethnicity. Findings do not support efforts to reduce ED utilization by increasing office-based visits alone.

  1. Preventing infections when visiting

    MedlinePlus

    ... Elsevier Saunders; 2013:chap 36. Infection control. In: Mills JE, ed. Nursing Procedures . 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:chap 2. Pollock M. Universal precautions. ...

  2. Validation of an algorithm to determine the primary care treatability of emergency department visits

    PubMed Central

    Jeffery, Molly Moore; Bellolio, M Fernanda; Wolfson, Julian; Abraham, Jean M; Dowd, Bryan E; Kane, Robert L

    2016-01-01

    Objectives We propose a new claims-computable measure of the primary care treatability of emergency department (ED) visits and validate it using a nationally representative sample of Medicare data. Study design and setting This is a validation study using 2011–2012 Medicare claims data for a nationally representative 5% sample of fee-for-service beneficiaries to compare the new measure's performance to the Ballard variant of the Billings algorithm in predicting hospitalisation and death following an ED visit. Outcomes Hospitalisation within 1 day or 1 week of an ED visit; death within 1 week or 1 month of an ED visit. Results The Minnesota algorithm is a strong predictor of hospitalisations and deaths, with performance similar to or better than the most commonly used existing algorithm to assess the severity of ED visits. The Billings/Ballard algorithm is a better predictor of death within 1 week of an ED visit; this finding is entirely driven by a small number of ED visits where patients appear to have been dead on arrival. Conclusions The procedure-based approach of the Minnesota algorithm allows researchers to use the clinical judgement of the ED physician, who saw the patient to determine the likely severity of each visit. The Minnesota algorithm may thus provide a useful tool for investigating ED use in Medicare beneficiaries. PMID:27566637

  3. Do Patient-Centered Medical Homes Reduce Emergency Department Visits?

    PubMed Central

    David, Guy; Gunnarsson, Candace; Saynisch, Philip A; Chawla, Ravi; Nigam, Somesh

    2015-01-01

    Objective To assess whether adoption of the patient-centered medical home (PCMH) reduces emergency department (ED) utilization among patients with and without chronic illness. Data Sources Data from approximately 460,000 Independence Blue Cross patients enrolled in 280 primary care practices, all converting to PCMH status between 2008 and 2012. Research Design We estimate the effect of a practice becoming PCMH-certified on ED visits and costs using a difference-in-differences approach which exploits variation in the timing of PCMH certification, employing either practice or patient fixed effects. We analyzed patients with and without chronic illness across six chronic illness categories. Principal Findings Among chronically ill patients, transition to PCMH status was associated with 5–8 percent reductions in ED utilization. This finding was robust to a number of specifications, including analyzing avoidable and weekend ED visits alone. The largest reductions in ED visits are concentrated among chronic patients with diabetes and hypertension. Conclusions Adoption of the PCMH model was associated with lower ED utilization for chronically ill patients, but not for those without chronic illness. The effectiveness of the PCMH model varies by chronic condition. Analysis of weekend and avoidable ED visits suggests that reductions in ED utilization stem from better management of chronic illness rather than expanding access to primary care clinics. PMID:25112834

  4. Improving ED efficiency to capture additional revenue.

    PubMed

    Mandavia, Sujal; Samaniego, Loretta

    2016-06-01

    An increase in the number of patients visiting emergency departments (EDs) presents an opportunity for additional revenue if hospitals take four steps to optimize resources: Streamline the patient pathway and reduce the amount of time each patient occupies a bed in the ED. Schedule staff according to the busy and light times for patient arrivals. Perform registration and triage bedside, reducing initial wait times. Create an area for patients to wait for test results so beds can be freed up for new arrivals. PMID:27451568

  5. Non–Emergency Department (ED) Interventions to Reduce ED Utilization: A Systematic Review

    PubMed Central

    Morgan, Sofie Rahman; Chang, Anna Marie; Alqatari, Mahfood; Pines, Jesse M.

    2014-01-01

    Objectives Recent health policy changes have focused efforts on reducing emergency department (ED) visits as a way to reduce costs and improve quality of care. This was a systematic review of interventions based outside the ED aimed at reducing ED use. Methods This study was designed as a systematic review. We reviewed the literature on interventions in five categories: patient education, creation of additional non-ED capacity, managed care, prehospital diversion, and patient financial incentives. Studies written in English, with interventions administered outside of the ED, and a comparison group where ED use was an outcome, were included. Two independent reviewers screened search results using MEDLINE, Cochrane, OAIster, or Scopus. The following data were abstracted from included studies: type of intervention, study design, population, details of intervention, effect on ED use, effect on non-ED health care use, and other health and financial outcomes. Quality of individual articles was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. Results Of 39 included studies, 34 were observational and five were randomized controlled trials. Two of five studies on patient education found reductions in ED use ranging from 21% to 80%. Out of 10 studies of additional non-ED capacity, four showed decreases of 9% to 54%, and one a 21% increase. Both studies on prehospital diversion found reductions of 3% to 7%. Of 12 studies on managed care, 10 had decreases ranging from 1% to 46%. Nine out of 10 studies on patient financial incentives found decreases of 3% to 50%, and one a 34% increase. Nineteen studies reported effect on non-ED use with mixed results. Seventeen studies included data on health outcomes, but 13 of these only included data on hospitalizations rather than morbidity and mortality. Seven studies included data on cost outcomes. According to the GRADE guidelines, all studies had at least some risk of bias, with four

  6. Presence of a Community Health Center and Uninsured Emergency Department Visit Rates in Rural Counties

    ERIC Educational Resources Information Center

    Rust, George; Baltrus, Peter; Ye, Jiali; Daniels, Elvan; Quarshie, Alexander; Boumbulian, Paul; Strothers, Harry

    2009-01-01

    Context: Community health centers (CHCs) provide essential access to a primary care medical home for the uninsured, especially in rural communities with no other primary care safety net. CHCs could potentially reduce uninsured emergency department (ED) visits in rural communities. Purpose: We compared uninsured ED visit rates between rural…

  7. Preliminary study on the relationship between visitation in the emergency department and posttraumatic mental health

    PubMed Central

    Lubomirsky, Bryan; Wang, Xin; Xie, Hong; Smirnoff, Jennifer B.; Biehn, Tracey L.; Contractor, Ateka A.; Elhai, Jon D.; Sutu, Christine; Brickman, Kristopher R.; Liberzon, Israel; McLean, Samuel A.; Tamburrino, Marijo B.

    2016-01-01

    This study documented family/friend support to patients in the Emergency Department (ED), including bedside visits and transportation of patients from the ED after discharge, and measured depression, anxiety, and stress symptoms within 2 weeks, 1 month and 3 months after motor vehicle accidents. Stress and depression symptoms significantly decreased during the initial three months. Family/friend visitation in the ED was negatively associated with anxiety and depression symptoms within 2 weeks and with stress symptoms months after trauma. This pilot study suggests family/friend visitation in the ED is associated with fewer mental health issues in the months following an accident. PMID:27536210

  8. Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003-2011.

    PubMed

    Mazer-Amirshahi, Maryann; Sun, Christie; Mullins, Peter; Perrone, Jeanmarie; Nelson, Lewis; Pines, Jesse M

    2016-09-01

    In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in 2003-2004 to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission. PMID:27342464

  9. Emergency Department Visits Related to Schizophrenia Among Adults Aged 18-64: United States, 2009-2011.

    PubMed

    Albert, Michael; McCaig, Linda F

    2015-09-01

    ED care is important for the treatment of acute presentations of schizophrenia and may serve as a safety net for schizophrenic patients not otherwise receiving care (4,5). This analysis of National Hospital Ambulatory Medical Care Survey (NHAMCS) data indicates that during 2009-2011, an average of 382,000 ED visits related to schizophrenia occurred each year among adults aged 18-64, corresponding to an overall visit rate of 20.1 per 10,000 adults. A visit having a first-, second-, or third-listed diagnosis of schizophrenia (i.e., whether the visit was directly or indirectly related to schizophrenia) was included in the analysis to provide a broader description of ED use by these patients. The distribution of the primary diagnosis of visits related to schizophrenia was: schizophrenia (58.8%), another mental disorder (15.4%), and a nonmental health disorder (25.7%) (data not shown). Among adults aged 18-64, the rate for ED visits related to schizophrenia was about twice as high for men as for women. Public insurance (Medicaid, Medicare, or dual Medicare and Medicaid) was more frequently the primary expected source of payment for ED visits related to schizophrenia compared with ED visits not related to schizophrenia. ED visits related to schizophrenia were more frequently made by patients who were homeless compared with ED visits not related to schizophrenia. About one-third of ED visits related to schizophrenia resulted in a hospital admission, and another 16.7% resulted in a transfer to a psychiatric hospital--both higher than the percentages for ED visits not related to schizophrenia. One of the goals of Healthy People 2020 is to improve mental health through prevention and by ensuring access to appropriate, quality mental health services (6). National data on the rates and characteristics of ED visits related to schizophrenia will help policymakers and practitioners address disparities and meet this goal.

  10. Contribution of ED admissions to inpatient hospital revenue.

    PubMed

    Sacchetti, Alfred; Harris, Russell H; Warden, Todd; Roth, Sandra

    2002-01-01

    Emergency department (ED) practices are traditionally profiled in terms of their patient encounters. Such evaluations reflect a preponderance of outpatient visits while crediting income from admitted patients to traditional hospital-based services. This study evaluates the contribution of ED admissions to inpatient hospital revenue. The study was set at an urban tertiary care community hospital with university affiliation. Information referable to ED patients was collected from the hospital's Universal Billing Code (UB-92)-based patient information warehouse. Data fields referable to hospital charges, insurance type, and disposition were used for analysis of a 1-year period from September 1, 1998 to August 31, 1999. Statistical analysis was through chi square and ANOVA. During the study period 33,174 patients were treated in the ED with 6,671 (20%) admitted to inpatient services. Total hospital charges for all ED patients during this time were $107 million dollars with $9.1 million (8.5%) generated from discharged patients and $98.0 million (91.5%) from admitted ED patients (P <.001). Mean charges for individual discharged patients were $344.10 whereas for individual admitted patients mean charges were $14,692.28. (P <.001) Medicaid and self pay represented 55.4% of the insurance coverage for discharged ED patients whereas these same insurance classes accounted for only 16.3% of admitted patients. (P <.001) Medicare visits accounted for 12.7% of discharged ED patients but 60.7% of admitted patients (P <.001). Total hospital gross revenue for inpatient services for the study period was $288 million of which 34% was contributed from admitted ED patients. ED services represent a major source of inpatient hospital revenue. The recognition of the ED's potential in this area may be lost if income from patients admitted through the ED is credited to traditional hospital-based services.

  11. Contribution of ED admissions to inpatient hospital revenue.

    PubMed

    Sacchetti, Alfred; Harris, Russell H; Warden, Todd; Roth, Sandra

    2002-01-01

    Emergency department (ED) practices are traditionally profiled in terms of their patient encounters. Such evaluations reflect a preponderance of outpatient visits while crediting income from admitted patients to traditional hospital-based services. This study evaluates the contribution of ED admissions to inpatient hospital revenue. The study was set at an urban tertiary care community hospital with university affiliation. Information referable to ED patients was collected from the hospital's Universal Billing Code (UB-92)-based patient information warehouse. Data fields referable to hospital charges, insurance type, and disposition were used for analysis of a 1-year period from September 1, 1998 to August 31, 1999. Statistical analysis was through chi square and ANOVA. During the study period 33,174 patients were treated in the ED with 6,671 (20%) admitted to inpatient services. Total hospital charges for all ED patients during this time were $107 million dollars with $9.1 million (8.5%) generated from discharged patients and $98.0 million (91.5%) from admitted ED patients (P <.001). Mean charges for individual discharged patients were $344.10 whereas for individual admitted patients mean charges were $14,692.28. (P <.001) Medicaid and self pay represented 55.4% of the insurance coverage for discharged ED patients whereas these same insurance classes accounted for only 16.3% of admitted patients. (P <.001) Medicare visits accounted for 12.7% of discharged ED patients but 60.7% of admitted patients (P <.001). Total hospital gross revenue for inpatient services for the study period was $288 million of which 34% was contributed from admitted ED patients. ED services represent a major source of inpatient hospital revenue. The recognition of the ED's potential in this area may be lost if income from patients admitted through the ED is credited to traditional hospital-based services. PMID:11781909

  12. WarpVisit

    SciTech Connect

    Loring, Burlen; Reubel, Oliver

    2015-06-10

    WarpVisit is an insitu simulation application that integrates the Warp laser plasma accelerator simulation framework with Visit a parallel visualization application. WarpVisit is written in python and supports interactive or live mode where user can connect to Warp with the Visit GUI and batch mode for batch for non-interactive use on high-performance computing resources.

  13. Heat Stress Illness Emergency Department Visits in National Environmental Public Health Tracking States, 2005-2010.

    PubMed

    Fechter-Leggett, Ethan D; Vaidyanathan, Ambarish; Choudhary, Ekta

    2016-02-01

    Variability of heat stress illness (HSI) by urbanicity and climate region has rarely been considered in previous HSI studies. We investigated temporal and geographic trends in HSI emergency department (ED) visits in CDC Environmental Public Health Tracking Network (Tracking) states for 2005-2010. We obtained county-level HSI ED visit data for 14 Tracking states. We used the National Center for Health Statistics Urban-Rural Classification Scheme to categorize counties by urbanicity as (1) large central metropolitan (LCM), (2) large fringe metropolitan, (3) small-medium metropolitan, or (4) nonmetropolitan (NM). We also assigned counties to one of six US climate regions. Negative binomial regression was used to examine trends in HSI ED visits over time across all counties and by urbanicity for each climate region, adjusting for pertinent variables. During 2005-2010, there were 98,462 HSI ED visits in the 14 states. ED visits for HSI decreased 3.0% (p < 0.01) per year. Age-adjusted incidence rates of HSI ED visits increased from most urban to most rural. Overall, ED visits were significantly higher for NM areas (IRR = 1.41, p < 0.01) than for LCM areas. The same pattern was observed in all six climate regions; compared with LCM, NM areas had from 14 to 90% more ED visits for HSI. These findings of significantly increased HSI ED visit rates in more rural settings suggest a need to consider HSI ED visit variability by county urbanicity and climate region when designing and implementing local HSI preventive measures and interventions.

  14. Inpatient Readmissions and Emergency Department Visits within 30 Days of a Hospital Admission

    PubMed Central

    Brennan, Jesse J.; Chan, Theodore C.; Killeen, James P.; Castillo, Edward M.

    2015-01-01

    Introduction Inpatient hospital readmissions have become a focus for healthcare reform and cost-containment efforts. Initiatives targeting unanticipated readmissions have included care coordination for specific high readmission diseases and patients and health coaching during the post-discharge transition period. However, little research has focused on emergency department (ED) visits following an inpatient admission. The objective of this study was to assess 30-day ED utilization and all-cause readmissions following a hospital admission. Methods This was a retrospective study using inpatient and ED utilization data from two hospitals with a shared patient population in 2011. We assessed the 30-day ED visit rate and 30-day readmission rate and compared patient characteristics among individuals with 30-day inpatient readmissions, 30-day ED discharges, and no 30-day visits. Results There were 13,449 patients who met the criteria of an index visit. Overall, 2,453 (18.2%) patients had an ED visit within 30 days of an inpatient stay. However, only 55.6% (n=1,363) of these patients were admitted at one of these 30-day visits, resulting in a 30-day all-cause readmission rate of 10.1%. Conclusion Approximately one in five patients presented to the ED within 30 days of an inpatient hospitalization and over half of these patients were readmitted. Readmission measures that incorporate ED visits following an inpatient stay might better inform interventions to reduce avoidable readmissions. PMID:26759647

  15. Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

    PubMed Central

    Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

    2014-01-01

    We analyzed 2010 U.S. National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million NTDC-related ED visits in 2010. Less than 1.0% (children) and 2.1% (adults) of all ED visits were for NTDC. There was no significant difference in NTDC-related ED visits or costs for children by ASD status. Adults with ASD had significantly lower odds of NTDC-related ED visits (OR=0.39; 95% CI: 0.29, 0.52; P<0.001) but incurred significantly greater mean costs for NTDC-related ED visits (P<0.006) than did adults without ASD. PMID:25374135

  16. Making Visits Work.

    ERIC Educational Resources Information Center

    Loar, Lynn

    1998-01-01

    Discusses factors in providing safe, supervised setting for visits between parents and children who have been removed from them by child protective services. Presents common overestimations of parental capacity that doom visits, principles for effective visiting, and practical and inexpensive suggestions that are easy to implement and enjoyable…

  17. Emergency Department Visits for Nontraumatic Dental Problems: A Mixed-Methods Study

    PubMed Central

    Chi, Donald L.; Schwarz, Eli; Milgrom, Peter; Yagapen, Annick; Malveau, Susan; Chen, Zunqui; Chan, Ben; Danner, Sankirtana; Owen, Erin; Morton, Vickie; Lowe, Robert A.

    2015-01-01

    Objectives. We documented emergency department (ED) visits for nontraumatic dental problems and identified strategies to reduce ED dental visits. Methods. We used mixed methods to analyze claims in 2010 from a purposive sample of 25 Oregon hospitals and Oregon’s All Payer All Claims data set and interviewed 51 ED dental visitors and stakeholders from 6 communities. Results. Dental visits accounted for 2.5% of ED visits and represented the second-most-common discharge diagnosis in adults aged 20 to 39 years, were associated with being uninsured (odds ratio [OR] = 5.2 [reference: commercial insurance]; 95% confidence interval [CI] = 4.8, 5.5) or having Medicaid insurance (OR = 4.0; 95% CI = 3.7, 4.2), resulted in opioid (56%) and antibiotic (56%) prescriptions, and generated $402 (95% CI = $396, $408) in hospital costs per visit. Interviews revealed health system, community, provider, and patient contributors to ED dental visits. Potential solutions provided by interviewees included Medicaid benefit expansion, care coordination, water fluoridation, and patient education. Conclusions. Emergency department dental visits are a significant and costly public health problem for vulnerable individuals. Future efforts should focus on implementing multilevel interventions to reduce ED dental visits. PMID:25790415

  18. PREFACE: EDS2010 Preface

    NASA Astrophysics Data System (ADS)

    Heggie, Malcolm I.

    2011-03-01

    The biennial international conference on Extended Defects in Semiconductors started in 1978 with a meeting in Hünfeld, Germany. Subsequent meetings rotated between Poland, France, Great Britain, Germany, Russia and Italy, culminating in EDS2004 in Chernogolovka, EDS2006 in Halle and EDS2008 in Poitiers. EDS2010 was held at the University of Sussex at Brighton, UK from September 19th to 24th. An extension of the tabulation of this history, which first appeared on the EDS2006 website, is given in the attached PDF. It is with sadness that we note one of the founders of the series, Prof. Dr Helmut Alexander, passed away on 3 December 2009 and we were proud to dedicate EDS2010 to his memory. It has become a tradition to make an award in his name, and this year it was made to Ivan Isacov for his poster "Electrical levels of dislocation networks in p- and n-type silicon". A short and warm celebration of Prof. Dr Alexander's life by his friends and colleagues, Prof. Drs Helmut Gottschalk, Eicke Weber and Wolfgang Schröter, is included in this volume. The conference was a forum for the state-of-the-art of investigation and modelling of extended defects in semiconductors. Scientists from universities, research institutes and industry made contributions to a deeper understanding of extended defects, their interaction with point defects and their role in the development of semiconductor technology. The remit of the conference included extended defects, nanostructures, nanoparticles, quantum dots and interfaces within semiconducting materials ranging from narrow to wide band gaps, including graphene-derived materials and diamond. Scientific interests range from defect geometry, electronic structure, dynamics, spectroscopy, microscopy, reactions and chemistry to introduction mechanisms, such as implantation and strained layers and the operation of devices such as integrated circuits, heterostructures, and solar cells. The organisers were confronted with a long period between

  19. Patterns and correlates of drug-related emergency department visits: Results from a national survey

    PubMed Central

    Perron, Brian E.; Bohnert, Amy S. B.; Monsell, Sarah E.; Vaughn, Michael G.; Epperson, Matthew; Howard, Matthew O.

    2010-01-01

    Purpose Drug treatment can be effective in community-based settings, but drug users tend to under-utilize these treatment options and instead seek services in emergency departments (ED) and other acute care settings. The goals of this study were to describe prevalence and correlates of drug-related ED visits. Basic procedures This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), which is a nationally representative survey of 43,093 U.S. residents. Main findings The overall prevalence of drug-related ED visits among lifetime drug users was 1.8%; for those with a lifetime drug use disorder, 3.7%. Persons with heroin dependence and inhalant dependence had the highest rates of ED visits, and marijuana dependence was associated with the lowest rates. Multivariate analyses revealed that being socially connected (i.e., marital status) were protective factors against ED visits, whereas psychopathology (i.e., personality or mood disorders) were risk factors. Conclusions Significant variability exists for risk of ED use for different types of drugs. These findings can help inform where links between EDs with local treatment programs can be formed to provide preventative care and injury-prevention interventions to reduce the risk of subsequent ED visits. PMID:20627209

  20. Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004–2013

    PubMed Central

    Lovegrove, Maribeth C.; Weidle, Nina J.; Budnitz, Daniel S.

    2015-01-01

    Background Following reports of increasing emergency department (ED) visits for unsupervised pediatric medication exposures in the 2000s, renewed efforts to improve safety packaging and education were initiated. National data on current trends and implicated medications can help further target interventions. Methods We used nationally-representative data from the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project (2004–2013) to assess trends in ED visits for unsupervised medication exposures in children aged <6 years. For 2010–2013, we identified the dosage form and prescription status of implicated medications. Results Based on 13,268 cases, there were an estimated 640,161 ED visits (95% confidence interval: 512,885–767,436) for unsupervised medication exposures from 2004–2013. From 2004–2010, the number of ED visits for unsupervised exposures increased by an average of 5.7% annually, peaking at 75,842. After 2010, this trend reversed and ED visits decreased by an average of 6.7% annually to 59,092 estimated visits in 2013. From 2010–2013, 91.0% of ED visits for unsupervised exposures involved 1 medication, most commonly an oral prescription solid (45.9%), oral over-the-counter (OTC) solid (22.3%), or oral OTC liquid (12.4%); 9.0% of visits involved >1 medication. Over 260 different prescription solids were implicated; opioids (13.8%) and benzodiazepines (12.7%) were the most commonly implicated classes. Four medications were implicated in 91.2% of OTC liquid exposure visits: acetaminophen (32.9%), cough and cold remedies (27.5%), ibuprofen (15.7%), and diphenhydramine (15.6%). Conclusions Targeting prevention efforts based on harm frequency and intervention feasibility can lead to continued reductions in ED visits for pediatric medication exposures. PMID:26347435

  1. National Trends in Resource Utilization Associated with Emergency Department Visits for Syncope

    PubMed Central

    Probst, Marc A.; Kanzaria, Hemal K.; Gbedemah, Misato; Richardson, Lynne D.; Sun, Benjamin C.

    2015-01-01

    Background Over the last 20 years, numerous research articles and clinical guidelines aimed at optimizing resource utilization for emergency department (ED) patients presenting with syncope have been published. Hypothesis We hypothesized there would be temporal trends in syncope-related ED visits and associated trends in imaging, hospital admissions, and diagnostic frequencies. Methods The ED component of National Hospital Ambulatory Medical Care Survey was analyzed from 2001 through 2010, comprising over 358,000 visits (representing an estimated 1.18 billion visits nationally). We selected ED visits with a reason for visit of syncope or fainting and calculated nationally representative weighted estimates for prevalence of such visits, and associated rates of advanced imaging utilization and admission. For admitted patients from 2005 to 2010, the most frequent hospital discharge diagnoses were tabulated. Results During the study period, there were over 3,500 actual ED visits (representing 11.9 million visits nationally) related to syncope, representing roughly 1% of all ED visits. Admission rates for syncope patients ranged from 27% to 35% and showed no significant downward trend (p=0.1). Advanced imaging rates increased from about 21% to 45% and showed a significant upward trend (p < 0.001). For admitted patients, the most common hospital discharge diagnosis was the symptomatic diagnosis of “syncope and collapse” (36.4%). Conclusions Despite substantial efforts by medical researchers and professional societies, resource utilization associated with ED visits for syncope appears to have actually increased. There have been no apparent improvements in diagnostic yield for admissions. Novel strategies may be needed to change practice patterns for such patients. PMID:25943042

  2. Air Pollution and Emergency Department Visits for Depression: A Multicity Case-Crossover Study

    PubMed Central

    Szyszkowicz, Mieczysław; Kousha, Termeh; Kingsbury, Mila; Colman, Ian

    2016-01-01

    BACKGROUND The aim of this study was to investigate the associations between ambient air pollution and emergency department (ED) visits for depression. METHODS Health data were retrieved from the National Ambulatory Care Reporting System. ED visits for depression were retrieved from the National Ambulatory Care Reporting System using the International Classification of Diseases (ICD-10), Tenth revision codes; ICD-10: F32 (mild depressive episode) and ICD-10: F33 (recurrent depressive disorder). A case-crossover design was employed for this study. Conditional logistic regression models were used to estimate odds ratios. RESULTS For females, exposure to ozone was associated with increased risk of an ED visit for depression between 1 and 7 days after exposure, for males, between 1 and 5, and 8 days after exposure, with odds ratios ranging between 1.02 and 1.03. CONCLUSIONS These findings suggest that, as hypothesized, there is a positive association between exposure to air pollution and ED visits for depression.

  3. Visiting Scholar Exchange Reports.

    ERIC Educational Resources Information Center

    Rubin, Kyna, Ed.

    1986-01-01

    Provides reports of four United States scholars who visited China as part of the Visiting Scholar Exchange Program. The titles of the reports are (1) "China Journey: A Political Scientist's Look at Yan'an," (2) "The Social Consequences of Land Reclamation in Chinese Coastal Ecosystems," (3) "Anthropology Lectures in South China," and (4) "The Use…

  4. Secondary Emergency Visits

    PubMed Central

    Mohr, Bruce; Wiley, Preston

    1991-01-01

    This study surveyed patients seeking emergency care at three Calgary hospitals during a 7-day period in February 1989. Twenty-one percent had seen another physician for the same medical problem within 72 hours. The study suggests that secondary visits at emergency departments affect health care costs. Further study is needed to investigate the extent and appropriateness of such visits. PMID:21229002

  5. Hosting the Presidential Visit.

    ERIC Educational Resources Information Center

    Sherouse, Mark A.

    This paper describes the visit of President Bush to the campus of Southern Methodist University (SMU) for the May, 1992 commencement and lessons learned from the experience. The paper describes how SMU made use of lead time and suggests how to estimate cost of such a visit. Discussion of strategies for organizing describes the formation and work…

  6. Presidential visit to MSFC

    NASA Technical Reports Server (NTRS)

    1990-01-01

    President George Bush and Alabama Governor Guy Hunt are greeted by Marshall's sixth Center Director Thomas J. Lee (1989-1994) upon their arrival at Redstone Arsenal (RSA) airfield. This was the first sitting president to visit Marshall Space Flight Center (MSFC) since President Kennedy's visit almost 30 years ago.

  7. ACS CCD Stability Monitor

    NASA Astrophysics Data System (ADS)

    Grogin, Norman

    2012-10-01

    A moderately crowded stellar field in the cluster 47 Tuc {6 arcmin West of the cluster core} is observed every four months with the WFC. The first visit exercises the full suite of broad and narrow band imaging filters and sub-array modes; following visits observe with only the six most popular Cycle 18 filters in full-frame mode. The positions and magnitudes of objects will be used to monitor local and large scale variations in the plate scale and the sensitivity of the detectors and to derive an independent measure of the detector CTE. One exposure in each sub-array mode with the WFC will allow us to verify that photometry obtained in full-frame and in sub-array modes are repeatable to better than 1%. This test is important for the ACS Photometric Cross-Calibration program, which uses sub-array exposures. This program may receive additional orbits to investigate ORIENT-dependent geometric distortion, which motivates the ORIENT and BETWEEN requirement on the first visit.

  8. Emergency department visits for motor vehicle traffic injuries: United States, 2010-2011.

    PubMed

    Albert, Michael; McCaig, Linda F

    2015-01-01

    Data from the National Hospital Ambulatory Medical Care Survey, 2010-2011. In 2010-2011, the emergency department (ED) visit rate for motor vehicle traffic injuries was highest among persons aged 16-24 years. The rates declined with age after 16-24, with rates for those aged 0-15 similar to those 65 and over. The overall ED visit rate for motor vehicle traffic injuries was higher among non-Hispanic black persons compared with non-Hispanic white and Hispanic persons. Imaging services were ordered or provided at 70.2% of ED visits for motor vehicle traffic injuries, which was higher than for other injury-related ED visits (55.9%). About one-half of ED visits for motor vehicle traffic injuries had a primary diagnosis of sprains and strains of the neck and back, contusion with intact skin surface, or spinal disorders. In spite of improvements in motor vehicle safety in recent years, motor vehicle crashes remain a major source of morbidity and mortality in the United States (1-3). Motor vehicle-related deaths and injuries also result in substantial economic and societal costs related to medical care and lost productivity (4). This report describes the rates and characteristics of emergency department (ED) visits for motor vehicle traffic injuries during 2010-2011 based on nationally representative data from the National Hospital Ambulatory Medical Care Survey (NHAMCS).

  9. AGU sponsors Argentinean's visit

    NASA Astrophysics Data System (ADS)

    Maria C. Azpiazu, an Argentinean space scientist, has been selected to receive travel support to attend the 1991 AGU Spring Meeting in Baltimore under AGU's Latin American Visiting Geophysicist Program. In addition to presenting a paper at the meeting on [Analysis of Electron Density and Temperature Profiles in the E-Region on Geomagnetically Quiet Days,] Azpiazu plans to visit several universities and research institutions.Azpiazu is an assistant professor at the University of Buenos Aires and an assistant researcher at the Argentinean National Research Council. While in the United States she plans to visit Boston and Harvard Universities, MIT, Hanscom Air Force Base, and the University of Colorado.

  10. Predicting asthma-related emergency department visits using big data.

    PubMed

    Ram, Sudha; Zhang, Wenli; Williams, Max; Pengetnze, Yolande

    2015-07-01

    Asthma is one of the most prevalent and costly chronic conditions in the United States, which cannot be cured. However, accurate and timely surveillance data could allow for timely and targeted interventions at the community or individual level. Current national asthma disease surveillance systems can have data availability lags of up to two weeks. Rapid progress has been made in gathering nontraditional, digital information to perform disease surveillance. We introduce a novel method of using multiple data sources for predicting the number of asthma-related emergency department (ED) visits in a specific area. Twitter data, Google search interests, and environmental sensor data were collected for this purpose. Our preliminary findings show that our model can predict the number of asthma ED visits based on near-real-time environmental and social media data with approximately 70% precision. The results can be helpful for public health surveillance, ED preparedness, and targeted patient interventions. PMID:25706935

  11. Prescription monitoring programs and emergency department visits involving opioids, 2004–2011

    PubMed Central

    Maughan, Brandon C.; Bachhuber, Marcus A.; Mitra, Nandita; Starrels, Joanna L.

    2016-01-01

    Objective To determine the association between prescription drug monitoring program (PDMP) implementation and emergency department (ED) visits involving opioid analgesics. Methods Rates of ED visits involving opioid analgesics per 100,000 residents were estimated from the Drug Abuse Warning Network dataset for 11 geographically diverse metropolitan areas in the United States on a quarterly basis from 2004 to 2011. Generalized estimating equations assessed whether implementation of a prescriber-accessible PDMP was associated with a difference in ED visits involving opioid analgesics. Models were adjusted for calendar quarter, metropolitan area, metropolitan area-specific linear time trends, and unemployment rate. Results Rates of ED visits involving opioid analgesics increased in all metropolitan areas. PDMP implementation was not associated with a difference in ED visits involving opioid analgesics (mean difference of 0.8 visits [95% CI: −3.7 to 5.2] per 100,000 residents per quarter). Conclusions During 2004–2011, PDMP implementation was not associated with a change in opioid-related morbidity, as measured by emergency department visits involving opioid analgesics. Urgent investigation is needed to determine the optimal PDMP structure and capabilities to improve opioid analgesic safety. PMID:26454836

  12. Edward (Ed) T. Schneider

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Research Pilot Edward T. Schneider is shown sitting in the cockpit of a McDonnell Douglas F/A-18 Hornet that was used in the High Angle-of-Attack Research Vehicle (HARV) program at the National Aeronautics and Space Administration's Ames - Dryden Flight Research Facility. When the aircraft arrived at the Dryden Facility in 1987, from the US Naval Air Test Center, Patuxent River, Maryland, it consisted of parts in crates. The aircraft crew made an airplane from those parts, and in doing so they took a 'sow's ear' and created a 'silk purse', thus the name on the side of the aircraft. Ed's helmet is from his time in the Navy. The design was taken from the Flag that is flown on the bow of a Navy ship, referred to as the Jack, and is navy blue with the 50 States being represented by the white stars. Ed arrived at the NASA Ames-Dryden Flight Research Facility (later renamed the Dryden Flight Research Center) on July 5, 1982, as a Navy Liaison Officer, becoming a NASA research pilot one year later. Ed was the project pilot for the F-18 High Angle-of-Attack program and later served as a project pilot for the F-15 aeronautical research aircraft, the NASA B-52 launch aircraft, and the SR-71 'Blackbird' aircraft. He served on active duty with the U.S. Navy from 1968 to 1983. Following squadron service he graduated from the U.S. Naval Test Pilot School, Patuxent River, Maryland, in 1973, and then served as an engineering test pilot, and test pilot school instructor at the Naval Air Test Center. Ed has been an active member of the Society of Experimental Test Pilots since 1974. He was made a Fellow of the Society in 1993 and served as its President in 1993/94. In 1996 he was awarded the NASA Exceptional Service Medal and the American Institute of Aeronautics and Astronautics' Chanute Flight Award. He retired as a NASA research pilot in September 2000.

  13. Students Request Supervisory Visits

    ERIC Educational Resources Information Center

    Mooney, Jewell

    1974-01-01

    The author stresses the importance of summer and regular school year visits to vocational agriculture student by the agriculture instructor as opportunities for both project advisement and personal counseling. (EA)

  14. Class Visit Short Cuts.

    ERIC Educational Resources Information Center

    Hofmann, Alice; Somerville, Mary

    1982-01-01

    Describes methods used by the Louisville Free Public Library's children's department to introduce the library's programs and services to elementary school children. Specific suggestions for one-person visitations are provided including pertinent book titles. (EJS)

  15. [The preoperative anaesthetic visit].

    PubMed

    Harms, Christoph; Kindler, Christoph H

    2009-07-01

    Anaesthetists often visit their patients in exceptional situations characterised by preoperative anxiety or distress. Therefore, even brief contact with the patient can be considered intense and meaningful. The initial preoperative anaesthetic visit is the beginning of the relationship between patient and anaesthetist, and should help to explain the planned anaesthetic technique. Preoperative anaesthetic visits are intense and last for 20 minutes on average. They should assert a professional approach to the patient's emotions, particularly to preoperative anxiety, and a structured and clear collection of information including the past history of the patient. These visits should also provide information about the anaesthesia itself and instructions for the patient with respect to the perioperative period. Communication about the side effects and risks of anaesthetic techniques, and the discussion of potential alternatives are mandatory. Worldwide, courts of law increasingly require a documented discussion between the anaesthetist and patient based on risk-benefit evidence. Today, there is in general a shift away from decisions made solely by physicians, reflecting an increased respect for the autonomy of the patient towards a model of shared decision-making and informed choice. Ideally, the preoperative visit follows the four key habits of highly effective clinicians, i.e., to rapidly establish a rapport with the patient and provide an agenda for the visit, to explore the patient's perspectives and expectations, to demonstrate empathy, and to focus on the end of the visit with providing information and including the patient in the decision-making process. Visits are then concluded upon obtaining informed consent from the patient. PMID:19565444

  16. Emergency Department Length-Of-Stay For Psychiatric Visits Was Significantly Longer Than For Nonpsychiatric Visits, 2002-11.

    PubMed

    Zhu, Jane M; Singhal, Astha; Hsia, Renee Y

    2016-09-01

    Despite increases in the use of emergency department (EDs) for mental health care, there are limited data on whether psychiatric patients disproportionately contribute to ED crowding. We conducted a retrospective analysis using a national database of ED visits in the period 2002-11 to describe trends in median and ninetieth-percentile length-of-stay for patients with psychiatric versus nonpsychiatric primary diagnoses. Psychiatric patients who visited the ED were transferred to another facility at six times the rate of nonpsychiatric patients. Median lengths-of-stay were similar for psychiatric and nonpsychiatric patients among those who were admitted to the hospital (264 versus 269 minutes) but significantly different for those who were admitted for observation (355 versus 279 minutes), transferred (312 versus 195 minutes), or discharged (189 versus 144 minutes). Overall, differences in ED length-of-stay between psychiatric and nonpsychiatric patients did not narrow over time. These findings suggest deficiencies in ED capacity for psychiatric care, which may necessitate improvements in both throughput and alternative models of care. PMID:27605653

  17. Emergency Department Visits by Older Adults for Motor Vehicle Collisions

    PubMed Central

    Vogel, Jody A.; Ginde, Adit A.; Lowenstein, Steven R.; Betz, Marian E.

    2013-01-01

    Introduction: To describe the epidemiology and characteristics of emergency department (ED) visits by older adults for motor vehicle collisions (MVC) in the United States (U.S.). Methods: We analyzed ED visits for MVCs using data from the 2003–2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Using U.S. Census data, we calculated annual incidence rates of driver or passenger MVC-related ED visits and examined visit characteristics, including triage acuity, tests performed and hospital admission or discharge. We compared older (65+ years) and younger (18–64 years) MVC patients and calculated odds ratios (OR) and 95% confidence intervals (CIs) to measure the strength of associations between age group and various visit characteristics. Multivariable logistic regression was used to identify independent predictors of admissions for MVC-related injuries among older adults. Results: From 2003–2007, there were an average of 237,000 annual ED visits by older adults for MVCs. The annual ED visit rate for MVCs was 6.4 (95% CI 4.6–8.3) visits per 1,000 for older adults and 16.4 (95% CI 14.0–18.8) visits per 1,000 for younger adults. Compared to younger MVC patients, after adjustment for gender, race and ethnicity, older MVC patients were more likely to have at least one imaging study performed (OR 3.69, 95% CI 1.46–9.36). Older MVC patients were not significantly more likely to arrive by ambulance (OR 1.47; 95% CI 0.76–2.86), have a high triage acuity (OR 1.56; 95% CI 0.77–3.14), or to have a diagnosis of a head, spinal cord or torso injury (OR 0.97; 95% CI 0.42–2.23) as compared to younger MVC patients after adjustment for gender, race and ethnicity. Overall, 14.5% (95% CI 9.8–19.2) of older MVC patients and 6.1% (95% CI 4.8–7.5) of younger MVC patients were admitted to the hospital. There was also a non-statistically significant trend toward hospital admission for older versus younger MVC patients (OR 1.78; 95% CI 0.71–4.43), and

  18. Effects of Cuts in Medicaid on Dental-Related Visits and Costs at a Safety-Net Hospital

    PubMed Central

    Neely, Martha; Rich, Sharron; Gutierrez, Lillelenny Santana; Mehra, Pushkar

    2014-01-01

    We used data from Boston Medical Center, Massachusetts, to determine whether dental-related emergency department (ED) visits and costs increased when Medicaid coverage for adult dental care was reduced in July 2010. In this retrospective study of existing data, we examined the safety-net hospital’s dental-related ED visits and costs for 3 years before and 2 years after Massachusetts Health Care Reform. Dental-related ED visits increased 2% the first and 14% the second year after Medicaid cuts. Percentage increases were highest among older adults, minorities, and persons receiving charity care, Medicaid, and Medicare. PMID:24825223

  19. Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review

    PubMed Central

    Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Chedi, Basheer A. Z.; Sha’aban, Abubakar; Rahman, Ab Fatah Ab

    2016-01-01

    Many studies have been conducted in health-care settings with regards to complementary and alternative medicine (CAM) use among patients. However, information regarding CAM use among patients in the emergency department (ED) is scarce. The aim of this article was to conduct a systematic review of published studies with regards to CAM use among the ED patients. A literature search of published studies from inception to September 2015 was conducted using PubMed, Scopus, and manual search of the reference list. 18 studies that met the inclusion criteria were reviewed. The prevalence rate of CAM use among ED patients across the studies ranged of 1.4-68.1%. Herbal therapy was the sub-modality of CAM most commonly used and frequently implicated in CAM-related ED visits. Higher education, age, female gender, religious affiliation, and chronic diseases were the most frequent factors associated with CAM use among the ED patients. Over 80% of the ED physicians did not ask the patients about the CAM therapy. Similarly, 80% of the ED patients were ready to disclose CAM therapy to the ED physician. The prevalence rate of CAM use among patients at ED is high and is growing with the current increasing popularity, and it has been a reason for some of the ED visits. There is a need for the health-care professionals to receive training and always ask patients about CAM therapy to enable them provide appropriate medical care and prevent CAM-related adverse events. PMID:27104042

  20. Predicting Emergency Department Visits

    PubMed Central

    Poole, Sarah; Grannis, Shaun; Shah, Nigam H.

    2016-01-01

    High utilizers of emergency departments account for a disproportionate number of visits, often for nonemergency conditions. This study aims to identify these high users prospectively. Routinely recorded registration data from the Indiana Public Health Emergency Surveillance System was used to predict whether patients would revisit the Emergency Department within one month, three months, and six months of an index visit. Separate models were trained for each outcome period, and several predictive models were tested. Random Forest models had good performance and calibration for all outcome periods, with area under the receiver operating characteristic curve of at least 0.96. This high performance was found to be due to non-linear interactions among variables in the data. The ability to predict repeat emergency visits may provide an opportunity to establish, prioritize, and target interventions to ensure that patients have access to the care they require outside an emergency department setting. PMID:27570684

  1. Association between ozone and asthma emergency department visits in Saint John, New Brunswick, Canada.

    PubMed Central

    Stieb, D M; Burnett, R T; Beveridge, R C; Brook, J R

    1996-01-01

    This study examines the relationship of asthma emergency department (ED) visits to daily concentrations of ozone and other air pollutants in Saint John, New Brunswick, Canada. Data on ED visits with a presenting complaint of asthma (n = 1987) were abstracted for the period 1984-1992 (May-September). Air pollution variables included ozone, sulfur dioxide, nitrogen dioxide, sulfate, and total suspended particulate (TSP); weather variables included temperature, humidex, dewpoint, and relative humidity. Daily ED visit frequencies were filtered to remove day of the week and long wave trends, and filtered values were regressed on air pollution and weather variables for the same day and the 3 previous days. The mean daily 1-hr maximum ozone concentration during the study period was 41.6 ppb. A positive, statistically significant (p < 0.05) association was observed between ozone and asthma ED visits 2 days later, and the strength of the association was greater in nonlinear models. The frequency of asthma ED visits was 33% higher (95% CI, 10-56%) when the daily 1-hr maximum ozone concentration exceeded 75 ppb (the 95th percentile). The ozone effect was not significantly influenced by the addition of weather or other pollutant variables into the model or by the exclusion of repeat ED visits. However, given the limited number of sampling days for sulfate and TSP, a particulate effect could not be ruled out. We detected a significant association between ozone and asthma ED visits, despite the vast majority of sampling days being below current U.S. and Canadian standards. Images Figure 1. A Figure 1. B Figure 2. Figure 3. PMID:9118879

  2. Continuity in a VA Patient-Centered Medical Home Reduces Emergency Department Visits

    PubMed Central

    Chaiyachati, Krisda H.; Gordon, Kirsha; Long, Theodore; Levin, Woody; Khan, Ali; Meyer, Emily; Justice, Amy; Brienza, Rebecca

    2014-01-01

    Background One major goal of the Patient-Centered Medical Home (PCMH) is to improve continuity of care between patients and providers and reduce the utilization of non-primary care services like the emergency department (ED). Objective To characterize continuity under the Veterans Health Administration’s PCMH model – the Patient Aligned Care Team (PACT), at one large Veterans Affair’s (VA’s) primary care clinic, determine the characteristics associated with high levels of continuity, and assess the association between continuity and ED visits. Design Retrospective, observational cohort study of patients at the West Haven VA (WHVA) Primary Care Clinic from March 2011 to February 2012. Patients The 13,495 patients with established care at the Clinic, having at least one visit, one year before March 2011. Main Measures Our exposure variable was continuity of care –a patient seeing their assigned primary care provider (PCP) at each clinic visit. The outcome of interest was having an ED visit. Results The patients encompassed 42,969 total clinic visits, and 3185 (24%) of them had 15,458 ED visits. In a multivariable logistic regression analysis, patients with continuity of care – at least one visit with their assigned PCP – had lower ED utilization compared to individuals without continuity (adjusted odds ratio [AOR] 0.54; 95% CI: 0.41, 0.71), controlling for frequency of primary care visits, comorbidities, insurance, distance from the ED, and having a trainee PCP assigned. Likewise, the adjusted rate of ED visits was 544/1000 person-year (PY) for patients with continuity vs. 784/1000 PY for patients without continuity (p = 0.001). Compared to patients with low continuity (<33% of visits), individuals with medium (33–50%) and high (>50%) continuity were less likely to utilize the ED. Conclusions Strong continuity of care is associated with decreased ED utilization in a PCMH model and improving continuity may help reduce the utilization of non

  3. Home Weatherization Visit

    SciTech Connect

    Chu, Steven

    2009-01-01

    Secretary Steven Chu visits a home that is in the process of being weatherized in Columbus, OH, along with Ohio Governor Ted Strickland and Columbus Mayor Michael Coleman. They discuss the benefits of weatherization and how funding from the recovery act is having a direct impact in communities across America.

  4. Congressman Clyburn Visit

    ScienceCinema

    Cody, Tom

    2016-07-12

    Congressman James Clyburn visits the new employees of the Savannah River Site. These new jobs the graduates have received are a result of the Recovery Act at work. Lisa Jackson of the Environmental Protection Agency speaks about how the ARRA is in line with President Obama's vision of a better economy and cleaner environment.

  5. Malaysian Students Visit Thailand.

    ERIC Educational Resources Information Center

    International Understanding at School, 1983

    1983-01-01

    Five students and one coordinator from the Unesco Associated Schools Project undertook a study visit to Bangkok to exchange views and experiences. Future joint projects/activities were discussed, and the students gained some insight into the life of their counterparts in Thailand. (RM)

  6. Home Weatherization Visit

    ScienceCinema

    Chu, Steven

    2016-07-12

    Secretary Steven Chu visits a home that is in the process of being weatherized in Columbus, OH, along with Ohio Governor Ted Strickland and Columbus Mayor Michael Coleman. They discuss the benefits of weatherization and how funding from the recovery act is having a direct impact in communities across America.

  7. Revisiting High School Visits

    ERIC Educational Resources Information Center

    Flagel, Andrew

    2012-01-01

    NACAC's anniversary is a great time to follow up on an article on high school visits, a topic of ongoing discussion in every admission and guidance office. The article highlights a variety of potential good outcomes that can be derived from collaborative interactions. Sadly, however, admission representatives are apt to be described by the…

  8. Pangeghtellghet (Visits to Siberia).

    ERIC Educational Resources Information Center

    Kaneshiro, Vera, Ed.

    This reader contains eight stories in St. Lawrence Island Yupik about visits by St. Lawrence Island people to their relatives and friends in Siberia over a quarter of a century ago. The book, which is intended for use in advanced levels of reading instruction, is part of a series of Siberian Yupik reading materials. (AMH)

  9. Congressman Clyburn Visit

    SciTech Connect

    Cody, Tom

    2010-01-01

    Congressman James Clyburn visits the new employees of the Savannah River Site. These new jobs the graduates have received are a result of the Recovery Act at work. Lisa Jackson of the Environmental Protection Agency speaks about how the ARRA is in line with President Obama's vision of a better economy and cleaner environment.

  10. [Visiting the Amana Colonies.

    ERIC Educational Resources Information Center

    Ohrn, Deborah Gore, Ed.

    1992-01-01

    This issue of "The Goldfinch: Iowa History for Young People" focuses upon the Amana Colonies, which were home to many German immigrants in the 19th century, and which retain much of their ethnic heritage today. The articles and activities included in this issue are "Amana Today"; "No Black Buggies in Amana"; "Visiting Tante Marie and Onkel…

  11. Rebooting the EdD

    ERIC Educational Resources Information Center

    Wergin, Jon F.

    2011-01-01

    In this essay, Jon Wergin reminds readers of the philosophical and historical foundations of the doctor of education (EdD) degree. He argues that the EdD should be based, in large part, on John Dewey's progressive ideals of democratization and Paulo Freire's concepts of emancipatory education. Drawing on theories of reflective practice,…

  12. Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007-2011).

    PubMed

    Fuhrmann, Christopher M; Sugg, Margaret M; Konrad, Charles E; Waller, Anna

    2016-02-01

    Extreme heat is the leading cause of weather-related mortality in the U.S. Extreme heat also affects human health through heat stress and can exacerbate underlying medical conditions that lead to increased morbidity and mortality. In this study, data on emergency department (ED) visits for heat-related illness (HRI) and other selected diseases were analyzed during three heat events across North Carolina from 2007 to 2011. These heat events were identified based on the issuance and verification of heat products from local National Weather Service forecast offices (i.e. Heat Advisory, Heat Watch, and Excessive Heat Warning). The observed number of ED visits during these events were compared to the expected number of ED visits during several control periods to determine excess morbidity resulting from extreme heat. All recorded diagnoses were analyzed for each ED visit, thereby providing insight into the specific pathophysiological mechanisms and underlying health conditions associated with exposure to extreme heat. The most common form of HRI was heat exhaustion, while the percentage of visits with heat stroke was relatively low (<10%). The elderly (>65 years of age) were at greatest risk for HRI during the early summer heat event (8.9 visits per 100,000), while young and middle age adults (18-44 years of age) were at greatest risk during the mid-summer event (6.3 visits per 100,000). Many of these visits were likely due to work-related exposure. The most vulnerable demographic during the late summer heat event was adolescents (15-17 years of age), which may relate to the timing of organized sports. This demographic also exhibited the highest visit rate for HRI among all three heat events (10.5 visits per 100,000). Significant increases (p < 0.05) in visits with cardiovascular and cerebrovascular diseases were noted during the three heat events (3-8%). The greatest increases were found in visits with hypotension during the late summer event (23%) and sequelae during

  13. Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 ...

    MedlinePlus

    ... Emergency Department (ED) Visits Involving Nonmedical Use of Pharmaceuticals* among Adults Aged 18 to 34, by Alcohol ... 2007 2008 2009 2010 2011 * Nonmedical use of pharmaceuticals includes taking more than the prescribed dose of ...

  14. Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES).

    PubMed

    Prevaldi, Carolina; Paolillo, Ciro; Locatelli, Carlo; Ricci, Giorgio; Catena, Fausto; Ansaloni, Luca; Cervellin, Gianfranco

    2016-01-01

    Traumatic wounds are one of the most common problems leading people to the Emergency Department (ED), accounting for approximately 5,4 % of all the visits, and up to 24 % of all the medical lawsuits. In order to provide a standardized method for wound management in the ED, we have organized a workshop, involving several Italian and European experts. Later, all the discussed statements have been submitted for external validation to a multidisciplinary expert team, based on the so called Delphi method. Eight main statements have been established, each of them comprising different issues, covering the fields of wound classification, infectious risk stratification, tetanus and rabies prophylaxis, wound cleansing, pain management, and suture. Here we present the results of this work, shared by the Academy of Emergency Medicine and Care (AcEMC), and the World Society of Emergency Surgery (WSES). PMID:27330546

  15. Goddard Visiting Scientist Program

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Under this Indefinite Delivery Indefinite Quantity (IDIQ) contract, USRA was expected to provide short term (from I day up to I year) personnel as required to provide a Visiting Scientists Program to support the Earth Sciences Directorate (Code 900) at the Goddard Space Flight Center. The Contractor was to have a pool, or have access to a pool, of scientific talent, both domestic and international, at all levels (graduate student to senior scientist), that would support the technical requirements of the following laboratories and divisions within Code 900: 1) Global Change Data Center (902); 2) Laboratory for Atmospheres (Code 910); 3) Laboratory for Terrestrial Physics (Code 920); 4) Space Data and Computing Division (Code 930); 5) Laboratory for Hydrospheric Processes (Code 970). The research activities described below for each organization within Code 900 were intended to comprise the general scope of effort covered under the Visiting Scientist Program.

  16. Frequent Emergency Department Visits and Hospitalizations Among Homeless People With Medicaid: Implications for Medicaid Expansion

    PubMed Central

    Bharel, Monica; Zhang, Jianying; O’Connell, Elizabeth; Clark, Robin E.

    2015-01-01

    Objectives. We examined factors associated with frequent hospitalizations and emergency department (ED) visits among Medicaid members who were homeless. Methods. We included 6494 Massachusetts Medicaid members who received services from a health care for the homeless program in 2010. We used negative binomial regression to examine variables associated with frequent utilization. Results. Approximately one third of the study population had at least 1 hospitalization and two thirds had 1 or more ED visits. More than 70% of hospitalizations and ED visits were incurred by only 12% and 21% of these members, respectively. Homeless individuals with co-occurring mental illness and substance use disorders were at greatest risk for frequent hospitalizations and ED visits (e.g., incidence rate ratios [IRRs] = 2.9–13.8 for hospitalizations). Individuals living on the streets also had significantly higher utilization (IRR = 1.5). Conclusions. Despite having insurance coverage, homeless Medicaid members experienced frequent hospitalizations and ED visits. States could consider provisions under the Patient Protection and Affordable Care Act (e.g., Medicaid expansion and Health Homes) jointly with housing programs to meet the needs of homeless individuals, which may improve the quality and cost effectiveness of care. PMID:26447915

  17. Variation in computed tomography imaging for pediatric injury-related emergency visits

    PubMed Central

    Marin, Jennifer R.; Wang, Li; Winger, Daniel G.; Mannix, Rebekah C.

    2016-01-01

    Objectives To assess variation in the use of computed tomography (CT) for pediatric injury-related emergency department (ED) visits. Study design Retrospective cohort study of visits to 14 network-affiliated EDs from November 2010 through February 2013. Visits were identified by International Classification of Diseases, 9th revision, Clinical Modification diagnosis codes. Primary outcome was CT use. We used descriptive statistics and performed multivariable logistic regression to evaluate the association of patient and ED covariates on any and body region-specific CT use. Results Of the 80,868 injury-related visits, 11.4% included CT, and 28.4% of those had more than one study. Across EDs, CT use ranged from 7.6%- 25.5% of visits and did not correlate with institutional injury severity score (P=0.33) or admission/transfer rates (P=0.07). In multivariable analysis of non-pediatric EDs, trauma centers and non-academic EDs were associated with CT use. Higher pediatric volume was associated with any CT use, however, there was an inverse relationship between volume and non-head CT use. When the pediatric ED was included in multivariable modeling, the effect of level 1-3 trauma center designation remained, and the pediatric level 1 trauma center was less likely to use most body region-specific CTs. Conclusions There is wide variation in CT imaging for pediatric injury-related visits not solely attributable to case mix. Future work to optimize CT utilization should focus on additional factors contributing to imaging practices and interventions. PMID:26233603

  18. Substance Abuse and Mental Health Visits Among Adolescents Presenting to US Emergency Departments

    PubMed Central

    Fahimi, Jahan; Aurrecoechea, Adrian; Anderson, Erik; Herring, Andrew; Alter, Harrison

    2015-01-01

    Objectives To identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. Methods We performed a secondary analysis of ED visits by adolescents (aged 11-24) using the National Hospital Ambulatory Medical Care Survey (1997-2010), identifying visits for mental health, substance use, and dual diagnosis. Univariate and multivariate statistics were used to analyze demographic and visit-level factors, factors associated with substance use and dual diagnosis visits, and the effects of substance use and mental health conditions on emergency department LOS and disposition. Results Substance use and mental health accounted for 2.1% and 4.3% of all adolescent visits, respectively, with 20.9% (95% confidence interval [CI] 18.3-23.5%) of substance abuse visits complicated by mental health. Factors significantly associated with substance use include: male gender, urban location, West region, ambulance arrival, night and weekend shift, anxiety disorders, mood disorders, and psychotic disorders. Additional LOS was 89.77 minutes for mental health, 71.33 minutes for substance use, and 139.97 minutes for dual diagnosis visits, as compared to visits where these conditions were not present. Both mental health and substance use were associated with admission/transfer as compared to other dispositions: mental health, odds ratio (OR) 5.93 (95% CI 5.14-6.84), illicit drug use, OR 3.56 (95% CI 2.72-4.64), and dual diagnosis, OR 6.86 (95% 4.67-10.09). Conclusions Substance abuse and dual diagnosis are common among adolescent ED visits and are strongly associated with increased use of prehospital resources, emergency department length of stay, and need for hospitalization. PMID:25875990

  19. ED Utilization Trends in Sports-Related Traumatic Brain Injury

    PubMed Central

    Pomerantz, Wendy J.; Gittelman, Mike

    2013-01-01

    BACKGROUND: Emergency department (ED) visits for sports-related traumatic brain injuries (TBIs) have risen. This study evaluated how the number and severity of admissions have changed as ED visits for sports-related TBIs have increased. METHODS: A retrospective study of children aged 0 to 19 years at a level 1 trauma center was performed. Patients from 2002 to 2011 with a primary or secondary diagnosis of TBI were identified from the hospital’s inpatient and outpatient trauma registries. Frequencies were used to characterize the population, χ2 analysis was performed to determine differences between groups, and regression analysis looked at relationship between year and injury severity score or length of stay. RESULTS: Sport was responsible for injury in 3878 (15.4%) cases during the study period; 3506 (90.4%) were discharged from the hospital, and 372 (9.6%) were admitted. Seventy-three percent were male patients and 78% Caucasian; mean age was 13 ± 3.5 years. ED visits for sports-related TBIs increased 92% over the study period, yet there was no significant change (χ2 = 9.8, df = 9, P = .37) in the percentage of children admitted. Mean injury severity score for those admitted decreased from 7.8 to 4.8 (β = –0.46; P = .006); length of stay trended downward (β = –0.05; P = .05). CONCLUSIONS: The percentage of children being admitted from the ED with sports-related TBI has not changed over the past 10 years. The severity of admitted sports-related TBI is decreasing. Additional research is needed to correlate these trends with other TBI mechanisms. PMID:24081999

  20. The impact of smoking-related illness in the ED: an attributable risk model.

    PubMed

    Bernstein, Steven L

    2002-05-01

    The objective of this study was to estimate the clinical and economic impact of smoking among adult emergency department (ED) patients. An attributable risk analysis of patients seen in 2 urban EDs in 1998 was performed. Data were obtained from hospital databases, national sources describing the prevalence of smoking in the state, and risk ratios for smoking-related illnesses. Of 78,617 patient visits, 12,573 (16.0%) had any smoking-related International Classification of Diseases, 9th Revision code. The smoking-attributable risk fraction (SARF) for all patients was 4.9% (95% confidence interval [CI] 4.7%-5.0%). Of 13,245 admissions, 6.8% (95% CI 6.4%-7.2%) were smoking attributable. Of $296,962,685 in hospital charges, 10.0% (95% CI 9.9%-10.1%) were smoking attributable. The SARFs for ED visits, admissions, and charges for men were higher than for women (all P <.0001). Smoking-attributable illness accounts for 4.9% of ED adult visits, 6.8% of ED adult admissions, and 10.0% of hospital charges. The use of ED-based smoking intervention remains to be determined.

  1. Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma

    PubMed Central

    Peterson, Cora; Xu, Likang; Florence, Curtis; Parks, Sharyn E.

    2015-01-01

    We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0–4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006–2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan® to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital’s ED) nationwide over the study period. The average medical cost per ED visit and admission were US$2,612 (error bound: 1,644–3,581) and US$31,901 (error bound: 29,266–34,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9–82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse. PMID:25911437

  2. Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma.

    PubMed

    Peterson, Cora; Xu, Likang; Florence, Curtis; Parks, Sharyn E

    2015-08-01

    We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0-4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006-2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan(®) to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital's ED) nationwide over the study period. The average medical cost per ED visit and admission were US$2,612 (error bound: 1,644-3,581) and US$31,901 (error bound: 29,266-34,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9-82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse.

  3. Google Flu Trends Spatial Variability Validated Against Emergency Department Influenza-Related Visits

    PubMed Central

    Jalalpour, Mehdi; Levin, Scott; Washington, Raynard E; Pines, Jesse M; Rothman, Richard E; Dugas, Andrea Freyer

    2016-01-01

    Background Influenza is a deadly and costly public health problem. Variations in its seasonal patterns cause dangerous surges in emergency department (ED) patient volume. Google Flu Trends (GFT) can provide faster influenza surveillance information than traditional CDC methods, potentially leading to improved public health preparedness. GFT has been found to correlate well with reported influenza and to improve influenza prediction models. However, previous validation studies have focused on isolated clinical locations. Objective The purpose of the study was to measure GFT surveillance effectiveness by correlating GFT with influenza-related ED visits in 19 US cities across seven influenza seasons, and to explore which city characteristics lead to better or worse GFT effectiveness. Methods Using Healthcare Cost and Utilization Project data, we collected weekly counts of ED visits for all patients with diagnosis (International Statistical Classification of Diseases 9) codes for influenza-related visits from 2005-2011 in 19 different US cities. We measured the correlation between weekly volume of GFT searches and influenza-related ED visits (ie, GFT ED surveillance effectiveness) per city. We evaluated the relationship between 15 publically available city indicators (11 sociodemographic, two health care utilization, and two climate) and GFT surveillance effectiveness using univariate linear regression. Results Correlation between city-level GFT and influenza-related ED visits had a median of .84, ranging from .67 to .93 across 19 cities. Temporal variability was observed, with median correlation ranging from .78 in 2009 to .94 in 2005. City indicators significantly associated (P<.10) with improved GFT surveillance include higher proportion of female population, higher proportion with Medicare coverage, higher ED visits per capita, and lower socioeconomic status. Conclusions GFT is strongly correlated with ED influenza-related visits at the city level, but unexplained

  4. Association between Rainfall and Pediatric Emergency Department Visits for Acute Gastrointestinal Illness

    PubMed Central

    Drayna, Patrick; McLellan, Sandra L.; Simpson, Pippa; Li, Shun-Hwa; Gorelick, Marc H.

    2010-01-01

    Background Microbial water contamination after periods of heavy rainfall is well described, but its link to acute gastrointestinal illness (AGI) in children is not well known. Objectives We hypothesize an association between rainfall and pediatric emergency department (ED) visits for AGI that may represent an unrecognized, endemic burden of pediatric disease in a major U.S. metropolitan area served by municipal drinking water systems. Methods We conducted a retrospective time series analysis of visits to the Children’s Hospital of Wisconsin ED in Wauwatosa, Wisconsin. Daily visit totals of discharge International Classification of Diseases, 9th Revision codes of gastroenteritis or diarrhea were collected along with daily rainfall totals during the study period from 2002 to 2007. We used an autoregressive moving average model, adjusting for confounding variables such as sewage release events and season, to look for an association between daily visits and rainfall after a lag of 1–7 days. Results A total of 17,357 AGI visits were identified (mean daily total, 7.9; range, 0–56). Any rainfall 4 days prior was significantly associated with an 11% increase in AGI visits. Expected seasonal effects were also seen, with increased AGI visits in winter months. Conclusions We observed a significant association between rainfall and pediatric ED visits for AGI, suggesting a waterborne component of disease transmission in this population. The observed increase in ED visits for AGI occurred in the absence of any disease outbreaks reported to public health officials in our region, suggesting that rainfall-associated illness may be underestimated. Further study is warranted to better address this association. PMID:20515725

  5. Epidemiology of Injury-Related Emergency Department Visits in the US among Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kalb, Luther G.; Vasa, Roma A; Ballard, Elizabeth D.; Woods, Steven; Goldstein, Mitchell; Wilcox, Holly C.

    2016-01-01

    Several reports suggest children with autism spectrum disorder (ASD) are more likely to be seen for injury-related ED visits; however, no nationally representative study has examined this question. Using data from the 2008 Nationwide Emergency Department Sample, over a quarter of all visits among those with ASD were related to injury. In the…

  6. The impact of a series of hurricanes on the visits to two central Florida Emergency Departments.

    PubMed

    Platz, Elke; Cooper, Herbert P; Silvestri, Salvatore; Siebert, Carl F

    2007-07-01

    We analyzed the impact of three consecutive hurricanes in 2004 on two central Florida Emergency Department (ED) patient volumes and types of presentations. Data were extracted from the hospital database and compared to the previous year. At both EDs visits dropped significantly on the day of all three hurricanes compared to 2003. The decrease in patient volume was even greater during the second and third hurricane compared to the first one. Once weather conditions improved, a dramatic rise in patient census was noted. During the aftermath of the first hurricane a significantly higher number of patients with injuries and carbon monoxide (CO) intoxications was seen, as well as ED visits due to lack of oxygen, electricity or hemodialysis. During the aftermath of a hurricane, EDs should be staffed and equipped to treat greater numbers of patients with acute injuries.

  7. Alcohol Use as Risk Factors for Older Adults’ Emergency Department Visits: A Latent Class Analysis

    PubMed Central

    Choi, Namkee G.; Marti, C. Nate Nathan; DiNitto, Diana M.; Choi, Bryan Y.

    2015-01-01

    Introduction Late middle-aged and older adults’ share of emergency department (ED) visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Methods Data came from the 2013 National Health Interview Survey’s Sample Adult file (n=15,713). Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA) modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/moderate drinkers, and current heavy drinkers), chronic health and mental health status, and past-year ED visits as indicators. Results LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group) were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/mental health problems; Class 2 (21%; low-risk group) consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group) was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group) included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Conclusion Alcohol nonuse/use (and quantity of use) and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex-drinkers improve chronic

  8. The air quality health index and emergency department visits for urticaria in Windsor, Canada.

    PubMed

    Kousha, Termeh; Valacchi, Giuseppe

    2015-01-01

    Ambient air pollution exposure has been associated with several health conditions, limited not only to respiratory and cardiovascular systems but also to cutaneous tissues. However, few epidemiological studies examined pollution exposure on skin problems. Basically, the common mechanism by which pollution may affect skin physiology is by induction of oxidative stress and inflammation. Urticaria is among the skin pathologies that have been associated with pollution. Based on the combined effects of three ambient air pollutants, ozone (O₃), nitrogen dioxide (NO₂), and fine particulate matter (PM) with a median aerodynamic diameter of less than 2.5 μm (PM(2.5)), on mortality, the Air Quality Health Index (AQHI) in Canada was developed. The aim of this study was to examine the associations of short-term changes in AQHI with emergency department (ED) visits for urticaria in Windsor-area hospitals in Canada. Diagnosed ED visits were retrieved from the National Ambulatory Care Reporting System (NACRS). A time-stratified case-crossover design was applied to 2905 ED visits (males = 1215; females = 1690) for urticaria from April 2004 through December 2010. Odds ratios (OR) and their corresponding 95% confidence intervals (95%CI) for ED visits associated with increase by one unit of risk index were calculated employing conditional logistic regression. Positive and significant results were observed between AQHI levels and OR for ED visits for urticaria in Windsor for lags 2 and 3 days. A distributed lag nonlinear model technique was applied to daily counts of ED visits for lags 0 to 10 and significant results were obtained from lag 2 to lag 5 and for lag 9. These findings demonstrated associations between ambient air pollution and urticarial confirming that air pollution affects skin conditions.

  9. The air quality health index and emergency department visits for urticaria in Windsor, Canada.

    PubMed

    Kousha, Termeh; Valacchi, Giuseppe

    2015-01-01

    Ambient air pollution exposure has been associated with several health conditions, limited not only to respiratory and cardiovascular systems but also to cutaneous tissues. However, few epidemiological studies examined pollution exposure on skin problems. Basically, the common mechanism by which pollution may affect skin physiology is by induction of oxidative stress and inflammation. Urticaria is among the skin pathologies that have been associated with pollution. Based on the combined effects of three ambient air pollutants, ozone (O₃), nitrogen dioxide (NO₂), and fine particulate matter (PM) with a median aerodynamic diameter of less than 2.5 μm (PM(2.5)), on mortality, the Air Quality Health Index (AQHI) in Canada was developed. The aim of this study was to examine the associations of short-term changes in AQHI with emergency department (ED) visits for urticaria in Windsor-area hospitals in Canada. Diagnosed ED visits were retrieved from the National Ambulatory Care Reporting System (NACRS). A time-stratified case-crossover design was applied to 2905 ED visits (males = 1215; females = 1690) for urticaria from April 2004 through December 2010. Odds ratios (OR) and their corresponding 95% confidence intervals (95%CI) for ED visits associated with increase by one unit of risk index were calculated employing conditional logistic regression. Positive and significant results were observed between AQHI levels and OR for ED visits for urticaria in Windsor for lags 2 and 3 days. A distributed lag nonlinear model technique was applied to daily counts of ED visits for lags 0 to 10 and significant results were obtained from lag 2 to lag 5 and for lag 9. These findings demonstrated associations between ambient air pollution and urticarial confirming that air pollution affects skin conditions. PMID:25849769

  10. Emergency department visits for drug poisoning: United States, 2008-2011.

    PubMed

    Albert, Michael; McCaig, Linda F; Uddin, Sayeedha

    2015-04-01

    Poisoning is the leading cause of injury-related mortality in the United States, with more than 40,000 deaths annually. Drugs account for 90% of poisoning deaths, and the number of deaths from drug poisoning has increased substantially in recent years. The emergency department (ED) plays an important role in the treatment of poisoning. This report describes nationally representative data on ED visits for drug poisoning during 2008-2011.

  11. What Is Ag-Ed?

    ERIC Educational Resources Information Center

    Linley, Judy; Mylne, Lee

    1998-01-01

    Ag-Ed, an agricultural education project for upper elementary students, was held in conjunction with the Toowoomba Show in Queensland, Australia. Agriculture industry representatives provided 20 interactive agricultural presentations for class groups, which were supplemented with a teacher resource-package containing a directory and 13 sections of…

  12. Study: To minimize errors, rely on interpreters when caring for LEP patients in the ED.

    PubMed

    2012-08-01

    A new study strongly suggests that it is important for EDs to rely on professional interpreters, rather than ad hoc interpreters or no interpreters at all, when caring for patients with limited English proficiency (LEP). The researchers examined health care encounters involving LEP patients at two pediatric EDs, and found that the encounters associated with professional interpreters were associated with far fewer errors of potential clinical consequence than the encounters associated with ad hoc interpreters or no interpreters. Experts say the most important first step in minimizing language-based errors is to identify patients with LEP when they present for care. Professional interpreters are defined as having at least 100 hours of training. Researchers say that when evaluating interpreters, professional training is more valuable in terms of minimizing errors than experience on the job. Make sure that interpreters are available to LEP patients throughout the course of their ED visit as well as during any follow-up visits or telephone calls.

  13. Washington state initiative trims Medicaid budget, ED utilization without denying access.

    PubMed

    2014-06-01

    In its first year of operation, Washington state's "ER is for Emergencies" initiative has helped to save the state's Medicaid budget $33.6 million. The initiative, which is based on the implementation of seven best practices, has succeeded in part by improving care coordination and by linking EDs across the state so information can be shared electronically. Leaders of the effort concede that while state pressure was essential in pushing providers to address excess use of the ED for nonemergency needs, they stress that the approach worked because all sides were willing to sit down and hammer out a solution. Further, they note that the infrastructure is now in place to address other problems in a similar fashion. An analysis of claims data shows that in the first year of the initiative, ED visits by Medicaid recipients declined by 9.9%, and the rate of visits by frequent ED utilizers declined by 10.7%. The analysis also shows that ED visits resulting in a scheduled drug prescription fell by 24%, and the rate of visits for a low-acuity diagnosis declined by 14.2%. While many EDs had to adjust their staffing and other resources to accommodate reduced volumes, others experienced few changes or even saw an uptick in volume, possibly from implementation of the Affordable Care Act. Leaders of the effort say the biggest challenge involved with implementing the initiative was securing administrative buy-in for investments that would likely result in improved efficiency and care, but also reduced revenue--at least initially.

  14. Identification of inappropriate medication use in elderly patients with frequent emergency department visits

    PubMed Central

    Wong, Jeffrey; Marr, Patricia; Kwan, Debbie; Meiyappan, Soumia; Adcock, Lesley

    2014-01-01

    Objective: To determine the demographic and health care characteristics of elderly family health team patients who are frequent emergency department (ED) users, focusing on potentially inappropriate medications (PIMs) and access to primary care services. Design: Cross-sectional retrospective chart review. Setting: Academic family medicine clinic in Toronto, Ontario. Participants: A total of 46 elderly patients (age >65 years) with 4 or more visits to a University Health Network–affiliated ED between April 1, 2010, and March 31, 2011. Main outcome measures: Using the validated STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions) criteria, PIMs were identified. The primary objective was to determine whether PIMs were associated with more frequent ED use. The secondary objective was to determine whether patients who had previously undergone a clinic pharmacist-led medication review had fewer PIMs. We also determined the health characteristics of these patients at the time of their last ED visit of the study period. Utilization of primary care resources, both prior to and after ED visits, was determined. Results: Sixty-five percent of patients were taking at least 1 PIM. The total number of PIMs in the study population was 71. Having more PIMs was significantly correlated with a higher number of ED visits (r = 0.32, p < 0.05). Patients with a previous medication review had a similar number of PIMs compared with those without a review. The mean number of concurrent medications was 12.1 and the mean Charlson Comorbidity Index score was 3.7. Significant delay between hospital discharge and primary care follow-up (median 13 days) was observed. Conclusion: Elderly patients who are more frequent ED users have a greater number of PIMs. Primary care resources appear to be underused in this population. PMID:25360151

  15. Gender Differences in Emergency Department Visits and Detox Referrals for Illicit and Nonmedical Use of Opioids

    PubMed Central

    Ryoo, Hyeon-Ju; Choo, Esther K.

    2016-01-01

    Introduction Visits to the emergency department (ED) for use of illicit drugs and opioids have increased in the past decade. In the ED, little is known about how gender may play a role in drug-related visits and referrals to treatment. This study performs gender-based comparison analyses of drug-related ED visits nationwide. Methods We performed a cross-sectional analysis with data collected from 2004 to 2011 by the Drug Abuse Warning Network (DAWN). All data were coded to capture major drug categories and opioids. We used logistic regression models to find associations between gender and odds of referral to treatment programs. A second set of models were controlled for patient “seeking detox,” or patient explicitly requesting for detox referral. Results Of the 27.9 million ED visits related to drug use in the DAWN database, visits by men were 2.69 times more likely to involve illicit drugs than visits by women (95% CI [2.56, 2.80]). Men were more likely than women to be referred to detox programs for any illicit drugs (OR 1.12, 95% CI [1.02–1.22]), for each of the major illicit drugs (e.g., cocaine: OR 1.27, 95% CI [1.15–1.40]), and for prescription opioids (OR 1.30, 95% CI [1.17–1.43]). This significant association prevailed after controlling for “seeking detox.” Conclusion Women are less likely to receive referrals to detox programs than men when presenting to the ED regardless of whether they are “seeking detox.” Future research may help determine the cause for this gender-based difference and its significance for healthcare costs and health outcomes. PMID:27330662

  16. Visit a Farm? Surely Not!

    ERIC Educational Resources Information Center

    Graham, Bill

    2012-01-01

    Popular myth has it that visiting a farm can be dangerous, but there are only a few occasions when children have become ill during a school visit to a farm. Simple, sensible precautions, including wearing appropriate clothing, such as trousers and wellington boots (if wet) or sensible shoes, and careful hand-washing, are all that is required. The…

  17. The Virginia Home Visiting Consortium

    ERIC Educational Resources Information Center

    Bodkin, Catherine

    2010-01-01

    The Virginia Home Visiting Consortium (HVC) is a collaboration of public and private organizations which work to improve the effectiveness and efficiency of home visiting services throughout the state. The HVC identified service needs and gaps and has focused on increasing the interagency state and local partnerships so that resources are…

  18. Overview of Deployed EDS Technologies

    SciTech Connect

    Martz, H E; Crawford, C

    2009-09-24

    The term explosive detection system (EDS) is used by the TSA to describe equipment that is certified to detect explosives in checked bags. The EDS, as certified, by the TSL must consist of device for interrogating a bag and an automated detection algorithm (ATD) for evaluating the results of the interrogation. We only consider CT as the interrogation device in this report. A schematic drawing of a CT-based EDS is shown in Figure 2. The output of the ATD is the binary decision of alarm or non-alarm. Alarms may true- or false-positives. Non-alarms may be true- or false-negatives. False positives are also denoted false alarms. The true detection means that the ATD reports an alarm when a threat is present in the scanned bag. The probability of detecting a threat given that a threat is present is denoted the probability of detection (PD). The probability of false alarm (PFA) is the case when an alarm is reported when a threat is not present in a bag. Certification in this context means passing tests for PD and PFA at the TSL. The results of the EDS include CT cross-sectional images of the bag and specifics about the alarmed objects generated by ATD. These results are presented on a display so that a person may override the decision of ATD and declare the alarm to be a non-alarm. This process is denoted clearing. Bags that are not cleared by the person are sent to a secondary inspection process. Here the bags may be opened or assessed with explosive trace detection (ETD) in order to clear the bags. Bags that are not cleared at this point are evaluated by an ordinance disposal team. The CT scanner along with ATD is denoted Level 1 screening. The process of clearing on a display is denoted Level 2 screening. Secondary inspection is denoted Level 3 screening. Vendors of the deployed EDSs supply the TSA with equipment for all three levels. Therefore, the term EDS may include the equipment provided for Levels 1, 2 and 3. A schematic diagram of an EDS and the levels of

  19. Impact of performance grading on annual numbers of acute myocardial infarction-associated emergency department visits in Taiwan

    PubMed Central

    Tzeng, I-Shiang; Liu, Su-Hsun; Chen, Kuan-Fu; Wu, Chin-Chieh; Chen, Jih-Chang

    2016-01-01

    Abstract To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007–2009. The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003–2007), during (2007–2009), and after (2009–2012) the initial audit program implementation. Using aggregated data from the MOHW of Taiwan, we estimated the annual incidence of AMI-associated ED visits by Poisson regression models. We used segmented regression techniques to evaluate differences in the annual rates and in the year-to-year changes in AMI-associated ED visits between 2003 and 2012. Medical comorbidities such as diabetes mellitus, hyperlipidemia, and hypertensive disease were considered as potential confounders. Overall, the number of AMI-associated patient visits increased from 8130 visits in 2003 to 12,695 visits in 2012 (P-value for trend < 0.001), corresponding to an average annual growth rate of 5.3% (95%confidence interval [CI]: 0.5–10%). Although age was a major risk factor for AMI-associated ED visits, the statistical association was observed in middle-to-old (aged 40–64; P-value < 0.001) and older aged individuals (aged ≥65; P-value <0.001). As compared to 2003–2007, AMI-associated ED visits increased slightly during the intervention roll-in period (2007–2009, slope = 394.5, P-value = 0.117) followed by a dramatic uptake in the early post-intervention period (2010–2012, slope = 1037, P-value = 0.083). There was evidence suggesting for a significant intervention effect of the GRHAC program on identifying critically ill patients with AMI-associated diagnosis at the ED

  20. Reduction in emergency department visits for children's asthma, ear infections, and respiratory infections after the introduction of state smoke-free legislation.

    PubMed

    Hawkins, Summer Sherburne; Hristakeva, Sylvia; Gottlieb, Mark; Baum, Christopher F

    2016-08-01

    Despite the benefits of smoke-free legislation on adult health, little is known about its impact on children's health. We examined the effects of tobacco control policies on the rate of emergency department (ED) visits for childhood asthma (N=128,807), ear infections (N=288,697), and respiratory infections (N=410,686) using outpatient ED visit data in Massachusetts (2001-2010), New Hampshire (2001-2009), and Vermont (2002-2010). We used negative binomial regression models to analyze the effect of state and local smoke-free legislation on ED visits for each health condition, controlling for cigarette taxes and health care reform legislation. We found no changes in the overall rate of ED visits for asthma, ear infections, and upper respiratory infections after the implementation of state or local smoke-free legislation or cigarette tax increases. However, an interaction with children's age revealed that among 10-17-year-olds state smoke-free legislation was associated with a 12% reduction in ED visits for asthma (adjusted incidence rate ratios (aIRR) 0.88; 95% CI 0.83, 0.95), an 8% reduction for ear infections (0.92; 0.88, 0.97), and a 9% reduction for upper respiratory infections (0.91; 0.87, 0.95). We found an overall 8% reduction in ED visits for lower respiratory infections after the implementation of state smoke-free legislation (0.92; 0.87, 0.96). The implementation of health care reform in Massachusetts was also associated with a 6-9% reduction in all children's ED visits for ear and upper respiratory infections. Our results suggest that state smoke-free legislation and health care reform may be effective interventions to improve children's health by reducing ED visits for asthma, ear infections, and respiratory infections. PMID:27283094

  1. Reduction in emergency department visits for children's asthma, ear infections, and respiratory infections after the introduction of state smoke-free legislation.

    PubMed

    Hawkins, Summer Sherburne; Hristakeva, Sylvia; Gottlieb, Mark; Baum, Christopher F

    2016-08-01

    Despite the benefits of smoke-free legislation on adult health, little is known about its impact on children's health. We examined the effects of tobacco control policies on the rate of emergency department (ED) visits for childhood asthma (N=128,807), ear infections (N=288,697), and respiratory infections (N=410,686) using outpatient ED visit data in Massachusetts (2001-2010), New Hampshire (2001-2009), and Vermont (2002-2010). We used negative binomial regression models to analyze the effect of state and local smoke-free legislation on ED visits for each health condition, controlling for cigarette taxes and health care reform legislation. We found no changes in the overall rate of ED visits for asthma, ear infections, and upper respiratory infections after the implementation of state or local smoke-free legislation or cigarette tax increases. However, an interaction with children's age revealed that among 10-17-year-olds state smoke-free legislation was associated with a 12% reduction in ED visits for asthma (adjusted incidence rate ratios (aIRR) 0.88; 95% CI 0.83, 0.95), an 8% reduction for ear infections (0.92; 0.88, 0.97), and a 9% reduction for upper respiratory infections (0.91; 0.87, 0.95). We found an overall 8% reduction in ED visits for lower respiratory infections after the implementation of state smoke-free legislation (0.92; 0.87, 0.96). The implementation of health care reform in Massachusetts was also associated with a 6-9% reduction in all children's ED visits for ear and upper respiratory infections. Our results suggest that state smoke-free legislation and health care reform may be effective interventions to improve children's health by reducing ED visits for asthma, ear infections, and respiratory infections.

  2. Factors Associated With Emergency Department Visits: A Multistate Analysis of Adult Fee-for-Service Medicaid Beneficiaries

    PubMed Central

    Agarwal, Parul; Bias, Thomas K.; Madhavan, Suresh; Sambamoorthi, Nethra; Frisbee, Stephanie; Sambamoorthi, Usha

    2016-01-01

    Objective The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. Methods A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. Results In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] = 1.47), Hispanics (IRR = 1.63), polypharmacy (IRR = 1.89), and tobacco use (IRR = 2.23). Patients with complex chronic illness had a higher number of ED visits (IRR = 3.33). The county-level factors associated with ED visits were unemployment rate (IRR = 0.94) and number of urgent care clinics (IRR = 0.96). Conclusion Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options.

  3. Factors Associated With Emergency Department Visits: A Multistate Analysis of Adult Fee-for-Service Medicaid Beneficiaries

    PubMed Central

    Agarwal, Parul; Bias, Thomas K.; Madhavan, Suresh; Sambamoorthi, Nethra; Frisbee, Stephanie; Sambamoorthi, Usha

    2016-01-01

    Objective The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. Methods A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. Results In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] = 1.47), Hispanics (IRR = 1.63), polypharmacy (IRR = 1.89), and tobacco use (IRR = 2.23). Patients with complex chronic illness had a higher number of ED visits (IRR = 3.33). The county-level factors associated with ED visits were unemployment rate (IRR = 0.94) and number of urgent care clinics (IRR = 0.96). Conclusion Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options. PMID:27512721

  4. Eliminating Medicaid adult dental coverage in California led to increased dental emergency visits and associated costs.

    PubMed

    Singhal, Astha; Caplan, Daniel J; Jones, Michael P; Momany, Elizabeth T; Kuthy, Raymond A; Buresh, Christopher T; Isman, Robert; Damiano, Peter C

    2015-05-01

    Dental coverage for adults is an elective benefit under Medicaid. As a result of budget constraints, California Medicaid eliminated its comprehensive adult dental coverage in July 2009. We examined the impact of this policy change on emergency department (ED) visits by Medicaid-enrolled adults for dental problems in the period 2006-11. We found that the policy change led to a significant and immediate increase in dental ED use, amounting to more than 1,800 additional dental ED visits per year. Young adults, members of racial/ethnic minority groups, and urban residents were disproportionately affected by the policy change. Average yearly costs associated with dental ED visits increased by 68 percent. The California experience provides evidence that eliminating Medicaid adult dental benefits shifts dental care to costly EDs that do not provide definitive dental care. The population affected by the Medicaid adult dental coverage policy is increasing as many states expand their Medicaid programs under the ACA. Hence, such evidence is critical to inform decisions regarding adult dental coverage for existing Medicaid enrollees and expansion populations. PMID:25941275

  5. Air Pollution and Emergency Department Visits for Depression: A Multicity Case-Crossover Study

    PubMed Central

    Szyszkowicz, Mieczysław; Kousha, Termeh; Kingsbury, Mila; Colman, Ian

    2016-01-01

    BACKGROUND The aim of this study was to investigate the associations between ambient air pollution and emergency department (ED) visits for depression. METHODS Health data were retrieved from the National Ambulatory Care Reporting System. ED visits for depression were retrieved from the National Ambulatory Care Reporting System using the International Classification of Diseases (ICD-10), Tenth revision codes; ICD-10: F32 (mild depressive episode) and ICD-10: F33 (recurrent depressive disorder). A case-crossover design was employed for this study. Conditional logistic regression models were used to estimate odds ratios. RESULTS For females, exposure to ozone was associated with increased risk of an ED visit for depression between 1 and 7 days after exposure, for males, between 1 and 5, and 8 days after exposure, with odds ratios ranging between 1.02 and 1.03. CONCLUSIONS These findings suggest that, as hypothesized, there is a positive association between exposure to air pollution and ED visits for depression. PMID:27597809

  6. Alcohol-Related Emergency Department Visits Associated with Collegiate Football Games

    ERIC Educational Resources Information Center

    Shook, Janice; Hiestand, Brian C.

    2011-01-01

    Objective: In 2003, after several post-college football game riots, multiple strategies including strict enforcement of open container laws were instituted by the authors' city and university. The authors compared alcohol-related visits to the on-campus emergency department (ED) associated with home football games in 2002 and 2006, hypothesizing…

  7. Relationship between summertime ambient ozone levels and emergency department visits for asthma in central New Jersey

    SciTech Connect

    Weisel, C.P.; Cody, R.P.; Lioy, P.J.

    1995-03-01

    The 5-year retrospective study of the association between temperature and emergency department (ED) visits for asthma with mean ambient ozone levels between 10:00 and 15:00 was conducted in central New Jersey during the summer months. An association was identified in each of the years (1986-1990). Between 8 and 34% of the total variance in ED visits for asthma was explained by the two environmental variables in the step-wise multiple regression analysis. ED visits occurred 28% more frequently when the mean ozone levels were >0.06 ppm than when they were < 0.06 ppm. This result was statistically significant in a covariance analysis. An evaluation of the effects of ozone on asthmatics reported in the literature was completed to determine if, as proposed by Bates, the results from different types of studies were coherent among the health metrics. A consistency in the magnitude of reported effects and the time lag between exposure and response for four different health indices (symptom reports, decrements in expiratory flow, ED visits, and hospital admissions) was identified and indicates a coherence between ozone and respiratory response to ozone exposure. This supports a proposition that ozone adversely affects asthmatics at levels below the current U.S. standard. 34 refs., 1 fig., 4 tabs.

  8. Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA

    PubMed Central

    Heidari, Leila; Winquist, Andrea; Klein, Mitchel; O’Lenick, Cassandra; Grundstein, Andrew; Ebelt Sarnat, Stefanie

    2016-01-01

    Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI) may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED) visits were collected in Atlanta, Georgia, USA during 1993–2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index) modeled using linear, quadratic, and cubic terms to allow for non-linear associations. Effect modification by potential determinants of heat susceptibility (sex; race; comorbid congestive heart failure, kidney disease, and diabetes; and neighborhood poverty and education levels) was assessed via stratification. Higher warm-season ambient temperature was significantly associated with FEI ED visits, regardless of temperature metric used. Stratified analyses suggested heat-related risks for all populations, but particularly for males. This work highlights the utility of FEI as an indicator of heat morbidity, the health threat posed by warm-season temperatures, and the importance of considering susceptible populations in heat-health research. PMID:27706089

  9. Incidence of Emergency Department Visits for ST-Elevation Myocardial Infarction in a Recent 6-Year Period in the United States

    PubMed Central

    Ward, Michael J.; Kripalani, Sunil; Zhu, Yuwei; Storrow, Alan B.; Dittus, Robert S.; Harrell, Frank E.; Self, Wesley H.

    2014-01-01

    The incidence and longitudinal trends of patients with ST-elevation myocardial infarction (STEMI) presenting to U.S. emergency departments (EDs) are currently unknown. Efforts to use effective treatments for cardiovascular disease may decrease ED STEMI presentation. We conducted a descriptive epidemiological analysis of STEMI visits to EDs between 2006 and 2011 using the Nationwide ED Sample (NEDS), the largest source of U.S. ED data, to determine the incidence of patients with STEMIs presenting to U.S. EDs. We included adult ED visits with an ICD-9CM diagnosis of STEMI and calculated incidence rates for STEMI ED visits using U.S. census population data. Incidence calculations were stratified by age group, geographic region, and year. From 2006–2011, there was a mean of 258,106 STEMIs presenting to EDs per year, declining from 300,466 in 2006 to 227,343 in 2011. Incidence of ED STEMI visits per 10,000 adults declined from 10.1 (95% CI 9.8, 10.8) in 2006 to 7.3 (95% CI 6.8, 7.8) in 2011. The Midwest had the highest rate of ED STEMIs at 10.0 (95% CI 9.2, 10.8) and the West had the lowest with 6.6 (95% CI 6.1, 7.0). The incidence of STEMI decreased for all age groups during the study period. In conclusion, we report the first national estimates of STEMI presentation to U.S. EDs, which demonstrate decreasing incidence across all age groups and all geographic regions between 2006 and 2011. A declining STEMI incidence may affect the quality and timeliness of STEMI care. Continued national STEMI surveillance is needed to guide healthcare resource allocation. PMID:25465931

  10. States leverage telepsychiatry solutions to ease ED crowding, accelerate care.

    PubMed

    2015-02-01

    Many states are having success turning to telepsychiatry-based solutions to connect mental health patients with needed care while also decompressing crowded EDs. Just one year into a statewide telepsychiatry initiative in North Carolina (NC-STeP), administrators say the approach has saved as much as $7 million, and hospital demand for the service is higher than anticipated. In Texas, mental health emergency centers (MHEC) that use telepsychiatry to connect patients in rural areas with needed psychiatric care are freeing up EDs to focus on medical care. In just 11 months, 91 North Carolina hospitals have at least started the process to engage in NC-STeP. Much of the savings from NC-STeP come from involuntary commitment orders being overturned as a result of the telepsychiatry consults, reducing the need for expensive inpatient care. Implementing NC-STeP has involved multiple hurdles including credentialing difficulties and technical/firewall challenges. The Texas model provides 24/7 availability of psychiatrists via telemedicine through a network of MHECs. In-person staff at the MHECs perform basic screening tests and blood draws so that medical clearance can be achieved without the need for an ED visit in most cases. Funding for the MHECs comes from the state, hospitals in the region, and local governmental authorities that reap savings or benefits from the initiative. PMID:25688413

  11. States leverage telepsychiatry solutions to ease ED crowding, accelerate care.

    PubMed

    2015-02-01

    Many states are having success turning to telepsychiatry-based solutions to connect mental health patients with needed care while also decompressing crowded EDs. Just one year into a statewide telepsychiatry initiative in North Carolina (NC-STeP), administrators say the approach has saved as much as $7 million, and hospital demand for the service is higher than anticipated. In Texas, mental health emergency centers (MHEC) that use telepsychiatry to connect patients in rural areas with needed psychiatric care are freeing up EDs to focus on medical care. In just 11 months, 91 North Carolina hospitals have at least started the process to engage in NC-STeP. Much of the savings from NC-STeP come from involuntary commitment orders being overturned as a result of the telepsychiatry consults, reducing the need for expensive inpatient care. Implementing NC-STeP has involved multiple hurdles including credentialing difficulties and technical/firewall challenges. The Texas model provides 24/7 availability of psychiatrists via telemedicine through a network of MHECs. In-person staff at the MHECs perform basic screening tests and blood draws so that medical clearance can be achieved without the need for an ED visit in most cases. Funding for the MHECs comes from the state, hospitals in the region, and local governmental authorities that reap savings or benefits from the initiative.

  12. Increases in heart failure visits after Christmas and New Year's Day.

    PubMed

    Reedman, Lisa Armstrong; Allegra, John R; Cochrane, Dennis G

    2008-01-01

    The authors hypothesized increased emergency department (ED) visits for heart failure (HF) during a 2-week Christmas holiday period similar to a recent study showing increased cardiac death rates. A retrospective analysis was performed from a database of 18 EDs in New Jersey and New York from January 1, 1996, to November 30, 2004, analyzing HF visits from December 1 to January 31. The authors compared the mean daily visits for the 2-week holiday period of December 25 to January 7, as well as December 26 to December 30 and January 2 to January 5, using the Student t test. A total of 4.7 million patients were studied, 65,646 with an ED diagnosis of HF and 11,525 during January and December. There was a 23% (95% confidence interval [CI], 14%-31%; P<.001) increase in daily visits for December 25 to January 7 and a 33% (95% CI, 16%-51%; P=.007) and 30% (95% CI, 22%-38%; P<.01) increase in the 4 days following Christmas and New Year's, respectively. The authors found a significant increase in daily HF visits in the 2-week holiday period and the 4 days following the holidays, even greater than that reported for sudden cardiac death.

  13. 28 CFR 540.46 - Attorney visits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Attorney visits. 540.46 Section 540.46... PERSONS IN THE COMMUNITY Visiting Regulations § 540.46 Attorney visits. Requirements for attorney visits... chapter). Provisions pertinent to attorney visits for pretrial inmates are contained in § 551.117 of...

  14. Skylab mission report, third visit

    NASA Technical Reports Server (NTRS)

    1974-01-01

    An evaluation is presented of the operational and engineering aspects of the third Skylab visit, including information on the performance of the command and service module and the experiment hardware, the crew's evaluation of the visit, and other visit-related areas of interest such as biomedical observations. The specific areas discussed are contained in the following: (1) solar physics and astrophysics investigations; (2) Comet Kohoutek experiments; (3) medical experiments; (4) earth observations, including data for the multispectral photographic facility, the earth terrain camera, and the microwave radiometer/scattermometer and altimeter; (5) engineering and technology experiments; (6) food and medical operational equipment; (7) hardware and experiment anomalies; and (8) mission support, mission objectives, flight planning, and launch phase summary. Conclusions discussed as a result of the third visit to Skylab involve the advancement of the sciences, practical applications, the durability of man and systems in space, and spaceflight effectiveness and economy.

  15. Astronaut Steve Swanson Visits Goddard

    NASA Video Gallery

    On Tuesday, 3 March 2015, a special guest visited NASA Goddard Space Flight Center during his time back on Earth. Steven Swanson, NASA astronaut, intrigued the audience by highlighting his adventur...

  16. Tests and visits before surgery

    MedlinePlus

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  17. Preparing for an Office Visit

    MedlinePlus

    ... a Neurologist Preparing for an Office Visit Your Rights as a Patient Family & Friends Communities Research Matters Donate Clinical Trials Animal Research Resources Neurology Now Magazine Patient Education Brochures ...

  18. The CACREP Site Visit Process

    ERIC Educational Resources Information Center

    Lee, Courtland C.

    2013-01-01

    An important step in the CACREP review process is the campus site visit. The visit involves a team, usually from comparable institutions, coming to a campus for a review of the counselor training program(s). The role of the team is to be the CACREP Board's representative on campus to verify the self-study. In this article, the author reviews…

  19. Visiting Vehicle Ground Trajectory Tool

    NASA Technical Reports Server (NTRS)

    Hamm, Dustin

    2013-01-01

    The International Space Station (ISS) Visiting Vehicle Group needed a targeting tool for vehicles that rendezvous with the ISS. The Visiting Vehicle Ground Trajectory targeting tool provides the ability to perform both realtime and planning operations for the Visiting Vehicle Group. This tool provides a highly reconfigurable base, which allows the Visiting Vehicle Group to perform their work. The application is composed of a telemetry processing function, a relative motion function, a targeting function, a vector view, and 2D/3D world map type graphics. The software tool provides the ability to plan a rendezvous trajectory for vehicles that visit the ISS. It models these relative trajectories using planned and realtime data from the vehicle. The tool monitors ongoing rendezvous trajectory relative motion, and ensures visiting vehicles stay within agreed corridors. The software provides the ability to update or re-plan a rendezvous to support contingency operations. Adding new parameters and incorporating them into the system was previously not available on-the-fly. If an unanticipated capability wasn't discovered until the vehicle was flying, there was no way to update things.

  20. Emergency Department Visits Involving Misuse and Abuse of the Antipsychotic Quetiapine: Results from the Drug Abuse Warning Network (DAWN).

    PubMed

    Mattson, Margaret E; Albright, Victoria A; Yoon, Joanna; Council, Carol L

    2015-01-01

    Case reports in medical literature suggest that the atypical antipsychotic quetiapine, a medication not previously considered to have abuse potential, is now being subject to misuse and abuse (MUA; ie, taken when not prescribed for them or used in a way other than instructed by their health professional). Here we present systematic, nationally representative data from the 2005 to 2011 Drug Abuse Warning Network (DAWN) for prevalence of emergency department (ED) visits among the U.S. general population involving quetiapine and related to MUA, suicide attempts, and adverse reactions. Nationally, quetiapine-related ED visits increased 90% between 2005 and 2011, from 35,581 ED visits to 67,497. DAWN data indicate that when used without medical supervision for recreational/self-medication purposes, quetiapine poses health risks for its users, especially among polydrug users and women. These findings suggest that the medical and public health communities should increase vigilance concerning this drug and its potential for MUA. PMID:26056465

  1. Emergency Department Visits Involving Misuse and Abuse of the Antipsychotic Quetiapine: Results from the Drug Abuse Warning Network (DAWN)

    PubMed Central

    Mattson, Margaret E; Albright, Victoria A; Yoon, Joanna; Council, Carol L

    2015-01-01

    Case reports in medical literature suggest that the atypical antipsychotic quetiapine, a medication not previously considered to have abuse potential, is now being subject to misuse and abuse (MUA; ie, taken when not prescribed for them or used in a way other than instructed by their health professional). Here we present systematic, nationally representative data from the 2005 to 2011 Drug Abuse Warning Network (DAWN) for prevalence of emergency department (ED) visits among the U.S. general population involving quetiapine and related to MUA, suicide attempts, and adverse reactions. Nationally, quetiapine-related ED visits increased 90% between 2005 and 2011, from 35,581 ED visits to 67,497. DAWN data indicate that when used without medical supervision for recreational/self-medication purposes, quetiapine poses health risks for its users, especially among polydrug users and women. These findings suggest that the medical and public health communities should increase vigilance concerning this drug and its potential for MUA. PMID:26056465

  2. Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits

    PubMed Central

    Chandra, Anupam; Crane, Sarah J; Tung, Ericka E; Hanson, Gregory J; North, Frederick; Cha, Stephen S; Takahashi, Paul Y

    2015-01-01

    There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age, a self-report of worse health, history of 2 or more falls, weight loss, and depressed mood were significantly associated with hospitalization or ED visits within 1 year. A score equal to or greater than 2 had a sensitivity of 0.74 and specificity of 0.45. The calculated AUC was 0.60. The MAGE questionnaire, which was completed by patients at an outpatient visit to screen for common geriatric issues, could also be used to assess risk for ED visits and hospitalization within 1 year. PMID:26029477

  3. Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

    2015-01-01

    We analyzed 2010 US National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million…

  4. Real time analysis under EDS

    NASA Astrophysics Data System (ADS)

    Schneberk, D.

    1985-07-01

    The analysis component of the Enrichment Diagnostic System (EDS) developed for the Atomic Vapor Laser Isotope Separation Program (AVLIS) at Lawrence Livermore National Laboratory (LLNL) is described. Four different types of analysis are performed on data acquired through EDS: (1) absorption spectroscopy on laser-generated spectral lines, (2) mass spectrometer analysis, (3) general purpose waveform analysis, and (4) separation performance calculations. The information produced from this data includes: measures of particle density and velocity, partial pressures of residual gases, and overall measures of isotope enrichment. The analysis component supports a variety of real-time modeling tasks, a means for broadcasting data to other nodes, and a great degree of flexibility for tailoring computations to the exact needs of the process. A particular data base structure and program flow is common to all types of analysis. Key elements of the analysis component are: (1) a fast access data base which can configure all types of analysis, (2) a selected set of analysis routines, (3) a general purpose data manipulation and graphics package for the results of real time analysis.

  5. Air Pollution and Emergency Department Visits for Otitis Media: A Case-Crossover Study in Edmonton, Canada

    PubMed Central

    Zemek, Roger; Szyszkowicz, Mieczysław; Rowe, Brian H.

    2010-01-01

    Background Otitis media (OM) is one of the most common early childhood infections, resulting in an enormous economic burden to the health care system through unscheduled doctor visits and antibiotic prescriptions. Objectives The objective of this study was to investigate the potential association between ambient air pollution exposure and emergency department (ED) visits for OM. Materials and Methods Ten years of ED data were obtained from Edmonton, Alberta, Canada, and linked to levels of air pollution: carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide, and particulate matter (PM) of median aerometric diameter ≤ 10 and 2.5 μm (PM10 and PM2.5 respectively). A time-stratified case-crossover technique was applied to analyze the associations between ambient air pollution and health outcomes. Conditional logistic regression analysis with the subject’s identification number as a stratum variable was used to obtain odds ratios (ORs) and their corresponding 95% confidence intervals after adjustment for meteorological factors. Results We based the analysis on 14,527 ED visits for OM over 10 years in children 1–3 years of age. We observed statistically significant positive associations between ED visits for OM and interquartile increases in CO and NO2 levels after adjusting for ambient temperature and relative humidity. We observed the strongest associations (expressed by ORs) in the warmer months (April–September) in girls and all patients for exposure to CO and NO2, and in boys for exposure to CO, for 2 days before an OM ED visit. Conclusions These results support the hypothesis that ED visits for OM are associated with ambient air pollution. PMID:20663739

  6. ACS: ALMA Common Software

    NASA Astrophysics Data System (ADS)

    Chiozzi, Gianluca; Šekoranja, Matej

    2013-02-01

    ALMA Common Software (ACS) provides a software infrastructure common to all ALMA partners and consists of a documented collection of common patterns and components which implement those patterns. The heart of ACS is based on a distributed Component-Container model, with ACS Components implemented as CORBA objects in any of the supported programming languages. ACS provides common CORBA-based services such as logging, error and alarm management, configuration database and lifecycle management. Although designed for ALMA, ACS can and is being used in other control systems and distributed software projects, since it implements proven design patterns using state of the art, reliable technology. It also allows, through the use of well-known standard constructs and components, that other team members whom are not authors of ACS easily understand the architecture of software modules, making maintenance affordable even on a very large project.

  7. Patient and Community-Level Socio-Demographic Characteristics Associated with Emergency Department Visits for Childhood Injury; A Retrospective Analysis of Data from the Pediatric Emergency Care Applied Research Network (PECARN) Core Data Project 2004–2008

    PubMed Central

    Macy, Michelle L.; Zonfrillo, Mark R.; Cook, Lawrence J.; Funai, Tomohiko; Goldstick, Jason; Stanley, Rachel M.; Chamberlain, James M.; Cunningham, Rebecca M.; Lipton, Robert; Alpern, Elizabeth R.

    2015-01-01

    Objective To examine pediatric emergency department (ED) visits over 5 years, trends in injury severity, and associations between injury-related ED visit outcome and patient and community-level socio-demographic characteristics. Study design Retrospective analysis of administrative data provided to the Pediatric Emergency Care Applied Research Network Core Data Project, 2004–2008. Home addresses were geocoded to determine census block group and associated socio-demographic characteristics. Maximum Abbreviated Injury Scale severity and Severity Classification System scores were calculated. Generalized estimating equations were used to test for associations between socio-demographic characteristics and admission or transfer among injury-related ED visits. Results Overall ED visits and injury-related visits increased from 2004 to 2008 at study sites. Of 2,833,676 successfully geocoded visits, 700,821 (24.7%) were injury-related. The proportion of higher severity injury-related visits remained consistent. Nearly 10% of injury-related visits resulted in admission or transfer each year. After adjusting for age, sex, payer, and injury severity, odds of admission or transfer were lower among minority children and children from areas with moderate and high prevalence of poverty. Conclusions Pediatric injury-related ED visits to included sites increased over the study period while injury severity, anticipated resource utilization, and visit outcomes remained stable, with low rates of admission or transfer. Socio-demographic differences in injury-related visits and ED disposition were apparent. ED-based injury surveillance is essential to understand disparities, inform targets for prevention programs, and reduce the overall burden of childhood injuries. PMID:26141551

  8. The many faces of access: reasons for medically nonurgent emergency department visits.

    PubMed

    Guttman, Nurit; Zimmerman, Deena R; Nelson, Myra Schaub

    2003-12-01

    Investigating why people use the hospital emergency department (ED) for visits considered medically nonurgent can enhance our understanding of people's expectations of health care services, of their conceptions of prudent lay judgment, and of difficulties in negotiating the logistics of primary care services. This study identified reasons for such ED use from users' perspectives in both pediatric and adult visits. Respondents were asked to explain what brought them to the ED and to define an emergency. The study was conducted in two northeastern U.S. hospital EDs. The analysis drew on a convenience sample of 408 (331 pediatric, 77 adult users) face-to-face interviews that employed both open- and closed-ended questions. Findings indicate most patients had medical insurance and a regular place of care and most arrived by car or taxi. Twelve main themes emerged under three main categories: conceptions of needs, appropriateness, and preference for the ED. The findings indicate that various reasons for ED use may be construed as access issues. These include beliefs regarding limited availability of after-hour consultation services and of timely appointments at one's primary care site. Drawing on the findings, a typology that distinguishes between groups of users according to their preference for the ED, a level of congruence between their own reason and their definition of an emergency was developed. The typology suggests that people's concerns that influence their decision to come to the ED cannot be solved simply by expanding primary care services or by educational interventions. Its application yields recommendations for services and interventions. PMID:14756500

  9. Instability of EDS maglev systems

    SciTech Connect

    Cai, Y.; Chen, S.S.

    1993-09-01

    Instabilities of an EDS maglev suspension system with 3 D.O.F. and 5 D.O.F. vehicles traveling on a double L-shaped set of guideway conductors have been investigated with various experimentally measured magnetical force data incorporated into the theoretical models. Divergence and flutter are obtained from both analytical and numerical solutions for coupled vibration of the 3 D.O.F. maglev vehicle model. Instabilities of five direction motions (heave, slip, rill, pitch and yaw) are observed for the 4 D.O.F. vehicle model. It demonstrates that system parameters, such as, system damping, vehicle geometry and coupling effects among five different motions play very important roles in the occurrence of dynamic instabilities of maglev vehicles.

  10. Visitation arrangements for impaired parents.

    PubMed

    Montgomery, Stephen A; Street, David F

    2011-07-01

    Forensic mental health professionals are frequently asked to evaluate the parenting skills of divorcing parents because the court seeks help in determining the custody, visitation, and parenting time arrangements for the children. When one of the parents is impaired, the court wants to know the way to help the children have a good relationship with that parent and keep the children safe. There is little empirical research to answer such questions. In this article, the authors describe their methodology for providing useful clinical information to the court to help guide their decisions regarding visitation with impaired parents.

  11. Stennis visits Lake Cormorant school

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Alexis Harry, assistant director of Astro Camp at NASA's John C. Stennis Space Center, talks with students at Lake Cormorant (Miss.) Elementary School during a 'Living and Working in Space' presentation March 30. Stennis hosted the school presentation during a visit to the Oxford area. Harry, who also is a high school biology teacher in Slidell, La., spent time discussing space travel with students and answering questions they had about the experience, including queries about how astronauts eat, sleep and drink in space. The presentation was sponsored by the NASA Office of External Affairs and Education at Stennis. For more information about NASA education initiatives, visit: http://education.ssc.nasa.gov/.

  12. Ketogenic Diet Decreases Emergency Room Visits and Hospitalizations Related to Epilepsy

    PubMed Central

    Luniova, Anastasia; Abdelmoity, Ahmed

    2016-01-01

    Background. Approximately, one-third of patients with epilepsy are refractory to pharmacological treatment which mandates extensive medical care and imposes significant economic burden on patients and their societies. This study intends to assess the impact of the treatment with ketogenic diet (KD) on reducing seizure-related emergency room visits and hospitalizations in children with refractory epilepsy. Methods. This is a retrospective review of children treated with the KD in one tertiary center. We compared a 12 months' period prior to KD with 12 months after the diet was started in regard to the number of emergency department (ED) visits, hospitalizations, and hospital days as well as their associated charges. Results. 37 patients (57% males) were included. Their ages at time of KD initiation were (4.0 ± 2.78) years. Twelve months after the KD initiation, the total number of ED visits was reduced by 36% with a significant decrease of associated charges (p = 0.038). The number of hospital admissions was reduced by 40% and the number of hospital days was reduced by 39%. The cumulative charges showed net cost savings after 9 months when compared to the prediet baseline. Conclusion. In children with refractory epilepsy, treatment with the ketogenic diet reduces the number of ED visits and hospitalizations and their corresponding costs. PMID:27752367

  13. Short-term Effects of Ambient Air Pollution on Emergency Department Visits for Asthma: An Assessment of Effect Modification by Prior Allergic Disease History

    PubMed Central

    Sohn, Jungwoo; Cho, Jaelim; Cho, Seong-Kyung; Choi, Yoon Jung; Shin, Dong Chun

    2016-01-01

    Objectives The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients’ prior history of allergic diseases. Methods Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [NO2], ozone [O3], sulfur dioxide [SO2], and particulate matter with an aerodynamic diameter <10 μm [PM10]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. Results A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in O3 concentration. IQR changes in NO2 and PM10 concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in PM10 concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. Conclusions Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis. PMID:27744674

  14. Emergency Department Visits for Asthma Exacerbation due to Weather Conditions and Air Pollution in Chuncheon, Korea: A Case-Crossover Analysis

    PubMed Central

    Kwon, Jae-Woo; Han, Young-Ji; Oh, Moo Kyung; Lee, Chang Youl; Kim, Ja Yeun; Kim, E Jin; Kim, Ho

    2016-01-01

    Purpose This retrospective study was conducted to estimate the effects of climate factors and air pollution on asthma exacerbations using a case-crossover analysis. Methods Patients who visited the emergency department (ED) of 2 university hospitals in Chuncheon for asthma exacerbations from January 1, 2006, to December 31, 2011, were enrolled. Daily average data for meteorological factors (temperature, daily temperature range, relative humidity, wind speed, atmospheric pressure, presence of rain, solar irradiation, and presence of fog) and the daily average levels of gaseous air pollutants (SO2, NO2, O3, CO, and PM10) were obtained. A case-crossover analysis was performed using variables about the weather and air pollution at 1-week intervals between cases and controls before and after ED visits. Results There were 660 ED visits by 583 patients with asthma exacerbations. Low relative humidity (lag 1 and 2) and high wind speed (lag 1, 2, and 3) were associated with ED visits for asthma. Fog (lag 2) showed protective effects against asthma exacerbations in Chuncheon (risk increase: -29.4% [95% CI=-46.3% to -7.2%], P=0.013). These relationships were stronger in patients ≤19 years old than in those >60 years old. High levels of ambient CO (lag 1, 2, and 3) and NO2 (lag 2 and 3) were associated with decreased ED visits for asthma. However, there were no significant relationships among levels of ambient CO or NO2 and asthma exacerbations after adjusting for wind speed and relative humidity. Conclusions High wind speed and low humidity were associated with an increased risk of asthma ED visits. Fog was associated with a decreased risk of asthma ED visits after controlling for seasonal variations in weather and air pollution. PMID:27582402

  15. 28 CFR 540.47 - Media visits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media...

  16. 28 CFR 540.47 - Media visits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media...

  17. 28 CFR 540.47 - Media visits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media...

  18. 28 CFR 540.47 - Media visits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media...

  19. 28 CFR 540.47 - Media visits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media...

  20. Paediatric trauma in the USA: patterns of emergency department visits and associated hospital resource use.

    PubMed

    Odetola, Folafoluwa O; Gebremariam, Achamyeleh

    2015-01-01

    Trauma is the leading cause of mortality and morbidity among children in the USA. To examine the variation in the epidemiology and patterns of visits to emergency departments (EDs), and test the hypothesis that children evaluated at trauma centre EDs will have higher injury severity and a higher likelihood of hospitalisation versus those evaluated at non-trauma centre EDs, we analysed a national database of all injured children aged 0-20 years evaluated at US EDs in 2009. Childhood injuries are a frequent cause of visits to US EDs, with a national point prevalence of 620 cases per 10,000 children aged 0-20 years. Epidemiology of childhood injuries in the USA is significant for male gender preponderance, significant seasonal and geographical variation, and disproportionately more frequent injury to the extremities than other sites of the body. National hospital resource use was significant, with greater burden borne by trauma centres which disproportionately provided care to the most severely injured children.

  1. Beautiful Science: Worth a Visit

    ERIC Educational Resources Information Center

    Bingham, Frederick M.

    2013-01-01

    For those in the profession of teaching physics who reside in or plan to visit the Los Angeles area, I would highly recommend a trip to the Huntington Library in San Marino, specifically to a permanent exhibit entitled "Beautiful Science: Ideas that Changed the World" in the Dibner Hall of the History of Science. The exhibit contains original…

  2. Visiting School Campuses: Reporter Guide

    ERIC Educational Resources Information Center

    Carr, Sarah

    2013-01-01

    Spending time in schools and classrooms can be one of the best ways for novice reporters to dive into the education beat, and for veteran journalists to find fresh inspiration. While it is certainly not necessary for every story, education journalists should try their best to make time to visit schools. Classroom observations and campus tours help…

  3. A Modern Visit to Galileo

    ERIC Educational Resources Information Center

    Freilich, Florence G.

    1970-01-01

    Describes the author's visit to the Italian cities where Galileo lived. Discusses the legendary swinging Cathedral lamp and the Leaning Tower of Pisa. Describes the science apparatus used by Galileo and other men of science which appear in the Museum of the History of Science in Florence. Presents six pictures of items viewed within the museum.…

  4. Bedside point of care toxicology screens in the ED: Utility and pitfalls

    PubMed Central

    Bhalla, Ashish

    2014-01-01

    Exposure to drugs and toxins is a major cause for patients’ visits to the emergency department (ED). For most drugs-of-abuse intoxication, ED physicians are skeptical to rely on results of urine drug testing for emergent management decisions. This is partially because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor intensive. Testing for toxic alcohols is needed, but rapid commercial assays are not available. ED physicians need stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs that could be used as agents of self-harm. In this review, we look at the potential limitations of these screening tests and suggest improvements and innovations needed for better clinical utilization. New drugs of abuse should be sought and assays should be developed to meet changing abuse patterns. PMID:25337490

  5. Bedside point of care toxicology screens in the ED: Utility and pitfalls.

    PubMed

    Bhalla, Ashish

    2014-07-01

    Exposure to drugs and toxins is a major cause for patients' visits to the emergency department (ED). For most drugs-of-abuse intoxication, ED physicians are skeptical to rely on results of urine drug testing for emergent management decisions. This is partially because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor intensive. Testing for toxic alcohols is needed, but rapid commercial assays are not available. ED physicians need stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs that could be used as agents of self-harm. In this review, we look at the potential limitations of these screening tests and suggest improvements and innovations needed for better clinical utilization. New drugs of abuse should be sought and assays should be developed to meet changing abuse patterns. PMID:25337490

  6. Randomized trial of pragmatic education for low-risk COPD patients: impact on hospitalizations and emergency department visits

    PubMed Central

    Siddique, Haamid H; Olson, Raymond H; Parenti, Connie M; Rector, Thomas S; Caldwell, Michael; Dewan, Naresh A; Rice, Kathryn L

    2012-01-01

    Background: Most interventions aimed at reducing hospitalizations and emergency department (ED) visits in patients with chronic obstructive pulmonary disease (COPD) have employed resource-intense programs in high-risk individuals. Although COPD is a progressive disease, little is known about the effectiveness of proactive interventions aimed at preventing hospitalizations and ED visits in the much larger population of low-risk (no known COPD-related hospitalizations or ED visits in the prior year) patients, some of whom will eventually become high-risk. Methods: We tested the effect of a simple educational and self-efficacy intervention (n = 2243) versus usual care (n = 2182) on COPD/breathing-related ED visits and hospitalizations in a randomized study of low-risk patients at three Veterans Affairs (VA) medical centers in the upper Midwest. Administrative data was used to track VA admissions and ED visits. A patient survey was used to determine health-related events outside the VA. Results: Rates of COPD-related VA hospitalizations in the education and usual care group were not significantly different (3.4 versus 3.6 admissions per 100 person-years, respectively; 95% CI of difference −1.3 to 1.0, P = 0.77). The much higher patient-reported rates of non-VA hospitalizations for breathing-related problems were lower in the education group (14.0 versus 19.0 per 100 person-years; 95% CI −8.6 to −1.4, P = 0.006). Rates of COPD-related VA ED visits were not significantly different (6.8 versus 5.3; 95% CI −0.1 to 3.0, P = 0.07), nor were non-VA ED visits (32.4 versus 36.5; 95% CI −9.3 to 1.1, P = 0.12). All-cause VA admission and ED rates did not differ. Mortality rates (6.9 versus 8.3 per 100 person-years, respectively; 95% CI −3.0 to 0.4, P = 0.13) did not differ. Conclusion: An educational intervention that is practical for large numbers of low-risk patients with COPD may reduce the rate of breathing-related hospitalizations. Further research that more

  7. For success with frequent ED utilizers, take steps to understand patient needs, connect them with appropriate resources.

    PubMed

    2013-05-01

    Through its newly created Consistent Care Program, St. Luke's Hospital in Cedar Rapids, IA, has been able to significantly reduce ED utilization among patients who have been identified as having used the ED at least 12 times in the past year. Patients who meet program criteria are automatically identified once per month. A committee of social workers, nurses, and providers then creates care plans for these individuals, so that when they present to the ED, emergency providers will have a consistent road map to follow. In one year, the program has reduced the number ED visits among frequent utilizers by one-third, saving the hospital close to $1 million. Of the original 103 patients who were first identified for the program in January of 2012, only 10 patients still meet the criteria of visiting the ED 12 times in 12 months. Administrators say that key elements of the program are case manager who can interact with the patients and their providers, a mechanism for flagging these patients when they present to the ED, and engaged providers. PMID:23667953

  8. Emergency Department Visits for Homelessness or Inadequate Housing in New York City before and after Hurricane Sandy.

    PubMed

    Doran, Kelly M; McCormack, Ryan P; Johns, Eileen L; Carr, Brendan G; Smith, Silas W; Goldfrank, Lewis R; Lee, David C

    2016-04-01

    Hurricane Sandy struck New York City on October 29, 2012, causing not only a large amount of physical damage, but also straining people's health and disrupting health care services throughout the city. In prior research, we determined that emergency department (ED) visits from the most vulnerable hurricane evacuation flood zones in New York City increased after Hurricane Sandy for several medical diagnoses, but also for the diagnosis of homelessness. In the current study, we aimed to further explore this increase in ED visits for homelessness after Hurricane Sandy's landfall. We performed an observational before-and-after study using an all-payer claims database of ED visits in New York City to compare the demographic characteristics, insurance status, geographic distribution, and health conditions of ED patients with a primary or secondary ICD-9 diagnosis of homelessness or inadequate housing in the first week after Hurricane Sandy's landfall versus the baseline weekly average in 2012 prior to Hurricane Sandy. We found statistically significant increases in ED visits for diagnosis codes of homelessness or inadequate housing in the week after Hurricane Sandy's landfall. Those accessing the ED for homelessness or inadequate housing were more often elderly and insured by Medicare after versus before the hurricane. Secondary diagnoses among those with a primary ED diagnosis of homelessness or inadequate housing also differed after versus before Hurricane Sandy. These observed differences in the demographic, insurance, and co-existing diagnosis profiles of those with an ED diagnosis of homelessness or inadequate housing before and after Hurricane Sandy suggest that a new population cohort-potentially including those who had lost their homes as a result of storm damage-was accessing the ED for homelessness or other housing issues after the hurricane. Emergency departments may serve important public health and disaster response roles after a hurricane, particularly for

  9. Microfabricated AC impedance sensor

    DOEpatents

    Krulevitch, Peter; Ackler, Harold D.; Becker, Frederick; Boser, Bernhard E.; Eldredge, Adam B.; Fuller, Christopher K.; Gascoyne, Peter R. C.; Hamilton, Julie K.; Swierkowski, Stefan P.; Wang, Xiao-Bo

    2002-01-01

    A microfabricated instrument for detecting and identifying cells and other particles based on alternating current (AC) impedance measurements. The microfabricated AC impedance sensor includes two critical elements: 1) a microfluidic chip, preferably of glass substrates, having at least one microchannel therein and with electrodes patterned on both substrates, and 2) electrical circuits that connect to the electrodes on the microfluidic chip and detect signals associated with particles traveling down the microchannels. These circuits enable multiple AC impedance measurements of individual particles at high throughput rates with sufficient resolution to identify different particle and cell types as appropriate for environmental detection and clinical diagnostic applications.

  10. Determining the effectiveness of the pentavalent rotavirus vaccine against rotavirus hospitalizations and emergency department visits using two study designs

    PubMed Central

    Donauer, Stephanie; Payne, Daniel C.; Edwards, Kathryn M.; Szilagyi, Peter G.; Hornung, Richard W.; Weinberg, Geoffrey A.; Chappell, James; Hall, Caroline B.; Parashar, Umesh D.; Staat, Mary Allen

    2015-01-01

    The objective of this study is to determine the vaccine effectiveness (VE) of the pentavalent rotavirus vaccine (RV5) for preventing rotavirus-related hospitalizations and emergency department (ED) visits during the 2006–07 and 2007–08 rotavirus seasons using two study designs. Active, prospective population-based surveillance was conducted to identify cases of laboratory-confirmed rotavirus-related hospitalizations and ED visits to be used in case-cohort and case-control designs. VE was calculated using one comparison group for the case-cohort method and two comparison groups for the case-control method. The VE estimates produced by the three analyses were similar. Three doses of RV5 were effective for preventing rotavirus-related hospitalizations and ED visits in each analysis, with VE estimated as 92% in all three analyses. Two doses of RV5 were also effective, with VE ranging from 79% to 83%. A single dose was effective in the case-cohort analysis, but was not significant in either of the case-control analyses. The case-cohort and the case-control study designs produced the same VE point estimates for completion of the three dose series. Two and three doses of RV5 were effective in preventing rotavirus-related hospitalizations and ED visits. PMID:23583814

  11. AC magnetohydrodynamic microfluidic switch

    SciTech Connect

    Lemoff, A V; Lee, A P

    2000-03-02

    A microfluidic switch has been demonstrated using an AC Magnetohydrodynamic (MHD) pumping mechanism in which the Lorentz force is used to pump an electrolytic solution. By integrating two AC MHD pumps into different arms of a Y-shaped fluidic circuit, flow can be switched between the two arms. This type of switch can be used to produce complex fluidic routing, which may have multiple applications in {micro}TAS.

  12. ED security: a national telephone survey.

    PubMed

    Ellis, G L; Dehart, D A; Black, C; Gula, M J; Owens, A

    1994-03-01

    To determine current practices regarding security measures in the emergency department (ED), a random sample of 250 hospitals with EDs was surveyed by telephone. Security issues addressed included personnel (in-house security, contract guards, or police), hours of staffing in the ED, how security is armed, whether ED doors are locked at off-hours, and whether alarm buttons, direct phone lines, a paging code, closed circuit surveillance, metal detectors, and seclusion rooms are used. This information was stratified according to hospital size, ED census, rural/suburban/urban setting, teaching/nonteaching status, and region. Generally, on-site security presence increases with increasing hospital size and ED census, suburban and urban locations, and teaching status. Small, rural hospitals are more likely to lock the ED doors at off-hours, whereas the use of security codes does not clearly follow demographic trends. Larger hospitals in suburban and urban settings and having a teaching status are more likely to have secure/detention rooms and closed circuit surveillance. The use of alarm buttons and/or direct telephone lines varies widely, but is generally more common in larger, teaching hospitals, located in urban and suburban settings.

  13. Isolation of sequences flanking Ac insertion sites by Ac casting.

    PubMed

    Wang, Dafang; Peterson, Thomas

    2013-01-01

    Localizing Ac insertions is a fundamental task in studying Ac-induced mutation and chromosomal rearrangements involving Ac elements. Researchers may sometimes be faced with the situation in which the sequence flanking one side of an Ac/Ds element is known, but the other flank is unknown. Or, a researcher may have a small sequence surrounding the Ac/Ds insertion site and needs to obtain additional flanking genomic sequences. One way to rapidly clone unknown Ac/Ds flanking sequences is via a PCR-based method termed Ac casting. This approach utilizes the somatic transposition activity of Ac during plant development, and provides an efficient means for short-range genome walking. Here we describe the principle of Ac casting, and show how it can be applied to isolate Ac macrotransposon insertion sites.

  14. Fine particulate matter components and emergency department visits among a privately insured population in Greater Houston.

    PubMed

    Liu, Suyang; Ganduglia, Cecilia M; Li, Xiao; Delclos, George L; Franzini, Luisa; Zhang, Kai

    2016-10-01

    Although adverse health effects of PM2.5 (particulate matter with aerodynamic diameter less than 2.5μm) mass have been extensively studied, it remains unclear regarding which PM2.5 components are most harmful. No studies have reported the associations between PM2.5 components and adverse health effects among a privately insured population. In our study, we estimated the short-term associations between exposure to PM2.5 components and emergency department (ED) visits for all-cause and cause-specific diseases in Greater Houston, Texas, during 2008-2013 using ED visit data extracted from a private insurance company (Blue Cross Blue Shield Texas [BCBSTX]). A total of 526,453 ED visits were included in our assessment, with an average of 236 (±63) visits per day. We selected 20 PM2.5 components from the U.S. Environmental Protection Agency's Chemical Speciation Network site located in Houston, and then applied Poisson regression models to assess the previously mentioned associations. Interquartile range increases in bromine (0.003μg/m(3)), potassium (0.048μg/m(3)), sodium ion (0.306μg/m(3)), and sulfate (1.648μg/m(3)) were statistically significantly associated with the increased risks in total ED of 0.71% (95% confidence interval (CI): 0.06, 1.37%), 0.71% (95% CI: 0.21, 1.22%), 1.28% (95% CI: 0.34, 2.24%), and 1.22% (95% CI: 0.23, 2.23%), respectively. Seasonal analysis suggested strongest associations occurred during the warm season. Our findings suggest that a privately insured population, presumably healthier than the general population, may be still at risk of adverse health effects due to exposure to ambient PM2.5 components. PMID:27235902

  15. Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder.

    PubMed

    Kalb, Luther G; Vasa, Roma A; Ballard, Elizabeth D; Woods, Steven; Goldstein, Mitchell; Wilcox, Holly C

    2016-08-01

    Several reports suggest children with autism spectrum disorder (ASD) are more likely to be seen for injury-related ED visits; however, no nationally representative study has examined this question. Using data from the 2008 Nationwide Emergency Department Sample, over a quarter of all visits among those with ASD were related to injury. In the multivariate analyses, the odds of an injury-related visit was 54 % greater among those with ASD compared to youth with intellectual disability (ID), but 48 % less compared to youth without ID or ASD. Compared to all other pediatric injury-visits in the US, visits among children with ASD were more likely to be due to self-inflicted injury and poisoning and were more likely to result in hospitalization (all p < 0.001).

  16. Data-driven process and operational improvement in the emergency department: the ED Dashboard and Reporting Application.

    PubMed

    Stone-Griffith, Suzanne; Englebright, Jane D; Cheung, Dickson; Korwek, Kimberly M; Perlin, Jonathan B

    2012-01-01

    Emergency departments (EDs) in the United States are expected to provide consistent, high-quality care to patients. Unfortunately, EDs are encumbered by problems associated with the demand for services and the limitations of current resources, such as overcrowding, long wait times, and operational inefficiencies. While increasing the effectiveness and efficiency of emergency care would improve both access and quality of patient care, coordinated improvement efforts have been hindered by a lack of timely access to data. The ED Dashboard and Reporting Application was developed to support data-driven process improvement projects. It incorporated standard definitions of metrics, a data repository, and near real-time analysis capabilities. This helped acute care hospitals in a large healthcare system evaluate and target individual improvement projects in accordance with corporate goals. Subsequently, there was a decrease in "arrival to greet" time--the time from patient arrival to physician contact--from an average of 51 minutes in 2007 to the goal level of less than 35 minutes by 2010. The ED Dashboard and Reporting Application has also contributed to data-driven improvements in length of stay and other measures of ED efficiency and care quality. Between January 2007 and December 2010, overall length of stay decreased 10.5 percent while annual visit volume increased 13.6 percent. Thus, investing in the development and implementation of a system for ED data capture, storage, and analysis has supported operational management decisions, gains in ED efficiency, and ultimately improvements in patient care. PMID:22724375

  17. Collaborative effort in Washington state slashes non-essential use of the ED by Medicaid patients, delivering millions in projected savings.

    PubMed

    2013-04-01

    Early data suggest a coordinated, state-wide effort has reduced non-essential use of the ED by 10% among Medicaid recipients in Washington state, and is projected to save the state an estimated $31 million in the first year of the approach. The effort includes the adoption of seven best practices by hospitals across the state.These include the creation of an Emergency Department Information Exchange, so that EDs can immediately access a patient's utilization history, strict narcotic prescribing guidelines, and regular feedback reports to hospitals regarding ED utilization patterns. The effort was prompted by threats by the state legislature to limit Medicaid payments for ED visits deemed not medically necessary in the emergency setting. The legislature backed down when emergency physicians in the state countered with their own proposal to reduce nonessential use of the ED. They worked with other health care groups in the state to develop the plan. Data on the first six months of the effort are included in a report to the state legislature by the Washington State Health Care Authority. Among the findings are a 23% reduction in ED visits among Medicaid recipients with five or more visits, a 250% increase in providers who have registered with the state's Prescription Monitoring Program, aimed at identifying patients with narcotic-seeking behavior, and a doubling in the number of shared care plans, intended to improve care coordination. Emergency providers say big challenges remain, including a need for more resources for patients with mental health and dental care needs.

  18. Co-op Site Visitation and beyond.

    ERIC Educational Resources Information Center

    Page, Norman R.

    1997-01-01

    A survey of 26 faculty cooperative education coordinators, 18 students, and 13 site supervisors found that 80% thought faculty site visits were important; barriers to visits were time and distance; and alternatives included visiting only new sites or those with problems, using telephone or video, and hosting site supervisors on campus. (SK)

  19. 28 CFR 540.42 - Visiting times.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish...

  20. 28 CFR 540.42 - Visiting times.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish...

  1. 28 CFR 540.42 - Visiting times.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish...

  2. 28 CFR 540.42 - Visiting times.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish...

  3. Case Study of Home-School Visits

    ERIC Educational Resources Information Center

    Aguerrebere, Yolanda

    2009-01-01

    This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…

  4. 28 CFR 540.42 - Visiting times.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish...

  5. Job Candidates' Views of Site Visits.

    ERIC Educational Resources Information Center

    Fink, Laurence S.; And Others

    1994-01-01

    Followed 62 Master of Business Administration students through job search involving 97 site visits to determine whether site visits changed perceptions of visited companies, attitudes toward those firms, and intentions to accept job offers. Findings suggest that organizations can improve recruitment success by paying attention to how site visits…

  6. Home Visits in Geropsychiatry Fellowship Training

    ERIC Educational Resources Information Center

    Roane, David M.; Teusink, J. Paul; Wortham, Jennifer A.

    2002-01-01

    Purpose: The psychiatric home visit is an effective intervention for elderly patients who otherwise would not receive mental health services. Home visits also have potential to be useful for training. Here, the current practice of home visits in geropsychiatry fellowship programs is examined. Design and Methods: The directors of 55 current…

  7. Emergency Department Visits and Neuroimaging for Concussion Patients from 2006–2011

    PubMed Central

    Zonfrillo, Mark R.; Kim, Konny H.; Arbogast, Kristy B.

    2015-01-01

    Objectives Concussion is the most common type of mild traumatic brain injury for which patients present to the emergency department (ED). It is critical to understand the contemporary epidemiology of concussion and rates of head computed tomography (CT) use in head-injured patients in order to inform education of evidence-based clinical practice guidelines to emergency medicine providers. Methods This was a cross-sectional analysis of the Nationwide Emergency Department Sample (NEDS) for years 2006 to 2011, representing a stratified probability sample of all U.S. hospital-based EDs. Patients of all ages with concussion diagnoses were included, and those with intracranial hemorrhages or prolonged loss of consciousness were excluded. Descriptive and bivariate statistics were summarized for patient demographics, injury mechanism, Injury Severity Scores (ISS), and concussion incidence rates, based on U.S. Census Bureau population estimates. Results There were 756,214,762 (weighted) ED visits in the NEDS between 2006 and 2011, of which 0.5% received diagnoses of concussion. The national incidence rate of concussion visits increased 22.6% from 195 visits per 100,000 person-years in 2006, to 239 visits per 100,000 person-years in 2011. The incidence of concussion visits increased by 28.1% from 2006 to 2011 overall (580,573 to 743,994) and within all age group categories. The rate of head CT use in patients diagnosed with concussion increased 35.7% (range 34.5% to 46.8%) for the entire group from 2006 to 2011 (p < 0.0001). The injury severity of patients’ injuries decreased over time (66.4% ISS < 5 in 2006, and 75% in 2011; p < 0.0001), while the proportion of discharged patients increased over time (78.1% in 2006, 86.6% in 2011; p < 0.0001). Conclusions ED visits for concussions have increased over time, with a corresponding increase in head CT utilization despite a decrease in injury severity. Increased visits may be due to more concussion awareness and recognition of

  8. 78 FR 55684 - ConnectED Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... stakeholders from the education, technology, and government sectors to share ideas, discuss policies, and... convene stakeholders from the education, technology, and government sectors to share ideas, discuss... National Telecommunications and Information Administration ConnectED Workshop AGENCY:...

  9. MicroED data collection and processing

    SciTech Connect

    Hattne, Johan; Reyes, Francis E.; Nannenga, Brent L.; Shi, Dan; Cruz, M. Jason de la; Leslie, Andrew G. W.; Gonen, Tamir

    2015-07-01

    The collection and processing of MicroED data are presented. MicroED, a method at the intersection of X-ray crystallography and electron cryo-microscopy, has rapidly progressed by exploiting advances in both fields and has already been successfully employed to determine the atomic structures of several proteins from sub-micron-sized, three-dimensional crystals. A major limiting factor in X-ray crystallography is the requirement for large and well ordered crystals. By permitting electron diffraction patterns to be collected from much smaller crystals, or even single well ordered domains of large crystals composed of several small mosaic blocks, MicroED has the potential to overcome the limiting size requirement and enable structural studies on difficult-to-crystallize samples. This communication details the steps for sample preparation, data collection and reduction necessary to obtain refined, high-resolution, three-dimensional models by MicroED, and presents some of its unique challenges.

  10. Beautiful Science: Worth a Visit

    NASA Astrophysics Data System (ADS)

    Bingham, Frederick M.

    2013-03-01

    For those in the profession of teaching physics who reside in or plan to visit the Los Angeles area, I would highly recommend a trip to the Huntington Library in San Marino, specifically to a permanent exhibit entitled "Beautiful Science: Ideas that Changed the World" in the Dibner Hall of the History of Science. The exhibit contains original books and manuscripts from the library's own collections. The sheer magnitude of human achievement represented here and the amount of effort and money that must have been required to amass these books boggles the mind.

  11. Emergency Department Visits and Inpatient Admissions Associated with Priapism among Males with Sickle Cell Disease in the United States, 2006–2010

    PubMed Central

    Dupervil, Brandi; Grosse, Scott; Burnett, Arthur; Parker, Christopher

    2016-01-01

    People with sickle cell disease (SCD) suffer from numerous acute complications that can result in multiple hospitalizations and emergency department (ED) and outpatient care visits. Priapism, a prolonged unwanted erection of the penis not due to sexual stimulation, is a serious complication among males with SCD. Variations in estimates of prevalence make it difficult to accurately assess the burden of this complication of SCD. We analyzed data from the Nationwide Emergency Department Sample (NEDS), a product of the Healthcare Cost and Utilization Project, for the years 2006 through 2010 to measure the numbers of ED visits and to examine patterns of subsequent hospitalizations associated with priapism among male patients with SCD. We find that among ED visits associated with males with SCD, those prompted by priapism are more likely to result in hospitalization than are those associated with pain. PMID:27078839

  12. The Arctic Visiting Speakers Program

    NASA Astrophysics Data System (ADS)

    Wiggins, H. V.; Fahnestock, J.

    2013-12-01

    The Arctic Visiting Speakers Program (AVS) is a program of the Arctic Research Consortium of the U.S. (ARCUS) and funded by the National Science Foundation. AVS provides small grants to researchers and other Arctic experts to travel and share their knowledge in communities where they might not otherwise connect. The program aims to: initiate and encourage arctic science education in communities with little exposure to arctic research; increase collaboration among the arctic research community; nurture communication between arctic researchers and community residents; and foster arctic science education at the local level. Individuals, community organizations, and academic organizations can apply to host a speaker. Speakers cover a wide range of arctic topics and can address a variety of audiences including K-12 students, graduate and undergraduate students, and the general public. Preference is given to tours that reach broad and varied audiences, especially those targeted to underserved populations. Between October 2000 and July 2013, AVS supported 114 tours spanning 9 different countries, including tours in 23 U.S. states. Tours over the past three and a half years have connected Arctic experts with over 6,600 audience members. Post-tour evaluations show that AVS consistently rates high for broadening interest and understanding of arctic issues. AVS provides a case study for how face-to-face interactions between arctic scientists and general audiences can produce high-impact results. Further information can be found at: http://www.arcus.org/arctic-visiting-speakers.

  13. Tevatron AC dipole system

    SciTech Connect

    Miyamoto, R.; Kopp, S.E.; Jansson, A.; Syphers, M.J.; /Fermilab

    2007-06-01

    The AC dipole is an oscillating dipole magnet which can induce large amplitude oscillations without the emittance growth and decoherence. These properties make it a good tool to measure optics of a hadron synchrotron. The vertical AC dipole for the Tevatron is powered by an inexpensive high power audio amplifier since its operating frequency is approximately 20 kHz. The magnet is incorporated into a parallel resonant system to maximize the current. The use of a vertical pinger magnet which has been installed in the Tevatron made the cost relatively inexpensive. Recently, the initial system was upgraded with a more powerful amplifier and oscillation amplitudes up to 2-3{sigma} were achieved with the 980 GeV proton beam. This paper discusses details of the Tevatron AC dipole system and also shows its test results.

  14. AC-3 audio coder

    NASA Astrophysics Data System (ADS)

    Todd, Craig

    1995-12-01

    AC-3 is a system for coding up to 5.1 channels of audio into a low bit-rate data stream. High quality may be obtained with compression ratios approaching 12-1 for multichannel audio programs. The high compression ratio is achieved by methods which do not increase decoder memory, and thus cost. The methods employed include: the transmission of a high frequency resolution spectral envelope; and a novel forward/backward adaptive bit allocation algorithm. In order to satisfy practical requirements of an emissions coder, the AC-3 syntax includes a number of features useful to broadcasters and consumers. These features include: loudness uniformity between programs; dynamic range control; and broadcaster control of downmix coefficients. The AC-3 coder has been formally selected for inclusion of the U.S. HDTV broadcast standard, and has been informally selected for several additional applications.

  15. ac bidirectional motor controller

    NASA Technical Reports Server (NTRS)

    Schreiner, K.

    1988-01-01

    Test data are presented and the design of a high-efficiency motor/generator controller at NASA-Lewis for use with the Space Station power system testbed is described. The bidirectional motor driver is a 20 kHz to variable frequency three-phase ac converter that operates from the high-frequency ac bus being designed for the Space Station. A zero-voltage-switching pulse-density-modulation technique is used in the converter to shape the low-frequency output waveform.

  16. Incidence of and Predictors for Early Return Visits to the Emergency Department

    PubMed Central

    Ko, Mingchung; Lee, Yaling; Chen, Chuchieh; Chou, Pesus; Chu, Dachen

    2015-01-01

    Abstract The aim of this study is to estimate the proportion of and predictors for early return visits (ERVs) to the emergency department (ED) in Taiwan. This is a population-based study using data of 1 million people randomly selected from all beneficiaries of the Taiwan National Health Insurance. All ED visits in 2012 were analyzed. The ERVs to the ED were defined as those ED revisits within 3 days after the initial ED visit. We employed a generalized estimation equation model to investigate the independent effects of various characteristics associated with the initial ED visit on ERVs. The overall proportion of ERVs within 3 days with a same dichotomous diagnostic category according to injury or noninjury was 4.3% (6740/158,132), and the overall proportion of hospitalizations after ERVs was 24.1% (1627/6740). Male subjects (4.3%) were more likely to have ERVs with an adjusted odds ratio (AOR) of 1.10 (95% confidence interval [CI]: 1.04–1.16). Compared with patients aged 18 to 64 years (4.0%), those aged >64 years had a significantly increased risk of ERVs (6.2%, AOR: 1.49, 95% CI: 1.39–1.59). In comparison to patients with injury diagnoses (2.2%), those with noninjury diagnoses had a higher risk of ERVs (5.2%, AOR: 2.50, 95% CI: 2.33–2.70). Compared with patients initially treated at medical centers (3.7%), those initially treated at regional (4.5%, AOR: 1.28, 95% CI: 1.20–1.37) or district hospitals (4.5%, AOR: 1.38, 95% CI: 1.27–1.49) had significantly higher risks of ERVs. Among the 6740 patients with ERVs, 2622 (38.9%) returned to a different hospital, and these patients tended to be those aged 18 to 64 years and initially treated at district hospitals. The risk of ERVs was associated with demographic characteristics and accreditation level of hospital. We noted a large proportion of patients with ERVs to a different hospital. The reason underlying this phenomenon warrants further investigations. PMID:26512573

  17. A Visit With a Curandero

    PubMed Central

    Mull, J. Dennis; Mull, Dorothy S.

    1983-01-01

    One author visited a Mexican-American folk healer in the Los Angeles area, not as a patient but as a fellow health professional. Information was obtained from this healer, a curandero, regarding his background, his clientele, the illnesses he treats, the therapeutic techniques he uses and his relationship with the official health care system. This information was generally consistent with statements about curanderismo that have appeared in the social sciences literature. It also provided additional insight into practices that have been alluded to in that literature but not described in detail. With few exceptions, curanderos would seem to be talented healers whose efforts often benefit their patients and whose continued popularity has important implications for physicians, especially those serving large numbers of people of Mexican descent. PMID:6659503

  18. AC/RF Superconductivity

    SciTech Connect

    Ciovati, Gianluigi

    2015-02-01

    This contribution provides a brief introduction to AC/RF superconductivity, with an emphasis on application to accelerators. The topics covered include the surface impedance of normal conductors and superconductors, the residual resistance, the field dependence of the surface resistance, and the superheating field.

  19. Understanding decisions leading to nonurgent visits to the paediatric emergency department: caregivers’ perspectives

    PubMed Central

    Kua, Phek Hui Jade; Wu, Li; Ong, E-Lin Tessa; Lim, Zi Ying; Yiew, Jinmian Luther; Thia, Xing Hui Michelle; Sung, Sharon Cohan

    2016-01-01

    INTRODUCTION A significant percentage of paediatric emergency department (ED) attendances worldwide are nonurgent, adversely affecting patient outcomes and healthcare systems. This study aimed to understand the reasons behind nonurgent ED visits, in order to develop targeted and effective preventive interventions. METHODS In-depth interviews were conducted with 49 caregivers to identify the decision-making factors related to taking children to the ED of KK Women’s and Children’s Hospital, Singapore. Interviews were carried out in the emergency room of the hospital after the children had been diagnosed with nonurgent conditions by the attending physician. Interview transcripts were analysed based on grounded theory principles. RESULTS The demographics of our study cohort were representative of the target population. The main reasons given by the caregivers for attending paediatric EDs included perceived severity of the child’s symptoms, availability of after-hours care, perceived advantage of a paediatric specialist hospital and mistrust of primary care physicians’ ability to manage paediatric conditions. Insurance or welfare was a contributing factor for only a small portion of caregivers. CONCLUSION The reasons provided by Singaporean caregivers for attending paediatric EDs were similar to those reported in studies conducted in Western countries. However, the former group had a unique understanding of the local healthcare system. The study’s findings may be used to develop interventions to change the knowledge, attitudes and behaviours of caregivers in Singapore. PMID:26805668

  20. Creating a national home visiting research network.

    PubMed

    Duggan, Anne; Minkovitz, Cynthia S; Chaffin, Mark; Korfmacher, Jon; Brooks-Gunn, Jeanne; Crowne, Sarah; Filene, Jill; Gonsalves, Kay; Landsverk, John; Harwood, Robin

    2013-11-01

    Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN's Coordinating Center supports the Work Teams and HVRN's Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN's rationale, approach, and anticipated products. We use home visiting-primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes.

  1. Creating a national home visiting research network.

    PubMed

    Duggan, Anne; Minkovitz, Cynthia S; Chaffin, Mark; Korfmacher, Jon; Brooks-Gunn, Jeanne; Crowne, Sarah; Filene, Jill; Gonsalves, Kay; Landsverk, John; Harwood, Robin

    2013-11-01

    Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN's Coordinating Center supports the Work Teams and HVRN's Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN's rationale, approach, and anticipated products. We use home visiting-primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes. PMID:24187127

  2. Plant immunity: the EDS1 regulatory node.

    PubMed

    Wiermer, Marcel; Feys, Bart J; Parker, Jane E

    2005-08-01

    ENHANCED DISEASE SUSCEPTIBILITY 1 (EDS1) and its interacting partner, PHYTOALEXIN DEFICIENT 4 (PAD4), constitute a regulatory hub that is essential for basal resistance to invasive biotrophic and hemi-biotrophic pathogens. EDS1 and PAD4 are also recruited by Toll-Interleukin-1 receptor (TIR)-type nucleotide binding-leucine rich repeat (NB-LRR) proteins to signal isolate-specific pathogen recognition. Recent work points to a fundamental role of EDS1 and PAD4 in transducing redox signals in response to certain biotic and abiotic stresses. These intracellular proteins are important activators of salicylic acid (SA) signaling and also mediate antagonism between the jasmonic acid (JA) and ethylene (ET) defense response pathways. EDS1 forms several molecularly and spatially distinct complexes with PAD4 and a newly discovered in vivo signaling partner, SENESCENCE ASSOCIATED GENE 101 (SAG101). Together, EDS1, PAD4 and SAG101 provide a major barrier to infection by both host-adapted and non-host pathogens.

  3. A Quantitative Content Analysis of Mercer University MEd, EdS, and Doctoral Theses

    ERIC Educational Resources Information Center

    Randolph, Justus J.; Gaiek, Lura S.; White, Torian A.; Slappey, Lisa A.; Chastain, Andrea; Harris, Rose Prejean

    2010-01-01

    Quantitative content analysis of a body of research not only helps budding researchers understand the culture, language, and expectations of scholarship, it helps identify deficiencies and inform policy and practice. Because of these benefits, an analysis of a census of 980 Mercer University MEd, EdS, and doctoral theses was conducted. Each thesis…

  4. 34 CFR 85.942 - ED Deciding Official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false ED Deciding Official. 85.942 Section 85.942 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 85.942 ED Deciding Official. The ED Deciding Official is an ED officer who has...

  5. Modification of the effect of ambient air pollution on pediatric asthma emergency visits: susceptible subpopulations

    PubMed Central

    Strickland, Matthew J; Klein, Mitchel; Flanders, W Dana; Chang, Howard H; Mulholland, James A; Tolbert, Paige E; Darrow, Lyndsey A

    2016-01-01

    Background Children may have differing susceptibility to ambient air pollution concentrations depending on various background characteristics of the children. Methods Using emergency department (ED) data linked with birth records from Atlanta, Georgia, we identified ED visits for asthma or wheeze among children aged 2–16 years from 1 January 2002 through 30 June 2010 (n=109,758). We stratified by preterm delivery, term low birth weight, maternal race, Medicaid status, maternal education, maternal smoking, delivery method, and history of a bronchiolitis ED visit. Population-weighted daily average concentrations were calculated for 1-hour maximum carbon monoxide and nitrogen dioxide; 8-hour maximum ozone; and 24-hour average particulate matter less than 10 microns in diameter, particulate matter less than 2.5 microns in diameter (PM2.5), and the PM2.5 components sulfate, nitrate, ammonium, elemental carbon, and organic carbon, using measurements from stationary monitors. Poisson time-series models were used to estimate rate ratios for associations between three-day moving average pollutant concentrations and daily ED visit counts and to investigate effect-measure modification by the stratification factors. Results Associations between pollutant concentrations and asthma exacerbations were larger among children born preterm and among children born to African American mothers. Stratification by race and preterm status together suggested that both factors affected susceptibility. The largest estimated effect size (for an interquartile-range increase in pollution) was observed for ozone among preterm births to African American mothers: rate ratio=1.138 (95% confidence interval=1.077–1.203). In contrast, the rate ration for the ozone association among full-term births to mothers of other races was 1.025 (0.970–1.083). Conclusions Results support the hypothesis that children vary in their susceptibility to ambient air pollutants. PMID:25192402

  6. MicroED data collection and processing.

    PubMed

    Hattne, Johan; Reyes, Francis E; Nannenga, Brent L; Shi, Dan; de la Cruz, M Jason; Leslie, Andrew G W; Gonen, Tamir

    2015-07-01

    MicroED, a method at the intersection of X-ray crystallography and electron cryo-microscopy, has rapidly progressed by exploiting advances in both fields and has already been successfully employed to determine the atomic structures of several proteins from sub-micron-sized, three-dimensional crystals. A major limiting factor in X-ray crystallography is the requirement for large and well ordered crystals. By permitting electron diffraction patterns to be collected from much smaller crystals, or even single well ordered domains of large crystals composed of several small mosaic blocks, MicroED has the potential to overcome the limiting size requirement and enable structural studies on difficult-to-crystallize samples. This communication details the steps for sample preparation, data collection and reduction necessary to obtain refined, high-resolution, three-dimensional models by MicroED, and presents some of its unique challenges. PMID:26131894

  7. MicroED data collection and processing

    PubMed Central

    Hattne, Johan; Reyes, Francis E.; Nannenga, Brent L.; Shi, Dan; de la Cruz, M. Jason; Leslie, Andrew G. W.; Gonen, Tamir

    2015-01-01

    MicroED, a method at the intersection of X-ray crystallography and electron cryo-microscopy, has rapidly progressed by exploiting advances in both fields and has already been successfully employed to determine the atomic structures of several proteins from sub-micron-sized, three-dimensional crystals. A major limiting factor in X-ray crystallography is the requirement for large and well ordered crystals. By permitting electron diffraction patterns to be collected from much smaller crystals, or even single well ordered domains of large crystals composed of several small mosaic blocks, MicroED has the potential to overcome the limiting size requirement and enable structural studies on difficult-to-crystallize samples. This communication details the steps for sample preparation, data collection and reduction necessary to obtain refined, high-resolution, three-dimensional models by MicroED, and presents some of its unique challenges. PMID:26131894

  8. Final Report - Summer Visit 2010

    SciTech Connect

    Bank, R

    2011-09-12

    During my visit to LLNL during the summer of 2010, I worked on algebraic multilevel solvers for large sparse systems of linear equations arising from discretizations of partial differential equations. The particular solver of interest is based on ILU decomposition. The setup phase for this AMG solve is just the single ILU decomposition, and its corresponding error matrix. Because the ILU uses a minimum degree or similar sparse matrix ordering, most of the fill-in, and hence most of the error, is concentrated in the lower right corner of the factored matrix. All of the major multigrid components - the smoother, the coarse level correction matrices, and the fine-to-coarse and coarse-to-fine rectangular transfer matrices, are defined in terms of various blocks of the ILU factorization. Although such a strategy is not likely to be optimal in terms of convergence properties, it has a relatively low setup cost, and therefore is useful in situations where setup costs for more traditional AMG approaches cannot be amortized over the solution of many linear systems using the same matrix. Such a situation arises in adaptive methods, where often just one linear system is solved at each step of an adaptive feedback loop, or in solving nonlinear equations by approximate Newton methods, where the approximate Jacobian might change substantially from iteration to iteration. In general terms, coarse levels are defined in terms of successively smaller lower right blocks of the matrix, typically decreasing geometrically in order. The most difficult issue was the coarse grid correction matrix. The preconditioner/smoother for a given level is just the corresponding lower right blocks of the ILU factorization. The coarse level matrix itself is just the Schur complement; this matrix is not known exactly using just the ILU decomposition in the setup phase. Thus we approximate this matrix using various combinations of the preconditioning matrix and the error matrix. During my visit, several

  9. Association of Age, Systolic Blood Pressure, and Heart Rate with Adult Morbidity and Mortality after Urgent Care Visits

    PubMed Central

    Hart, James; Woodruff, Michael; Joy, Elizabeth; Dalto, Joseph; Snow, Gregory; Srivastava, Rajendu; Isaacson, Brad; Allen, Todd

    2016-01-01

    Introduction Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. Methods We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008–2013. Adult patients (≥18 years) were included if they had a unique UC visit and HR or SBP data. Three endpoints following UC visit were assessed: emergency department (ED) visit within three days, hospitalization within three days, and death within seven days. We analyzed associations between age, SBP, HR and endpoints using local regression with a binomial likelihood. Five age groups were chosen from previously published national surveys. Vital sign (VS) distributions were determined for each age group, and the central tendency was compared against previously published norms (90–120mmHg for SBP and 60–100bpm for HR.) Results A total of 1,720,207 encounters (714,339 unique patients) met the inclusion criteria; 51,446 encounters (2.99%) had ED visit within three days; 12,397 (0.72%) experienced hospitalization within three days; 302 (0.02%) died within seven days of UC visit. Heart rate and SBP combined with advanced age predicted the probability of ED visit (p<0.0001) and hospitalization (p<0.0001) following UC visit. Significant associations between advancing age and death (p<0.0001), and VS and death (p<0.0001) were observed. Odds ratios of risk were highest for elderly patients with lower SBP or higher HR. Observed distributions of SBP were higher than published normal ranges for all age groups. Conclusion Among adults seeking care in the UC, associations between HR and SBP and likelihood of ED visits and hospitalization were more

  10. Association of Age, Systolic Blood Pressure, and Heart Rate with Adult Morbidity and Mortality after Urgent Care Visits

    PubMed Central

    Hart, James; Woodruff, Michael; Joy, Elizabeth; Dalto, Joseph; Snow, Gregory; Srivastava, Rajendu; Isaacson, Brad; Allen, Todd

    2016-01-01

    Introduction Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. Methods We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008–2013. Adult patients (≥18 years) were included if they had a unique UC visit and HR or SBP data. Three endpoints following UC visit were assessed: emergency department (ED) visit within three days, hospitalization within three days, and death within seven days. We analyzed associations between age, SBP, HR and endpoints using local regression with a binomial likelihood. Five age groups were chosen from previously published national surveys. Vital sign (VS) distributions were determined for each age group, and the central tendency was compared against previously published norms (90–120mmHg for SBP and 60–100bpm for HR.) Results A total of 1,720,207 encounters (714,339 unique patients) met the inclusion criteria; 51,446 encounters (2.99%) had ED visit within three days; 12,397 (0.72%) experienced hospitalization within three days; 302 (0.02%) died within seven days of UC visit. Heart rate and SBP combined with advanced age predicted the probability of ED visit (p<0.0001) and hospitalization (p<0.0001) following UC visit. Significant associations between advancing age and death (p<0.0001), and VS and death (p<0.0001) were observed. Odds ratios of risk were highest for elderly patients with lower SBP or higher HR. Observed distributions of SBP were higher than published normal ranges for all age groups. Conclusion Among adults seeking care in the UC, associations between HR and SBP and likelihood of ED visits and hospitalization were more

  11. [Time analysis of pharmacists' home visit duties].

    PubMed

    Horii, Kota; Hirasawa, Shinichiro; Toshima, Chiaki; Morimoto, Masao; Shiraishi, Takeya; Maeda, Keigo; Hirohara, Masayoshi; Kushida, Kazuki

    2014-12-01

    Pharmacists' home visit duties include accepting prescriptions, making inquiries with the attending physician, preparing medication, giving guidance on medication, going on home visits(round trips), and handling insurance claims. In the present study, we measured the time required for each duty and determined work duration per visit. The study took place during September 2013; the sample included 116 subjects and 211 home visits were conducted. Pharmacists' mean work duration per visit was 73 min and 15 s; they spent an average of 36 min and 13 s of this period on round trips involving home visits and providing guidance on medication. Pharmacists are responsible for preparing medication for outpatients; therefore, it can be assumed that they can visit patients at their homes only during the estimated 2-h period after lunch and before the commencement of outpatient service in the evening. Therefore, it is difficult for one pharmacist to visit more than five patients a day. The number of patients that each pharmacist can visit in one week(6 working days)is estimated at 25-30.

  12. Validation of ICD-9-CM codes for identification of acetaminophen-related emergency department visits in a large pediatric hospital

    PubMed Central

    2013-01-01

    Background Acetaminophen overdose is a major concern among the pediatric population. Our objective was to assess the validity of International Classification of Disease (ICD-9-CM) codes for identification of pediatric emergency department (ED) visits resulting from acetaminophen exposure or overdose. Methods We conducted a retrospective medical record review of ED visits at Texas Children’s Hospital in Houston, Texas, between January 1, 2005, and December 31, 2010. Visits coded with 1 or more ICD-9 codes for poisoning (965, 977, and their subcodes and supplemental E-codes E850, E858, E935, E947, and E950 and their subcodes) were identified from an administrative database, and further review of the medical records was conducted to identify true cases of acetaminophen exposure or overdose. We then examined the sensitivity, positive predictive value, and percentage of false positives identified by various codes and code combinations to establish which codes most accurately identified acetaminophen exposure or overdose. Results Of 1,215 ED visits documented with 1 or more of the selected codes, 316 (26.0%) were a result of acetaminophen exposure or overdose. Sensitivity was highest (87.0%) for the combination of codes 965.4 (poisoning by aromatic analgesics, not elsewhere classified) and E950.0 (suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics), with a positive predictive value of 86.2%. Code 965.4 alone yielded a sensitivity of 85.1%, with a positive predictive value of 92.8%. Code performance varied among age groups and depending on the type of exposure (intentional or unintentional). Conclusion ICD-9 codes are useful for ascertaining which ED visits are a result of acetaminophen exposure or overdose within the pediatric population. However, because ICD-9 coding differs by age group and depending on the type of exposure, hypothesis-driven strategies must be utilized for each pediatric age group to avoid misclassification. PMID

  13. Adolescent Female Text Messaging Preferences to Prevent Pregnancy After an Emergency Department Visit: A Qualitative Analysis

    PubMed Central

    Schnall, Rebecca; Stockwell, Melissa S; Castaño, Paula M; Higgins, Tracy; Westhoff, Carolyn; Santelli, John; Dayan, Peter S

    2016-01-01

    Background Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. Objective The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females. Methods We conducted semistructured, open-ended interviews in one urban ED in the United States with adolescent females aged 14-19 years. Eligible subjects were adolescents who were sexually active in the past 3 months, presented to the ED for a reproductive health complaint, owned a mobile phone, and did not use effective contraception. Using an interview guide, enrollment continued until saturation of key themes. The investigators designed sample text messages using the Health Beliefs Model and participants viewed these on a mobile phone. The team recorded, transcribed, and coded interviews based on thematic analysis using the qualitative analysis software NVivo and Excel. Results Participants (n=14) were predominantly Hispanic (13/14; 93%), insured (13/14; 93%), ED users in the past year (12/14; 86%), and frequent text users (10/14; 71% had sent or received >30 texts per day). All were interested in receiving text messages from the ED about pregnancy prevention, favoring messages that were “brief,” “professional,” and “nonaccusatory.” Respondents favored texts with links to websites, repeated information regarding places to receive “confidential” care, and focused information on contraception options and misconceptions. Preferences for text message frequency varied from daily to monthly, with random hours of delivery to

  14. Canadian EdGEO National Workshop Program

    NASA Astrophysics Data System (ADS)

    Clinton, L. A.; Haidl, F. M.; Hymers, L. A.; van der Flier-Keller, E.

    2009-05-01

    Established in the early 1970s, EdGEO supports locally driven geosciences workshops for Canadian teachers. Workshops are organized by geoscientists and teachers, and typically have field, laboratory and classroom components. Grants of up to $3000 per workshop are available from the National EdGEO Program. By providing educational opportunities for today's teachers and, through them, their students, EdGEO seeks to cultivate a heightened awareness of our planet. EdGEO workshops provide teachers with potential fieldtrip sites for their students and the knowledge, enthusiasm and materials to inspire their students to engage in geoscience. Networking opportunities with local experts promote the importance of the geoscience profession. The expected result is an improved capacity on the part of Canadians to understand the Earth and to make informed decisions, especially with regard to the use of mineral and energy resources, the maintenance and remediation of the environment, and response to geological hazards. There exists a critical need to provide teachers with training and resources to tackle their Earth science curricula. In 2008, EdGEO supported fourteen workshops, with an unprecedented 521 teachers attending. These teachers then used our resources to reach an estimated 14,000 students during that single academic year. EdGEO workshops are locally driven and are therefore very diverse. Workshops are strongly tied to the provincial curriculum, focus on a specific geoscience topic, or may be largely field-based to demonstrate and practice how field activities could be incorporated into Earth science teaching. Many strive to include all of these important components. Geoscientists and teachers work collaboratively to develop and deliver EdGEO workshops to ensure that the activities can be effectively used in the classroom. The length of these professional development opportunities range from two-hour sessions to several days, and can generally accommodate up to twenty

  15. AC power systems handbook

    SciTech Connect

    Whitaker, J.

    1991-01-01

    Transient disturbances are what headaches are made of. Whatever you call them-spikes, surges, are power bumps-they can take your equipment down and leave you with a complicated and expensive repair job. Protection against transient disturbances is a science that demands attention to detail. This book explains how the power distribution system works, what can go wrong with it, and how to protect a facility against abnormalities. system grounding and shielding are covered in detail. Each major method of transient protection is analyzed and its relative merits discussed. The book provides a complete look at the critical elements of the ac power system. Provides a complete look at the ac power system from generation to consumption. Discusses the mechanisms that produce transient disturbances and how to protect against them. Presents diagrams to facilitate system design. Covers new areas, such as the extent of the transient disturbance problem, transient protection options, and stand-by power systems.

  16. Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis

    PubMed Central

    2009-01-01

    Background Relatively few studies have been conducted of the association between air pollution and emergency department (ED) visits, and most of these have been based on a small number of visits, for a limited number of health conditions and pollutants, and only daily measures of exposure and response. Methods A time-series analysis was conducted on nearly 400,000 ED visits to 14 hospitals in seven Canadian cities during the 1990s and early 2000s. Associations were examined between carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), and particulate matter (PM10 and PM2.5), and visits for angina/myocardial infarction, heart failure, dysrhythmia/conduction disturbance, asthma, chronic obstructive pulmonary disease (COPD), and respiratory infections. Daily and 3-hourly visit counts were modeled as quasi-Poisson and analyses controlled for effects of temporal cycles, weather, day of week and holidays. Results 24-hour average concentrations of CO and NO2 lag 0 days exhibited the most consistent associations with cardiac conditions (2.1% (95% CI, 0.0–4.2%) and 2.6% (95% CI, 0.2–5.0%) increase in visits for myocardial infarction/angina per 0.7 ppm CO and 18.4 ppb NO2 respectively; 3.8% (95% CI, 0.7–6.9%) and 4.7% (95% CI, 1.2–8.4%) increase in visits for heart failure). Ozone (lag 2 days) was most consistently associated with respiratory visits (3.2% (95% CI, 0.3–6.2%), and 3.7% (95% CI, -0.5–7.9%) increases in asthma and COPD visits respectively per 18.4 ppb). Associations tended to be of greater magnitude during the warm season (April – September). In particular, the associations of PM10 and PM2.5with asthma visits were respectively nearly three- and over fourfold larger vs. all year analyses (14.4% increase in visits, 95% CI, 0.2–30.7, per 20.6 μg/m3 PM10 and 7.6% increase in visits, 95% CI, 5.1–10.1, per 8.2 μg/m3 PM2.5). No consistent associations were observed between three hour average pollutant concentrations and

  17. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment

    PubMed Central

    Wong, Amy WY; Zhang, Chengfei; Chu, Chun-hung

    2014-01-01

    Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy) AND (single-visit OR one-visit OR 1-visit). Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of single-visit versus multiple-visit endodontic treatment. PMID:24855389

  18. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment.

    PubMed

    Wong, Amy Wy; Zhang, Chengfei; Chu, Chun-Hung

    2014-01-01

    Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy) AND (single-visit OR one-visit OR 1-visit). Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of single-visit versus multiple-visit endodontic treatment.

  19. Increased Ac excision (iae): Arabidopsis thaliana mutations affecting Ac transposition.

    PubMed

    Jarvis, P; Belzile, F; Page, T; Dean, C

    1997-05-01

    The maize transposable element Ac is highly active in the heterologous hosts tobacco and tomato, but shows very much reduced levels of activity in Arabidopsis. A mutagenesis experiment was undertaken with the aim of identifying Arabidopsis host factors responsible for the observed low levels of Ac activity. Seed from a line carrying a single copy of the Ac element inserted into the streptomycin phosphotransferase (SPT) reporter fusion, and which displayed typically low levels of Ac activity, were mutagenized using gamma rays. Nineteen mutants displaying high levels of somatic Ac activity, as judged by their highly variegated phenotypes, were isolated after screening the M2 generation on streptomycin-containing medium. The mutations fall into two complementation groups, iae1 and iae2, are unlinked to the SPT::Ac locus and segregate in a Mendelian fashion. The iae1 mutation is recessive and the iae2 mutation is semi-dominant. The iae1 and iae2 mutants show 550- and 70-fold increases, respectively, in the average number of Ac excision sectors per cotyledon. The IAE1 locus maps to chromosome 2, whereas the SPT::Ac reporter maps to chromosome 3. A molecular study of Ac activity in the iae1 mutant confirmed the very high levels of Ac excision predicted using the phenotypic assay, but revealed only low levels of Ac re-insertion. Analyses of germinal transposition in the iae1 mutant demonstrated an average germinal excision frequency of 3% and a frequency of independent Ac re-insertions following germinal excision of 22%. The iae mutants represents a possible means of improving the efficiency of Ac/Ds transposon tagging systems in Arabidopsis, and will enable the dissection of host involvement in Ac transposition and the mechanisms employed for controlling transposable element activity.

  20. Impact of Mental Health and Substance Use Disorders on Emergency Department Visit Outcomes for HIV Patients

    PubMed Central

    Choi, Brian Y.; DiNitto, Diana M.; Marti, C. Nathan; Choi, Namkee G.

    2016-01-01

    Introduction A disproportionate number of individuals with human immunodeficiency virus (HIV) have mental health and substance-use disorders (MHSUDs), and MHSUDs are significantly associated with their emergency department (ED) visits. With an increasing share of older adults among HIV patients, this study investigated the associations of MHSUDs with ED outcomes of HIV patients in four age groups: 21–34, 35–49, 50–64, and 65+ years. Methods We used the 2012 Nationwide Emergency Department Sample (NEDS) dataset (unweighted n=23,244,819 ED events by patients aged 21+, including 115,656 visits by patients with HIV). Multinomial and binary logistic regression analyses, with “treat-and-release” as the base outcome, were used to examine associations between ED outcomes and MHSUDs among visits that included a HIV diagnosis in each age group. Results Mood and “other” mental disorders had small effects on ED-to-hospital admissions, as opposed to treat-and-release, in age groups younger than 65+ years, while suicide attempts had medium effects (RRR=3.56, CI [2.69–4.70]; RRR=4.44, CI [3.72–5.30]; and RRR=5.64, CI [4.38–7.26] in the 21–34, 35–49, and 50–64 age groups, respectively). Cognitive disorders had medium-to-large effects on hospital admissions in all age groups and large effects on death in the 35–49 (RRR=7.29, CI [3.90–13.62]) and 50–64 (RRR=5.38, CI [3.39–8.55]) age groups. Alcohol use disorders (AUDs) had small effects on hospital admission in all age groups (RRR=2.35, 95% CI [1.92–2.87]; RRR=2.15, 95% CI [1.95–2.37]; RRR=1.92, 95% CI [1.73–2.12]; and OR=1.93, 95% CI [1.20–3.10] in the 21–34, 35–49, 50–64, and 65+ age groups, respectively). Drug use disorders (DUDs) had small-to-medium effects on hospital admission (RRR=4.40, 95% CI [3.87–5.0]; RRR=4.07, 95% CI [3.77–4.40]; RRR=4.17, 95% CI [3.83–4.55]; and OR=2.53, 95% CI [2.70–3.78] in the 21–34, 35–49, 50–64, and 65+ age groups, respectively). AUDs

  1. The Trouble with the Ed.D

    ERIC Educational Resources Information Center

    Flessa, Joseph

    2007-01-01

    This article review examines Arthur Levine's 2005 "Educating School Leaders," a report that recommended the elimination of the Ed.D. and the establishment of a new degree, the Master's in Educational Administration. The article review draws attention to the central irony of Levine's report: after chronicling the many ways that schools of education…

  2. Precipitator rehabilitation ComEd Waukegan station

    SciTech Connect

    Sanda, L.; Hermanas, G.

    1996-12-31

    ComEd`s Waukegan Station successfully completed a total rehabilitation of its Unit 8 electrostatic precipitator (ESP) and recovered 66 MW that has been lost due to burning Western Coal. This practice began in the 1970`s for emission`s compliance. The unit now operates at it maximum continuous rating (MCR) with increased fuel flexibility.

  3. The Consequences of edTPA

    ERIC Educational Resources Information Center

    Greenblatt, Deborah

    2016-01-01

    States and teacher preparation programs across the country are increasingly using a teacher candidate assessment called edTPA. The purpose? To make sure that teacher candidates are ready and able to teach before they begin their careers. The teacher performance assessment requires candidates to compile a portfolio that consists of lesson plans,…

  4. Factors associated with healthcare visits by young children for nontoxic poisoning exposures.

    PubMed

    Polivka, Barbara J; Casavant, Marcel; Baker, S David

    2010-12-01

    Poison control centers have been shown to be a cost-effective alternative to healthcare visits for poisoning exposures, yet emergency departments (ED) and urgent care centers (UCC) continue to be frequently accessed for poisoning exposures in young children. We sought to identify predictors of young children who obtain healthcare for a nontoxic poisoning exposure. Poisoning exposure cases for children ≤5 years old who sought ED, UCC, or clinic care between 2001 and 2005 from an urban regional pediatric hospital system were identified from poisoning ICD-9 codes in the hospital administrative data and from a poisoning designation in the National Electronic Injury Surveillance System (NEISS) data. Cases (n = 2,494) were reviewed and categorized as either toxic or nontoxic. Toxic exposures were those with more than minimal potential for clinical effects. Most cases were between 1 and 2 years old, male, White, enrolled in Medicaid, sought ED care, had no referring physician, and brought to the facility by a parent/guardian. Logistic regression analysis revealed that the odds of seeking healthcare for a nontoxic poisoning exposure were significantly greater if the child was African American, enrolled in Medicaid, had a non-medication related poisoning, and was brought to the healthcare site by a parent/guardian. Healthcare costs and unnecessary use of healthcare resources for nontoxic poisoning exposures could be reduced by educating parents and providers of children at high risk for inappropriate healthcare visits for nontoxic poisonings to initially contact the poison control center (1-800-222-1222).

  5. How to Host a School Visit

    ERIC Educational Resources Information Center

    Eboch, Chris

    2006-01-01

    Bringing a "real live" author into the school can be a great fun for both kids and staff. However, it can also be a disaster. In this article, the author offers ideas on how to host a school visit. Library media specialists can help ensure a successful visit by preparing in advance: define the goals, communicate the expectations, provide…

  6. Should Supervisors Intervene during Classroom Visits?

    ERIC Educational Resources Information Center

    Marshall, Kim

    2015-01-01

    Real-time coaching has become the go-to supervisory model in some schools (especially charters), with supervisors routinely jumping in during teacher observations and sometimes taking over the class to model a more effective approach. The author sets out goals and guidelines for impromptu classroom visits that include visiting each classroom at…

  7. Home Visitation--A Chance for Counseling

    ERIC Educational Resources Information Center

    Crosen, Roger L.

    1976-01-01

    Some ideas for improving the effectiveness of home visitation of students by vocational agriculture instructors include: planning for the visit, getting to know the student, assessing the home situation for influencing factors, using home responsibilities for plant and animal care as learning experiences, and considering life goals. (MS)

  8. 42 CFR 409.48 - Visits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... covered each time an HHA employee or someone providing home health services under arrangements enters the... INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.48 Visits. (a) Number of allowable... home health visits. All Medicare home health services are covered under hospital insurance unless...

  9. 28 CFR 551.120 - Visiting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting. 551.120 Section 551.120 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MISCELLANEOUS... special visits to protect the inmate's business interests or to help prepare for trial....

  10. Home visits in family medicine residency

    PubMed Central

    Jakubovicz, Difat; Srivastava, Anita

    2015-01-01

    Abstract Problem addressed There has been a decline in family physicians providing home visits to housebound patients. Objective of program To increase family medicine residents’ exposure to home visits; their comfort and skills in providing home visits; and their willingness to provide home visits after graduation. Program description Between 2000 and 2010, each family practice resident at St Joseph’s Health Centre Family Medicine Teaching Unit in Toronto, Ont, was assigned at least 1 housebound patient to care for longitudinally over 2 years; the rationale for this was to increase the sense of “ownership” and responsibility among residents for their assigned homebound patients. Starting in 2003, until the program’s conclusion in 2010, residents were asked to fill out surveys before and after the program to assess their comfort with and confidence in providing home visits, as well as their satisfaction with the program. Survey responses were analyzed for changes over the course of residency training. A total of 85 residents completed the home visit teaching program between 2003 and 2010 inclusive. Conclusion While residents’ willingness to provide home visits did not increase over the course of residency, their confidence in making housecalls did increase. There was also a trend toward increased confidence among residents in working with community agencies. Thus, having home visit patients be a part of resident practices might play an important role in increasing the likelihood that future family physicians will continue to care for their patients when those patients are no longer ambulatory. PMID:26052599

  11. 28 CFR 548.19 - Pastoral visits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS... clergyperson's or faith group representative's credentials. (b) Pastoral visits may not be counted as...

  12. 28 CFR 548.19 - Pastoral visits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS... clergyperson's or faith group representative's credentials. (b) Pastoral visits may not be counted as...

  13. 28 CFR 548.19 - Pastoral visits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS... clergyperson's or faith group representative's credentials. (b) Pastoral visits may not be counted as...

  14. 28 CFR 548.19 - Pastoral visits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS... clergyperson's or faith group representative's credentials. (b) Pastoral visits may not be counted as...

  15. 28 CFR 548.19 - Pastoral visits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS... clergyperson's or faith group representative's credentials. (b) Pastoral visits may not be counted as...

  16. 28 CFR 540.62 - Institutional visits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A...

  17. Home Visiting: Looking Back and Moving Forward

    ERIC Educational Resources Information Center

    Boller, Kimberly; Strong, Debra A.; Daro, Deborah

    2010-01-01

    Recent large federal investments in services for pregnant women and young children will fuel the expansion of home visiting services across the U.S. The authors summarize the history of home visiting and describe trends toward evidence-based and national program models. Moving to an integrated system requires supports for implementation with…

  18. Assessing Quality in Home Visiting Programs

    ERIC Educational Resources Information Center

    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  19. Implementing and Preparing for Home Visits

    ERIC Educational Resources Information Center

    McWilliam, R. A.

    2012-01-01

    The most common setting for early intervention services for infants and toddlers with disabilities and their families is the home. This article discusses home- and community-based early intervention and how the routines-based interview (RBI) can set the stage for successful home visits. It also addresses what has been learned about home visiting,…

  20. 28 CFR 540.62 - Institutional visits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A...

  1. Time Allocation in Primary Care Office Visits

    PubMed Central

    Tai-Seale, Ming; McGuire, Thomas G; Zhang, Weimin

    2007-01-01

    Objectives To use an innovative videotape analysis method to examine how clinic time was spent during elderly patients' visits to primary care physicians. Secondary objectives were to identify the factors that influence time allocations. Data Sources A convenience sample of 392 videotapes of routine office visits conducted between 1998 and 2000 from multiple primary care practices in the United States, supplemented by patient and physician surveys. Research Design Videotaped visits were examined for visit length and time devoted to specific topics—a novel approach to study time allocation. A survival analysis model analyzed the effects of patient, physician, and physician practice setting on how clinic time was spent. Principal Findings Very limited amount of time was dedicated to specific topics in office visits. The median visit length was 15.7 minutes covering a median of six topics. About 5 minutes were spent on the longest topic whereas the remaining topics each received 1.1 minutes. While time spent by patient and physician on a topic responded to many factors, length of the visit overall varied little even when contents of visits varied widely. Macro factors associated with each site had more influence on visit and topic length than the nature of the problem patients presented. Conclusions Many topics compete for visit time, resulting in small amount of time being spent on each topic. A highly regimented schedule might interfere with having sufficient time for patients with complex or multiple problems. Efforts to improve the quality of care need to recognize the time pressure on both patients and physicians, the effects of financial incentives, and the time costs of improving patient–physician interactions. PMID:17850524

  2. From Napkin to Orbit in 9 Months; The TechEdSat Spacecraft Mission

    NASA Technical Reports Server (NTRS)

    Cohen, Aaron; Hoppins, Nicholas; Trinh, Greenfield; Schulte, Jan; Bruhn, Fredrik; Loefgren, Henrik; Selin, Per

    2013-01-01

    The TechEdSat spacecraft mission saw one of the fastest turn around times for concept through launch of a CubeSat. On 26 October 2011, John Hines sketched on a brown paper napkin the outline for which components would be in this 1U CubeSat, and how they would be stacked; 269 days later that spacecraft launched from Tanegashima Space Center aboard the HTV-3 ISS resupply mission, with a total development time of only eight months. TechEdSat was among the first of five CubeSats deployed from the ISS. The goals of the TechEdSat mission were to explore the use of the Space Plug-n-Play Architecture (SPA) in a CubeSat, and to evaluate Commercial Off The Shelf (COTS) space-to-space communication solutions. TechEdSat featured an array of processors from ÅAC Microtec including four NanoRTU's and the RTULite main processor, all communicating using the SPA-1 protocol. TechEdSat featured two primary payloads: an Iridium 9602 Modem, and a Quake Global Q1000 OrbComm modem. After a successful deployment on 4 October 2012 from the ISS, over 2000 packets of 122 bytes each (250 kB total) were received in the first four months of the mission. In this paper we discuss the challenges to rapid CubeSat development, the experience of having a CubeSat approved for deployment from the ISS, the ongoing results of the mission and lessons learned.

  3. Characteristics of Cannabis-Only and Other Drug Users Who Visit the Emergency Department

    PubMed Central

    Woodruff, Susan I.; McCabe, Cameron T.; Hohman, Melinda; Clapp, John D.; Shillington, Audrey M.; Eisenberg, Kimberly; Sise, C. Beth; Castillo, Edward M.; Chan, Theodore C.; Sise, Michael J.

    2016-01-01

    Abstract Emergency department (ED) settings have gained interest as venues for illegal drug misuse prevention and intervention, with researchers and practitioners attempting to capitalize on the intersection of need and opportunity within these settings. This study of 686 adult patients visiting two EDs for various reasons who admitted drug use compared daily cannabis-only users, nondaily cannabis-only users, and other drug users on sociodemographic and drug-related severity outcomes. The three drug use groups did not differ on most sociodemographic factors or medical problem severity scores. Forty-five percent of the sample was identified as having a drug use problem. ED patients who used drugs other than cannabis were at particular risk for high drug use severity indicators and concomitant problems such as psychiatric problems and alcohol use severity. However, 19–29% of cannabis-only users were identified as having problematic drug use. Furthermore, daily cannabis-only users fared less well than nondaily cannabis users with regard to drug use severity indicators and self-efficacy for avoiding drug use. Results may assist emergency medicine providers and medical social workers in matching patients to appropriate intervention. For example, users of drugs other than cannabis (and perhaps heavy, daily cannabis-only users) may need referral to specialty services for further assessment. Enhancement of motivation and self-efficacy beliefs could be an important target of prevention and treatment for cannabis-only users screened in the ED. PMID:27689138

  4. Characteristics of Cannabis-Only and Other Drug Users Who Visit the Emergency Department

    PubMed Central

    Woodruff, Susan I.; McCabe, Cameron T.; Hohman, Melinda; Clapp, John D.; Shillington, Audrey M.; Eisenberg, Kimberly; Sise, C. Beth; Castillo, Edward M.; Chan, Theodore C.; Sise, Michael J.

    2016-01-01

    Abstract Emergency department (ED) settings have gained interest as venues for illegal drug misuse prevention and intervention, with researchers and practitioners attempting to capitalize on the intersection of need and opportunity within these settings. This study of 686 adult patients visiting two EDs for various reasons who admitted drug use compared daily cannabis-only users, nondaily cannabis-only users, and other drug users on sociodemographic and drug-related severity outcomes. The three drug use groups did not differ on most sociodemographic factors or medical problem severity scores. Forty-five percent of the sample was identified as having a drug use problem. ED patients who used drugs other than cannabis were at particular risk for high drug use severity indicators and concomitant problems such as psychiatric problems and alcohol use severity. However, 19–29% of cannabis-only users were identified as having problematic drug use. Furthermore, daily cannabis-only users fared less well than nondaily cannabis users with regard to drug use severity indicators and self-efficacy for avoiding drug use. Results may assist emergency medicine providers and medical social workers in matching patients to appropriate intervention. For example, users of drugs other than cannabis (and perhaps heavy, daily cannabis-only users) may need referral to specialty services for further assessment. Enhancement of motivation and self-efficacy beliefs could be an important target of prevention and treatment for cannabis-only users screened in the ED.

  5. Cytoplasmic Streaming - Skylab Student Experiment ED-63

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment (ED-63), Cytoplasmic Streaming, proposed by Cheryl A. Peitz of Arapahoe High School, Littleton, Colorado. Experiment ED-63 was to observe the effect of zero-gravity on cytoplasmic streaming in the aquatic plant named Elodea, commonly called water weed or water thyme. The phenomenon of cytoplasmic streaming is not well understood, but it is recognized as the circulation mechanism of the internal materials or cytoplasm of a cell. Cytoplasm is a gelatinous substance that has the ability to change its viscosity and flow, carrying various cell materials with it. The activity can be stimulated by sunlight or heat. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  6. Terrorism drill shows ED response plan flaws.

    PubMed

    2005-07-01

    Valuable lessons can be learned by paying attention to your processes and communication equipment during a disaster drill. Did your radios and pagers work adequately? If not, it may be time for a new vendor. Going through the drill helps remind the entire ED staff to funnel all communications and key decisions through the disaster response leader. Make sure to update your disaster response handbook to reflect important lessons learned during the drill.

  7. Material Interface Reconstruction in VisIt

    SciTech Connect

    Meredith, J S

    2005-01-27

    In this paper, we first survey a variety of approaches to material interface reconstruction and their applicability to visualization, and we investigate the details of the current reconstruction algorithm in the VisIt scientific analysis and visualization tool. We then provide a novel implementation of the original VisIt algorithm that makes use of a wide range of the finite element zoo during reconstruction. This approach results in dramatic improvements in quality and performance without sacrificing the strengths of the VisIt algorithm as it relates to visualization.

  8. AC resistance measuring instrument

    DOEpatents

    Hof, P.J.

    1983-10-04

    An auto-ranging AC resistance measuring instrument for remote measurement of the resistance of an electrical device or circuit connected to the instrument includes a signal generator which generates an AC excitation signal for application to a load, including the device and the transmission line, a monitoring circuit which provides a digitally encoded signal representing the voltage across the load, and a microprocessor which operates under program control to provide an auto-ranging function by which range resistance is connected in circuit with the load to limit the load voltage to an acceptable range for the instrument, and an auto-compensating function by which compensating capacitance is connected in shunt with the range resistance to compensate for the effects of line capacitance. After the auto-ranging and auto-compensation functions are complete, the microprocessor calculates the resistance of the load from the selected range resistance, the excitation signal, and the load voltage signal, and displays of the measured resistance on a digital display of the instrument. 8 figs.

  9. AC Resistance measuring instrument

    DOEpatents

    Hof, Peter J.

    1983-01-01

    An auto-ranging AC resistance measuring instrument for remote measurement of the resistance of an electrical device or circuit connected to the instrument includes a signal generator which generates an AC excitation signal for application to a load, including the device and the transmission line, a monitoring circuit which provides a digitally encoded signal representing the voltage across the load, and a microprocessor which operates under program control to provide an auto-ranging function by which range resistance is connected in circuit with the load to limit the load voltage to an acceptable range for the instrument, and an auto-compensating function by which compensating capacitance is connected in shunt with the range resistance to compensate for the effects of line capacitance. After the auto-ranging and auto-compensation functions are complete, the microprocessor calculates the resistance of the load from the selected range resistance, the excitation signal, and the load voltage signal, and displays of the measured resistance on a digital display of the instrument.

  10. Regional Energy Deployment System (ReEDS)

    SciTech Connect

    Short, W.; Sullivan, P.; Mai, T.; Mowers, M.; Uriarte, C.; Blair, N.; Heimiller, D.; Martinez, A.

    2011-12-01

    The Regional Energy Deployment System (ReEDS) is a deterministic optimization model of the deployment of electric power generation technologies and transmission infrastructure throughout the contiguous United States into the future. The model, developed by the National Renewable Energy Laboratory's Strategic Energy Analysis Center, is designed to analyze the critical energy issues in the electric sector, especially with respect to potential energy policies, such as clean energy and renewable energy standards or carbon restrictions. ReEDS provides a detailed treatment of electricity-generating and electrical storage technologies and specifically addresses a variety of issues related to renewable energy technologies, including accessibility and cost of transmission, regional quality of renewable resources, seasonal and diurnal generation profiles, variability of wind and solar power, and the influence of variability on the reliability of the electrical grid. ReEDS addresses these issues through a highly discretized regional structure, explicit statistical treatment of the variability in wind and solar output over time, and consideration of ancillary services' requirements and costs.

  11. Pediatric Emergency Visits and Short-Term Changes in PM2.5 Concentrations in the U.S. State of Georgia

    PubMed Central

    Strickland, Matthew J.; Hao, Hua; Hu, Xuefei; Chang, Howard H.; Darrow, Lyndsey A.; Liu, Yang

    2015-01-01

    Background: Associations between pediatric emergency department (ED) visits and ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) have been reported in previous studies, although few were performed in nonmetropolitan areas. Objective: We estimated associations between daily PM2.5 concentrations, using a two-stage model that included land use parameters and satellite aerosol optical depth measurements at 1-km resolution, and ED visits for six pediatric conditions in the U.S. state of Georgia by urbanicity classification. Methods: We obtained pediatric ED visits geocoded to residential ZIP codes for visits with nonmissing PM2.5 estimates and admission dates during 1 January 2002–30 June 2010 for 2- to 18-year-olds for asthma or wheeze (n = 189,816), and for 0- to 18-year-olds for bronchitis (n = 76,243), chronic sinusitis (n = 15,745), otitis media (n = 237,833), pneumonia (n = 52,946), and upper respiratory infections (n = 414,556). Daily ZIP code–level estimates of 24-hr average PM2.5 were calculated by averaging concentrations within ZIP code boundaries. We used time-stratified case-crossover models stratified on ZIP code, year, and month to estimate odds ratios (ORs) between ED visits and same-day and previous-day PM2.5 concentrations at the ZIP code level, and we investigated effect modification by county-level urbanicity. Results: A 10-μg/m3 increase in same-day PM2.5 concentrations was associated with ED visits for asthma or wheeze (OR = 1.013; 95% CI: 1.003, 1.023) and upper respiratory infections (OR = 1.015; 95% CI: 1.008, 1.022); associations with previous-day PM2.5 concentrations were lower. Differences in the association estimates across levels of urbanicity were not statistically significant. Conclusion: Pediatric ED visits for asthma or wheeze and for upper respiratory infections were associated with PM2.5 concentrations in Georgia. Citation: Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y. 2016. Pediatric

  12. Identification of /sup 233/Ac

    SciTech Connect

    Chu, Y.Y.; Zhou, M.L.

    1983-09-01

    We report in this paper identification of the new isotope /sup 233/Ac. Uranium targets were irradiated with 28 GeV protons; after rapid retrieval of the target and separation of actinium from thorium, /sup 233/Ac was allowed to decay into the known /sup 233/Th daughter. Exhaustive chemical purification was employed to permit the identification of /sup 233/Th via its characteristic ..gamma.. radiations. The half-life derived for /sup 233/Ac from several experiments is 2.3 +- 0.3 min. The production cross section for /sup 233/Ac is 100 ..mu..b.

  13. AC and DC power transmission

    SciTech Connect

    Not Available

    1985-01-01

    The technical and economic assessment of AC and DC transmission systems; long distance transmission, cable transmission, system inter-connection, voltage support, reactive compensation, stabilisation of systems; parallel operation of DC links with AC systems; comparison between alternatives for particular schemes. Design and application equipment: design, testing and application of equipment for HVDC, series and shunt static compensated AC schemes, including associated controls. Installations: overall design of stations and conductor arrangements for HVDC, series and shunt static AC schemes including insulation co-ordination. System analysis and modelling.

  14. Interprofessional Collaboration to Improve Discharge from Skilled Nursing Facility to Home: Preliminary Data on Postdischarge Hospitalizations and Emergency Department Visits.

    PubMed

    Reidt, Shannon L; Holtan, Haley S; Larson, Tom A; Thompson, Bruce; Kerzner, Lawrence J; Salvatore, Toni M; Adam, Terrence J

    2016-09-01

    An interprofessional collaborative practice model was established at Hennepin County Medical Center to improve discharge management from the transitional care unit of the skilled nursing facility (SNF) to home. The practice model involves a geriatrician, nurse practitioner, and pharmacist who care for individuals at a community-based SNF. Before SNF discharge, the pharmacist conducts a chart and in-person medication review and collaborates with the nurse practitioner to determine the discharge medication regimen. The pharmacist's review focuses on assessing the indication, safety, effectiveness, and convenience of medications. The pharmacist provides follow-up in-home or over the telephone 1 week after SNF discharge, focusing on reviewing medications and assessing adherence. Hospitalizations and emergency department (ED) visits 30 days after SNF discharge of individuals who received care from this model was compared with those of individuals who received usual care from a nurse practitioner and geriatrician. From October 2012 through December 2013, the intervention was delivered to 87 individuals, with 189 individuals serving as the control group. After adjusting for age, sex, race, and payor, those receiving the intervention had a lower risk of ED visits (odds ratio (OR) = 0.46, 95% confidence interval (CI) = 0.22-0.97), although there was no significant difference in hospitalizations (OR = 0.47, 95% CI = 0.21-1.08). The study suggests that an interprofessional approach involving a pharmacist may be beneficial in reducing ED visits 30 days after SNF discharge. PMID:27385197

  15. Annual Checkups Are Becoming Wellness Visits

    MedlinePlus

    ... family history and lifestyle, medication reviews, checks of vital signs and scheduling preventive screenings and vaccinations. "When you ... another important element of wellness visits. "Electronic medical records have the potential to be powerful tools to ...

  16. Smokey Visits Station Flight Control Room

    NASA Video Gallery

    Smokey Bear celebrated his 68th birthday with a special visit to the International Space Station Flight Control Room at Johnson Space Center in Houston. On May 14, Smokey went where no bear had gon...

  17. Indiana School for the Blind Visits Goddard

    NASA Video Gallery

    This video shows highlights of the Indiana School for the Blind and Visually Impaired, and the Indian Creek Public High School visit to NASA's Goddard Space Flight Center in June 2011. Both blind a...

  18. 28 CFR 540.41 - Visiting facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... required by the type of institution. The Warden shall ensure that the visiting area is as comfortable and... perimeter, but always under supervision of staff. (b) Institutions of medium and high security levels,...

  19. 28 CFR 540.41 - Visiting facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... required by the type of institution. The Warden shall ensure that the visiting area is as comfortable and... perimeter, but always under supervision of staff. (b) Institutions of medium and high security levels,...

  20. Drug-Related Hospital Emergency Room Visits

    MedlinePlus

    ... supplements. Highlights from the 2009 Drug Abuse Warning Network In 2009, there were nearly 4.6 million ... Report: Highlights of the 2009 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits . ...

  1. President Obama and Family Visit KSC

    NASA Video Gallery

    President Obama, accompanied by First Lady Michelle Obama and their two daughters, visited NASA’s Kennedy Space Center on Friday, Apr. 29. The First Family then boarded the Marine One helicopter ...

  2. Mid-term NEAT review: analysing the improvements in hospital ED performance.

    PubMed

    Khanna, Sankalp; Boyle, Justin; Good, Norm; Lind, James

    2014-01-01

    Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. Recent reports however show that the majority of hospitals are still far from being able to meet this target. We investigate the NEAT journey of 30 Queensland hospitals over the past two years and compare this performance to a previous study that investigated the 4 hour ED discharge performance of these hospitals at various times of day and under varying occupancy conditions. Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning.

  3. Digital ac monitor

    DOEpatents

    Hart, G.W.; Kern, E.C. Jr.

    1987-06-09

    An apparatus and method is provided for monitoring a plurality of analog ac circuits by sampling the voltage and current waveform in each circuit at predetermined intervals, converting the analog current and voltage samples to digital format, storing the digitized current and voltage samples and using the stored digitized current and voltage samples to calculate a variety of electrical parameters; some of which are derived from the stored samples. The non-derived quantities are repeatedly calculated and stored over many separate cycles then averaged. The derived quantities are then calculated at the end of an averaging period. This produces a more accurate reading, especially when averaging over a period in which the power varies over a wide dynamic range. Frequency is measured by timing three cycles of the voltage waveform using the upward zero crossover point as a starting point for a digital timer. 24 figs.

  4. Digital ac monitor

    DOEpatents

    Hart, George W.; Kern, Jr., Edward C.

    1987-06-09

    An apparatus and method is provided for monitoring a plurality of analog ac circuits by sampling the voltage and current waveform in each circuit at predetermined intervals, converting the analog current and voltage samples to digital format, storing the digitized current and voltage samples and using the stored digitized current and voltage samples to calculate a variety of electrical parameters; some of which are derived from the stored samples. The non-derived quantities are repeatedly calculated and stored over many separate cycles then averaged. The derived quantities are then calculated at the end of an averaging period. This produces a more accurate reading, especially when averaging over a period in which the power varies over a wide dynamic range. Frequency is measured by timing three cycles of the voltage waveform using the upward zero crossover point as a starting point for a digital timer.

  5. Cooling Floor AC Systems

    NASA Astrophysics Data System (ADS)

    Jun, Lu; Hao, Ding; Hong, Zhang; Ce, Gao Dian

    The present HVAC equipments for the residential buildings in the Hot-summer-and-Cold-winter climate region are still at a high energy consuming level. So that the high efficiency HVAC system is an urgently need for achieving the preset government energy saving goal. With its advantage of highly sanitary, highly comfortable and uniform of temperature field, the hot-water resource floor radiation heating system has been widely accepted. This paper has put forward a new way in air-conditioning, which combines the fresh-air supply unit and such floor radiation system for the dehumidification and cooling in summer or heating in winter. By analyze its advantages and limitations, we found that this so called Cooling/ Heating Floor AC System can improve the IAQ of residential building while keep high efficiency quality. We also recommend a methodology for the HVAC system designing, which will ensure the reduction of energy cost of users.

  6. Health, ED use, and early identification of young children exposed to trauma

    PubMed Central

    Roberts, Yvonne Humenay; Huang, Cindy Y.; Crusto, Cindy A.; Kaufman, Joy S.

    2014-01-01

    Background Childhood trauma is an important public health problem with financial, physical health, and mental health repercussions. Emergency Departments are often the first point of contact for many young children affected by emotionally or psychologically traumatic events (e.g., neglect, separation from primary caregiver, maltreatment, witness to domestic violence within the family, natural disasters). Study Objectives Describe the prevalence of physical health symptoms, ED use and health related problems in young children (birth through 5 years) affected by trauma, and to predict whether or not children experiencing trauma are more likely to be affected by health related problems. Methods Community-based, cross-sectional survey of 208 young children. Traumatic events were assessed by the Traumatic Events Screening Inventory – Parent Report Revised. Child health symptoms and health related problems were measured using the Caregiver Information Questionnaire, developed by ORC Macro. Results Seventy-two percent of children had experienced at least one type of traumatic event. Children exposed to trauma were also experiencing recent health related events, including visits to the ED (32.2%) and the doctor (76.9%) for physical health symptoms, and recurring physical health problems (40.4%). Children previously exposed to high levels of trauma (4 or more types of events) were 2.9 times more likely to report having had recently visited the ED for health purposes. Conclusions Preventing recurrent trauma or recognizing early trauma exposure is difficult but essential if long-term negative consequences are to be mitigated or prevented. Within emergency departments, there are missed opportunities for identification and intervention for trauma-exposed children, as well as great potential for expanding primary and secondary prevention of maltreatment-associated illness, injury and mortality. PMID:24565881

  7. EDS Coal Liquefaction Process Development. Phase V. Laboratory evaluation of the characteristics of EDS Illinois bottoms

    SciTech Connect

    Lao, T C; Levasseur, A A

    1984-02-01

    This interim report documents work carried out by Combustion Engineering, Inc. under a contract to Exxon Research and Engineering Company to develop a conceptual Hybrid Boiler design fueled by the vacuum distillation residue (vacuum bottoms) derived from Illinois No. 6 coal in the EDS Coal Liquefaction Process. This report was prepared by Combustion Engineering, Inc., and is the first of two reports on the predevelopment phase of the Hybrid Boiler program. This report covers the results of a laboratory investigation to assess the fuel and ash properties of EDS vacuum bottoms. The results of the laboratory testing reported here were used in conjunction with Combustion Engineering's design experience to predict fuel performance and to develop appropriate boiler design parameters. These boiler design parameters were used to prepare the engineering design study reported in EDS Interim Report FE-2893-113, the second of the two reports on the predevelopment phase of the Hybrid Boiler Program. 46 figures, 29 tables.

  8. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy

    PubMed Central

    Barbadoro, Pamela; Di Tondo, Elena; Menditto, Vincenzo Giannicola; Pennacchietti, Lucia; Regnicoli, Februa; Di Stanislao, Francesco; D’Errico, Marcello Mario; Prospero, Emilia

    2015-01-01

    Objective The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED) for non-urgent visits. Methods The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use. Results Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32–6.47) of re-admissions have been registered; the distribution shows a high frequency of events in the age 65–84 years group, and in the intermediate care hospitals (51.97%; 95%CI 51.37–52.57). The regression model has shown the significant role played by age, type of structure (geriatric acute care), and deprivation index of the area of residence on the readmission, however, after adjusting for the intensity of primary care, the role of deprivation was no more significant. Non-urgent ED visits accounted for the 12.10%, (95%CI 9.38–15.27) of the total number of respondents to the questionnaire (N = 504). The likelihood of performing a non-urgent ED visit was higher among patients aged <65 years (OR 3.2, 95%CI 1.3–7.8 p = 0.008), while it was lower among those perceiving as urgent their health problem (OR 0.50, 95%CI 0.30–0.90). Conclusions In the Italian context repeated readmissions and ED utilization are linked to different trajectories, besides the increasing age and comorbidity of patients are the factors that are related to repeated admissions, the self-perceived trust in diagnostic technologies is an important risk factor in determining ED visits. Better use of public national health care service is mandatory, since its correct utilization is associated to increasing equity and better health care utilization. PMID:26076346

  9. Wait watchers. Smart organizations are demonstrating that while they can't erase ED wait times, they can leverage technology to keep patients better informed.

    PubMed

    Gamble, Kate Huvane

    2010-04-01

    Increases in ED visits are significantly affecting patient access, quality, cost and care management--a trend that is expected to continue. A number of organizations are dealing with the increased demand for services by implementing technologies to keep patients better informed of wait times. Publishing ED wait times online offers hospitals a way to communicate information to patients quickly without requiring a significant investment from the IT staff. Hospitals are also utilizing visibility boards to keep both patients and staff updated on patient conditions and room status. PMID:20426236

  10. Illness episodes, physician visits, and depressive symptoms.

    PubMed

    Berkanovic, E; Hurwicz, M L

    1992-08-01

    Although there is a large literature examining the effects of distress on the demand for medical care, the data on which this literature is based are equivocal. Nonetheless, this literature is cited frequently by those who advocate a national mental health policy designed to produce a cost-effective "medical offset effect." In this study, longitudinal data on illness episodes, physician visits, and depressive symptoms were collected from 940 Medicare recipients enrolled in a health maintenance organization (HMO) under a Tax Equity and Fiscal Responsibility Act (TEFRA) contract. Seven waves of interviews were conducted over a period of 1 year. This article presents two sets of analyses. In the first, controlling for chronic conditions and demographics reported at baseline, the relationships between depressive symptoms reported at baseline, and all illness episodes and physician visits that occurred over the subsequent year are examined. In the second, controlling for depressive symptoms and demographics reported at baseline, the relationships between illness episodes and physician visits over the study year, and depressive symptoms recorded at the final interview are examined. The data indicate that, whereas depressive symptoms at baseline are virtually unrelated to subsequent illness episodes and physician visits, illness episodes and physician visits are related to subsequent depressive symptoms. These data indicate, therefore, that policies aimed at diverting the distressed from seeking medical care may result in further inequities in the receipt of needed care. PMID:10120227

  11. Passive damping in EDS maglev systems.

    SciTech Connect

    Rote, D. M.

    2002-05-03

    There continues to be strong interest in the subjects of damping and drag forces associated with electrodynamic suspension (EDS) systems. While electromagnetic drag forces resist the forward motion of a vehicle and therefore consume energy, damping forces control, at least in part, the response of the vehicle to disturbances. Ideally, one would like to reduce the drag forces as much as possible while retaining adequate damping forces to insure dynamic stability and satisfactory ride quality. These two goals turn out to be difficult to achieve in practice. It is well known that maglev systems tend to be intrinsically under damped. Consequently it is often necessary in a practical system design to enhance the damping passively or actively. For reasons of cost and simplicity, it is desirable to rely as much as possible on passive damping mechanisms. In this paper, rough estimates are made of the passive damping and drag forces caused by various mechanisms in EDS systems. No attention will be given to active control systems or secondary suspension systems which are obvious ways to augment passive damping mechanisms if the latter prove to be inadequate.

  12. Operation Method for AC Motor Control during Power Interruption in Direct AC/AC Converter System

    NASA Astrophysics Data System (ADS)

    Shizu, Keiichiro; Azuma, Satoshi

    Direct AC/AC converters have been studied due to their potential use in power converters with no DC-link capacitor, which can contribute to the miniaturization of power converters. However, the absence of a DC-link capacitor makes it difficult to control the AC motor during power interruption. First, this paper proposes a system that realizes AC motor control during power interruption by utilizing a clamp capacitor. In general, direct AC/AC converters have a clamp circuit consisting of a rectifier diode(s) and a clamp capacitor in order to avoid over-voltages. In the proposed system, there is an additional semiconductor switch reverse-parallel to the rectifier diode(s), and the clamp capacitor voltage can be utilized for AC motor control by turning on the additional switch. Second, this paper discusses an operation method for AC motor control and clamp capacitor voltage control during power interruption. In the proposed method “DC-link voltage control”, the kinetic energy in the AC motor is transformed into electrical energy and stored in the clamp capacitor; the clamp capacitor is therefore charged and the capacitor voltage is controlled to remain constant at an instruction value. Third, this paper discusses a switching operation during power interruption. A dead-time is introduced between the operation of turning off all switches on the rectifier side and the operation of turning on the additional switch, which prevents the occurrence of a short circuit between the interrupted power source and the clamp capacitor. Finally, experimental results are presented. During power interruptions, an output current was continuously obtained and the clamp capacitor voltage was maintained to be equal to the instruction value of the capacitor voltage. These results indicate that both AC motor control and capacitor voltage control were successfully achieved by using the proposed system.

  13. Text message program improves outcomes, decreases ED utilization among ED patients with poorly controlled diabetes.

    PubMed

    2014-02-01

    Diabetic patients who lack access to primary care tend to frequent the ED, often with complications from their disease that could have been prevented with proper management and education. To get around the problem of access, researchers tested an automated program that continuously delivered educational messaging via text to a group of patients who presented to the ED with poorly controlled diabetes. After six months, researchers noted improvements in Hb A1c levels, self-reported medication adherence, and ED utilization when compared with a control group. And the impact was particularly noteworthy among Latinos, according to the researchers. The text messaging program, dubbed TExT-Med, was developed by four physicians and two diabetes educators. The messages were delivered daily, and contained educational as well motivational content derived from the National Diabetes Education Program.There were also medication reminders, healthy living challenges, and trivia questions about diabetes. At six months, Hb A1c levels decreased by 1.05% in the intervention group, compared to 0.60% in the control group, and self-reported medication adherence improved from 4.5 to 5.4 (as measured on an 8 point scale) in the intervention group versus a decrease of 0.1 in the control group. During the six-month study period, 35.9% of patients in the intervention group presented to the ED for care, as compared to 51.6% of patients in the control group.

  14. Managing ecotourism visitation in protected areas

    USGS Publications Warehouse

    Marion, J.L.; Farrell, T.A.; Lindberg, Kreg; Wood, Megan Epler; Engeldrum, David

    1998-01-01

    Ecotourism management seeks to integrate and balance several potentially conflicting objectives: protection of natural and cultural resources, provision of recreation opportunities and generation of economic benefits. In the absence of effective planning and management, ecotourism can lead to significant negative impacts on vegetation, soil, water, wildlife, historic resources, cultures, and visitor experiences. This chapter reviews visitor-related natural resource and experience impacts associated with ecotourism within protected areas. The influence of factors that control the nature and extent of impacts are also reviewed, including type and amount of use, the variable resistance and resilience of environmental attributes such as vegetation and soil types, and the role of management in shaping visitation, resources and facilities to support visitation while minimizing associated impacts. Implications for managing the effects of protected area visitation are highlighted, including carrying capacity decision frameworks and selecting management strategies and tactics.

  15. "When Are You Coming to Visit?" Home Visits and Seeing Our Students

    ERIC Educational Resources Information Center

    Schlessman, Elizabeth

    2013-01-01

    The process that led the author to home visits was a gradual one. She sensed that on the other side of the bus ride home, students' lives were much richer and more varied than could be taken into account by classroom conversations, curriculum, and conferences. Home visits made her even more aware of the need to provide opportunities for students…

  16. Overview of the federal home visiting program.

    PubMed

    Adirim, Terry; Supplee, Lauren

    2013-11-01

    On March 23, 2010, the President signed into law the Affordable Care Act (Public Law 111-148), which included an amendment of Title V of the Social Security Act authorizing the creation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. Authorized and funded at $1.5 billion for 5 years, the MIECHV represents a large investment in health and development outcomes for at-risk children through evidence-based home visiting programs. The MIECHV presents unprecedented opportunities to integrate early childhood services systems, not only on the federal level but also within states and local communities. The MIECHV is funded in escalating amounts over 5-year period authorized, as follows: $100 million in fiscal year (FY) 2010, $250 million in FY 2011, $350 million in FY 2012, $400 million in FY 2013, and $400 million in FY 2014. Most of the funding is being provided to states and territories to provide home visiting services in their at-risk communities. In addition, the legislation included a 3% set-aside for tribes, tribal organizations, and urban Indian organizations and a 3% set-aside for research and evaluation. This investment has spurred the creation of more comprehensive and coordinated early childhood service systems across the United States. This article provides an overview of the MIECHV program, including descriptions of the various requirements under the Affordable Care Act. These include partnering with states to provide evidence-based home visiting services to at-risk families, working with tribal communities to implement culturally competent home visiting programs, and developing a mechanism to systematically review the evidence of effectiveness for home visiting program models and to conduct a national evaluation of the MIECHV program. PMID:24187124

  17. AC photovoltaic module magnetic fields

    SciTech Connect

    Jennings, C.; Chang, G.J.; Reyes, A.B.; Whitaker, C.M.

    1997-12-31

    Implementation of alternating current (AC) photovoltaic (PV) modules, particularly for distributed applications such as PV rooftops and facades, may be slowed by public concern about electric and magnetic fields (EMF). This paper documents magnetic field measurements on an AC PV module, complementing EMF research on direct-current PV modules conducted by PG and E in 1993. Although not comprehensive, the PV EMF data indicate that 60 Hz magnetic fields (the EMF type of greatest public concern) from PV modules are comparable to, or significantly less than, those from household appliances. Given the present EMF research knowledge, AC PV module EMF may not merit considerable concern.

  18. The AAS Visiting Professor Programs: Three Anniversaries

    NASA Astrophysics Data System (ADS)

    Philip, A. G. Davis

    2003-05-01

    The AAS Program of Visiting Professors was started in 1958 with three astronomers as lecturers. They were Paul Merrill (Mt. Wilson and Palomar Observatories), Seth Nicholson (Mt. Wilson and Palomar Observatories) and Harlow Shapley (Harvard College Observatory). The program was run by a Committee on Visiting Professors from 1958 through 1963. The program was funded by grants from the National Science Foundation. The Executive Officer of the AAS, Paul Routley headed the program from the 1963 - 64 academic year through the 1968 - 69 academic year. Larry Fredrick headed the program for 1969 - 70 and then Hank Gurin headed it through 1973 -74, the last year of the program. At the end of this summer meeting, the combined Visiting Professors Program and the Shapley Program will be starting their 47th year. The Shapley Visiting Lectureships in Astronomy Program was started in the 1974 - 75 academic year under the leadership of Hank Gurin. The original funding came from the Perkin Fund and a three year grant from the Research Corporation. In 1975 the Shapley Endowment fund was set up to help pay the expenses of the program. In 1976 there was support from the Slipher fund which lasted through the 1978 - 79 academic year. From 1979 to the present the program is financed by the Shapley Endowment Fund and by the contributions made by institutions which host the visits. In the fall of 1998 the fee that Institutions pay to the AAS in support of their Shapley visits was reduced from 300 to 250 to make it easier for them to apply for visits. Members of the AAS have made contributions to the program over the years and we are very appreciative of this support. In 1974 there were 42 lecturers in the program, of whom four are still active giving lectures (George Carruthers, Larry Fredrick, Arlo Landolt and Davis Philip). After the summer meeting, the Shapley Program will be embarking on its 30th year. Now there are 82 astronomers in the program and we get from 40 to 60 requests a year

  19. METAvivor Reps Visit NCI at Frederick | Poster

    Cancer.gov

    Three representatives of METAvivor visited NCI at Frederick on April 13 to meet and tour with Balamurugan Kuppusamy, Ph.D., staff scientist in the laboratory of Esta Sterneck, Ph.D., senior investigator, Laboratory of Cell and Developmental Signaling, Center for Cancer Research.  The purpose of the visit was to learn more about Kuppusamy’s research. Kuppusamy is a recipient of a $50,000, two-year grant awarded by METAvivor to study the role of the CEBPD-FBXW7 signaling pathway in inflammatory breast cancer.

  20. Bringing your child to visit a very ill sibling

    MedlinePlus

    ... patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005. Crit Care Clin . ... In: Fuhrman BP and Zimmerman JJ, eds. Pediatric Critical Care . 3rd ed. Philadelphia, PA: Elsevier Mosby; 2005:chap ...

  1. Capillary Study - Skylab Student Experiment ED-72

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This chart describes the Skylab student experiment ED-72, Capillary Study, proposed by Roger G. Johnson of St. Paul, Mirnesota. Johnson theorized that capillary rise might continue to infinity in Skylab's zero-gravity environment. The behavior of fluids, particularly their flow properties in a low-gravity environment, had been important from the time that Robert H. Goddard launched his liquid-fueled rockets in the 1920's to the more sophisticated space systems of the day. It was necessary to design fluid-flow systems that would not only overcome the lack of gravity but also overcome, or take advantage of, the effect of surface tension. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  2. 29 CFR 1908.6 - Conduct of a visit.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CONSULTATION AGREEMENTS § 1908.6 Conduct of a visit. (a) Preparation. (1) An onsite consultative visit shall be made only after appropriate preparation by the consultant. Prior to the visit, the consultant shall... conference. An initial visit may include training and education for employers and employees, if the need...

  3. 29 CFR 1908.6 - Conduct of a visit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CONSULTATION AGREEMENTS § 1908.6 Conduct of a visit. (a) Preparation. (1) An onsite consultative visit shall be made only after appropriate preparation by the consultant. Prior to the visit, the consultant shall... conference. An initial visit may include training and education for employers and employees, if the need...

  4. 22 CFR 125.5 - Exemptions for plant visits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Exemptions for plant visits. 125.5 Section 125... EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.5 Exemptions for plant visits. (a) A... course of a classified plant visit by a foreign person, provided: The classified visit has itself...

  5. 22 CFR 125.5 - Exemptions for plant visits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Exemptions for plant visits. 125.5 Section 125... EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.5 Exemptions for plant visits. (a) A... course of a classified plant visit by a foreign person, provided: The classified visit has itself...

  6. A Visitation/Training Program for Institutionalized Elderly.

    ERIC Educational Resources Information Center

    Fling, Sheila; Tayloe, Bryan

    Research on the use of paraprofessionals and trained volunteers for visitation programs with elders is limited. To determine the effects of a visitation program on nursing home residents and their college student and elder visitors, and to explore the effectiveness of special training for such visitation, nursing home residents (N=25) visited with…

  7. 22 CFR 125.5 - Exemptions for plant visits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Exemptions for plant visits. 125.5 Section 125... EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.5 Exemptions for plant visits. (a) A... course of a classified plant visit by a foreign person, provided: The classified visit has itself...

  8. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... visit. (3) Visit—Mental health. A mental health visit is a face-to-face encounter between a RHC or FQHC... or FQHC practitioner, in accordance with paragraph (b)(1) of this section, for mental health services... diagnosis or treatment on the same day; (ii) Has a medical visit and a mental health visit on the same...

  9. Vitamin C Deficiency of Korean Homeless Patients Visiting to Emergency Department with Acute Alcohol Intoxication.

    PubMed

    Lee, Hui Jai; Shin, Jonghwan; Hong, Kijeong; Jung, Jin Hee

    2015-12-01

    Vitamins are essential micronutrients for maintenance of tissue functions. Vitamin deficiency is one of the most serious and common health problems among both chronic alcoholics and the homeless. However, the vitamin-level statuses of such people have been little studied. We evaluated the actual vitamin statuses of alcoholic homeless patients who visited an emergency department (ED). In this study the blood levels of vitamins B1, B12, B6, and C of 217 alcoholic homeless patients were evaluated retrospectively in a single urban teaching hospital ED. Vitamin C deficiency was observed in 84.3% of the patients. The vitamin B1, B12, and B6 deficiency rates, meanwhile, were 2.3%, 2.3%, and 23.5%, respectively. Comparing the admitted patients with those who were discharged, only the vitamin C level was lower. (P=0.003) In fact, the patients' vitamin C levels were markedly diminished, vitamin C replacement therapy for homeless patients should be considered in EDs.

  10. Vitamin C Deficiency of Korean Homeless Patients Visiting to Emergency Department with Acute Alcohol Intoxication

    PubMed Central

    2015-01-01

    Vitamins are essential micronutrients for maintenance of tissue functions. Vitamin deficiency is one of the most serious and common health problems among both chronic alcoholics and the homeless. However, the vitamin-level statuses of such people have been little studied. We evaluated the actual vitamin statuses of alcoholic homeless patients who visited an emergency department (ED). In this study the blood levels of vitamins B1, B12, B6, and C of 217 alcoholic homeless patients were evaluated retrospectively in a single urban teaching hospital ED. Vitamin C deficiency was observed in 84.3% of the patients. The vitamin B1, B12, and B6 deficiency rates, meanwhile, were 2.3%, 2.3%, and 23.5%, respectively. Comparing the admitted patients with those who were discharged, only the vitamin C level was lower. (P=0.003) In fact, the patients' vitamin C levels were markedly diminished, vitamin C replacement therapy for homeless patients should be considered in EDs. PMID:26713065

  11. PTSD in Depressed Mothers in Home Visitation

    PubMed Central

    Ammerman, Robert T.; Putnam, Frank W.; Chard, Kathleen M.; Stevens, Jack; Van Ginkel, Judith B.

    2013-01-01

    Recent research has suggested that mothers participating in home visitation programs have a high incidence of mental health problems, particularly depression. Posttraumatic stress disorder (PTSD) is a common comorbidity with depression, yet its prevalence among home visiting populations and implications for parenting and maternal functioning have not been examined. This study contrasted depressed mothers with (n = 35) and without PTSD (n = 55) who were enrolled in a home visitation program. Results indicated that depressed mothers with comorbid PTSD were more likely to have experienced childhood sexual abuse, had greater severity of depressive symptoms, increased social isolation, and lower overall functioning than their counterparts without PTSD. Among PTSD mothers, greater severity of PTSD symptoms, in particular avoidance and emotional numbness, were associated with increased maternal psychopathology and parenting deficits even after controlling for depression severity. These findings add to the literature documenting the negative impacts of PTSD on maternal functioning and parenting. Implications for screening and treatment in the context of home visitation are discussed. PMID:24307928

  12. CoSN Delegation Visits Scandinavia

    ERIC Educational Resources Information Center

    Technology & Learning, 2008

    2008-01-01

    In November 2007, a delegation from the Consortium for School Networking visited three Scandinavian countries to examine best practices. The delegates were motivated by their desire to understand the high achievement levels of students in Finland, Sweden, and Denmark. For several years, students in these countries have been outperforming their…

  13. A Visit to Three Parisian School Libraries.

    ERIC Educational Resources Information Center

    PEB Exchange, 1998

    1998-01-01

    Presents brief site-visit reports of three Paris (France) public schools to study the planning and use of each school's library. Observations from an elementary, middle, and high school include the overall library design, book classification and access systems, technology use, budgeting, and librarian role. (GR)

  14. Innovative technology offers virtual visitation for families.

    PubMed

    Thibeau, Shelley; Ricouard, Dawn; Gilcrease, Carolyn

    2012-10-01

    Parents of preterm infants and infants with congenital anomalies requiring treatment must begin their relationship with their infant in the unfamiliar and often stressful neonatal intensive care unit, full of strange sights and sounds. Innovative technology such as webcams offers virtual visitation, which holds potential to improve parent-infant bonding and reduce parents' self-perceived stress.

  15. Toward Population Impact from Home Visiting

    ERIC Educational Resources Information Center

    Dodge, Kenneth A.; Goodman, W. Benjamin; Murphy, Robert; O'Donnell, Karen J.; Sato, Jeannine M.

    2013-01-01

    Although some home visiting programs have proven effective with the families they serve, no program has yet demonstrated broader impact on an entire county or state population. This article describes the Durham Connects program, which aims to achieve broad county-level effects by coalescing community agencies to serve early-intervention goals…

  16. Visiting a science centre: what's on offer?

    NASA Astrophysics Data System (ADS)

    Russell, Ian

    1990-09-01

    Science centres are a valuable resource, used more frequently by family groups and primary school parties than by secondary schools. The importance of affective learning, involving attitude changes, is stressed. Provided the right approach is used, accompanying adults can help children get the most out of a visit.

  17. Parent Involvement in Early Childhood Home Visiting

    ERIC Educational Resources Information Center

    Korfmacher, Jon; Green, Beth; Staerkel, Fredi; Peterson, Carla; Cook, Gina; Roggman, Lori; Faldowski, Richard A.; Schiffman, Rachel

    2008-01-01

    This review provides an overview of an important aspect of early childhood home visiting research: understanding how parents are involved in program services and activities. Involvement is defined as the process of the parent connecting with and using the services of a program to the best of the client's and the program's ability. The term…

  18. Home Visitation Assessing Progress, Managing Expectations

    ERIC Educational Resources Information Center

    Daro, Deborah

    2006-01-01

    Early intervention efforts to promote healthy child development have long been a central feature of social service and public health reforms. Today, prenatal care, well-baby visits, and assessments to detect possible developmental delays are commonplace in most communities. Recently, child abuse prevention advocates have applied a developmental…

  19. Using quality improvement to promote implementation and increase well child visits in home visiting.

    PubMed

    Goyal, Neera K; Ammerman, Robert T; Massie, Julie A; Clark, Margaret; Van Ginkel, Judith B

    2016-03-01

    A key goal of home visiting is to connect children with medical homes through anticipatory guidance regarding recommended well child care (WCC). Substantial barriers to WCC among low socioeconomic families can limit achievement of this outcome. Quality improvement strategies have been widely adopted in healthcare but only recently implemented in home visiting to achieve program outcomes. The objective of this initiative was to increase the percentage of infants enrolled in home visiting who completed at least 3 recommended WCC visits in the first 6 months of life within a large, multi-model program comprised of 11 sites. A series of 33 quality improvement cycles were conducted at 3 sites involving 18 home visitors and 139 families with infants in the target age range. These were deployed sequentially, and changes within and across sites were monitored using trend charts over time. Adopted strategies were then implemented program-wide. Initiatives focused on staff training in WCC recommendations, data collection processes, monthly family tracking reports, and enhanced communication with primary care offices. Data were shared in iterative sessions to identify methods for improving adherence. Wide baseline variability across sites was observed, with the percentage of infants with recommended care ranging from 35% to 83%. Over the project timeline, the percentage of infants receiving at least 3 WCC visits in the first 6 months increased from 58% to 86%. Quality improvement within home visiting can be used to improve WCC adherence and provides an example of maximizing implementation of home visiting interventions. PMID:26699456

  20. Life Satisfaction and Frequency of Doctor Visits

    PubMed Central

    Kim, Eric S.; Park, Nansook; Sun, Jennifer K.; Smith, Jacqui; Peterson, Christopher

    2015-01-01

    Objective Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information is available about the association between life satisfaction and health care use. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. Methods Participants were 6,379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults over the age of 50. Participants were tracked for four years. We analyzed the data using a generalized linear model with a gamma distribution and log link. Results Higher life satisfaction was associated with fewer doctor visits. On a six-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits—after adjusting for sociodemographic factors (RR = 0.89, 95% CI = 0.86 to 0.93). The most satisfied respondents (N=1,121; 17.58%) made 44% fewer doctor visits than the least satisfied (N=182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (RR = 0.96, 95% CI = 0.93 to 0.99). Conclusions Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs. PMID:24336427

  1. Feasibility of Non-Mydriatic Ocular Fundus Photography in the Emergency Department: Phase I of the FOTO-ED Study

    PubMed Central

    Bruce, Beau B.; Lamirel, Cédric; Biousse, Valérie; Ward, Antionette; Heilpern, Katherine L.; Newman, Nancy J.; Wright, David W.

    2011-01-01

    Objectives Examination of the ocular fundus is imperative in many acute medical and neurologic conditions, but direct ophthalmoscopy by non-ophthalmologists is underutilized, poorly performed, and difficult without pharmacologic pupillary dilation. The objective was to examine the feasibility of non-mydriatic fundus photography as a clinical alternative to direct ophthalmoscopy by emergency physicians (EPs). Methods Adult patients presenting to the emergency department (ED) with headache, acute focal neurologic deficit, diastolic blood pressure ≥ 120 mmHg, or acute visual change had ocular fundus photographs taken by nurse practitioners using a non-mydriatic fundus camera. Photographs were reviewed by a neuro-ophthalmologist within 24 hours for findings relevant to acute ED patient care. Nurse practitioners and patients rated ease, comfort, and speed of non-mydriatic fundus photography on a 10-point Likert scale (10 best). Timing of visit and photography were recorded by automated electronic systems. Results Three hundred fifty patients were enrolled. There were 1,734 photographs taken during 230 nurse practitioner shifts. Eighty-three percent of the 350 patients had at least one eye with a high quality photograph, while only 3% of patients had no photographs of diagnostic value. Mean ratings were ≥ 8.7 (standard deviation [SD] ≤ 1.9) for all measures. The median photography session lasted 1.9 minutes (interquartile range [IQR] 1.3 to 2.9 minutes), typically accounting for less that 0.5% of the patient’s total ED visit. Conclusions Non-mydriatic fundus photography taken by nurse practitioners is a feasible alternative to direct ophthalmoscopy in the ED. It is performed well by non-physician staff, is well-received by staff and patients, and requires a trivial amount of time to perform. PMID:21906202

  2. Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse

    PubMed Central

    Tien, Yu-Yu; Hsia, Renee Y.

    2016-01-01

    Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED. We examined racial-ethnic disparities in opioid prescription at ED visits for pain-related complaints often associated with drug-seeking behavior and contrasted them with conditions objectively associated with pain. We hypothesized a priori that racial-ethnic disparities will be present among opioid prescriptions for conditions associated with non-medical use, but not for objective pain-related conditions. Using data from the National Hospital Ambulatory Medical Care Survey for 5 years (2007–2011), the odds of opioid prescription during ED visits made by non-elderly adults aged 18–65 for ‘non-definitive’ conditions (toothache, back pain and abdominal pain) or ‘definitive’ conditions (long-bone fracture and kidney stones) were modeled. Opioid prescription at discharge and opioid administration at the ED were the primary outcomes. We found significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56–0.67, p-value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariates. Differential prescription of opioids by race-ethnicity could lead to widening of existing disparities in health, and may have implications for disproportionate burden of opioid abuse among whites. The findings have important implications for medical

  3. Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse.

    PubMed

    Singhal, Astha; Tien, Yu-Yu; Hsia, Renee Y

    2016-01-01

    Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED. We examined racial-ethnic disparities in opioid prescription at ED visits for pain-related complaints often associated with drug-seeking behavior and contrasted them with conditions objectively associated with pain. We hypothesized a priori that racial-ethnic disparities will be present among opioid prescriptions for conditions associated with non-medical use, but not for objective pain-related conditions. Using data from the National Hospital Ambulatory Medical Care Survey for 5 years (2007-2011), the odds of opioid prescription during ED visits made by non-elderly adults aged 18-65 for 'non-definitive' conditions (toothache, back pain and abdominal pain) or 'definitive' conditions (long-bone fracture and kidney stones) were modeled. Opioid prescription at discharge and opioid administration at the ED were the primary outcomes. We found significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56-0.67, p-value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariates. Differential prescription of opioids by race-ethnicity could lead to widening of existing disparities in health, and may have implications for disproportionate burden of opioid abuse among whites. The findings have important implications for medical provider education

  4. An Analysis of US Emergency Department Visits From Falls From Skiing, Snowboarding, Skateboarding, Roller-Skating, and Using Nonmotorized Scooters.

    PubMed

    Nathanson, Brian H; Ribeiro, Kara; Henneman, Philip L

    2016-07-01

    We analyzed the US incidence of emergency department (ED) visits and hospitalizations for falls from skiing, snowboarding, skateboarding, roller-skating, and nonmotorized scooters in 2011. The outcome was hospital admission from the ED. The primary analysis compared pediatric patients aged 1 to 17 years to adults aged 18 to 44 years. The analysis used ICD-9 E-codes E885.0 to E885.4 using discharge data from the Nationwide Emergency Department Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Approximately 214 000 ED visits met study criteria. Skiing injuries had the highest percentage of hospitalizations (3.30% in pediatric patients and 6.65% in adults 18-44 years old). Skateboard and snowboard injuries were more likely to require hospitalization than roller skating injuries in pediatric patients (odds ratio = 2.42; 95% CI = 2.14-2.75 and odds ratio = 1.83; 95% CI =1.55-2.15, respectively). In contrast, skateboard and snowboard injuries were less severe than roller-skating injuries in adults.

  5. ExpandED Options: Learning beyond High School Walls

    ERIC Educational Resources Information Center

    ExpandED Schools, 2014

    2014-01-01

    Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…

  6. Teaching Elementary School Social Studies Methods under edTPA

    ERIC Educational Resources Information Center

    An, Sohyun

    2016-01-01

    This article reports a self-study that analyzes my experience as a teacher educator navigating a turbulent educational landscape with the advent of edTPA. The data consist of my journal entries, the syllabi, handouts, work submitted by my students, and course evaluations. Data were analyzed by using an inductive process to describe how the edTPA…

  7. Visit to Shikhany, 1987. Technical report

    SciTech Connect

    Not Available

    1988-08-29

    In August 1987, the Soviet Union invited participants in the chemical weapons negotiations at the Conference on Disarmament in Geneva to visit the Soviet military chemical facility at Shikhany. The presentation at Shikhany of chemical weapons and of weapon destruction took place on 3 and 4 October 1987. Six members of the US delegation attended. The presentation provided unclassified information on seven chemical agents or agent composites and nineteen weapons for delivery of chemical agents. This report provides a ready reference to the information obtained from the Shikhany visit. Information is included on principal agent types and weapons types. Shikhany is the site of a Soviet military facility and is located in the Volsk district nine hundred kilometers southeast of Moscow, and lies northwest of and adjacent to the Volga river. This report provides descriptions of the chemical munitions displayed for the visitors, the chemical agents for use in the munitions, and Soviet chemical agent demilitarization.

  8. A practical three visit complete denture system.

    PubMed

    Ling, B C

    2000-10-01

    Standard prosthodontic procedures require five visits to construct a set of complete maxillary and mandibular dentures. Various attempts have been made to reduce these procedures to four or three appointments. However, most of these techniques require the use of visible light polymerized resin as the final denture base materials. Visible light-cured resin materials have inferior physical properties and biocompatibility problems as compared with heat cured polymethylmethacrylate. This paper describes a system of complete denture construction which requires three clinical appointments instead of the usual five visits. This system is made possible by using the VLC base/tray material as the preliminary impression material as well as the application of a new biometric wax occlusion rim. It retains the use of polymethylmethacrylate as the denture base material. This system also utilizes all the procedures used in the conventional five appointment system of complete denture construction. PMID:11709981

  9. National Ice Center Visiting Scientist Program

    NASA Technical Reports Server (NTRS)

    Austin, Meg

    2002-01-01

    The long-term goal of the University Corporation for Atmospheric Research (UCAR) Visiting Scientist Program at the National Ice Center (NIC) is to recruit the highest quality visiting scientists in the ice research community for the broad purpose of strengthening the relationship between the operational and research communities in the atmospheric and oceanic sciences. The University Corporation for Atmospheric Research supports the scientific community by creating, conducting, and coordinating projects that strengthen education and research in the atmospheric, oceanic and earth sciences. UCAR accomplishes this mission by building partnerships that are national or global in scope. The goal of UCAR is to enable researchers and educators to take on issues and activities that require the combined and collaborative capabilities of a broadly engaged scientific community.

  10. United States-Russia exchange visits

    SciTech Connect

    Desmond, W.J.; Czajkowski, A.F.; Zack, N.R.; Martin, H.R.; Gardner, B.; Schlegel, S.; Von Hippel, F.

    1995-09-01

    The Department of Energy, under a government-to-government program, hosted the first visit with the Russian Federation to exchange information and technologies for special nuclear material control, accounting, and physical protection at a plutonium storage facility. The Russian specialists toured a storage facility at the Hanford Site near Richland, Washington, and were shown the physical protection and materials control systems that DOE employs to protect excess nuclear materials. Technical discussions included topics associated with protective forces and their operation, perimeter and interior intrusion detection and assessment equipment/systems, vulnerability assessment demonstrations, and the vault monitoring and materials control systems. In October, the Russian Federation hosted a reciprocal visit to the Mayak Enterprise civil plutonium storage facility, previously known as Chelyabinsk-65. The US specialists participated in technical discussions on the protection and control of plutonium and supported an evaluation of safeguards and security at the Mayak storage facility.

  11. Web Formation - Skylab Student Experiment ED-52

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Judith S. Miles of Lexington High School, Lexington, Massachusetts, proposed skylab student experiment ED-52, Web Formation. This experiment was a study of a spider's behavior in a weightless environment. The geometrical structure of the web of the orb-weaving spider provides a good measure of the condition of its central nervous system. Since the spider senses its own weight to determine the required thickness of web material and uses both the wind and gravity to initiate construction of its web, the lack of gravitational force in Skylab provided a new and different stimulus to the spider's behavioral response. Two common cross spiders, Arabella and Anita, were used for the experiment aboard the Skylab-3 mission. After initial disoriented attempts, both spiders produced almost Earth-like webs once they had adapted to weightlessness. This photograph is of Arabella, a cross spider, in her initial attempt at spirning a web. This picture was taken by the crew of the Skylab 3 mission before Arabella adapted to her new environment.

  12. Neuroscientists’ Classroom Visits Positively Impact Student Attitudes

    PubMed Central

    Fitzakerley, Janet L.; Michlin, Michael L.; Paton, John; Dubinsky, Janet M.

    2013-01-01

    The primary recommendation of the 2010 President’s Council of Advisors on Science and Technology report on K-12 education was to inspire more students so that they are motivated to study science. Scientists’ visits to classrooms are intended to inspire learners and increase their interest in science, but verifications of this impact are largely qualitative. Our primary goal was to evaluate the impact of a longstanding Brain Awareness classroom visit program focused on increasing learners understanding of their own brains. Educational psychologists have established that neuroscience training sessions can improve academic performance and shift attitudes of students from a fixed mindset to a growth mindset. Our secondary goal was to determine whether short interactive Brain Awareness scientist-in-the-classroom sessions could similarly alter learners’ perceptions of their own potential to learn. Teacher and student surveys were administered in 4th-6th grade classrooms throughout Minnesota either before or after one-hour Brain Awareness sessions that engaged students in activities related to brain function. Teachers rated the Brain Awareness program as very valuable and said that the visits stimulated students’ interest in the brain and in science. Student surveys probed general attitudes towards science and their knowledge of neuroscience concepts (particularly the ability of the brain to change). Significant favorable improvements were found on 10 of 18 survey statements. Factor analyses of 4805 responses demonstrated that Brain Awareness presentations increased positive attitudes toward science and improved agreement with statements related to growth mindset. Overall effect sizes were small, consistent with the short length of the presentations. Thus, the impact of Brain Awareness presentations was positive and proportional to the efforts expended, demonstrating that short, scientist-in-the-classroom visits can make a positive contribution to primary school

  13. Building Relationships by Revisiting Home Visits

    ERIC Educational Resources Information Center

    Hillman, Carol B.

    2011-01-01

    The author can't think of any better way to begin a relationship with a young school-bound child than to make a home visit. Home is where the heart is. Home is where the child feels most comfortable, where a child feels safe. When he is at home, a child can more easily welcome a new adult into his world and take the lead in establishing this…

  14. Neuroscientists' classroom visits positively impact student attitudes.

    PubMed

    Fitzakerley, Janet L; Michlin, Michael L; Paton, John; Dubinsky, Janet M

    2013-01-01

    The primary recommendation of the 2010 President's Council of Advisors on Science and Technology report on K-12 education was to inspire more students so that they are motivated to study science. Scientists' visits to classrooms are intended to inspire learners and increase their interest in science, but verifications of this impact are largely qualitative. Our primary goal was to evaluate the impact of a longstanding Brain Awareness classroom visit program focused on increasing learners understanding of their own brains. Educational psychologists have established that neuroscience training sessions can improve academic performance and shift attitudes of students from a fixed mindset to a growth mindset. Our secondary goal was to determine whether short interactive Brain Awareness scientist-in-the-classroom sessions could similarly alter learners' perceptions of their own potential to learn. Teacher and student surveys were administered in 4(th)-6(th) grade classrooms throughout Minnesota either before or after one-hour Brain Awareness sessions that engaged students in activities related to brain function. Teachers rated the Brain Awareness program as very valuable and said that the visits stimulated students' interest in the brain and in science. Student surveys probed general attitudes towards science and their knowledge of neuroscience concepts (particularly the ability of the brain to change). Significant favorable improvements were found on 10 of 18 survey statements. Factor analyses of 4805 responses demonstrated that Brain Awareness presentations increased positive attitudes toward science and improved agreement with statements related to growth mindset. Overall effect sizes were small, consistent with the short length of the presentations. Thus, the impact of Brain Awareness presentations was positive and proportional to the efforts expended, demonstrating that short, scientist-in-the-classroom visits can make a positive contribution to primary school

  15. John Dewey's Visits to Hawai'i

    ERIC Educational Resources Information Center

    McEwan, Hunter

    2015-01-01

    John Dewey visited Hawai'i on three separate occasions. Of all three trips, by far the most important, as far as Dewey's influence on education in Hawai'i is concerned, was in 1899 when he came with his wife, Alice Chipman Dewey, to help launch the University Extension program in Honolulu. The Deweys' second trip was a very brief one--twenty years…

  16. Visit of the Federal President of Germany

    SciTech Connect

    2007-12-05

    Le D.G. H.Schopper a le plaisir de souhaiter la bienvenue au président de la République fédérale allemande, Richard von Weizsäcker (président féderale de 1984-1994). C'est la première visite d'un président allemand dans l'histoire du Cern.

  17. Visit of the Federal President of Germany

    ScienceCinema

    None

    2016-07-12

    Le D.G. H.Schopper a le plaisir de souhaiter la bienvenue au président de la République fédérale allemande, Richard von Weizsäcker (président féderale de 1984-1994). C'est la première visite d'un président allemand dans l'histoire du Cern.

  18. TechEdSat Nano-Satellite Series Fact Sheet

    NASA Technical Reports Server (NTRS)

    Murbach, Marcus; Martinez, Andres; Guarneros Luna, Ali

    2014-01-01

    TechEdSat-3p is the second generation in the TechEdSat-X series. The TechEdSat Series uses the CubeSat standards established by the California Polytechnic State University Cal Poly), San Luis Obispo. With typical blocks being constructed from 1-unit (1U 10x10x10 cm) increments, the TechEdSat-3p has a 3U volume with a 30 cm length. The project uniquely pairs advanced university students with NASA researchers in a rapid design-to-flight experience lasting 1-2 semesters.The TechEdSat Nano-Satellite Series provides a rapid platform for testing technologies for future NASA Earth and planetary missions, as well as providing students with an early exposure to flight hardware development and management.

  19. Characteristics of patients who made a return visit within 72 hours to the emergency department of a Singapore tertiary hospital

    PubMed Central

    Chan, Amy Hui Sian; Ho, Shu Fang; Fook-Chong, Stephanie Man Chung; Lian, Sherman Wei Qiang; Liu, Nan; Ong, Marcus Eng Hock

    2016-01-01

    INTRODUCTION 72-hour emergency department (ED) reattendance is a widely-used quality indicator for quality of care and patient safety. It is generally assumed that patients who return within 72 hours of ED discharge (72-hour re-attendees) received inadequate treatment or evaluation. The current literature also suggests considerable variation in probable causes of 72-hour ED reattendances internationally. This study aimed to understand the characteristics of these patients at the ED of a Singapore tertiary hospital. METHODS We conducted a retrospective cohort study on all ED visits between 1 January 2013 and 31 December 2013. 72-hour re-attendees were compared against non-re-attendees based on patient demographics, mode of arrival, patient acuity category status (i.e. P1/P2/P3/P4), seniority ranking of doctor-in-charge and medical diagnoses. Multivariate analysis using the generalised linear model was conducted on variables associated with 72-hour ED re-attendance. RESULTS Among 104,751 unique patients, 3,065 (2.93%) were in the 72-hour re-attendees group. Multivariate analysis showed that the following risk factors were associated with higher risk of returning within 72 hours: male gender, older age, arrival by ambulance, triaged as P2, diagnoses of heart problems, abdominal pain or viral infection (all p < 0.001), and Chinese ethnicity (p = 0.006). There was no significant difference in the seniority ranking of the doctor-in-charge between both groups (p = 0.419). CONCLUSION Several patient and event factors were associated with higher risk of being a 72-hour re-attendee. This study forms the basis for hypothesis generation and further studies to explore reasons behind reattendances so that interventions can be developed to target high-risk groups. PMID:27353286

  20. Practice visits as a tool in quality improvement: mutual visits and feedback by peers compared with visits and feedback by non-physician observers

    PubMed Central

    Van den Hombergh, P.; Grol, R.; van den Hoogen, H.; van den Bosch, W.

    1999-01-01

    Objective - To evaluate and compare the effects of two programmes of assessment of practice management in a practice visit: mutual visits and feedback by peers compared with visits and feedback by non- physician observers. Design - Prospective, randomised intervention study, with follow up after one year. Setting - General practices in the Netherlands in 1993 and 1994. Subjects - A total of 90 general practitioners (GPs) in 68 practices; follow up after one year comprised 81 GPs in 62 practices. Main measures - Scores on indicators and dimensions of practice management in the visit instrument to assess practice management and organisation (a validated Dutch method to assess practice management in a practice visit). Change was defined as the difference in score between the first visit and the visit after one year on 208 indicators and on 33 dimensions of practice management. Results - Data of 44 mutual visits by peers were compared with data of 46 visits by non-physician observers. After a year both programmes showed improvements on many aspects of practice management, but different aspects changed in each of the two programmes. After mutual practice visits, GPs scored significantly higher on content of the doctor's bag, on collaboration with colleagues, on collaboration with other care providers, and on accessibility of patient information than after a visit by a non-physician observer. The visits by non-physician observers resulted in a higher score on extent of use of records and on assessment on outcome and year report. Conclusion - Change after mutual practice visits and feedback by peers is more marked than after a visit and feedback by a non-physician observer. PMID:10847872

  1. Application of change point analysis to daily influenza-like illness emergency department visits

    PubMed Central

    Xu, Zhiheng; McMurray, Paul; Park, Soyoun; Buckeridge, David L; Brownstein, John S; Finelli, Lyn; Groseclose, Samuel L

    2012-01-01

    Background The utility of healthcare utilization data from US emergency departments (EDs) for rapid monitoring of changes in influenza-like illness (ILI) activity was highlighted during the recent influenza A (H1N1) pandemic. Monitoring has tended to rely on detection algorithms, such as the Early Aberration Reporting System (EARS), which are limited in their ability to detect subtle changes and identify disease trends. Objective To evaluate a complementary approach, change point analysis (CPA), for detecting changes in the incidence of ED visits due to ILI. Methodology and principal findings Data collected through the Distribute project (isdsdistribute.org), which aggregates data on ED visits for ILI from over 50 syndromic surveillance systems operated by state or local public health departments were used. The performance was compared of the cumulative sum (CUSUM) CPA method in combination with EARS and the performance of three CPA methods (CUSUM, structural change model and Bayesian) in detecting change points in daily time-series data from four contiguous US states participating in the Distribute network. Simulation data were generated to assess the impact of autocorrelation inherent in these time-series data on CPA performance. The CUSUM CPA method was robust in detecting change points with respect to autocorrelation in time-series data (coverage rates at 90% when −0.2≤ρ≤0.2 and 80% when −0.5≤ρ≤0.5). During the 2008–9 season, 21 change points were detected and ILI trends increased significantly after 12 of these change points and decreased nine times. In the 2009–10 flu season, we detected 11 change points and ILI trends increased significantly after two of these change points and decreased nine times. Using CPA combined with EARS to analyze automatically daily ED-based ILI data, a significant increase was detected of 3% in ILI on April 27, 2009, followed by multiple anomalies in the ensuing days, suggesting the onset of the H1N1 pandemic in

  2. Male Patient Visits to the Emergency Department Decline During the Play of Major Sporting Events

    PubMed Central

    Jerrard, David A.

    2009-01-01

    Objectives: To study whether emergency department (ED) visits by male patients wane simultaneously with the play of scheduled professional and college sports events. Methods: Retrospective cohort analysis looked at ED male patient registration rates during a time block lasting from two hours before, during, and two hours after the play of professional football games (Monday night, Sundays, post-season play), major league baseball, and a Division I college football and basketball team, respectively. These registration rates were compared to rates at similar times on similar days of the week during the year devoid of a major sporting contest. Games were assumed to have a play time of three hours. Data was collected from April 2000 through March 2003 at an urban academic ED seeing 33,000 male patients above the age of 18 years annually. Results: A total of 782 games were identified and used for purposes of the study. Professional football game dates had a mean of 17.9 males (95% confidence interval [CI] 17.4–18.4) registering vs. 26.8 males (95% CI 25.9–27.6) on non-game days. A registration rate for major league baseball was 18.4 patients (95% CI 17.6–18.4). The mean for registration on comparable non-game days was 23.9 patients (95% CI 22.8–24.3). For the regional Division I college football team, the mean number of patients registering on game days and non-game days was 21.7 (95% CI 20.9–22.4) and 23.4 (95% CI 22.9–23.7), respectively. Division I college basketball play for game and non-game days had mean rates of registration of 14.5 (95% CI 13.9–15.1) and 15.5 (95% CI 15.1–15.9) patients, respectively. For all sports dates collectively, a comparison of two means yielded a mean of 18.2 patients (95% CI 17.4–18.8) registering during the study hours on game days vs. 23.3 patients (95% CI 22.0–23.7) on non-game days. The mean difference was 5.1 patients (95% CI 3.7 to 7.0) with p < .000074. Conclusion: Male patient visits to the ED decline during

  3. Disease surveillance methods used in the 8-site MAL-ED cohort study.

    PubMed

    Richard, Stephanie A; Barrett, Leah J; Guerrant, Richard L; Checkley, William; Miller, Mark A

    2014-11-01

    Describing the early life associations between infectious disease episodes and growth, cognitive development, and vaccine response in the first 2 years of life is one of the primary goals of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study. To collect high-resolution data during a critical early period of development, field staff visit each study participant at their house twice weekly from birth to 2 years of age to collect daily reported illness and treatment data from caregivers. Detailed infectious disease histories will not only allow us to relate the overall burden of infectious disease with the primary outcomes of the study, but will also allow us to describe the ages at which infectious diseases have the greatest effect on child health. In addition, twice-weekly visits allow for sample collection when diarrhea episodes are identified. This article describes the methods used to collect illness and treatment history data and discusses the a priori definitions of diarrhea and acute lower respiratory illness episodes. PMID:25305290

  4. Drinking Water Turbidity and Emergency Department Visits for Gastrointestinal Illness in New York City, 2002-2009

    PubMed Central

    Hsieh, Jennifer L.; Nguyen, Trang Quyen; Matte, Thomas; Ito, Kazuhiko

    2015-01-01

    Background Studies have examined whether there is a relationship between drinking water turbidity and gastrointestinal (GI) illness indicators, and results have varied possibly due to differences in methods and study settings. Objectives As part of a water security improvement project we conducted a retrospective analysis of the relationship between drinking water turbidity and GI illness in New York City (NYC) based on emergency department chief complaint syndromic data that are available in near-real-time. Methods We used a Poisson time-series model to estimate the relationship of turbidity measured at distribution system and source water sites to diarrhea emergency department (ED) visits in NYC during 2002-2009. The analysis assessed age groups and was stratified by season and adjusted for sub-seasonal temporal trends, year-to-year variation, ambient temperature, day-of-week, and holidays. Results Seasonal variation unrelated to turbidity dominated (~90% deviance) the variation of daily diarrhea ED visits, with an additional 0.4% deviance explained with turbidity. Small yet significant multi-day lagged associations were found between NYC turbidity and diarrhea ED visits in the spring only, with approximately 5% excess risk per inter-quartile-range of NYC turbidity peaking at a 6 day lag. This association was strongest among those aged 0-4 years and was explained by the variation in source water turbidity. Conclusions Integrated analysis of turbidity and syndromic surveillance data, as part of overall drinking water surveillance, may be useful for enhanced situational awareness of possible risk factors that can contribute to GI illness. Elucidating the causes of turbidity-GI illness associations including seasonal and regional variations would be necessary to further inform surveillance needs. PMID:25919375

  5. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services as defined in part 410, subpart G of this chapter; or a qualified provider of outpatient diabetes... visit also includes a separately billable medical nutrition therapy visit or a diabetes outpatient...

  6. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... services as defined in part 410, subpart G of this chapter; or a qualified provider of outpatient diabetes... visit also includes a separately billable medical nutrition therapy visit or a diabetes outpatient...

  7. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... services as defined in part 410, subpart G of this chapter; or a qualified provider of outpatient diabetes... visit also includes a separately billable medical nutrition therapy visit or a diabetes outpatient...

  8. 42 CFR 405.2463 - What constitutes a visit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... services as defined in part 410, subpart G of this chapter; or a qualified provider of outpatient diabetes... visit also includes a separately billable medical nutrition therapy visit or a diabetes outpatient...

  9. The ac53, ac78, ac101, and ac103 Genes Are Newly Discovered Core Genes in the Family Baculoviridae

    PubMed Central

    Garavaglia, Matías Javier; Miele, Solange Ana Belén; Iserte, Javier Alonso; Belaich, Mariano Nicolás

    2012-01-01

    The family Baculoviridae is a large group of insect viruses containing circular double-stranded DNA genomes of 80 to 180 kbp, which have broad biotechnological applications. A key feature to understand and manipulate them is the recognition of orthology. However, the differences in gene contents and evolutionary distances among the known members of this family make it difficult to assign sequence orthology. In this study, the genome sequences of 58 baculoviruses were analyzed, with the aim to detect previously undescribed core genes because of their remote homology. A routine based on Multi PSI-Blast/tBlastN and Multi HaMStR allowed us to detect 31 of 33 accepted core genes and 4 orthologous sequences in the Baculoviridae which were not described previously. Our results show that the ac53, ac78, ac101 (p40), and ac103 (p48) genes have orthologs in all genomes and should be considered core genes. Accordingly, there are 37 orthologous genes in the family Baculoviridae. PMID:22933288

  10. Semiconductor ac static power switch

    NASA Technical Reports Server (NTRS)

    Vrancik, J.

    1968-01-01

    Semiconductor ac static power switch has long life and high reliability, contains no moving parts, and operates satisfactorily in severe environments, including high vibration and shock conditions. Due to their resistance to shock and vibration, static switches are used where accidental switching caused by mechanical vibration or shock cannot be tolerated.

  11. VisitSense: Sensing Place Visit Patterns from Ambient Radio on Smartphones for Targeted Mobile Ads in Shopping Malls.

    PubMed

    Kim, Byoungjip; Kang, Seungwoo; Ha, Jin-Young; Song, Junehwa

    2015-01-01

    In this paper, we introduce a novel smartphone framework called VisitSense that automatically detects and predicts a smartphone user's place visits from ambient radio to enable behavioral targeting for mobile ads in large shopping malls. VisitSense enables mobile app developers to adopt visit-pattern-aware mobile advertising for shopping mall visitors in their apps. It also benefits mobile users by allowing them to receive highly relevant mobile ads that are aware of their place visit patterns in shopping malls. To achieve the goal, VisitSense employs accurate visit detection and prediction methods. For accurate visit detection, we develop a change-based detection method to take into consideration the stability change of ambient radio and the mobility change of users. It performs well in large shopping malls where ambient radio is quite noisy and causes existing algorithms to easily fail. In addition, we proposed a causality-based visit prediction model to capture the causality in the sequential visit patterns for effective prediction. We have developed a VisitSense prototype system, and a visit-pattern-aware mobile advertising application that is based on it. Furthermore, we deploy the system in the COEX Mall, one of the largest shopping malls in Korea, and conduct diverse experiments to show the effectiveness of VisitSense. PMID:26193275

  12. VisitSense: Sensing Place Visit Patterns from Ambient Radio on Smartphones for Targeted Mobile Ads in Shopping Malls

    PubMed Central

    Kim, Byoungjip; Kang, Seungwoo; Ha, Jin-Young; Song, Junehwa

    2015-01-01

    In this paper, we introduce a novel smartphone framework called VisitSense that automatically detects and predicts a smartphone user’s place visits from ambient radio to enable behavioral targeting for mobile ads in large shopping malls. VisitSense enables mobile app developers to adopt visit-pattern-aware mobile advertising for shopping mall visitors in their apps. It also benefits mobile users by allowing them to receive highly relevant mobile ads that are aware of their place visit patterns in shopping malls. To achieve the goal, VisitSense employs accurate visit detection and prediction methods. For accurate visit detection, we develop a change-based detection method to take into consideration the stability change of ambient radio and the mobility change of users. It performs well in large shopping malls where ambient radio is quite noisy and causes existing algorithms to easily fail. In addition, we proposed a causality-based visit prediction model to capture the causality in the sequential visit patterns for effective prediction. We have developed a VisitSense prototype system, and a visit-pattern-aware mobile advertising application that is based on it. Furthermore, we deploy the system in the COEX Mall, one of the largest shopping malls in Korea, and conduct diverse experiments to show the effectiveness of VisitSense. PMID:26193275

  13. Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010.

    PubMed

    Jones, Christopher M; Paulozzi, Leonard J; Mack, Karin A

    2014-10-10

    The abuse of prescription drugs has led to a significant increase in emergency department (ED) visits and drug-related deaths over the past decade. Opioid pain relievers (OPRs) and benzodiazepines are the prescription drugs most commonly involved in these events. Excessive alcohol consumption also accounts for a significant health burden and is common among groups that report high rates of prescription drug abuse. When taken with OPRs or benzodiazepines, alcohol increases central nervous system depression and the risk for overdose. Data describing alcohol involvement in OPR or benzodiazepine abuse are limited. To quantify alcohol involvement in OPR and benzodiazepine abuse and drug-related deaths and to inform prevention efforts, the Food and Drug Administration (FDA) and CDC analyzed 2010 data for drug abuse-related ED visits in the United States and drug-related deaths that involved OPRs and alcohol or benzodiazepines and alcohol in 13 states. The analyses showed alcohol was involved in 18.5% of OPR and 27.2% of benzodiazepine drug abuse-related ED visits and 22.1% of OPR and 21.4% of benzodiazepine drug-related deaths. These findings indicate that alcohol plays a significant role in OPR and benzodiazepine abuse. Interventions to reduce the abuse of alcohol and these drugs alone and in combination are needed.

  14. ED's nonemergent patients must pay first or be referred.

    PubMed

    2008-09-01

    Patients presenting to your ED with complaints that should be seen by a primary care physician can exacerbate overcrowding and tie up staff unnecessarily. The ED at Metro Health Medical Center in Cleveland has addressed this problem with a two-pronged approach: Nonemergent patients who are uninsured but wish to be treated in the ED must pay $75 before treatment can begin. Patients also are offered the option of being referred to one of the system's neighborhood clinics. Referred patients are guaranteed they will be seen within 72 hours. PMID:18807396

  15. Com Ed's fuel buying probed by Illinois Commerce Commission

    SciTech Connect

    Galvin, C.

    1982-06-07

    The Illinois Commerce Commission (ICC) challenged Commonwealth Edison Company's oversupply of coal, which could damage the utility's credit rating and raise rates, after an earlier move to prevent the utility from collecting fuel-adjustment charges. Com Ed also purchased an oversupply of high-priced oil. A loss of credit will worsen Com Ed's financial problems and its nuclear-construction program. Regulators object to poor utility procurement practices following an accepted rate increase. Com Ed testified that the surplus inventory is due to poor planning, but the company is taking corrective steps to adjust its coal contracts despite a glut of coal and a sluggish economy. (DCK)

  16. Clinic Visit Data as a Tool to Improve Student Health

    ERIC Educational Resources Information Center

    Lamping, Jerry

    2012-01-01

    Typically, the number of student visits to a school clinic is interesting only to the health services department as a metric for setting levels for clinic staffing and medical supply stocking. However, the number of visits and the reasons for those visits can gauge a school's indoor environmental quality (IEQ) and can motivate the facility…

  17. Visiting Professorships Take on New Uses in Changing Market

    ERIC Educational Resources Information Center

    Dunn, Sydni

    2013-01-01

    In a tight job market, visiting professorships can be appealing way stations for new Ph.D.'s while they search for permanent posts. Unlike adjunct positions, which are often renewed semester by semester, visiting professorships are set by annual or even multiyear contracts, with most capped at three years. The visiting jobs often come with health…

  18. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with...

  19. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with...

  20. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with...

  1. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with...

  2. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with...

  3. Grandparent Visitation Rights: An Inappropriate Intrusion or Appropriate Protection?

    ERIC Educational Resources Information Center

    Keith, Pat M.; Wacker, Robbyn R.

    2002-01-01

    Increased divorce rates, longevity in multi-generational families, and activism by older persons are a part of the context in which the role of grandparents in the family, an overview of grandparent visitation statutes, and controversy about visitation rights are discussed. The history and characteristics of grandparent visitation statutes, the…

  4. Hillary Clinton visits Pathfinder projects in Brazil.

    PubMed

    1996-01-01

    In October 1995, US First Lady Hillary Clinton visited a maternity hospital in Salvador, Brazil, in which a family planning (FP)/reproductive health program has been administered by Pathfinder International since 1981 with funding from USAID. During her tour of the facility, Clinton learned about the high degree of unmet need for FP in the region which results from a lack of sufficient resources to meet demand. Clinton, in turn, praised the state of Bahia for its emphasis on FP in low-income areas.

  5. A Home Visit Checklist to Reduce Rehospitalizations.

    PubMed

    Wood, Sharon L

    2015-09-01

    Hospital readmission rates have become the subject of national attention among healthcare providers. Home healthcare agencies work to bridge the gap between hospital and home/community, and share a vested interest in reducing hospital readmissions. Evidence supports the use of checklists to improve safety and decrease risk by reducing errors of omission, facilitating communication and improving clinician accountability. This article proposes that the use of checklists in home healthcare agencies may reduce rehospitalizations, and presents the experience of a large home healthcare agency's creation and implementation of a pilot study to introduce a home visit checklist. PMID:26323007

  6. [The visit prior to returning home].

    PubMed

    Blond, Héléne

    2015-01-01

    Towards the end of a hospital stay, the question of the elderly person's future is raised. Depending on the situation, a return home, follow-up and rehabilitation care or admission to a nursing home may be envisaged. When a return home is considered, the preparatory home visit is important, both for the nursing team as well as for the patient and their family, as it enables the feasibility and suitability of the project to be assessed. Often coming down to an assessment regarding accessibility, it also makes the patient and their family think about the capacities of the hospitalised person and their future day-to-day reality.

  7. Hillary Clinton visits Pathfinder projects in Brazil.

    PubMed

    1996-01-01

    In October 1995, US First Lady Hillary Clinton visited a maternity hospital in Salvador, Brazil, in which a family planning (FP)/reproductive health program has been administered by Pathfinder International since 1981 with funding from USAID. During her tour of the facility, Clinton learned about the high degree of unmet need for FP in the region which results from a lack of sufficient resources to meet demand. Clinton, in turn, praised the state of Bahia for its emphasis on FP in low-income areas. PMID:12179683

  8. The preteen visit: an opportunity for prevention.

    PubMed

    Campos-Outcalt, Doug

    2006-12-01

    All early adolescents should visit a physician at age 11 or 12 years to receive a set of recommended vaccines. Two vaccines are recommended for boys in this age group-quadrivalent meningococcal conjugate vaccine (MCV4) and tetanus toxoid, reduced diphtheria, and acellular pertussis vaccine (Tdap). Three vaccines are recommended for girls--MCV4, Tdap, and human papilloma virus (HPV) vaccine. In addition, 2 doses of varicella vaccine are now recommended before age 5 years; both boys and girls at age 11 or 12 who have received only 1 dose should be given a second. PMID:17137541

  9. ACS Expands Role In High School Chemistry.

    ERIC Educational Resources Information Center

    Chemical and Engineering News, 1979

    1979-01-01

    Describes some of the services and programs of special interests to high school chemistry teachers that are being provided by ACS, and meant to make ACS membership more attractive to the teachers. (GA)

  10. National Ice Center Visiting Scientist Program

    NASA Technical Reports Server (NTRS)

    Austin, Meg

    2001-01-01

    The objectives of the work done by Dr. Kim Partington were to manage NASA's polar research program, including its strategic direction, research funding and interagency and international collaborations. The objectives of the UCAR Visiting Scientist Program at the National Ice Center (NIC) are to: (1) Manage a visiting scientist program for the NIC Science Center in support of the mission of the NIC; (2) Provide a pool of researchers who will share expertise with the NIC and the science community; (3) Facilitate communications between the research and operational communities for the purpose of identifying work ready for validation and transition to an operational environment; and (4) Act as a focus for interagency cooperation. The NIC mission is to provide worldwide operational sea ice analyses and forecasts for the armed forces of the US and allied nations, the Departments of Commerce and Transportation, and other US Government and international agencies, and the civil sector. The NIC produces these analyses and forecasts of Arctic, Antarctic, Great Lakes, and Chesapeake Bay ice conditions to support customers with global, regional, and tactical scale interests. The NIC regularly deploys Naval Ice Center NAVICECEN Ice Reconnaissance personnel to the Arctic and Antarctica in order to perform aerial ice observation and analysis in support of NIC customers. NIC ice data are a key part of the US contribution to international global climate and ocean observing systems.

  11. Florivory and pollinator visitation: a cautionary tale

    PubMed Central

    Tsuji, Kaoru; Dhami, Manpreet K.; Cross, David J.R.; Rice, Carolyn P.; Romano, Nic H.; Fukami, Tadashi

    2016-01-01

    Florivory, or damage to flowers by herbivores, can make flowers less attractive to pollinators, potentially resulting in reduced plant fitness. However, not many studies have combined observations with experiments to assess the causal link between florivory and pollination. We conducted field observations at eight sites in northern California, combined with field experiments that involved artificial floral damage, to study the effect of florivory on pollination in the hummingbird-pollinated sticky monkeyflower, Mimulus aurantiacus. We used two indicators of pollinator visitation, stigma closure and the presence of microorganisms in floral nectar. The field observations revealed that stigma closure was less frequent in damaged flowers than in intact flowers. In the experiments, however, floral damage did not decrease stigma closure or microbial detection in nectar. Instead, neighbouring flowers were similar for both indicators. These results suggest that the observed negative association between florivory and pollination is not causal and that the location of flowers is more important to pollinator visitation than florivory in these populations of M. aurantiacus. PMID:27178063

  12. Florivory and pollinator visitation: a cautionary tale.

    PubMed

    Tsuji, Kaoru; Dhami, Manpreet K; Cross, David J R; Rice, Carolyn P; Romano, Nic H; Fukami, Tadashi

    2016-01-01

    Florivory, or damage to flowers by herbivores, can make flowers less attractive to pollinators, potentially resulting in reduced plant fitness. However, not many studies have combined observations with experiments to assess the causal link between florivory and pollination. We conducted field observations at eight sites in northern California, combined with field experiments that involved artificial floral damage, to study the effect of florivory on pollination in the hummingbird-pollinated sticky monkeyflower, Mimulus aurantiacus We used two indicators of pollinator visitation, stigma closure and the presence of microorganisms in floral nectar. The field observations revealed that stigma closure was less frequent in damaged flowers than in intact flowers. In the experiments, however, floral damage did not decrease stigma closure or microbial detection in nectar. Instead, neighbouring flowers were similar for both indicators. These results suggest that the observed negative association between florivory and pollination is not causal and that the location of flowers is more important to pollinator visitation than florivory in these populations of M. aurantiacus. PMID:27178063

  13. Many Teens Give Sex Ed a Failing Grade

    MedlinePlus

    ... gov/news/fullstory_160906.html Many Teens Give Sex Ed a Failing Grade International study finds courses ... HealthDay News) -- Teens around the world are getting sex education in schools that fail to address their ...

  14. Structure of catalase determined by MicroED

    PubMed Central

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir

    2014-01-01

    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination. DOI: http://dx.doi.org/10.7554/eLife.03600.001 PMID:25303172

  15. Structure of catalase determined by MicroED.

    PubMed

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir

    2014-01-01

    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination. PMID:25303172

  16. Elephants or Dinosaurs? A Call to Action for Ed Schools

    ERIC Educational Resources Information Center

    Murphy, Jerome T.

    2006-01-01

    To conclude this special section, guest editor Murphy examines why Ed Schools should redesign their leadership education programs, explores what it will take to foster change, and presents a model program to stimulate debate and action. (Contains 21 endnotes.)

  17. Predictors of Violence Following Emergency Department Visit for Cocaine-Related Chest Pain

    PubMed Central

    Walton, Maureen A.; Cunningham, Rebecca; Chermack, Stephen T.; Tripathi, Shanti; Weber, James; Maio, Ronald F.; Booth, Brenda M.

    2009-01-01

    This study examined one-year violence outcomes among non-injured patients treated in the Emergency Department (ED) for cocaine-related chest pain. An urban Level I ED required patients with chest pain (age 60 and younger) provide a urine sample for cocaine testing. Cocaine-positive consenting patients (n=219) were interviewed in the ED; 80% completed follow-up interviews over 12-months (n=174; 59% male, 79% African-American, mean age = 38.8, standard deviation 9.06; range = 19 to 60). Baseline rates of past year violent victimization and perpetration history were: 38% and 30%, respectively. During the12-month follow-up, rates of victimization and perpetration outcomes were 35% and 30%, respectively. Predictors of violence outcomes (either victimization or perpetration) in the year post-ED visit based on characteristics measured at baseline or during the follow-up period (i.e., gender, age, psychological distress, binge drinking days, cocaine use days, marijuana use days, substance abuse/dependence diagnosis, victimization/perpetration history). Victimization during the follow-up was related to younger age, more frequent binge drinking and marijuana use at baseline, and victimization history, and to substance abuse/dependence, more frequent binge drinking, and psychiatric distress at follow-up. Specifically, participants who reported victimization at baseline were approximately 3 times more likely to report victimization at 12-month follow-up. Perpetration during the follow-up was related to younger age and more frequent binge drinking at baseline, and to substance abuse/dependence, more frequent binge drinking, and psychiatric distress at follow-up. Overall, no significant gender differences were observed in violence; however, women were more likely than men to report injury during the most severe partner violence incident. Violence is a common problem among patients presenting to an inner city ED for cocaine-related chest pain, with younger age and frequency of

  18. Q & A with Ed Tech Leaders: Interview with Harold Stolovitch

    ERIC Educational Resources Information Center

    Shaughnessy, Michael F.

    2016-01-01

    Harold Stolovitch is Emeritus Professor of Workplace Learning & Performance, Université de Montréal, where he also served as Associate Dean of Research and Chair of the Instructional & Performance Technology graduate programs. He has also been a Distinguished Visiting Scholar and Visiting Professor at the University of Southern California.…

  19. Ice storm puts staff in ED to the test.

    PubMed

    2005-11-01

    Creativity, planning ahead can help offset the problems severe winter weather can create for your ED. "Super-size" your wintertime staff to help deal with the inevitable patient surge during cold-weather months. Make sure your ED is fully stocked with blanket warmers and intravenous fluid warmers year-round, so you're always prepared for first winter storm. Optimize staff health by stressing re-education in procedures such as hand washing. PMID:16749577

  20. Redefining the EdD: Seeking a Separate Identity

    ERIC Educational Resources Information Center

    Boyce, Barbara Ann

    2012-01-01

    The purpose of this manuscript was to discuss the recommendations and guidelines of the Carnegie Group's 2007 effort to "Reclaim the EdD" as well as to outline the work completed at the University of Virginia related to their re-design of the Doctor of Education (EdD) degree. In order to address the re-envision and re-formulation of the Doctor of…

  1. Bacteria and Spores - Skylab Student Experiment ED-31

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Pictures 1 and 2 show samples of Bacillus Subtillus grown during the first performance of Robert Staehle's experiment (ED-31) aboard Skylab. Pictures 3 and 4 show colonies of the same bacteria that developed during the second performance of the experiment. The experiment ED-31 was proposed by Robert L. Staehle of Rochester, New York to determine the effect of the Skylab environment (particularly weightlessness) on the survival, growth rates, and mutations of certain bacteria and spores.

  2. Changes in AIDS case reporting after hospital site visits.

    PubMed Central

    Fife, D; McAnaney, J; Rahman, M A

    1991-01-01

    In an effort to improve AIDS case reporting, site visits (meetings with hospital staff to encourage reporting) were made to all Philadelphia hospitals. Comparisons of hospitals visited during a 7-week period with hospitals not visited during that period indicated that the site visits were followed by a marked increase in case reports. No similar increase was observed at the comparison hospitals. The increased reporting was accompanied by an increased lag time from diagnosis to report, suggesting that the additional reports at visited hospitals were the result of the identification of previously missed cases rather than a speedup of reporting. Cases reported after the visits were more likely to have white-collar occupations or private medical insurance than were those reported before the visits. PMID:1746665

  3. Shared decision making in the ED: ethical considerations.

    PubMed

    Kraus, Chadd K; Marco, Catherine A

    2016-08-01

    The process of shared decision making (SDM) is an ethical imperative in the physician-patient relationship, especially in the emergency department (ED), where SDM can present unique challenges because patients and emergency physicians often have no established relationship and decisions about diagnosis, treatment, and disposition are time dependent. SDM should be guided by the ethical principles of autonomy, beneficence, nonmaleficence, and justice and the related principle of stewardship of finite resources. The objective of this article is to outline the ethical considerations of SDM in the ED in the context of diagnostic evaluations, therapeutic interventions, disposition decisions, and conflict resolution and to explore strategies for reaching decision consensus. Several cases are presented to highlight the ethical principles in SDM in the ED. SDM is an important approach to diagnostic testing in the ED. Achieving agreement regarding diagnostic evaluations requires a balance of respect for patient autonomy and stewardship of resources. SDM regarding ED therapeutic interventions is an important component of the balance of respect for patient autonomy and beneficence. While respecting patient autonomy, emergency physicians also recognize the importance of the application of professional judgment to achieve the best possible outcome for patients. SDM as an ethical imperative in the context of ED disposition is especially important because of the frequent ambiguity of equipoise in these situations. Unique clinical situations such as pediatric patients or patients who lack decisional capacity merit special consideration. PMID:27260552

  4. New Research Strengthens Home Visiting Field: The Pew Home Visiting Campaign

    ERIC Educational Resources Information Center

    Doggett, Libby

    2013-01-01

    Extensive research has shown that home visiting parental education programs improve child and family outcomes, and they save money for states and taxpayers. Now, the next generation of research is deepening understanding of those program elements that are essential to success, ways to improve existing models, and factors to consider in tailoring…

  5. Visiting People on a Dairy Farm [and] Visiting People on a Dairy Farm: Teacher's Guide.

    ERIC Educational Resources Information Center

    Department of Agriculture, Washington, DC. Office of Governmental and Public Affairs.

    These booklets are designed to present an elementary-level unit that describes a visit to a dairy farm. In a narrative format with many black and white photographs, the student booklet explains some typical activities, such as milking and haying, on the Schwartzbeck dairy farm in Maryland. The booklet is divided into seven parts, each of which can…

  6. Weather and Prey Predict Mammals' Visitation to Water.

    PubMed

    Harris, Grant; Sanderson, James G; Erz, Jon; Lehnen, Sarah E; Butler, Matthew J

    2015-01-01

    Throughout many arid lands of Africa, Australia and the United States, wildlife agencies provide water year-round for increasing game populations and enhancing biodiversity, despite concerns that water provisioning may favor species more dependent on water, increase predation, and reduce biodiversity. In part, understanding the effects of water provisioning requires identifying why and when animals visit water. Employing this information, by matching water provisioning with use by target species, could assist wildlife management objectives while mitigating unintended consequences of year-round watering regimes. Therefore, we examined if weather variables (maximum temperature, relative humidity [RH], vapor pressure deficit [VPD], long and short-term precipitation) and predator-prey relationships (i.e., prey presence) predicted water visitation by 9 mammals. We modeled visitation as recorded by trail cameras at Sevilleta National Wildlife Refuge, New Mexico, USA (June 2009 to September 2014) using generalized linear modeling. For 3 native ungulates, elk (Cervus Canadensis), mule deer (Odocoileus hemionus), and pronghorn (Antilocapra americana), less long-term precipitation and higher maximum temperatures increased visitation, including RH for mule deer. Less long-term precipitation and higher VPD increased oryx (Oryx gazella) and desert cottontail rabbits (Sylvilagus audubonii) visitation. Long-term precipitation, with RH or VPD, predicted visitation for black-tailed jackrabbits (Lepus californicus). Standardized model coefficients demonstrated that the amount of long-term precipitation influenced herbivore visitation most. Weather (especially maximum temperature) and prey (cottontails and jackrabbits) predicted bobcat (Lynx rufus) visitation. Mule deer visitation had the largest influence on coyote (Canis latrans) visitation. Puma (Puma concolor) visitation was solely predicted by prey visitation (elk, mule deer, oryx). Most ungulate visitation peaked during May and

  7. [Public hospital emergency department visits due to burns in Brazil, 2009].

    PubMed

    Gawryszewski, Vilma Pinheiro; Bernal, Regina Tomie Ivata; Silva, Nilza Nunes da; Morais Neto, Otaliba Libânio de; Silva, Marta Maria Alves da; Mascarenhas, Márcio Dênis Medeiros; Sá, Naíza Nayla Bandeira de; Monteiro, Rosane Aparecida; Malta, Deborah Carvalho

    2012-04-01

    The objective was to analyze the characteristics of burn injuries treated in emergency departments (ED) and associated factors. This was a cross-sectional study of 761 ED visits collected through the National Injury Surveillance System in 2009. The majority of patients were males (58.6%), and the most prevalent age brackets were 30-49 years (23.1%) and 0-4 years (23%). Most burns occurred at home (62.1%), especially among females and children, and in commerce/services/industry/construction (19.1%), mainly among males 20-49 years. Work-related burns comprised 29.1% of the overall sample. Alcohol use prior to the injury was reported in 5.1% of cases. Causal agents across all age brackets were: contact with hot substances (43.6%) and exposure to fire and flames (24.2%); among the economically productive age groups, association with chemicals substances was common. Burns in children 0-14 years were associated with injuries at home, contact with heat and hot substances, and subsequent hospitalization; burns in the 15-49-year bracket were associated with exposure to fire/flames and electrical current, injuries occurring in public places, and outpatient treatment and discharge. The study highlights the importance of burn prevention strategies targeting children and workers.

  8. [Public hospital emergency department visits due to burns in Brazil, 2009].

    PubMed

    Gawryszewski, Vilma Pinheiro; Bernal, Regina Tomie Ivata; Silva, Nilza Nunes da; Morais Neto, Otaliba Libânio de; Silva, Marta Maria Alves da; Mascarenhas, Márcio Dênis Medeiros; Sá, Naíza Nayla Bandeira de; Monteiro, Rosane Aparecida; Malta, Deborah Carvalho

    2012-04-01

    The objective was to analyze the characteristics of burn injuries treated in emergency departments (ED) and associated factors. This was a cross-sectional study of 761 ED visits collected through the National Injury Surveillance System in 2009. The majority of patients were males (58.6%), and the most prevalent age brackets were 30-49 years (23.1%) and 0-4 years (23%). Most burns occurred at home (62.1%), especially among females and children, and in commerce/services/industry/construction (19.1%), mainly among males 20-49 years. Work-related burns comprised 29.1% of the overall sample. Alcohol use prior to the injury was reported in 5.1% of cases. Causal agents across all age brackets were: contact with hot substances (43.6%) and exposure to fire and flames (24.2%); among the economically productive age groups, association with chemicals substances was common. Burns in children 0-14 years were associated with injuries at home, contact with heat and hot substances, and subsequent hospitalization; burns in the 15-49-year bracket were associated with exposure to fire/flames and electrical current, injuries occurring in public places, and outpatient treatment and discharge. The study highlights the importance of burn prevention strategies targeting children and workers. PMID:22488309

  9. Lunar Phases and Emergency Department Visits for Renal Colic Due to Ureteral Calculus

    PubMed Central

    Yang, Andy W.; Johnson, Justin D.; Fronczak, Carolyn M.; LaGrange, Chad A.

    2016-01-01

    Background Urolithiasis affects an estimated 5% of the population and the lifetime risk of passing a stone in the urinary tract is estimated to be 8–10%. Urinary calculus formation is highly variable and while certain risk factors such as age, gender, seasonality, anatomic abnormality, and metabolic diseases have been identified, not much is known regarding the association of environmental factors such as lunar phases on renal colic. We conducted a retrospective study to test the hypothesis that full moon phase is an environmental factor associated for increased emergency department (ED) visits for renal colic due to ureteral calculus. Methods We analyzed 559 renal colic diagnoses by the ED at the University of Nebraska Medical Center in a 24-month period and compared them with corresponding lunar phases as well as supermoon events. The lunar phases were defined as full moon ± two days, new moon ± two days, and the days in-between as normal days according to the lunar calendar. Supermoon event dates were obtained from NASA. Results 90 cases (16.1%) were diagnosed during full moon phase, 89 cases (15.9%) were diagnosed during new moon phase, and 380 cases (68.0%) were diagnosed during normal days. The incidence of renal colic showed no statistically significant association with lunar phases or supermoon events. Conclusion In this retrospective longitudinal study with adequate power, neither full moon phase nor supermoon event exhibited an association with increased renal colic diagnoses due to ureteral calculus by the ED at the University of Nebraska Medical Center. PMID:27299307

  10. Simultaneous distribution of AC and DC power

    DOEpatents

    Polese, Luigi Gentile

    2015-09-15

    A system and method for the transport and distribution of both AC (alternating current) power and DC (direct current) power over wiring infrastructure normally used for distributing AC power only, for example, residential and/or commercial buildings' electrical wires is disclosed and taught. The system and method permits the combining of AC and DC power sources and the simultaneous distribution of the resulting power over the same wiring. At the utilization site a complementary device permits the separation of the DC power from the AC power and their reconstruction, for use in conventional AC-only and DC-only devices.

  11. Microgravity sciences application visiting scientist program

    NASA Technical Reports Server (NTRS)

    Glicksman, Martin; Vanalstine, James

    1995-01-01

    Marshall Space Flight Center pursues scientific research in the area of low-gravity effects on materials and processes. To facilitate these Government performed research responsibilities, a number of supplementary research tasks were accomplished by a group of specialized visiting scientists. They participated in work on contemporary research problems with specific objectives related to current or future space flight experiments and defined and established independent programs of research which were based on scientific peer review and the relevance of the defined research to NASA microgravity for implementing a portion of the national program. The programs included research in the following areas: protein crystal growth, X-ray crystallography and computer analysis of protein crystal structure, optimization and analysis of protein crystal growth techniques, and design and testing of flight hardware.

  12. Re-visiting the electrophysiology of language.

    PubMed

    Obleser, Jonas

    2015-09-01

    This editorial accompanies a special issue of Brain and Language re-visiting old themes and new leads in the electrophysiology of language. The event-related potential (ERP) as a series of characteristic deflections ("components") over time and their distribution on the scalp has been exploited by speech and language researchers over decades to find support for diverse psycholinguistic models. Fortunately, methodological and statistical advances have allowed human neuroscience to move beyond some of the limitations imposed when looking at the ERP only. Most importantly, we currently witness a refined and refreshed look at "event-related" (in the literal sense) brain activity that relates itself more closely to the actual neurobiology of speech and language processes. It is this imminent change in handling and interpreting electrophysiological data of speech and language experiments that this special issue intends to capture.

  13. Maternal Psychological Distress and Visitation to the NICU

    PubMed Central

    Greene, Michelle M; Rossman, Beverly; Patra, Kousiki; Kratovil, Amanda; Khan, Samah; Meier, Paula P

    2016-01-01

    Aim To examine associations between maternal NICU visitation rates, maternal psychological distress (“distress”), and preterm infant outcome post-NICU discharge in a contemporary cohort of very low birth weight (VLBW) infants. Methods This was a prospective study of 69 mothers and their VLBW infants. Distress was assessed 1 month post-birth, 2 weeks prior to NICU discharge and after NICU discharge at 4 months corrected age [CA]. Maternal NICU visitation rates were calculated for the first 2 weeks and 1 month post-birth as well as for the entire NICU hospitalization. Regression analyses adjusted for the impact of 1. maternal and infant characteristics and distress on maternal visitation rates and 2. the impact of visitation on long-term maternal distress, and rates of infant clinic attendance and rehospitalization. Results Greater number of children in the home, maternal exposure to a greater number of potentially traumatic events prior to childbirth, and lower maternal anxiety consistently predicted lower visitation rate. Lower maternal visitation rate predicted higher maternal depression scores at infants’ 4 month CA visit. Maternal NICU visitation rate did not predict post-NICU discharge infant clinic attendance or rehospitalization. Conclusion Distress is an important predictor of visitation. In turn, visitation is associated with long-term maternal distress. PMID:25684177

  14. Chick embryo proliferation studies using EdU labeling

    PubMed Central

    Warren, Michelle; Puskarczyk, Karolina; Chapman, Susan C.

    2009-01-01

    Cell proliferation studies are an important experimental tool. The most commonly used thymidine analogues, tritiated thymidine and BrdU label cells during S-phase. Both methods have significant drawbacks; low sensitivity in the case of tritiated thymidine and a denaturation step during BrdU detection that destroys most cellular epitopes, requiring careful optimization. The antibody against BrdU is also large and tissue penetration can be difficult. EdU is a closely chemically related to BrdU, with detection achieved by a copper catalyzed reaction requiring a small fluorescently conjugated azide. Cell cultures, flow cytometry and high throughput studies using EdU labeled cells is exceptionally fast and does not require denaturation or antibodies. We have developed a tissue labeling technique in chick embryos using EdU. Following EdU chemistry to detect proliferating cells the tissue can undergo immunolabeling. We demonstrate fluorescent EdU chemistry followed by Tuj1 antibody staining resulting in multiplex fluorescent tissues. PMID:19253396

  15. UTOPIA: a consultation system for visit-by-visit diabetes management.

    PubMed

    Deutsch, T; Roudsari, A V; Leicester, H J; Theodorou, T; Carson, E R; Sönksen, P H

    1996-01-01

    UTOPIA (UTilities for OPtimizing Insulin Adjustment) is a prototype computer system proposed to support home data analysis and therapy recommendations for the individual patient. The paper describes methods of analysis and their incorporation into an overall system design that matches the iterative practices at the physician-patient consultation from visit to visit. Four modules support home data display and comparison with clinical measurements; extraction of blood glucose trends and daily cycles using time series analysis, learning relationships between insulin adjustments and changes in time series patterns via a parametric, linear systems model; and advice generation by solving the linear equation for candidate insulin adjustments. Concepts and methods are placed in context, with a discussion of comparable and related research.

  16. Low correlation between visit-to-visit variability and 24-hour variability of blood pressure

    PubMed Central

    Muntner, Paul; Shimbo, Daichi; Diaz, Keith M.; Newman, Jonathan; Sloan, Richard P.; Schwartz, Joseph E.

    2013-01-01

    Visit-to-visit variability (VVV) of clinic systolic blood pressure (SBP) has been associated with cardiovascular disease risk. Given the need for obtaining blood pressure (BP) at multiple visits to calculate VVV, substituting BP variability from ambulatory blood pressure monitoring (ABPM) may be a practical alternative. We assessed the correlation between VVV of BP and BP variability from ABPM using data from 146 untreated, mostly normotensive participants (mean age 47.9 years) in a substudy of the ongoing Masked Hypertension Study. VVV of SBP and diastolic blood pressure (DBP) was estimated by the standard deviation (SDvvv) and average real variability (ARVvvv) from 6 study visits over a median of 216 days. ABPM data were used to calculate the day-night SD (SDdn) and the ARV of SBP and DBP over 24 hours (ARV24). For SBP, the mean SDvvv and SDdn were 6.3 (SD=2.5) and 8.8 (SD=1.8) mmHg, respectively, and mean ARVvvv and ARV24 were 7.2 (SD=3.2) and 8.4 (SD=2.1) mmHg, respectively. The Spearman correlation coefficient between SDvvv and SDdn of SBP was rs=0.25 and between ARVvvv and ARV24 was rs=0.17. Participants in the highest quartile of SDdn of SBP were 1.66 (95% CI: 0.93 – 2.75) times more likely to be in the highest quartile of SDvvv of SBP. The observed-to-expected ratio between the highest quartiles of ARVvvv and ARV24 of SBP was 0.89 (95% CI: 0.41 – 1.69). The correlations for SDvvv and SDdn and ARVvvv and ARV24 of DBP were minimal. These data suggest VVV and 24-hour variability are weakly correlated and not interchangeable. PMID:23784506

  17. The importance of age and statin therapy in the interpretation of Lp-PLA(2) in ACS patients, and relation to CRP.

    PubMed

    Franeková, J; Kettner, J; Kubíček, Z; Jabor, A

    2015-01-01

    C-reactive protein (CRP) is a marker of arterial inflammation while lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is related to plaque instability. The aim of this study was to evaluate the correlation between the risk of unstable plaque presenting as acute coronary syndrome (ACS) and Lp-PLA(2), and to assess the influence of statins on interpretation of Lp-PLA(2). A total of 362 consecutive patients presenting to the emergency department (ED) with acute chest pain suggestive of ACS were evaluated by cardiologists as STEMI, NSTEMI, or unstable angina, and non-ACS. Serum biomarkers measured on admission: troponin I, C-reactive protein (Abbott), and Lp-PLA(2) (DiaDexus). Four groups were defined according to the final diagnosis and history of statin medication: ACS/statin-; ACS/statin+; non-ACS/statin-; non-ACS/statin+. Lp-PLA(2) was highest in ACS/statin- group; statins decreased Lp-PLA(2) both in ACS and non-ACS of about 20 %. Lp-PLA(2) was higher in ACS patients in comparison with non-ACS patients group without respect to statin therapy (p<0.001). Lp-PLA(2) predicted worse outcome (in terms of acute coronary syndrome) effectively in patients up to 62 years; limited prediction was found in older patients. C-reactive protein (CRP) failed to discriminate four groups of patients. Statin therapy and age should be taken into consideration while interpreting Lp-PLA(2) concentrations and lower cut-off values should be used for statin-treated persons.

  18. Small-Signal ac Analysis

    NASA Technical Reports Server (NTRS)

    Jagielski, James M.; Chen, Jess

    1987-01-01

    Program simulates power circuits and systems. Small Signal A.C. Analysis program (SSAC) valuable tool for design and analysis of electrical-power-system circuits. By combining "black box" power-system components operating in specified manner, user characterizes system modeled. Menu-driven program proved simple and cost effective in development and modification of arbitrary power-system configurations. Package includes sample data from Dynamic Explorer satellite family. Results compared favorable to calculations from such general circuit-analysis programs as SPICE. Written in FORTRAN 77.

  19. ER vs. ED: A Comparison of Televised and Real-Life Emergency Medicine

    PubMed Central

    Primack, Brian A.; Roberts, Traci; Fine, Michael J.; Dillman Carpentier, Francesca R.; Rice, Kristen R.; Barnato, Amber E.

    2013-01-01

    Background Although accurate health-related representations of medical situations on television can be valuable, inaccurate portrayals can engender misinformation. Objective The purpose of this study was to compare socio-demographic and medical characteristics of patients depicted on television vs. actual U.S. Emergency Department (ED) patients. Methods Two independently working coders analyzed all 22 programs in one complete year of the popular emergency room drama ER. Inter-rater reliability was excellent, and all initial coding differences were easily adjudicated. Actual health data were obtained from the National Heath and Ambulatory Medical Care Survey data from the same year. We used Pearson’s chi-squared test to compare televised vs. real distribution across key socio-demographic and medical variables. Results Ages at the extremes (e.g., ≤4 and ≥45) were less commonly represented on television compared with reality. Compared with reality, characters on television were less commonly women (31.2% vs. 52.9%), African American (12.7% vs. 20.3%) or Hispanic (7.1% vs. 12.5%). The two most common acuity categories for television were the extreme categories “non-urgent” and “emergent,” whereas the two most common categories for reality were the middle categories “semi-urgent” and “urgent.” Compared with reality, televised visits were most commonly due to injury (63.5% vs. 37.0%), and televised injuries were less commonly work-related (4.2% vs. 14.8%). Conclusions Comparison of represented and actual characteristics of ED patients may be valuable in helping us determine what types of patient misperceptions may exist as well as what types of interventions may be beneficial in correcting that potential misinformation. PMID:22766407

  20. Preventing avoidable incidents leading to a presentation to the emergency department (ED) by older adults with cognitive impairment: protocol for a scoping review

    PubMed Central

    Provencher, Véronique; Généreux, Mélissa; Gagnon-Roy, Mireille; Veillette, Nathalie; Egan, Mary; Sirois, Marie-Josée; Lacasse, Francis; Rose, Kathy; Stocco, Stéphanie

    2016-01-01

    Introduction Older adults with cognitive impairment represent a large portion (21–42%) of people (65+) who consult at an emergency department (ED). Because this sub-group is at higher risk for hospitalisation and mortality following an ED visit, awareness about ‘avoidable’ incidents should be increased in order to prevent presentations to the ED due to such incidents. This study aims to synthetise the actual knowledge related to ‘avoidable’ incidents (ie, traumatic injuries, poisoning and other consequences of external causes) (WHO, 2016) leading to ED presentations in older people with cognitive impairment. Methodology and analysis A scoping review will be performed. Scientific and grey literature (1996–2016) will be searched using a combination of key words pertaining to avoidable incidents, ED presentations, older adults and cognitive impairment. A variety of databases (MEDLINE, CINAHL, Ageline, SCOPUS, ProQuest Dissertations/theses, EBM Reviews, Healthstar), online library catalogues, governmental websites and published statistics will be examined. Included sources will pertain to community-dwelling older adults presenting to the ED as a result of an avoidable incident, with the main focus on those with cognitive impairment. Data (eg, type, frequency, severity, circumstances of incidents, preventive measures) will be extracted and analysed using a thematic chart and content analysis. Discussion and dissemination This scoping review will provide a picture of the actual knowledge on the subject and identify knowledge gaps in existing literature to be filled by future primary researches. Findings will help stakeholders to develop programmes in order to promote safe and healthy environments and behaviours aimed at reducing avoidable incidents in seniors, especially those with cognitive impairment. PMID:26873049

  1. Fine Particulate Matter Components and Emergency Department Visits for Cardiovascular and Respiratory Diseases in the St. Louis, Missouri–Illinois, Metropolitan Area

    PubMed Central

    Winquist, Andrea; Schauer, James J.; Turner, Jay R.

    2015-01-01

    Background: Given that fine particulate matter (≤ 2.5 μm; PM2.5) is a mixture of multiple components, it has been of high interest to identify its specific health-relevant physical and/or chemical features. Objectives: We conducted a time-series study of PM2.5 and cardiorespiratory emergency department (ED) visits in the St. Louis, Missouri–Illinois metropolitan area, using 2 years of daily PM2.5 and PM2.5 component measurements (including ions, carbon, particle-phase organic compounds, and elements) made at the St. Louis-Midwest Supersite, a monitoring site of the U.S. Environmental Protection Agency Supersites ambient air monitoring research program. Methods: Using Poisson generalized linear models, we assessed short-term associations between daily cardiorespiratory ED visit counts and daily levels of 24 selected pollutants. Associations were estimated for interquartile range changes in each pollutant. To allow comparison of relationships among multiple pollutants and outcomes with potentially different lag structures, we used 3-day unconstrained distributed lag models controlling for time trends and meteorology. Results: Considering results of our primary models, as well as sensitivity analyses and models assessing co-pollutant confounding, we observed robust associations of cardiovascular disease visits with 17α(H),21β(H)-hopane and congestive heart failure visits with elemental carbon. We also observed a robust association of respiratory disease visits with ozone. For asthma/wheeze, associations were strongest with ozone and nitrogen dioxide; observed associations of asthma/wheeze with PM2.5 and its components were attenuated in two-pollutant models with these gases. Differential measurement error due to differential patterns of spatiotemporal variability may have influenced patterns of observed associations across pollutants. Conclusions: Our findings add to the growing field examining the health effects of PM2.5 components. Combustion

  2. The Visit-Data Warehouse: Enabling Novel Secondary Use of Health Information Exchange Data

    PubMed Central

    Fleischman, William; Lowry, Tina; Shapiro, Jason

    2014-01-01

    Introduction/Objectives: Health Information Exchange (HIE) efforts face challenges with data quality and performance, and this becomes especially problematic when data is leveraged for uses beyond primary clinical use. We describe a secondary data infrastructure focusing on patient-encounter, nonclinical data that was built on top of a functioning HIE platform to support novel secondary data uses and prevent potentially negative impacts these uses might have otherwise had on HIE system performance. Background: HIE efforts have generally formed for the primary clinical use of individual clinical providers searching for data on individual patients under their care, but many secondary uses have been proposed and are being piloted to support care management, quality improvement, and public health. Description of the HIE and Base Infrastructure: This infrastructure review describes a module built into the Healthix HIE. Healthix, based in the New York metropolitan region, comprises 107 participating organizations with 29,946 acute-care beds in 383 facilities, and includes more than 9.2 million unique patients. The primary infrastructure is based on the InterSystems proprietary Caché data model distributed across servers in multiple locations, and uses a master patient index to link individual patients’ records across multiple sites. We built a parallel platform, the “visit data warehouse,” of patient encounter data (demographics, date, time, and type of visit) using a relational database model to allow accessibility using standard database tools and flexibility for developing secondary data use cases. These four secondary use cases include the following: (1) tracking encounter-based metrics in a newly established geriatric emergency department (ED), (2) creating a dashboard to provide a visual display as well as a tabular output of near-real-time de-identified encounter data from the data warehouse, (3) tracking frequent ED users as part of a regional-approach to

  3. Grandparent visitation rights: an inappropriate intrusion or appropriate protection?

    PubMed

    Keith, Pat M; Wacker, Robbyn R

    2002-01-01

    Increased divorce rates, longevity in multi-generational families, and activism by older persons are a part of the context in which the role of grandparents in the family, an overview of grandparent visitation statutes, and controversy about visitation rights are discussed. The history and characteristics of grandparent visitation statutes, the process of filing, and criteria used to grant visitation provide insight into the complexities of the request for, and determination of, these rights. Family dynamics interact with a myriad of state statutes to suggest implications for research and policy.

  4. Effect of the magnetic material on AC losses in HTS conductors in AC magnetic field carrying AC transport current

    NASA Astrophysics Data System (ADS)

    Wan, Xing-Xing; Huang, Chen-Guang; Yong, Hua-Dong; Zhou, You-He

    2015-11-01

    This paper presents an investigation on the AC losses in several typical superconducting composite conductors using the H-formulation model. A single superconducting strip with ferromagnetic substrate or cores and a stack of coated conductors with ferromagnetic substrates are studied. We consider all the coated conductors carrying AC transport currents and simultaneously exposed to perpendicular AC magnetic fields. The influences of the amplitude, frequency, phase difference and ferromagnetic materials on the AC losses are investigated. The results show that the magnetization losses of single strip and stacked strips have similar characteristics. The ferromagnetic substrate can increase the magnetization loss at low magnetic field, and decrease the loss at high magnetic field. The ferromagnetic substrate can obviously increase the transport loss in stacked strips. The trends of total AC losses of single strip and stacked strips are similar when they are carrying current or exposed to a perpendicular magnetic field. The effect of the frequency on the total AC losses of single strip is related to the amplitude of magnetic field. The AC losses decrease with increasing frequency in low magnetic field region while increase in high magnetic field region. As the phase difference changes, there is a periodic variation for the AC losses. Moreover, when the strip is under only the transport current and magnetic field, the ferromagnetic cores will increase the AC losses for large transport current or field.

  5. Solar power-desalination PV*ED system

    SciTech Connect

    Kvajic, G.

    1980-12-01

    Photovoltaic-electrodialysis, PV*ED, power-desalination system is studied in which the seawater feed is heated in the PV-cells. Under simplified assumptions of a constancy of thermal PV efficiency and conversion factor of 0.5 for ED brakish water system, it is found that maximum potable water production per unit of insolation depends strongly on the temperature of seawater feed and the concentration factor of the optical collector. By varying these two parameters of the PV*ED system, it seems possible that one could control the ratio of power to water production within a large range so that various potential demands for power and water could be met.

  6. The Visiting Nurse Association of Los Angeles.

    PubMed

    1987-10-01

    In short, the VNA of Los Angeles has a proud tradition. For almost 50 years, it has been providing needed health care and supportive services to the chronically ill and disabled in their own homes. Thanks to the efforts of all who made these traditions, the VNA also has a bright future. The VNA is a source of pride in California not only because of what it has accomplished but also because of what the good people of the VNA will be able to accomplish in the future. The VNA of Los Angeles is a valuable community resource whose services will be needed now more than ever before. The combination of demographics, consequences of the greying of America, the effects of the expected AIDS epidemic, and the evolution of new technology all point in the direction of home care. The VNA is already in the vanguard of what surely will become a national trend. Because of these contributions--past, present, and future--CARING is proud to salute the Visiting Nurse Association of Los Angeles.

  7. A visit to the village of Saye.

    PubMed

    1992-01-01

    This brief article describes the changes in the village of Saye, Burkina Faso which were recognizable after 20 years absence. Rainfall was plentiful and it was the best season for agriculture in 20 years; the sorghum swayed in the breezes ready for harvest. There are 28 women and village elders who still recognized their visitor, Ramata. The changes in family planning attitudes and sexuality were evident in the way men and women freely joke and laugh about sexual issues in a good humored but not superficial way. The respected El Hadj (meaning that he had visited Mecca) Sawadogo, president of the local Naam group, was the one who cracked jokes which brought laughter to the audience. The taboos are still there, but everyone agrees that family planning is a good idea because it reduces suffering and the people do not still have enough food to eat. Birth spacing is generally accepted, but there is resistance to stopping births. There is growing tolerance toward premarital pregnancies, and polygamy among younger women, which leads to fractious polygamous wives. 20 years ago it was a radical act to show a film on sex education, where pen and ink outlines gave shape to a naked teenaged boy and girl next to each other on the screen. The audience response was a roar of disbelief and the author feared that the local prefet would put him in jail for disturbing public order and violating a taboo.

  8. Former Astronaut Neil A. Armstrong Visits MSFC

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Among several other NASA dignitaries, former astronaut Neil A. Armstrong visited the Marshall Space Flight Center (MSFC) in attendance of the annual NASA Advisory Council Meeting. While here, Mr. Armstrong was gracious enough to allow the casting of his footprint. This casting will join those of other astronauts on display at the center. Armstrong was first assigned to astronaut status in 1962. He served as command pilot for the Gemini 8 mission, launched March 16, 1966, and performed the first successful docking of two vehicles in space. In 1969, Armstrong was commander of Apollo 11, the first manned lunar landing mission, and gained the distinction of being the first man to land a craft on the Moon and the first man to step on its surface. Armstrong subsequently held the position of Deputy Associate Administrator for Aeronautics, NASA Headquarters Office of Advanced Research and Technology, from 1970 to 1971. He resigned from NASA in 1971. Pictured with Armstrong is MSFC employee Daniel McFall, who assisted with the casting procedure.

  9. Microgravity sciences application visiting scientist program

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Contract NAS8-38785, Microgravity Experimental and Theoretical Research, is a project involving a large number of individual research programs related to: determination of the structure of human serum albumin and other biomedically important proteins; analysis of thermodynamic properties of various proteins and models of protein nucleation; development of experimental techniques for the growth of protein crystals in space; study of the physics of electrical double layers in the mechanics of liquid interfaces; computational analysis of vapor crystal growth processes in microgravity; analysis of the influence of magnetic fields in damping residual flows in directional solidification processes; crystal growth and characterization of II-VI semiconductor alloys; and production of thin films for nonlinear optics. It is not intended that the programs will be necessarily limited to this set at any one time. The visiting scientists accomplishing these programs shall serve on-site at MSFC to take advantage of existing laboratory facilities and the daily opportunities for technical communications with various senior scientists.

  10. Incorporating OASIS into the Visiting Nurses Association.

    PubMed

    Clark, L L

    1998-01-01

    Beginning in 1994, the Visiting Nurses Association, Western Pennsylvania, began to investigate incorporating an outcome measurement system within its organization for the purposes of marketing quality results, benchmarking achievements, and defining quality of care for both internal and external review groups. In the fall of 1995, this agency was accepted into the Outcome Based Quality Improvement (OBQI) Demonstration Project, also known as the Medicare Quality Assurance Project, which the Health Care Financing Administration has funded for the purpose of measuring clinical and utilization outcomes in the home care arena. This article reviews the processes the agency used to develop and incorporate the entire OBQI process into its systems, including the incorporation of the Outcome Assessment Information Set (OASIS). The OASIS is a set of outcome measurement questions developed by Dr. Peter Shaughnessy at the Center for Health Policy Research in Denver. The process also includes training of staff and development of forms, point-of-care software with a vendor, and plans of action for improving outcomes that have been quantified through OBQI efforts.

  11. ac electroosmosis in rectangular microchannels.

    PubMed

    Campisi, Michele; Accoto, Dino; Dario, Paolo

    2005-11-22

    Motivated by the growing interest in ac electroosmosis as a reliable no moving parts strategy to control fluid motion in microfluidic devices for biomedical applications, such as lab-on-a-chip, we study transient and steady-state electrokinetic phenomena (electroosmosis and streaming currents) in infinitely extended rectangular charged microchannels. With the aid of Fourier series and Laplace transforms we provide a general formal solution of the problem, which is used to study the time-dependent response to sudden ac applied voltage differences in case of finite electric double layer. The Debye-Huckel approximation has been adopted to allow for an algebraic solution of the Poisson-Boltzmann problem in Fourier space. We obtain the expressions of flow velocity profiles, flow rates, streaming currents, as well as expressions of the complex hydraulic and electrokinetic conductances. We analyze in detail the dependence of the electrokinetic conductance on the extension of linear dimensions relative to the Debye length, with an eye on finite electric double layer effects. PMID:16351310

  12. Multivariate statistical analysis of low-voltage EDS spectrum images

    SciTech Connect

    Anderson, I.M.

    1998-03-01

    Whereas energy-dispersive X-ray spectrometry (EDS) has been used for compositional analysis in the scanning electron microscope for 30 years, the benefits of using low operating voltages for such analyses have been explored only during the last few years. This paper couples low-voltage EDS with two other emerging areas of characterization: spectrum imaging and multivariate statistical analysis. The specimen analyzed for this study was a finished Intel Pentium processor, with the polyimide protective coating stripped off to expose the final active layers.

  13. Characterization of pyrotechnic reaction residue particles by SEM/EDS.

    PubMed

    Kosanke, Ken L; Dujay, Richard C; Kosanke, Bonnie

    2003-05-01

    Today the method commonly used for detecting gunshot residue is through the combined use of scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). In recent years, this same methodology began to find use in detecting and characterizing pyrotechnic reaction residue (PRR) particles whether produced by explosion or burning. This is accomplished by collecting particulate samples from a surface in the immediate area of the pyrotechnic reaction. Suspect PRR particles are identified by their morphology (typically 1 to 20 microm spheroidal particles) using an SEM; then they are analyzed for the elements they contain using X-ray EDS. This can help to identify the general type of pyrotechnic composition involved.

  14. Automated SEM-EDS GSR Analysis for Turkish Ammunitions

    SciTech Connect

    Cakir, Ismail; Uner, H. Bulent

    2007-04-23

    In this work, Automated Scanning Electron Microscopy with Energy Dispersive X-ray Spectrometry (SEM-EDS) was used to characterize 7.65 and 9mm cartridges Turkish ammunition. All samples were analyzed in a SEM Jeol JSM-5600LV equipped BSE detector and a Link ISIS 300 (EDS). A working distance of 20mm, an accelerating voltage of 20 keV and gunshot residue software was used in all analysis. Automated search resulted in a high number of particles analyzed containing gunshot residues (GSR) unique elements (PbBaSb). The obtained data about the definition of characteristic GSR particles was concordant with other studies on this topic.

  15. An unusual syncope cause in the ED: favism.

    PubMed

    Soyuncu, Secgin; Bektas, Firat; Isik, Soner; Yigit, Ozlem

    2011-04-01

    Favism is an acute hemolytic syndrome occurring in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals after the consumption of fava beans. The highest incidence is in boys aged 2-6 years. We report a 56-year-old man presented to the emergency department (ED) with recurrent syncope attacks due to favism. In our knowledge, this is the first report of favism-caused syncope in an adult patient without a G6PD deficiency diagnosis in the past and diagnosed in ED. PMID:20930025

  16. Microbiologic Methods Utilized in the MAL-ED Cohort Study

    PubMed Central

    Houpt, Eric; Gratz, Jean; Kosek, Margaret; Zaidi, Anita K. M.; Qureshi, Shahida; Kang, Gagandeep; Babji, Sudhir; Mason, Carl; Bodhidatta, Ladaporn; Samie, Amidou; Bessong, Pascal; Barrett, Leah; Lima, Aldo; Havt, Alexandre; Haque, Rashidul; Mondal, Dinesh; Taniuchi, Mami; Stroup, Suzanne; McGrath, Monica; Lang, Dennis

    2014-01-01

    A central hypothesis of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is that enteropathogens contribute to growth faltering. To examine this question, the MAL-ED network of investigators set out to achieve 3 goals: (1) develop harmonized protocols to test for a diverse range of enteropathogens, (2) provide quality-assured and comparable results from 8 global sites, and (3) achieve maximum laboratory throughput and minimum cost. This paper describes the rationale for the microbiologic assays chosen and methodologies used to accomplish the 3 goals. PMID:25305291

  17. ED becomes 'lean' and cuts LBTC, LOS times.

    PubMed

    2008-04-01

    Lean manufacturing techniques, first developed by Toyota, can be successfully adapted to help improve processes in your ED. St. Luke's Episcopal Hospital in Houston, has used Lean to reduce median length of stay, frequency of diversions, and the percentage of patients who left before treatment was complete (LBTC). Here's why "Lean" can help improve the performance of your ED: It enables you and your staff to see things from the patient's point of view. Lean tools enable you to view the status of your department in real-time and to compare that status with your performance goals. Exercises help identify areas where your processes break down and determine the most likely solutions.

  18. Microbiologic methods utilized in the MAL-ED cohort study.

    PubMed

    Houpt, Eric; Gratz, Jean; Kosek, Margaret; Zaidi, Anita K M; Qureshi, Shahida; Kang, Gagandeep; Babji, Sudhir; Mason, Carl; Bodhidatta, Ladaporn; Samie, Amidou; Bessong, Pascal; Barrett, Leah; Lima, Aldo; Havt, Alexandre; Haque, Rashidul; Mondal, Dinesh; Taniuchi, Mami; Stroup, Suzanne; McGrath, Monica; Lang, Dennis

    2014-11-01

    A central hypothesis of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is that enteropathogens contribute to growth faltering. To examine this question, the MAL-ED network of investigators set out to achieve 3 goals: (1) develop harmonized protocols to test for a diverse range of enteropathogens, (2) provide quality-assured and comparable results from 8 global sites, and (3) achieve maximum laboratory throughput and minimum cost. This paper describes the rationale for the microbiologic assays chosen and methodologies used to accomplish the 3 goals. PMID:25305291

  19. Early interruption of exclusive breastfeeding: results from the eight-country MAL-ED study.

    PubMed

    Patil, Crystal L; Turab, Ali; Ambikapathi, Ramya; Nesamvuni, Cebisa; Chandyo, Ram Krishna; Bose, Anuradha; Islam, M Munirul; Ahmed, A M Shamsir; Olortegui, Maribel Paredes; de Moraes, Milena Lima; Caulfield, Laura E

    2015-01-01

    We report the infant feeding experiences in the first month of life for 2,053 infants participating in "Malnutrition and Enteric Infections: Consequences for Child Health and Development" (MAL-ED). Eight sites (in Bangladesh, India, Nepal, Pakistan, Brazil, Peru, South Africa, Tanzania), each followed a cohort of children from birth (by day 17), collecting detailed information on infant feeding practices, diet and illness episodes. Mothers were queried twice weekly regarding health status, breastfeeding and the introduction (or no) of non-breast milk liquids and foods. Here, our goal is to describe the early infant feeding practices in the cohort and evaluate factors associated with termination of exclusive breastfeeding in the first month of life. With data from enrollment to a visit at 28-33 days of life, we characterized exclusive, predominant or partial breastfeeding (using a median of 6-9 visits per child across the sites). Only 6 of 2,053 infants were never breastfed. By one month, the prevalences of exclusive breastfeeding were < 60% in 6 of 8 sites, and of partial breastfeeding (or no) were > 20% in 6 of 8 sites. Logistic regression revealed that prelacteal feeding (given to 4-63% of infants) increased the likelihood of partial breastfeeding (Odds Ratio (OR): 1.48 (95% confidence interval (CI): 1.04, 2.10), as did the withholding of colostrum (2-16% of infants) (OR: 1.63:1.01, 2.62), and being a first-time mother (OR: 1.38:1.10, 1.75). Our results reveal diversity across these sites, but an overall trend of early transition away from exclusive breastfeeding in the first month of life. Interventions which introduce or reinforce the WHO/UNICEF Ten Steps for Successful Breastfeeding are needed in these sites to improve breastfeeding initiation, to reinforce exclusive breastfeeding and delay introduction of non-breast milk foods and/or liquids. PMID:26825923

  20. RHIC spin flipper AC dipole controller

    SciTech Connect

    Oddo, P.; Bai, M.; Dawson, C.; Gassner, D.; Harvey, M.; Hayes, T.; Mernick, K.; Minty, M.; Roser, T.; Severino, F.; Smith, K.

    2011-03-28

    The RHIC Spin Flipper's five high-Q AC dipoles which are driven by a swept frequency waveform require precise control of phase and amplitude during the sweep. This control is achieved using FPGA based feedback controllers. Multiple feedback loops are used to and dynamically tune the magnets. The current implementation and results will be presented. Work on a new spin flipper for RHIC (Relativistic Heavy Ion Collider) incorporating multiple dynamically tuned high-Q AC-dipoles has been developed for RHIC spin-physics experiments. A spin flipper is needed to cancel systematic errors by reversing the spin direction of the two colliding beams multiple times during a store. The spin flipper system consists of four DC-dipole magnets (spin rotators) and five AC-dipole magnets. Multiple AC-dipoles are needed to localize the driven coherent betatron oscillation inside the spin flipper. Operationally the AC-dipoles form two swept frequency bumps that minimize the effect of the AC-dipole dipoles outside of the spin flipper. Both AC bumps operate at the same frequency, but are phase shifted from each other. The AC-dipoles therefore require precise control over amplitude and phase making the implementation of the AC-dipole controller the central challenge.

  1. Factors Influencing Hospital Admissions and Emergency Department Visits Among Children with Complex Chronic Conditions: A Qualitative Study of Parents' and Providers' Perspectives

    PubMed Central

    Hudson, Shannon M.; Newman, Susan D.; Hester, William H.; FAAFP; Magwood, Gayenell S.; Mueller, Martina; Laken, Marilyn A.

    2015-01-01

    Children with complex chronic conditions (CCC) have greater health care needs and use rates than children in general. Elevated health care use includes more frequent hospital admissions, longer hospital stays, and greater health care expenses. Prior studies have examined population characteristics associated with increased hospital admissions, emergency department (ED) use, and general healthcare use, yet few studies have investigated these events from the parents' or health care providers' point of view. The purpose of this study was to explore parents/caregivers' and health care providers' perceptions of the factors placing infants and young children with CCC at risk for or protecting them against hospital admissions and ED visits. Parents or primary caregivers participated in interviews, and health care providers in pediatric acute care, pediatric primary care, and emergency care participated in focus groups. Interview and focus group data were analyzed using directed content analysis and an ecological risk and protective factors model. The analysis revealed that parents/caregivers and health care providers described risk factors and protective factors on multiple ecological levels surrounding the child with CCC. This article presents these findings, which add to current knowledge of factors influencing hospital admissions and ED visits and may be used to inform interventions addressing high health care utilization in this population. This article concludes with the implications of the findings for future research and nursing practice. PMID:24423943

  2. Home Visiting Processes: Relations with Family Characteristics and Outcomes

    ERIC Educational Resources Information Center

    Peterson, Carla A.; Roggman, Lori A.; Green, Beth; Chazan-Cohen, Rachel; Korfmacher, Jon; McKelvey, Lorraine; Zhang, Dong; Atwater, Jane B.

    2013-01-01

    Variations in dosage, content, and family engagement with Early Head Start (EHS) home visiting services were examined for families participating in the EHS Research and Evaluation Project. Families were grouped by characteristics of maternal age, maternal ethnicity, and level of family risk. All home visiting variables were related differentially…

  3. Facilitating Visitation for Infants with Prenatal Substance Exposure

    ERIC Educational Resources Information Center

    Burry, Caroline Long; Wright, Lois

    2006-01-01

    Permanency planning for infants with prenatal substance exposure is challenging due to characteristics of the infants and the ongoing substance use or relapse of the parents. Visitation is a primary mechanism through which child welfare workers determine and support permanency planning. Productive use of visitation for permanency planning for…

  4. Home Visitation Programs: Critical Issues and Future Directions

    ERIC Educational Resources Information Center

    Azzi-Lessing, Lenette

    2011-01-01

    As support for intervening early in the lives of vulnerable children has risen in the United States in recent years, so has interest in home-visitation programs. Home visitation is increasingly recognized for its potential to foster early child development and competent parenting, as well as to reduce risk for child abuse and neglect and other…

  5. 26 CFR 521.114 - Visiting professors or teachers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Visiting professors or teachers. 521.114... of Denmark and of Danish Corporations § 521.114 Visiting professors or teachers. Under Article XIV of... States for the purpose of teaching, lecturing, or instructing at any university, college, school,...

  6. The Shapley Visiting Lectureships Program - 2002 and On

    NASA Astrophysics Data System (ADS)

    Philip, A. G. Davis

    2001-12-01

    The Shapley Visiting Lectureships Program Web page [www.union.edu/orgs/shapley] is attached to the AAS Web homepage and now is in its fourth year of operation. The complete Shapley brochure is presented here as well as an application form that can be filled out on line and sent back to Union College in Schenectady. On a number of occasions an electronic form is received in the morning and the Shapley visit is set up by the afternoon of the same day. Instead of mailing out the hardcopy multi-paged brochures we now mail over 2000 postcards to institutions with instructions on how to go to the AAS Shapley Web page. We have built up a larger body of institutions that know about the Shapley Program and they can apply whenever they decide they would like to have a visit. The Shapley Program has been expanded to include Mexico. At present three Mexican visits have been made and one Mexican astronomer has made a visit to the the United States. Canada has been part of the Shapley Program since 1977 and a total of 52 Shapley visits have been made. Although the majority of US visits are still made by car we have increased the number of visits made by air travel to satisfy the requests of some institutions for specific speakers or topics.

  7. The National Home Visiting Coalition: A History of Collaboration

    ERIC Educational Resources Information Center

    Callahan, Jane; Gavaghan, Bridget; Howard, Karen; Kelley, Melissa L.; Schwartz, Marvin; Walzer, Sarah

    2010-01-01

    The Home Visiting Coalition represents more than 75 organizations working together to articulate the effectiveness of home visiting to a range of policymakers and stakeholders in the early childhood field. Despite varying program goals and service delivery strategies, the Coalition participants share a commitment to expanding access to…

  8. Corrections Education Evaluation System Project. Site Visit Report.

    ERIC Educational Resources Information Center

    Nelson, Orville; And Others

    Site visits to five correctional institutions in Wisconsin were conducted as part of the development of an evaluation model for the competency-based vocational education (CBVE) project for the Wisconsin Correctional System. The evaluators' perceptions of the CBVE system are presented with recommendations for improvement. Site visits were conducted…

  9. Virtual Visits in Home Health Care for Older Adults

    PubMed Central

    Husebø, Anne Marie Lunde

    2014-01-01

    Background. This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. Design. An integrative literature review. Method. Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. Results. Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. Conclusions. The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home. PMID:25506616

  10. 33 CFR 6.04-7 - Visitation, search, and removal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Visitation, search, and removal. 6.04-7 Section 6.04-7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Visitation, search, and removal. The Captain of the Port may cause to be inspected and searched at any...

  11. 33 CFR 6.04-7 - Visitation, search, and removal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Visitation, search, and removal. 6.04-7 Section 6.04-7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Visitation, search, and removal. The Captain of the Port may cause to be inspected and searched at any...

  12. 33 CFR 6.04-7 - Visitation, search, and removal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Visitation, search, and removal. 6.04-7 Section 6.04-7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Visitation, search, and removal. The Captain of the Port may cause to be inspected and searched at any...

  13. 33 CFR 6.04-7 - Visitation, search, and removal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Visitation, search, and removal. 6.04-7 Section 6.04-7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Visitation, search, and removal. The Captain of the Port may cause to be inspected and searched at any...

  14. 33 CFR 6.04-7 - Visitation, search, and removal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Visitation, search, and removal. 6.04-7 Section 6.04-7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Visitation, search, and removal. The Captain of the Port may cause to be inspected and searched at any...

  15. Expert Panel Reviews of Research Centers: The Site Visit Process

    ERIC Educational Resources Information Center

    Lawrenz, Frances; Thao, Mao; Johnson, Kelli

    2012-01-01

    Site visits are used extensively in a variety of settings within the evaluation community. They are especially common in making summative value decisions about the quality and worth of research programs/centers. However, there has been little empirical research and guidance about how to appropriately conduct evaluative site visits of research…

  16. 32 CFR 536.20 - Claims assistance visits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims assistance visits. 536.20 Section 536.20 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.20 Claims assistance visits. Members of USARCS...

  17. 29 CFR 1954.11 - Visits to State agencies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) PROCEDURES FOR THE EVALUATION AND MONITORING OF APPROVED STATE PLANS State Monitoring Reports and Visits to State Agencies § 1954.11 Visits to State agencies. As a part of the continuing monitoring...

  18. Custody and Visitation: An Explication of Prevalent Patterns.

    ERIC Educational Resources Information Center

    Moore, Nancy V.; Davenport, Caroline V.

    A review of the literature on custody and visitation reveals many contradictory opinions, little empirical evidence and lack of a conceptual framework for assessing issues. An exploratory study is reported in which 99 custodial parents, 71 noncustodial parents and 70 children of divorce expressed their opinions on custody and visitation. The data…

  19. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a... resident of Switzerland, who temporarily visits the United States for the purpose of teaching for a period... States or who is not a resident of Switzerland. (d) Nonresidence presumed. An individual who...

  20. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a... resident of Switzerland, who temporarily visits the United States for the purpose of teaching for a period... States or who is not a resident of Switzerland. (d) Nonresidence presumed. An individual who...

  1. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a... resident of Switzerland, who temporarily visits the United States for the purpose of teaching for a period... States or who is not a resident of Switzerland. (d) Nonresidence presumed. An individual who...

  2. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a... resident of Switzerland, who temporarily visits the United States for the purpose of teaching for a period... States or who is not a resident of Switzerland. (d) Nonresidence presumed. An individual who...

  3. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) REGULATIONS UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a... resident of Switzerland, who temporarily visits the United States for the purpose of teaching for a period... States or who is not a resident of Switzerland. (d) Nonresidence presumed. An individual who...

  4. The Visiting Women Scientists Program, 1978-79: Final Report.

    ERIC Educational Resources Information Center

    Place, Carol; And Others

    This is the final report of a program in which 51 women scientists visited 12 junior high and high schools in North Carolina and a total of 128 schools in four large American metropolitan areas. The purpose of these visits was to provide students with a chance to meet women scientists as role models. The report is divided into 9 chapters and 8…

  5. 29 CFR 1908.6 - Conduct of a visit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... health. (e) Onsite activity. (1) Activity during the onsite consultative visit will focus primarily on... the visit is reduced, the consultant remains obligated to work with the employer to ensure correction... report to the extent required by 29 CFR 1910.1020 or other applicable OSHA standards or regulations....

  6. Federal Home Visiting under the Affordable Care Act

    ERIC Educational Resources Information Center

    Strader, Kathleen; Counts, Jacqueline; Filene, Jill

    2013-01-01

    The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

  7. Prescribed Fire: The Influence of Site Visits on Citizen Attitudes

    ERIC Educational Resources Information Center

    Toman, Eric; Shindler, Bruce; Reed, Michelle

    2004-01-01

    This research employed a panel design to measure the effect of site visits on public perceptions of prescribed fire. On-site survey questions were devised to compare answers to a mail questionnaire previously completed by the same respondents. Questions were designed to examine how site visits influence public opinion and affect acceptance of…

  8. Designing a Marketing Course with Field Site Visits

    ERIC Educational Resources Information Center

    Van Doren, Doris; Corrigan, Hope Bober

    2008-01-01

    A key goal of including field site visits in marketing courses is to give business students increased interaction with industry professionals and community leaders. Site visits give students a concrete idea of how different marketing disciplines work in the business world. Business students gain greater insight into a career in marketing from this…

  9. Daytime School Guided Visits to an Astronomical Observatory in Brazil

    ERIC Educational Resources Information Center

    Colombo, Pedro Donizete, Jr.; Silva, Cibelle Celestino; Aroca, Silvia Calbo

    2010-01-01

    This article analyzes the activity "Daytime School Guided Visits" at an astronomical observatory in Brazil with pupils from primary school. The adopted research methodology relied on questionnaire applications and semistructured interviews. The objectives were to identify the influences of the visits on learning of astronomical concepts and on…

  10. Computerized recording of visits to an outpatient sports clinic.

    PubMed

    Kannus, P; Aho, H; Järvinen, M; Niittymäki, S

    1987-01-01

    At the Tampere Research Station of Sports Medicine (TRSSM) a continuous coding system of patient visits was started on March 1, 1985. The registration form contained 25 variables including all essential information about the patient's identification, sports, time of and reason for the visit, physician, examinations, diagnosis, treatment, and possible further measures. To classify and number the diagnosis, a specific classification of sports injuries and diseases was drawn up. The data were stored and analyzed using a DEC-2060 computer at the University of Tampere. During 6 months a total of 814 visits were recorded. The three most common sports were soccer, long-distance running, and orienteering. Competitive athletes totalled 337 (62%); 43 of these were top-ranking athletes. The most common reasons for visits were problems of the knee (266 visits, 33%), ankle (80, 10%), and low back (71, 9%). Knee sprains accounted for 10% of all visits. Problems related to the musculoskeletal system were the reason for 751 (92%) of all visits. Operative treatment was needed by 49 patients (6%). The continuous coding system of patient visits at an outpatient sports clinic showed great advantages as a basic data bank for scientific research, annual statistics, and patient identification and filing. The system described has been adopted as part of the daily routine at the TRSSM. PMID:3812865

  11. 50 CFR 216.81 - Visits to fur seal rookeries.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 10 2014-10-01 2014-10-01 false Visits to fur seal rookeries. 216.81... MAMMALS Pribilof Islands Administration § 216.81 Visits to fur seal rookeries. From June 1 to October 15... any fur seal rookery or hauling grounds nor pass beyond any posted sign forbidding passage....

  12. 50 CFR 216.81 - Visits to fur seal rookeries.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 10 2013-10-01 2013-10-01 false Visits to fur seal rookeries. 216.81... MAMMALS Pribilof Islands Administration § 216.81 Visits to fur seal rookeries. From June 1 to October 15... any fur seal rookery or hauling grounds nor pass beyond any posted sign forbidding passage....

  13. 50 CFR 216.81 - Visits to fur seal rookeries.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Visits to fur seal rookeries. 216.81... MAMMALS Pribilof Islands Administration § 216.81 Visits to fur seal rookeries. From June 1 to October 15... any fur seal rookery or hauling grounds nor pass beyond any posted sign forbidding passage....

  14. 50 CFR 216.81 - Visits to fur seal rookeries.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 10 2012-10-01 2012-10-01 false Visits to fur seal rookeries. 216.81... MAMMALS Pribilof Islands Administration § 216.81 Visits to fur seal rookeries. From June 1 to October 15... any fur seal rookery or hauling grounds nor pass beyond any posted sign forbidding passage....

  15. 50 CFR 216.81 - Visits to fur seal rookeries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Visits to fur seal rookeries. 216.81... MAMMALS Pribilof Islands Administration § 216.81 Visits to fur seal rookeries. From June 1 to October 15... any fur seal rookery or hauling grounds nor pass beyond any posted sign forbidding passage....

  16. Behavioral Correlates of Parental Visiting during Family Foster Care.

    ERIC Educational Resources Information Center

    Cantos, Arthur L.; And Others

    1997-01-01

    Explored effects of parental visiting on emotional and behavioral adjustment of 49 children in care, using Child Behavior Checklist and Wide Range Achievement Test. Found that children who were visited more frequently exhibited fewer externalizing and internalizing behavior problems. Also found that these behavioral correlates depended on type of…

  17. Weather and Prey Predict Mammals’ Visitation to Water

    PubMed Central

    Harris, Grant; Sanderson, James G.; Erz, Jon; Lehnen, Sarah E.; Butler, Matthew J.

    2015-01-01

    Throughout many arid lands of Africa, Australia and the United States, wildlife agencies provide water year-round for increasing game populations and enhancing biodiversity, despite concerns that water provisioning may favor species more dependent on water, increase predation, and reduce biodiversity. In part, understanding the effects of water provisioning requires identifying why and when animals visit water. Employing this information, by matching water provisioning with use by target species, could assist wildlife management objectives while mitigating unintended consequences of year-round watering regimes. Therefore, we examined if weather variables (maximum temperature, relative humidity [RH], vapor pressure deficit [VPD], long and short-term precipitation) and predator-prey relationships (i.e., prey presence) predicted water visitation by 9 mammals. We modeled visitation as recorded by trail cameras at Sevilleta National Wildlife Refuge, New Mexico, USA (June 2009 to September 2014) using generalized linear modeling. For 3 native ungulates, elk (Cervus Canadensis), mule deer (Odocoileus hemionus), and pronghorn (Antilocapra americana), less long-term precipitation and higher maximum temperatures increased visitation, including RH for mule deer. Less long-term precipitation and higher VPD increased oryx (Oryx gazella) and desert cottontail rabbits (Sylvilagus audubonii) visitation. Long-term precipitation, with RH or VPD, predicted visitation for black-tailed jackrabbits (Lepus californicus). Standardized model coefficients demonstrated that the amount of long-term precipitation influenced herbivore visitation most. Weather (especially maximum temperature) and prey (cottontails and jackrabbits) predicted bobcat (Lynx rufus) visitation. Mule deer visitation had the largest influence on coyote (Canis latrans) visitation. Puma (Puma concolor) visitation was solely predicted by prey visitation (elk, mule deer, oryx). Most ungulate visitation peaked during May and

  18. Weather and Prey Predict Mammals' Visitation to Water.

    PubMed

    Harris, Grant; Sanderson, James G; Erz, Jon; Lehnen, Sarah E; Butler, Matthew J

    2015-01-01

    Throughout many arid lands of Africa, Australia and the United States, wildlife agencies provide water year-round for increasing game populations and enhancing biodiversity, despite concerns that water provisioning may favor species more dependent on water, increase predation, and reduce biodiversity. In part, understanding the effects of water provisioning requires identifying why and when animals visit water. Employing this information, by matching water provisioning with use by target species, could assist wildlife management objectives while mitigating unintended consequences of year-round watering regimes. Therefore, we examined if weather variables (maximum temperature, relative humidity [RH], vapor pressure deficit [VPD], long and short-term precipitation) and predator-prey relationships (i.e., prey presence) predicted water visitation by 9 mammals. We modeled visitation as recorded by trail cameras at Sevilleta National Wildlife Refuge, New Mexico, USA (June 2009 to September 2014) using generalized linear modeling. For 3 native ungulates, elk (Cervus Canadensis), mule deer (Odocoileus hemionus), and pronghorn (Antilocapra americana), less long-term precipitation and higher maximum temperatures increased visitation, including RH for mule deer. Less long-term precipitation and higher VPD increased oryx (Oryx gazella) and desert cottontail rabbits (Sylvilagus audubonii) visitation. Long-term precipitation, with RH or VPD, predicted visitation for black-tailed jackrabbits (Lepus californicus). Standardized model coefficients demonstrated that the amount of long-term precipitation influenced herbivore visitation most. Weather (especially maximum temperature) and prey (cottontails and jackrabbits) predicted bobcat (Lynx rufus) visitation. Mule deer visitation had the largest influence on coyote (Canis latrans) visitation. Puma (Puma concolor) visitation was solely predicted by prey visitation (elk, mule deer, oryx). Most ungulate visitation peaked during May and

  19. BR 06-1 CLINICAL APPLICATIONS OF VISIT TO VISIT BLOOD PRESSURE VARIABILITY.

    PubMed

    Shin, Jinho

    2016-09-01

    Since the introduction of visit to visit blood pressure variability (VVBPV) for cardiovascular outcome, it has long been awaited for prospective intervention trial to reduce VVBPV for evidence based medicine. But because of several hurdles, most importantly, pending measure to reduce VVBPV, such trial may not be available in the near future. It means that current understanding on the VVBPV is not casual but related to the cardiovascular outcome.Waiting for more sound evidence, which can be remained in a clinician's mind struggling not to be indifferent for potential benefit? Firstly, the most important potential confounder in spite of the strict statistical analyses to be published may be the mean blood pressure. Secondly, the population candidate for monitoring VVBPV needs to be understood. In general, the higher the risk, the more the value of considering the VVBPV. Thirdly, understanding the biological confounders for VVBPV such as arterial stiffness, low grade systemic inflammation, and sympathetic over-reactivity may inspire the clinician and/or patient the importance of the well-known lifestyle modification such as physical activity. Lastly, therapeutic aspects previously drawing less attention such as the class of drug with less inter-individual blood pressure variability, the relationship between the class of a drug and the volume status, adherence in general, the clinic protocol for the timing of drug intake with or without exercise and office visit, and the general conditions which can affect the volume status and thereby blood pressure level.Even without evidence of direct intervention on VVBPV, by monitoring and understanding VVPBV, a clinician can be developed to a new level of blood pressure management which is not only simply prescribing antihypertensive drugs but also more comprehensive understanding of the patient factors closely related to the blood pressure. PMID:27643152

  20. Group visits for chronic illness management: implementation challenges and recommendations.

    PubMed

    Jones, Katherine R; Kaewluang, Napatsawan; Lekhak, Nirmala

    2014-01-01

    The group visit approach to improve chronic illness self-management appears promising in terms of selected outcomes, but little information is available about best ways to organize and implement group visits. This literature review of 84 articles identified group visit implementation challenges, including lack of a group visit billing code, inadequate administrative support and resources, difficult participant recruitment and retention, and logistical issues such as space and scheduling. Recommendations for future implementation initiatives were also abstracted from the literature. Patients and providers can benefit from well-planned and well-conducted group visits. These benefits include greater patient and provider satisfaction, reduced overall utilization, improved clinical outcomes, and greater provider efficiency and productivity.

  1. Ambulatory Care Visits to Pediatricians in Taiwan: A Nationwide Analysis

    PubMed Central

    Yang, Ling-Yu; Lynn, An-Min; Chen, Tzeng-Ji

    2015-01-01

    Pediatricians play a key role in the healthy development of children. Nevertheless, the practice patterns of pediatricians have seldom been investigated. The current study analyzed the nationwide profiles of ambulatory visits to pediatricians in Taiwan, using the National Health Insurance Research Database. From a dataset that was randomly sampled one out of every 500 records among a total of 309,880,000 visits in 2012 in the country, 9.8% (n = 60,717) of the visits were found paid to pediatricians. Children and adolescents accounted for only 69.3% of the visits to pediatricians. Male pediatricians provided 80.5% of the services and the main workforces were those aged 40–49 years. The most frequent diagnoses were respiratory tract diseases (64.7%) and anti-histamine agents were prescribed in 48.8% of the visits to pediatricians. Our detailed results could contribute to evidence-based discussions on health policymaking. PMID:26540064

  2. Optimizing robot placement for visit-point tasks

    SciTech Connect

    Hwang, Y.K.; Watterberg, P.A.

    1996-06-01

    We present a manipulator placement algorithm for minimizing the length of the manipulator motion performing a visit-point task such as spot welding. Given a set of points for the tool of a manipulator to visit, our algorithm finds the shortest robot motion required to visit the points from each possible base configuration. The base configurations resulting in the shortest motion is selected as the optimal robot placement. The shortest robot motion required for visiting multiple points from a given base configuration is computed using a variant of the traveling salesman algorithm in the robot joint space and a point-to-point path planner that plans collision free robot paths between two configurations. Our robot placement algorithm is expected to reduce the robot cycle time during visit- point tasks, as well as speeding up the robot set-up process when building a manufacturing line.

  3. FETC, TCEA Commemorate 25 Years of Serving Ed Tech Industry

    ERIC Educational Resources Information Center

    T.H.E. Journal, 2005

    2005-01-01

    There's only one way to prepare for all of the exciting things that the ed tech market has in store for 2005-- by attending a conference. That's why T.H.E. Journal hopes readers will join them at this year's FETC (Booth 1505) and TCEA (Booth 1934) conferences to help celebrate their 25th anniversaries. Overviews are provided for both conferences…

  4. Creating a Minnesota Statewide SNAP-Ed Program Evaluation

    ERIC Educational Resources Information Center

    Gold, Abby; Barno, Trina Adler; Sherman, Shelley; Lovett, Kathleen; Hurtado, G. Ali

    2013-01-01

    Systematic evaluation is an essential tool for understanding program effectiveness. This article describes the pilot test of a statewide evaluation tool for the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). A computer algorithm helped Community Nutrition Educators (CNEs) build surveys specific to their varied educational settings…

  5. Three Ways edTPA Prepared Me for the Classroom

    ERIC Educational Resources Information Center

    Butler, Matthew

    2015-01-01

    edTPA, a capstone assessment designed to assess whether new teachers are ready for the job by evaluating their teaching and their analysis of their teaching, helped prepare the author for the classroom in three ways. First, he became accountable to his students. Second, he learned to analyze his teaching. Third, he discovered how to relate…

  6. Engaging the public through writing an op-ed

    NASA Astrophysics Data System (ADS)

    Labosier, Chris; Zhu, Laiyin; Quiring, Steven

    2012-10-01

    In May, prior to the start of the 2012 hurricane season, AGU asked us to write an op-ed for the Houston Chronicle on the importance of funding hurricane research. We were excited to be asked and pleased that AGU facilitated the process by providing us with some guidance on writing the op-ed. Given the impact that Hurricane Ike had in Texas just a few years ago, we felt it was important to remind the citizens of the greater Houston metropolitan area of the societal benefits of funding hurricane research. Thanks to the assistance of AGU staff, writing the article required only a few hours of time. Our op-ed was published in the print edition of the Houston Chronicle on 1 June 2012, the official start of the hurricane season (http://www.chron.com/default/article/Tight-budgets-posing-threat-to-Texas-hurricane-3600363.php). It was picked up by the media relations office in the College of Geosciences at Texas A&M University and featured on the college's Web site in the dean's biweekly briefing and on its Facebook page. As a result, the op-ed reached a large and diverse audience.

  7. Candidate Success and edTPA: Looking at the Data

    ERIC Educational Resources Information Center

    Evans, Lesley A.; Kelly, Mary K.; Baldwin, Joni L.; Arnold, Jackie M.

    2016-01-01

    This descriptive study looks at the correlations between Teacher Performance Assessment (edTPA) data and numerous program data points, including GPA, major GPA, and benchmark assignment scores, gathered in an Early Childhood Education (ECE) program. Previous studies have looked to correlate grade point average (GPA) with pre-service teacher…

  8. EdMOO: One Approach to a Multimedia Collaborative Environment.

    ERIC Educational Resources Information Center

    Holkner, Bernard

    The nature of the multiuser object oriented (MOO) environment lends itself to flexible and rich interactive collaboration space providing interactive discussion, mail, mailing list, and news features to its virtual denizens. EdMOO (HREF1) was created in mid-1995 as an environment for teachers to experience the text based virtual reality…

  9. Inside the Sex Ed Studio: An Interview with Peggy Brick

    ERIC Educational Resources Information Center

    Taverner, William J.

    2008-01-01

    "Inside the Sex Ed Studio" profiles leaders in the field of sexuality education. Peggy Brick, former director of Planned Parenthood of Greater Northern New Jersey's Center for Family Life Education (CFLE) and author of numerous sexuality education resources used worldwide, is the subject of this interview. Ms. Brick was interviewed by William J.…

  10. 5 Ways That edX Could Change Education

    ERIC Educational Resources Information Center

    Parry, Marc

    2012-01-01

    Since MIT and Harvard started edX, their joint experiment with free online courses, the venture has attracted enormous attention for opening the ivory tower to the world. But in the process, the world will become part of an expensive and ambitious experiment testing some of the most interesting--and difficult--questions in digital education. Can…

  11. HAZ-ED Classroom Activities for Understanding Hazardous Waste.

    ERIC Educational Resources Information Center

    Environmental Protection Agency, Washington, DC.

    The Federal Superfund Program investigates and cleans up hazardous waste sites throughout the United States. Part of this program is devoted to informing the public and involving people in the process of cleaning up hazardous waste sites from beginning to end. The Haz-Ed program was developed to assist the Environmental Protection Agency's (EPA)…

  12. Teaching Russian Via Distance Learning, the EdNet Experience.

    ERIC Educational Resources Information Center

    Zsiray, Stephen W., Jr.; And Others

    In Utah, the statewide distance education network (EdNet) enables students from five rural and suburban high schools to learn Russian and earn college credits. Courses in Russian are offered through a partnership involving the Cache County School District, Utah State University, and the Utah State Office of Education. Classes are taught on one…

  13. Self-Instructional Workbook for the ED Form 799.

    ERIC Educational Resources Information Center

    Office of Postsecondary Education, Washington DC. Student Financial Assistance Programs.

    To assist in making funds available for student higher education loans and to keep their interest rates as low as possible, the Department of Education compensates participating lending institutions using a combination of interest subsidies and special allowance payments. Lenders use ED Form 799, Lender's Interest and Special Allowance Request and…

  14. CCR5 is a receptor for Staphylococcus aureus leukotoxin ED

    PubMed Central

    III, Francis Alonzo; Kozhaya, Lina; Rawlings, Stephen A.; Reyes-Robles, Tamara; DuMont, Ashley L.; Myszka, David G.; Landau, Nathaniel; Unutmaz, Derya; Torres, Victor J.

    2012-01-01

    Pore-forming toxins are critical virulence factors for many bacterial pathogens and are central to Staphylococcus aureus-mediated killing of host cells. S. aureus encodes pore-forming bi-component leukotoxins that are toxic toward neutrophils, but also specifically target other immune cells. Despite decades since the first description of Staphylococcal leukocidal activity, the host factors responsible for the selectivity of leukotoxins toward different immune cells remain unknown. Here we identified the HIV co-receptor, CCR5, as a cellular determinant required for cytotoxic targeting of subsets of myeloid cells and T lymphocytes by the S. aureus leukotoxin ED (LukED). We further demonstrate that LukED-dependent cell killing is blocked by CCR5 receptor antagonists, including the HIV drug maraviroc. Remarkably, CCR5-deficient mice are largely resistant to lethal S. aureus infection, highlighting the importance of CCR5 targeting in S. aureus pathogenesis. Thus, depletion of CCR5+ leukocytes by LukED suggests a novel S. aureus immune evasion mechanism that can be therapeutically targeted. PMID:23235831

  15. About Issues Facing High Schools. EdFact Resource Guide.

    ERIC Educational Resources Information Center

    EdSource, Inc., Palo Alto, CA.

    The list of resources printed in this guide were taken from the EdSource report, "High Schools in the Hot Seat," an overview of the challenges facing California's high schools. The information is divided into three sections: students, standards, and high-school reform. The topics covered include peer culture, disengagement, and motivation; the…

  16. Home Visiting Family Support Programs: Benefits of the Maternal, Infant, and Early Childhood Home Visiting Program. Fact Sheet

    ERIC Educational Resources Information Center

    Home Visiting Campaign, 2015

    2015-01-01

    The federally funded, locally administered Maternal, Infant, and Early Childhood Home Visiting Program sponsors family support programs that are often called "home visiting" because they take place in the homes of at-risk families. These families often lack support, experience, and knowledge of basic parenting skills. Because children…

  17. Visiting Again? Subjective Well-Being of Children in Elementary School and Repeated Visits to School Health Nurses

    ERIC Educational Resources Information Center

    Leaver, Cynthia A.

    2014-01-01

    Background: Children with vague complaints are without chronic illness, and who repeatedly visit the school nurse may be at risk for limited academic success. This study compares student reports of subjective well-being between children who do and do not repeatedly visit the school nurse with vague complaints. Methods: Children in grades 4 through…

  18. Violence prevention in the ED: linkage of the ED to a social service agency.

    PubMed

    Zun, Leslie S; Downey, La Vonne; Rosen, Jodi

    2003-10-01

    was a strong positive correlation of using services and case management (Pearson coefficient = 0.728, significance =.00). The referral of young victims of violence from the ED to psychosocial services could be successful using a case management model and an alliance between a healthcare system and a social service agency. PMID:14574650

  19. Ceres: Dawn visits a Warm Wet Planet

    NASA Astrophysics Data System (ADS)

    McCord, T. B.; Combe, J. P.

    2014-12-01

    Ceres likely contains considerable water, has differentiated, and formed a hydrated silicate core and water mantle. There were major dimensional, thermal and chemical changes over its history, making it more a planet than an asteroid. These factors created the present day body, which the Dawn misson will visit next March. I will summarize our current understanding of Ceres and suggest what Dawn will find. A major uncertainty is how processes, such as aqueous mineralization, impact and cratering, infall of external material, mixing, and viscous relaxation of surface features have altered the formation materials and surface, hiding Ceres' secrets. Ceres' bulk density of 2100 kg/m3, suggest major water content. Modeling of Ceres' thermodynamic evolution for different times of accretion, assuming several radioactive heating scenarios, produces results ranging from a dry Vestal-like object (earlier, hotter formation) to retention and melting of the ice and differentiation of silicates from liquid water. Mixing of liquid water and silicates leads to exothermic hydration reactions, formation of a core and a liquid mantle. Large dimensional changes are associated. A crust stays frozen but founders at times due to gravitational instability, dimensional changes and impacts. The liquid mantle freezes from top, down, but a layer of salty liquid water probably exists today near the core. Hydrated silicates from the initial differentiation would likely dehydrate near the core center due to temperature and pressure. From observations, only subdued spatial albedo and color variations are observed at UV and IR wavelengths on Ceres' surface at the scale possible from Earth (~50-100 km) and an oblate spheroid shape is found, consistent with a differentiated body. Compositional evidence includes the long known similarity of Ceres' albedo and visual-IR reflectance spectrum to those for carbonaceous chondrite meteorites. Thus, the surface is likely made of carbon-bearing, hydroxolated

  20. Incidence of Postoperative Pain after Single Visit and Two Visit Root Canal Therapy: A Randomized Controlled Trial

    PubMed Central

    Joshi, Sonal B.; Bhagwat, S.V; Patil, Sanjana A

    2016-01-01

    Introduction Root Canal Treatment (RCT) has become a mainstream procedure in dentistry. A successful RCT is presented by absence of clinical signs and symptoms in teeth without any radiographic evidence of periodontal involvement. Completing this procedure in one visit or multiple visits has long been a topic of discussion. Aim To evaluate the incidence of postoperative pain after root canal therapy performed in single visit and two visits. Material and Methods An unblinded/ open label randomized controlled trial was carried out in the endodontic department of the Dental Institute, where 78 patients were recruited from the regular pool of patients. A total of 66 maxillary central incisors requiring root canal therapy fulfilled the inclusion and exclusion criteria. Using simple randomization by biased coin randomization method, the selected patients were assigned into two groups: group A (n=33) and group B (n=33). Single visit root canal treatment was performed for group A and two visit root canal treatment for group B. Independent sample t-test was used for statistical analysis. Results Thirty three patients were allotted to group A where endodontic treatment was completed in single visit while 33 patients were allotted to group B where endodontic treatment was completed in two visits. One patient dropped-out from Group A. Hence in Group A, 32 patients were analysed while in Group B, 33 patients were analysed. After 6 hours, 12 hours and 24 hours of obturation, pain was significantly higher in Group B as compared to Group A. However, there was no significant difference in the pain experienced by the patients 48 hours after treatment in both the groups. Conclusion Incidence of pain after endodontic treatment being performed in one-visit or two-visits is not significantly different. PMID:27437339

  1. Energy expenditure on recreational visits to different natural environments.

    PubMed

    Elliott, Lewis R; White, Mathew P; Taylor, Adrian H; Herbert, Stephen

    2015-08-01

    Physical inactivity poses a significant challenge to physical and mental health. Environmental approaches to tackle physical inactivity have identified natural environments as potentially important public health resources. Despite this, little is known about characteristics of the activity involved when individuals visit different types of natural environment. Using Natural England's Monitor of Engagement with the Natural Environment Survey, we examined 71,603 English respondents' recreational visits to natural environments in the past week. Specifically, we examined the intensity of the activities they undertook on the visits (METs), the duration of their visit, and the associated total energy expenditure (MET minutes). Visits to countryside and urban greenspace environments were associated with more intense activities than visits to coastal environments. However, visits to coastal environments were associated with the most energy expenditure overall due to their relatively long duration. Results differed by the urbanity or rurality of the respondent's residence and also how far respondents travelled to their destination. Knowledge of what types of natural environment afford the highest volumes and intensities of physical activity could inform landscape architecture and exercise prescriptions. Isolating activity-supporting characteristics of natural environments that can be translated into urban design is important in providing physical activity opportunities for those less able to access expansive environments.

  2. Hydrocarbon footprints as a record of bumblebee flower visitation.

    PubMed

    Witjes, Sebastian; Eltz, Thomas

    2009-11-01

    Bumblebees leave traces of cuticular hydrocarbons on flowers they visit, with the amount deposited being positively related to the number of visits. We asked whether such footprint hydrocarbons are retained on flowers for sufficiently long periods of time so as to reflect bee visitation in pollination studies. In laboratory experiments, flower corollae (Primula veris, Digitalis grandiflora) visited by Bombus terrestris workers retained bee-derived nonacosenes (C(29)H(58)) in near-unchanged quantities for 24 hours, both at 15 and 25 degrees C. Additionally, synthetic (Z)-9-tricosene applied to flower corollae of the deadnettle Lamium maculatum was retained for 48 hours in an unchanged quantity. In a field survey, the amount of footprint alkenes on flowers of comfrey (Symphytum officinale) plants was positively correlated with the number of bumblebee visits that those plants had received during the day. Together, these data suggest that flowers retain a long-term quantitative record of bumblebee visitation. The analysis of petal extracts by gas chromatography could provide a cheap and reliable way of quantifying bumblebee visits in landscape scale studies of pollination. PMID:20013038

  3. Effects of Early Dental Office Visits on Dental Caries Experience

    PubMed Central

    Rozier, R. Gary; Preisser, John S.; Stearns, Sally C.; Lee, Jessica Y.

    2014-01-01

    Objectives. We determined the association between timing of a first dentist office visit before age 5 years and dental disease in kindergarten. Methods. We used North Carolina Medicaid claims (1999–2006) linked to state oral health surveillance data to compare caries experience for kindergarten students (2005–2006) who had a visit before age 60 months (n = 11 394) to derive overall exposure effects from a zero-inflated negative binomial regression model. We repeated the analysis separately for children who had preventive and tertiary visits. Results. Children who had a visit at age 37 to 48 and 49 to 60 months had significantly less disease than children with a visit by age 24 months (incidence rate ratio [IRR] = 0.88; 95% confidence interval [CI] = 0.81, 0.95; IRR = 0.75; 95% CI = 0.69, 0.82, respectively). Disease status did not differ between children who had a tertiary visit by age 24 months and other children. Conclusions. Medicaid-enrolled children in our study followed an urgent care type of utilization, and access to dental care was limited. Children at high risk for dental disease should be given priority for a preventive dental visit before age 3 years. PMID:24134364

  4. Energy expenditure on recreational visits to different natural environments.

    PubMed

    Elliott, Lewis R; White, Mathew P; Taylor, Adrian H; Herbert, Stephen

    2015-08-01

    Physical inactivity poses a significant challenge to physical and mental health. Environmental approaches to tackle physical inactivity have identified natural environments as potentially important public health resources. Despite this, little is known about characteristics of the activity involved when individuals visit different types of natural environment. Using Natural England's Monitor of Engagement with the Natural Environment Survey, we examined 71,603 English respondents' recreational visits to natural environments in the past week. Specifically, we examined the intensity of the activities they undertook on the visits (METs), the duration of their visit, and the associated total energy expenditure (MET minutes). Visits to countryside and urban greenspace environments were associated with more intense activities than visits to coastal environments. However, visits to coastal environments were associated with the most energy expenditure overall due to their relatively long duration. Results differed by the urbanity or rurality of the respondent's residence and also how far respondents travelled to their destination. Knowledge of what types of natural environment afford the highest volumes and intensities of physical activity could inform landscape architecture and exercise prescriptions. Isolating activity-supporting characteristics of natural environments that can be translated into urban design is important in providing physical activity opportunities for those less able to access expansive environments. PMID:26151390

  5. A dog and a "happy person" visit nursing home residents.

    PubMed

    Kaiser, Lana; Spence, Linda J; McGavin, Lily; Struble, Laura; Keilman, Linda

    2002-10-01

    Recent recognition of the importance of the human-animal bond has led to the proliferation of programs designed to improve the lives of nursing home residents through the use of animals. Because human-human interaction in the nursing home setting is often of an obligatory nature, we wondered if a visit from a nonjudgmental, outgoing, enthusiastic young adult ("a happy person") could elicit the same positive influence as a visit from a nonjudgmental dog. The purpose of this study was to determine if elderly residents of a midwestern nursing home had a preference for the type of visitor (dog vs. person) when both visits were nonobligatory and nonjudgmental. Behaviors were evaluated to determine if one visitor was more likely to influence prosocial behaviors (moving closer, patting, smiling). Six residents were visited by both the dog and the happy person: 5 of 6 completed the final interview. Residents were equally likely to smile at and move closer to both visitors. Residents were more likely to pat the dog. Three residents liked both visits equally: 1 preferred the dog, and 1 preferred the happy person. These data suggest that nonobligatory visits to nursing home residents from a happy person may be as beneficial to the resident as visits from a dog. PMID:12365767

  6. A dog and a "happy person" visit nursing home residents.

    PubMed

    Kaiser, Lana; Spence, Linda J; McGavin, Lily; Struble, Laura; Keilman, Linda

    2002-10-01

    Recent recognition of the importance of the human-animal bond has led to the proliferation of programs designed to improve the lives of nursing home residents through the use of animals. Because human-human interaction in the nursing home setting is often of an obligatory nature, we wondered if a visit from a nonjudgmental, outgoing, enthusiastic young adult ("a happy person") could elicit the same positive influence as a visit from a nonjudgmental dog. The purpose of this study was to determine if elderly residents of a midwestern nursing home had a preference for the type of visitor (dog vs. person) when both visits were nonobligatory and nonjudgmental. Behaviors were evaluated to determine if one visitor was more likely to influence prosocial behaviors (moving closer, patting, smiling). Six residents were visited by both the dog and the happy person: 5 of 6 completed the final interview. Residents were equally likely to smile at and move closer to both visitors. Residents were more likely to pat the dog. Three residents liked both visits equally: 1 preferred the dog, and 1 preferred the happy person. These data suggest that nonobligatory visits to nursing home residents from a happy person may be as beneficial to the resident as visits from a dog.

  7. [History and testimonies of visiting nurses (1905-1938)].

    PubMed

    Henry, Stéphane

    2012-06-01

    Although short-lived, the history of visiting nurses is rich in political, social and health consequences it has generated. It involves the establishment of a new know-how in the first part of the twentieth century, mostly social, by the fact that the nurse comes out of the hospital to go and visit families in need. How this profession has been built and what is the impact of its social intervention on the population before the Second World War? Based on contemporary studies, institutional archives and biographical works, this study considers an immersion in the heart of the visiting nurse profession, through unwavering dedication, female emancipation and unexpected misery.

  8. Factors affecting ED length-of-stay in surgical critical care patients.

    PubMed

    Davis, B; Sullivan, S; Levine, A; Dallara, J

    1995-09-01

    To determine what patient characteristics are associated with prolonged emergency department (ED) length-of-stay (LOS) for surgical critical care patients, the charts of 169 patients admitted from the ED directly to the operating room (OR) or intensive care unit (ICU) during a 6-week period in 1993 were reviewed. The ED record was reviewed for documentation of factors that might be associated with prolonged ED LOS, such as use of computed tomographic (CT), radiology special procedures, and the number of plain radiographs and consultants. ED LOS was considered to be the time from triage until a decision was made to admit the patient. Using a Cox proportional hazards model, use of CT and special procedures were the strongest independent predictors of prolonged ED length-of-stay. The number of plain radiographs and consultants had only a minimal effect. Use of a protocol-driven trauma evaluation system was associated with a shorter ED LOS. In addition to external factors that affect ED overcrowding, ED patient management decisions may also be associated with prolonged ED length-of-stay. Such ED-based factors may be more important in surgical critical care patients, whose overall ED LOS is affected more by the length of the ED work-up rather than the time spent waiting for a ICU bed or operating suite.

  9. Direct interaction between the Arabidopsis disease resistance signaling proteins, EDS1 and PAD4.

    PubMed

    Feys, B J; Moisan, L J; Newman, M A; Parker, J E

    2001-10-01

    The Arabidopsis EDS1 and PAD4 genes encode lipase-like proteins that function in resistance (R) gene-mediated and basal plant disease resistance. Phenotypic analysis of eds1 and pad4 null mutants shows that EDS1 and PAD4 are required for resistance conditioned by the same spectrum of R genes but fulfil distinct roles within the defence pathway. EDS1 is essential for elaboration of the plant hypersensitive response, whereas EDS1 and PAD4 are both required for accumulation of the plant defence-potentiating molecule, salicylic acid. EDS1 is necessary for pathogen-induced PAD4 mRNA accumulation, whereas mutations in PAD4 or depletion of salicylic acid only partially compromise EDS1 expression. Yeast two-hybrid analysis reveals that EDS1 can dimerize and interact with PAD4. However, EDS1 dimerization is mediated by different domains to those involved in EDS1-PAD4 association. Co-immunoprecipitation experiments show that EDS1 and PAD4 proteins interact in healthy and pathogen-challenged plant cells. We propose two functions for EDS1. The first is required early in plant defence, independently of PAD4. The second recruits PAD4 in the amplification of defences, possibly by direct EDS1-PAD4 association.

  10. Three phase AC motor controller

    DOEpatents

    Vuckovich, Michael; Wright, Maynard K.; Burkett, John P.

    1984-03-20

    A motor controller for a three phase AC motor (10) which is adapted to operate bidirectionally from signals received either from a computer (30) or a manual control (32). The controller is comprised of digital logic circuit means which implement a forward and reverse command signal channel (27, 29) for the application of power through the forward and reverse power switching relays (16, 18, 20, 22). The digital logic elements are cross coupled to prevent activation of both channels simultaneously and each includes a plugging circuit (65, 67) for stopping the motor upon the removal of control signal applied to one of the two channels (27, 29) for a direction of rotation desired. Each plugging circuit (65, 67) includes a one-shot pulse signal generator (88, 102) which outputs a single pulse signal of predetermined pulsewidth which is adapted to inhibit further operation of the application of power in the channel which is being activated and to apply a reversal command signal to the other channel which provides a reversed phase application of power to the motor for a period defined by the pulse-width output of the one-shot signal generator to plug the motor (10) which will then be inoperative until another rotational command signal is applied to either of the two channels.

  11. Patient's jewelry stolen as she rests in the ED.

    PubMed

    2007-12-01

    In a hospital ED in Rhode Island, a 96-year-old patient was robbed of her jewelry while she rested in her room. The thief was dressed in scrubs. Identification badges are only one way of keeping unwanted intruders out and your patients' belongings safe. Other suggestions: Have different groups of staff members, i.e., ED doctors and nurses, wear color-coded scrubs that distinguish them from other hospital personnel. If your staff see a strangely dressed person or someone who looks lost or like they don't fit in, they should question them about their identity. Create protocols for the removal and safekeeping of patients' jewelry that cover several different scenarios.

  12. 28 CFR 540.43 - Frequency of visits and number of visitors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.43 Frequency of visits..., to prevent overcrowding in the visiting room or unusual difficulty in supervising a visit. Exceptions... visitor must travel, frequency of the inmate's visits, or health problems of the inmate or visitor....

  13. ISCCP-D2like-GEO Ed3A

    Atmospheric Science Data Center

    2016-10-12

    ISCCP-D2like-GEO Ed3A Project Title:  CERES Discipline:  ... Order Data Guide Documents:  GEO Description/Abstract Detailed CERES ISCCP-D2like Product ... Data Products Catalog:  DPC_ISCCP-D2like-GEO_R5V3  (PDF) Readme Files:  Readme GEO R5-987 ...

  14. ISCCP-D2like-GEO Ed2A

    Atmospheric Science Data Center

    2014-07-24

    ISCCP-D2like-GEO Ed2A Project Title:  CERES Discipline:  ... Order Data Guide Documents:  GEO Description/Abstract Detailed CERES ISCCP-D2like Product ... Data Products Catalog:  DPC_ISCCP-D2like-GEO_R5V3  (PDF) Readme Files:  Readme GEO R5-909 ...

  15. 77 FR 48992 - Tobacco Product Manufacturing Facility Visits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... HUMAN SERVICES Food and Drug Administration Tobacco Product Manufacturing Facility Visits AGENCY: Food... for Tobacco Products (CTP) is announcing an invitation for participation in its Tobacco Product... involved in the manufacturing of tobacco products, including any related laboratory testing, and...

  16. Listening to parents to improve health visiting practice.

    PubMed

    Morton, Alison; Hargreaves, Sharon; Taylor, Liz

    2015-05-01

    Listening to the "voice" of the service user is now widely accepted as central to the delivery of high quality healthcare. This paper presents an overview of the importance of service user engagement and personalised care in health visiting with a brief review of recent policy and research. A personalised approach to health visiting practice is recommended to improve service user experience and uptake of the health visiting service offer and this is considered most significant when engaging "hard to reach" groups. A project report on a service user experience strategy within the 0-19 service of a NHS Trust in England is presented which describes initiatives to develop a health visiting and school nursing service that listens to service users. A cyclical service user engagement model which incorporates continuous reviews and service reconfiguration is described with examples of service changes in response to expressed local needs. PMID:26364334

  17. First Visiting Astronomers at VLT KUEYEN

    NASA Astrophysics Data System (ADS)

    2000-04-01

    A Deep Look into the Universal Hall of Mirrors Starting in the evening of April 1, 2000, Ghislain Golse and Francisco Castander from the Observatoire Midi-Pyrénées (Toulouse, France) [1] were the first "visiting astronomers" at Paranal to carry out science observations with the second 8.2-m VLT Unit Telescope, KUEYEN . Using the FORS2 multi-mode instrument as a spectrograph, they measured the distances to a number of very remote galaxies, located far out in space behind two clusters of galaxies. Such observations may help to determine the values of cosmological parameters that define the geometry and fate of the Universe. After two nights of observations, the astronomers came away from Paranal with a rich harvest of data and a good feeling. "We are delighted that the telescope performed so well. It is really impressive how far out one can reach with the VLT, compared to the `smaller' 4-meter telescopes with which we previously observed. It opens a new window towards the distant, early Universe. Now we are eager to start reducing and analysing these data!" , Francisco Castander said. Measuring the Geometry of the Universe with Multiple Images in Cluster Lenses The present programme is typical of the fundamental cosmological studies that are now being undertaken with the ESO Very Large Telescope (VLT). Clusters of galaxies are very massive objects. Their gravitational fields intensify ("magnify") and distort the images of galaxies behind them. The magnification factor for the faint background galaxy population seen within a few arcminutes of the centre of a massive cluster at intermediate distance (redshift z ~ 0.2 - 0.4, i.e., corresponding to a look-back time of approx. 2 - 4 billion years) is typically larger than 2, and occasionally much larger. The clusters thus function as gravitational lenses . They may be regarded as "natural telescopes" that help us to see fainter objects further out into space than would otherwise be possible with our own telescopes. In a

  18. Edward (Ed) T. Schneider preparing for an F-104 flight

    NASA Technical Reports Server (NTRS)

    1989-01-01

    NASA research pilot Edward T. Scheider is shown standing in the cockpit of a two-seat F-104. He is wearing a full pressure suit, which is required on all flights above 50,000 feet. Ed served in the U.S. Navy from 1968 to 1983. He attended the U.S. Naval Test Pilot School and graduated in 1973. He was then assigned as an engineering test pilot, and as an instructor at the Naval Test Pilot School. He first arrived at what was then called the Ames-Dryden Flight Research Facility (now the Dryden Flight Research Center) as a Navy Liaison Officer on July 5, 1982. He joined NASA as a research pilot a year later. Ed was a project pilot on the F-18 High Angle-of-Attack program, the F-15 aeronautical research aircraft, the B-52 launch aircraft, and the NASA-operated SR-71 Blackbirds. Ed retired as a NASA research pilot in September 2000.

  19. Teachers are students in ZPG program called 'Pop Ed.'.

    PubMed

    Schline, S

    1977-01-01

    Zero Population Growth's Population Education (Pop Ed) program began in 1975 as an ongoing effort to bring the "real world" into the classroom by demonstrating the relationships among population trends, food and energy resources, and environmental and economic problems. The training workshops which last for a day or 2 have the following goals: 1) to offer a brief demographic overview for teachers, 2) to provide lesson plans and techniques readily usable in the classroom, 3) to alert teachers to the best written and audiovisual materials available, 4) to identify local resources for teaching Pop Ed, and 5) to provide sample materials. In the 1st year of program operation 10 workshops were held. These workshops are credited, at least partly, with the subsequent population instruction that reached over 10,400 students and 1600 teachers. Another 15 workshops were held in the 2nd year of operation. Obstacles to the program are the assumption on the part of some teachers that Pop Ed belongs in disciplines other than their own and the belief on the part of many teachers that they will require extensive training. PMID:12308748

  20. Fresh policies and procedures, transparency fuel ED turnaround.

    PubMed

    2016-05-01

    The ED at Banner Payson Medical Center in Payson, AZ, has charted dramatic improvements on key metrics through a range of staff and policy changes. In just a few months, the ED has halved wait times, patient satisfaction has improved, and daily volume is up. Administrators say the secret to the success of the effort is a move to be transparent by posting key metrics regarding patient flow, a tactic that has helped the team pull together and feel a sense of accomplishment when performance goals are achieved. Administrators adjusted staff schedules to better match patient volume patterns in the ED, and they added staff to help nurses during peak hours. A new provider group enlisted the assistance of scribes during peak hours to manage the documentation workload while also enabling physicians to focus more patient interaction. Physicians hold end-of-shift huddles to review successes and challenges, and to improve physician/nurse communication. The tactic also helps develop the staff from an educational standpoint. PMID:27266001

  1. Superconductor coil geometry and ac losses

    NASA Technical Reports Server (NTRS)

    Pierce, T. V., Jr.; Zapata, R. N.

    1976-01-01

    An empirical relation is presented which allows simple computation of volume-averaged winding fields from central fields for coils of small rectangular cross sections. This relation suggests that, in certain applications, ac-loss minimization can be accomplished by use of low winding densities, provided that hysteresis losses are independent of winding density. The ac-loss measurements on coils wound of twisted multifilamentary composite superconductors show no significant dependence on ac losses on winding density, thus permitting the use of winding density as an independent design parameter in loss minimization.

  2. Does the Op-Ed Page Have a Chance to Become a Public Forum?

    ERIC Educational Resources Information Center

    Ciofalo, Andrew; Traverso, Kim

    1994-01-01

    Surveys op-ed page editors, finding that fewer than half of the responding papers have op-ed pages; that professional journalists, public figures, and propagandists dominate the pages; and that editors firmly control the agenda. (SR)

  3. Characterizing Primary Care Visit Activities at Veterans Health Administration Clinics.

    PubMed

    Gutierrez, Jennifer C; Terwiesch, Christian; Pelak, Mary; Pettit, Amy R; Marcus, Steven C

    2015-01-01

    Medical home models seek to increase efficiency and maximize the use of resources by ensuring that all care team members work at the top of their licenses. We sought to break down primary care office visits into measurable activities to better under stand how primary care providers (PCPs) currently spend visit time and to provide insight into potential opportunities for revision or redistribution of healthcare tasks. We videotaped 27 PCPs during office visits with 121 patients at four Veterans Health Administration medical centers. Based on patterns emerging from the data, we identified a taxonomy of 12 provider activity categories that enabled us to quantify the frequency and duration of activities occurring during routine primary care visits. We conducted descriptive and multivariate analyses to examine associations between visit characteristics and provider and clinic characteristics. We found that PCPs spent the greatest percentage of their visit time discussing existing conditions (20%), discussing new conditions (18%), record keeping (13%), and examining patients (13%). Providers spent the smallest percentage of time on preventive care and coordination of care. Mean visit length was 22.9 minutes (range 7.9-58.0 minutes). Site-level ratings of medical home implementation were not associated with differences in how visit time was spent. These data provide a window into how PCPs are spending face-to-face time with patients. The methodology and taxonomy presented here may prove useful for future quality improvement and research endeavors, particularly those focused on opportunities to increase nonappointment care and to ensure that team members work at the top of their skill level.

  4. Proceedings of the scientific visit on crystalline rock repository development.

    SciTech Connect

    Mariner, Paul E.; Hardin, Ernest L.; Miksova, Jitka

    2013-02-01

    A scientific visit on Crystalline Rock Repository Development was held in the Czech Republic on September 24-27, 2012. The visit was hosted by the Czech Radioactive Waste Repository Authority (RAWRA), co-hosted by Sandia National Laboratories (SNL), and supported by the International Atomic Energy Agency (IAEA). The purpose of the visit was to promote technical information exchange between participants from countries engaged in the investigation and exploration of crystalline rock for the eventual construction of nuclear waste repositories. The visit was designed especially for participants of countries that have recently commenced (or recommenced) national repository programmes in crystalline host rock formations. Discussion topics included repository programme development, site screening and selection, site characterization, disposal concepts in crystalline host rock, regulatory frameworks, and safety assessment methodology. Interest was surveyed in establishing a %E2%80%9Cclub,%E2%80%9D the mission of which would be to identify and address the various technical challenges that confront the disposal of radioactive waste in crystalline rock environments. The idea of a second scientific visit to be held one year later in another host country received popular support. The visit concluded with a trip to the countryside south of Prague where participants were treated to a tour of the laboratory and underground facilities of the Josef Regional Underground Research Centre.

  5. Returning to health visiting practice: completing the circle.

    PubMed

    Abbott, Stephen; Anto-Awuakye, Sandra; Bryar, Rosamund; Trivedi, Seema G

    2012-09-01

    One strategic health authority, NHS London, initiated a pilot return to health visiting/nursing practice scheme in London in 2010. This paper reports on the experiences of the first three cohorts of returnees on the City University London programme, one of the London programmes, and the adaptations that have been made to the programme to help provide returnees with the theory base and practice experience to equip them to work in today's health visiting. Written evaluation forms were completed by the returnees and information gathered from their application forms. This information was supplemented for Cohort 1 with some interviews with practice teachers and lecturers and a mid-stage questionnaire to the returnees. Of the 54 students in the three cohorts over half were still on one or both Nursing and Midwifery Council registers, which had not been anticipated at the start of the programme and led to modifications to the programme after Cohort 1 with an increase in the health visiting specific content. The returnees had a wide range of experience to bring back to health visiting reflecting the fact that a large number had been out of health visiting for more than 11 years. The evaluation shows that providing support by the university to the practice placement areas; ensuring that the taught element is current and useful to health visiting practice and having a relevant but not too onerous assessment process are critical.

  6. Returning to health visiting practice: completing the circle.

    PubMed

    Abbott, Stephen; Anto-Awuakye, Sandra; Bryar, Rosamund; Trivedi, Seema G

    2012-09-01

    One strategic health authority, NHS London, initiated a pilot return to health visiting/nursing practice scheme in London in 2010. This paper reports on the experiences of the first three cohorts of returnees on the City University London programme, one of the London programmes, and the adaptations that have been made to the programme to help provide returnees with the theory base and practice experience to equip them to work in today's health visiting. Written evaluation forms were completed by the returnees and information gathered from their application forms. This information was supplemented for Cohort 1 with some interviews with practice teachers and lecturers and a mid-stage questionnaire to the returnees. Of the 54 students in the three cohorts over half were still on one or both Nursing and Midwifery Council registers, which had not been anticipated at the start of the programme and led to modifications to the programme after Cohort 1 with an increase in the health visiting specific content. The returnees had a wide range of experience to bring back to health visiting reflecting the fact that a large number had been out of health visiting for more than 11 years. The evaluation shows that providing support by the university to the practice placement areas; ensuring that the taught element is current and useful to health visiting practice and having a relevant but not too onerous assessment process are critical. PMID:23029774

  7. Molecular cloning and characterization of enhanced disease susceptibility 1 (EDS1) from Gossypium barbadense.

    PubMed

    Su, Xiaofeng; Qi, Xiliang; Cheng, Hongmei

    2014-06-01

    Arabidopsis enhanced disease susceptibility 1 (EDS1) plays an important role in plant defense against biotrophic and necrotrophic pathogens. The necrotrophic pathogen Verticillium dahliae infection of Gossypium barbadense could lead to Verticillium wilt which seriously reduces the cotton production. Here, we cloned and characterized a G. barbadense homolog of EDS1, designated as GbEDS1. The full-length cDNA of the GbEDS1 gene was obtained by the technique of rapid-amplification of cDNA ends. The open reading frame of the GbEDS1 gene was 1,647 bp long and encoded a protein of 548 amino acids residues. Comparison of the cDNA and genomic DNA sequence of GbEDS1 indicated that this gene contained a single intron and two exons. Like other EDS1s, GbEDS1 contained a conserved N-terminal lipase domain and an EDS1-specific KNEDT motif. Subcellular localization assay revealed that GbEDS1-green fluorescence protein fusion protein was localized in both cytosol and nucleus. Interestingly, the transcript levels of GbEDS1 were dramatically increased in response to pathogen V. dahliae infection. To investigate the role of GbEDS1 in plant resistance against V. dahliae, a conserved fragment derived from GbEDS1 was used to knockdown the endogenous EDS1 in Nicotiana benthamiana by heterologous virus-induced gene silencing. Our data showed that silencing of NbEDS1 resulted in increased susceptibility to V. dahliae infection in N. benthamiana, suggesting a possible involvement of the novelly isolated GbEDS1 in the regulation of plant defense against V. dahliae.

  8. Analysis of microtraces in invasive traumas using SEM/EDS.

    PubMed

    Vermeij, E J; Zoon, P D; Chang, S B C G; Keereweer, I; Pieterman, R; Gerretsen, R R R

    2012-01-10

    Scanning electron microscopy in combination with energy-dispersive X-ray spectrometry (SEM/EDS) is a proven forensic tool and has been used to analyze several kinds of trace evidence. A forensic application of SEM/EDS is the examination of morphological characteristics of tool marks that tools and instruments leave on bone. The microtraces that are left behind by these tools and instruments on the bone are, however, often ignored or not noticed at all. In this paper we will describe the use of SEM/EDS for the analysis of microtraces in invasive sharp-force, blunt-force and bone-hacking traumas in bone. This research is part of a larger multi-disciplinary approach in which pathologists, forensic anthropologists, toolmark and microtrace experts work together to link observed injuries to a suspected weapon or, in case of an unknown weapon, to indicate a group of objects that could have been used as a weapon. Although there are a few difficulties one have to consider, the method itself is rather simple and straightforward to apply. A sample of dry and clean bone is placed into the SEM sample chamber and brightness and contrast are set such that bone appears grey, metal appears white and organic material appears black. The sample is then searched manually to find relevant features. Once features are found their elemental composition is measured by an energy dispersive X-ray spectrometer (EDS). This method is illustrated using several cases. It is shown that SEM/EDS analysis of microtraces in bone is a valuable tool to get clues about an unknown weapon and can associate a specific weapon with injuries on the basis of appearance and elemental composition. In particular the separate results from the various disciplines are complementary and may be combined to reach a conclusion with a stronger probative value. This is not only useful in the courtroom but above all in criminal investigations when one have to know for what weapon or object to look for. PMID:21871744

  9. Pain management trend of vaso-occulsive crisis (VOC) at a community hospital emergency department (ED) for patients with sickle cell disease.

    PubMed

    Inoue, Susumu; Khan, Isra'a; Mushtaq, Rao; Sanikommu, Srinivasa Reddy; Mbeumo, Carline; LaChance, Jenny; Roebuck, Michael

    2016-01-01

    Pain management at the emergency department (ED) for vaso-occulsive crisis (VOC) for patients with sickle cell disease has not been optimum, with a long delay in giving the initial analgesic. We conducted a retrospective survey over a 7-year period to determine our ED's timing in giving pain medication to patients with VOC as a quality improvement project. We compared different periods, children vs adults, and the influence of gender in the analgesic administration timing. This is a retrospective chart review of three different periods: (1) years 2007-2008, (2) years 2011-2012, and (3) year 2013. We extracted relevant information from ED records. Data were analyzed using Student t test, chi-square analysis, and the Kruskal-Wallis test. There was a progressive improvement in the time interval to the 1st analgesic over these three periods. Children received analgesics more quickly than adults in all periods. Male adult patients received pain medication faster than female adult patients, although initial pain scores were higher in female than in male patients. Progressively fewer pediatric patients utilized ED over these three periods, but no difference for adult patients was observed. The proportion of pediatric patients admitted to the hospital increased with each period. The progressive decrease in both the number of patients and the number of visits to the ED by children suggested that the collective number of VOC in children has decreased, possibly secondary to the dissemination of hydroxyurea use. We failed to observe the same trend in adult patients. The need for IV access, and ordering laboratory tests or imaging studies tends to delay analgesic administration. Delay in administration of the first analgesic was more pronounced for female adult patients than male adult patients in spite of their higher pain score. Health care providers working in ED should make conscious efforts to respect pain in women as well as pain in men. Though not proven from this study

  10. EDS coal liquefaction process development. Phase V. EDS commercial plant study design update. Illinois coal. Volume 1. Main report

    SciTech Connect

    Epperly, W. R.

    1981-03-01

    The objectives of the Study Design Update (SDU) were to identify the technical issues facing a potential commercial-size EDS plant design; to provide a reliable basis for estimating the cost of EDS products; and to furnish research guidance to the EDS Project. The SDU consists of two distinct studies in which different processing schemes are used to produce the hydrogen and fuel gas required by the plant. These studies are referred to as the Base Case and the Market Flexibility Sensitivity Case. In the Base Case, hydrogen is generated by steam reforming of the light hydrocarbon gases produced in the plant. Fuel gas is generated by feeding the bottoms stream from the liquefaction section vacuum pipestill to a FLEXICOKING unit. In the FLEXICOKING unit reactor, the bottoms stream is converted to coke; additional liquid product is also recovered. The coke is converted to low-Btu fuel gas in the FLEXICOKING unit gasifier. In the Market Flexibility Sensitivity (MFS) Case, the bottoms stream from the vacuum pipestill is split, and about half is sent to the FLEXICOKING unit for recovery of additional liquid product and production of fuel gas. The remainder of the bottoms stream is converted to hydrogen in a Partial Oxidation Unit. Hence the MFS Case does not consume light hydrocarbon gases produced and they are available for sale. The study of these two cases has demonstrated the importance of bottoms process selection to the economics and thermal efficiency of an EDS plant. Volume 1 - Main Report has been developed to be a stand-alone document. Both the Base Case and Market Flexibility Sensitivity (MFS) Case are covered. This volume includes an overview and detailed case summaries. It also covers economics, product recovery factors, material and energy balances, cost estimates and enviromental considerations.

  11. A functional EDS1 ortholog is differentially regulated in powdery mildew resistant and susceptible grapevines and complements an Arabidopsis eds1 mutant.

    PubMed

    Gao, Fei; Shu, Xiaomei; Ali, Mohammad Babar; Howard, Susanne; Li, Nan; Winterhagen, Patrick; Qiu, Wenping; Gassmann, Walter

    2010-04-01

    Vitis vinifera (grapevine) is the most economically important deciduous fruit crop, but cultivated grapevine varieties lack adequate innate immunity to a range of devastating diseases. To identify genetic resources for grapevine innate immunity and understand pathogen defense pathways in a woody perennial plant, we focus in this study on orthologs of the central Arabidopsis thaliana defense regulator ENHANCED DISEASE SUSCEPTIBILITY1 (EDS1). The family of EDS1-like genes is expanded in grapevine, and members of this family were previously found to be constitutively upregulated in the resistant variety 'Norton' of the North American grapevine species Vitis aestivalis, while they were induced by Erysiphe necator, the causal agent of grapevine powdery mildew (PM), in the susceptible V. vinifera variety 'Cabernet Sauvignon'. Here, we determine the responsiveness of individual EDS1-like genes in grapevine to PM and salicylic acid, and find that EDS1-like paralogs are differentially regulated in 'Cabernet Sauvignon', while two are constitutively upregulated in 'Norton'. Sequencing of VvEDS1 and VaEDS1 cDNA and genomic clones revealed high conservation in the protein-encoding sequence and some divergence of the promoter sequence in the two grapevine varieties. Complementation of the Arabidopsis eds1-1 mutant showed that the EDS1-like gene with highest predicted amino acid sequence similarity to AtEDS1 from either grapevine varieties is a functional ortholog of AtEDS1. Together, our analyses show that differential susceptibility to PM is correlated with differences in EDS1 expression, not differences in EDS1 function, between resistant 'Norton' and susceptible 'Cabernet Sauvignon'.

  12. EDS1 mediates pathogen resistance and virulence function of a bacterial effector in soybean

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Enhanced disease susceptibility 1 (EDS1) and phytoalexin deficient 4 (PAD4) are well known regulators of both basal and resistance (R) protein-mediated plant defense. We identified two EDS1- (GmEDS1a/b) and one PAD4-like (GmPAD4) protein that are required for resistance signaling in soybean. Consist...

  13. Self-Esteem and Emotional Intelligence among B.Ed Trainees of Tsunami Affected Coastal Belt

    ERIC Educational Resources Information Center

    Babu M, Sameer

    2008-01-01

    Through this study the author investigates the relationship between self-esteem and emotional intelligence among B.Ed trainees of Tsunami affected coastal belt of Alappey district of Kerala, India. Stream of study, marital status and age based comparisons were made among the B.Ed trainees. 92 B.Ed trainees were the participants in the study. It…

  14. Reading between the lines: building collaboration with ED clinicians can increase revenue.

    PubMed

    Edelberg, Caral

    2009-05-01

    Steps hospitals can take to enhance their ED billing, coding, and compliance include: Auditing records regularly to ensure ED nurses understand which procedures require specialized documentation. Determining whether assessment criteria would pass a compliance review. Ensuring ED documentation guidelines can be easily used by staff. Maintaining dated copies of revisions to these guidelines. PMID:19445397

  15. High School Teachers Win ACS Prizes

    NASA Astrophysics Data System (ADS)

    Editorial Staff, Jce

    2009-07-01

    William E. Snyder is the 2009 winner of the ACS Division of Chemical Education Central Region Award for Excellence in High School Teaching; Sally Mitchell is the winner of the 2009 James Bryant Conant Award in High School Chemistry Teaching.

  16. Tevatron optics measurements using an AC dipole

    SciTech Connect

    Miyamoto, R.; Kopp, S.E.; Jansson, A.; Syphers, M.J.; /Fermilab

    2007-06-01

    The AC dipole is a device to study beam optics of hadron synchrotrons. It can produce sustained large amplitude oscillations with virtually no emittance growth. A vertical AC dipole for the Tevatron is recently implemented and a maximum oscillation amplitude of 2{sigma} (4{sigma}) at 980 GeV (150 GeV) is achieved [1]. When such large oscillations are measured with the BPM system of the Tevatron (20 {micro}m resolution), not only linear but even nonlinear optics can be directly measured. This paper shows how to measure {beta} function using an AC dipole and the result is compared to the other measurement. The paper also shows a test to detect optics changes when small changes are made in the Tevatron. Since an AC dipole is nondestructive, it allows frequent measurements of the optics which is necessary for such an test.

  17. The AC-120: The advanced commercial transport

    NASA Technical Reports Server (NTRS)

    Duran, David; Griffin, Ernest; Mendoza, Saul; Nguyen, Son; Pickett, Tim; Noernberg, Clemm

    1993-01-01

    The main objective of this design was to fulfill a need for a new airplane to replace the aging 100 to 150 passenger, 1500 nautical mile range aircraft such as the Douglas DC9 and Boeing 737-100 airplanes. After researching the future aircraft market, conducting extensive trade studies, and analysis on different configurations, the AC-120 Advanced Commercial Transport final design was achieved. The AC-120's main design features include the incorporation of a three lifting surface configuration which is powered by two turboprop engines. The AC-120 is an economically sensitive aircraft which meets the new FM Stage Three noise requirements, and has lower NO(x) emissions than current turbofan powered airplanes. The AC-120 also improves on its contemporaries in passenger comfort, manufacturing, and operating cost.

  18. Electrodeposition of Au/Ag bimetallic dendrites assisted by Faradaic AC-electroosmosis flow

    SciTech Connect

    Ji, Jianlong; Li, Pengwei; Sang, Shengbo Zhang, Wendong Li, Gang; Hu, Jie; Zhou, Zhaoying Yang, Xing; Dong, Hualai

    2014-03-15

    Au/Ag bimetallic dendrites were synthesized successfully from the corresponding aqueous solution via the AC electrodeposition method. Both of the morphologies and compositions could be tuned by the electrolyte concentration and AC frequency. The prepared bimetallic dendrites were characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectrometer (EDS), transmission electron microscopy (TEM) and UV–vis spectroscopy. The underlying dendrite growth mechanism was then proposed in the context of the Directed Electrochemical Nanowires Assembly (DENA) models. Owing to the unscreened voltage dropping in the electrolyte bulk, electromigration dominates the species flux process, and cations tend to accumulate in areas with strong electric field intensity, such as electrode edges. Moreover, Faradaic AC-electro-osmosis (ACEO) flow could increase the effective diffusion layer thickness in these areas during the electrochemical reaction, and leads to dendrite growth. Further Micro-Raman observations illustrated that the Au/Ag bimetallic dendrites exhibited pronounced surface-enhanced Raman scattering (SERS) activity, using 4-mercaptopyridine (4-MP) as model molecules.

  19. Electrodeposition of Au/Ag bimetallic dendrites assisted by Faradaic AC-electroosmosis flow

    NASA Astrophysics Data System (ADS)

    Ji, Jianlong; Li, Pengwei; Sang, Shengbo; Zhang, Wendong; Zhou, Zhaoying; Yang, Xing; Dong, Hualai; Li, Gang; Hu, Jie

    2014-03-01

    Au/Ag bimetallic dendrites were synthesized successfully from the corresponding aqueous solution via the AC electrodeposition method. Both of the morphologies and compositions could be tuned by the electrolyte concentration and AC frequency. The prepared bimetallic dendrites were characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectrometer (EDS), transmission electron microscopy (TEM) and UV-vis spectroscopy. The underlying dendrite growth mechanism was then proposed in the context of the Directed Electrochemical Nanowires Assembly (DENA) models. Owing to the unscreened voltage dropping in the electrolyte bulk, electromigration dominates the species flux process, and cations tend to accumulate in areas with strong electric field intensity, such as electrode edges. Moreover, Faradaic AC-electro-osmosis (ACEO) flow could increase the effective diffusion layer thickness in these areas during the electrochemical reaction, and leads to dendrite growth. Further Micro-Raman observations illustrated that the Au/Ag bimetallic dendrites exhibited pronounced surface-enhanced Raman scattering (SERS) activity, using 4-mercaptopyridine (4-MP) as model molecules.

  20. Visit the MedlinePlus Search Cloud | NIH MedlinePlus the Magazine

    MedlinePlus

    ... page please turn Javascript on. Visit the MedlinePlus Search Cloud Past Issues / Winter 2011 Table of Contents ... information Visit the new MedlinePlus Visit the MedlinePlus search cloud, featuring the top 100 search terms of ...

  1. Extreme Precipitation and Emergency Room Visits for Gastrointestinal Illness in Areas with and without Combined Sewer Systems: An Analysis of Massachusetts Data, 2003–2007

    PubMed Central

    Li, Quanlin; Wang, Shiliang; Messier, Kyle P.; Wade, Timothy J.; Hilborn, Elizabeth D.

    2015-01-01

    Background Combined sewer overflows (CSOs) occur in combined sewer systems when sewage and stormwater runoff are released into water bodies, potentially contaminating water sources. CSOs are often caused by heavy precipitation and are expected to increase with increasing extreme precipitation associated with climate change. Objectives The aim of this study was to assess whether the association between heavy rainfall and rate of emergency room (ER) visits for gastrointestinal (GI) illness differed in the presence of CSOs. Methods For the study period 2003–2007, time series of daily rate of ER visits for GI illness and meteorological data were organized for three exposure regions: a) CSOs impacting drinking water sources, b) CSOs impacting recreational waters, c) no CSOs. A distributed lag Poisson regression assessed cumulative effects for an 8-day lag period following heavy (≥ 90th and ≥ 95th percentile) and extreme (≥ 99th percentile) precipitation events, controlling for temperature and long-term time trends. Results The association between extreme rainfall and rate of ER visits for GI illness differed among regions. Only the region with drinking water exposed to CSOs demonstrated a significant increased cumulative risk for rate (CRR) of ER visits for GI for all ages in the 8-day period following extreme rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared with no rainfall. Conclusions The rate of ER visits for GI illness was associated with extreme precipitation in the area with CSO discharges to a drinking water source. Our findings suggest an increased risk for GI illness among consumers whose drinking water source may be impacted by CSOs after extreme precipitation. Citation Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015. Extreme precipitation and emergency room visits for gastrointestinal illness in areas with and without combined sewer systems: an analysis of Massachusetts data, 2003–2007. Environ Health Perspect 123:873–879;

  2. Peat Bog Wildfire Smoke Exposure in Rural North Carolina Is Associated with Cardiopulmonary Emergency Department Visits Assessed through Syndromic Surveillance

    PubMed Central

    Stone, Susan L.; Cascio, Wayne E.; Neas, Lucas M.; Kilaru, Vasu J.; Carraway, Martha Sue; Szykman, James J.; Ising, Amy; Cleve, William E.; Meredith, John T.; Vaughan-Batten, Heather; Deyneka, Lana; Devlin, Robert B.

    2011-01-01

    Background: In June 2008, burning peat deposits produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina. Although the association of mortality and morbidity with exposure to urban air pollution is well established, the health effects associated with exposure to wildfire emissions are less well understood. Objective: We investigated the effects of exposure on cardiorespiratory outcomes in the population affected by the fire. Methods: We performed a population-based study using emergency department (ED) visits reported through the syndromic surveillance program NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool). We used aerosol optical depth measured by a satellite to determine a high-exposure window and distinguish counties most impacted by the dense smoke plume from surrounding referent counties. Poisson log-linear regression with a 5-day distributed lag was used to estimate changes in the cumulative relative risk (RR). Results: In the exposed counties, significant increases in cumulative RR for asthma [1.65 (95% confidence interval, 1.25–2.1)], chronic obstructive pulmonary disease [1.73 (1.06–2.83)], and pneumonia and acute bronchitis [1.59 (1.07–2.34)] were observed. ED visits associated with cardiopulmonary symptoms [1.23 (1.06–1.43)] and heart failure [1.37 (1.01–1.85)] were also significantly increased. Conclusions: Satellite data and syndromic surveillance were combined to assess the health impacts of wildfire smoke in rural counties with sparse air-quality monitoring. This is the first study to demonstrate both respiratory and cardiac effects after brief exposure to peat wildfire smoke. PMID:21705297

  3. Pediatric emergency room visits: a risk factor for acquiring measles.

    PubMed

    Farizo, K M; Stehr-Green, P A; Simpson, D M; Markowitz, L E

    1991-01-01

    In recent years, measles outbreaks have occurred among unimmunized children in inner cities in the United States. From May 1988 through June 1989, 1214 measles cases were reported in Los Angeles, and from October 1988 through June 1989, 1730 cases were reported in Houston. More than half of cases were in children younger than 5 years of age, most of whom were unvaccinated. Of cases of measles in preschool-aged children, nearly one fourth in Los Angeles and more than one third in Houston were reported by one inner-city emergency room. To evaluate whether emergency room visits were a risk factor for acquiring measles, in Los Angeles, 35 measles patients and 109 control patients with illnesses other than measles, and in Houston, 49 measles patients and 128 control patients, who visited these emergency rooms, were enrolled in case-control studies. Control patients were matched to case patients for ethnicity, age, and week of visit. Records were reviewed to determine whether case patients had visited the emergency room during the period of potential measles exposure, which was defined as 10 to 18 days before rash onset, and whether control patients had visited 10 to 18 days before their enrollment visit. In Los Angeles, 23% of case patients and 5% of control patients (odds ratio = 5.2, 95% confidence interval = 1.7, 15.9; P less than .01), and in Houston, 41% of case patients and 6% of control patients (odds ratio = 8.4, 95% confidence interval = 3.3, 21.2; P less than .01), visited the emergency room during these periods.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Inbreeding in Mimulus guttatus Reduces Visitation by Bumble Bee Pollinators

    PubMed Central

    Carr, David E.; Roulston, T’ai H.; Hart, Haley

    2014-01-01

    Inbreeding in plants typically reduces individual fitness but may also alter ecological interactions. This study examined the effect of inbreeding in the mixed-mating annual Mimulus guttatus on visitation by pollinators (Bombus impatiens) in greenhouse experiments. Previous studies of M. guttatus have shown that inbreeding reduced corolla size, flower number, and pollen quantity and quality. Using controlled crosses, we produced inbred and outbred families from three different M. guttatus populations. We recorded the plant genotypes that bees visited and the number of flowers probed per visit. In our first experiment, bees were 31% more likely to visit outbred plants than those selfed for one generation and 43% more likely to visit outbred plants than those selfed for two generations. Inbreeding had only a small effect on the number of flowers probed once bees arrived at a genotype. These differences were explained partially by differences in mean floral display and mean flower size, but even when these variables were controlled statistically, the effect of inbreeding remained large and significant. In a second experiment we quantified pollen viability from inbred and self plants. Bees were 37–54% more likely to visit outbred plants, depending on the population, even when controlling for floral display size. Pollen viability proved to be as important as floral display in predicting pollinator visitation in one population, but the overall explanatory power of a multiple regression model was weak. Our data suggested that bees use cues in addition to display size, flower size, and pollen reward quality in their discrimination of inbred plants. Discrimination against inbred plants could have effects on plant fitness and thereby reinforce selection for outcrossing. Inbreeding in plant populations could also reduce resource quality for pollinators, potentially resulting in negative effects on pollinator populations. PMID:25036035

  5. Volunteers' experiences visiting the cognitively impaired in nursing homes: a friendly visiting program.

    PubMed

    Damianakis, Thecla

    2007-01-01

    Two challenges facing nursing-home care today are understanding the concept of quality of life as it relates to cognitively impaired residents and finding effective ways to ensure that it is achieved. Canadian director Allan King's documentary, Memory for Max, Claire, Ida and Company , filmed at Baycrest, captures a method for enhancing the quality of life of six cognitively impaired residents. While the film suggests an intervention model implemented by volunteers, there are challenges unique to institution-based programs (i.e., the recruitment and retention of volunteers). One of the challenges is the fear that volunteers may experience when interacting with the cognitively impaired. We conducted a pilot study of a model for training volunteers to provide friendly visiting and evaluated the impact on the participating residents. Observational accounts of volunteer-resident interactions and seven volunteer interviews were analysed and yielded several themes-(a) relationship building, (b) contribution of the environment, (c) preserving personhood, (d) resident-centred presence and the quality of the moment-and several themes related to the volunteers' role and their perceived impact on the residents. Discussed are the implications for volunteer programs in long-term health care settings.

  6. Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios.

    PubMed

    Toloo, Ghasem Sam; Hu, Wenbiao; FitzGerald, Gerry; Aitken, Peter; Tong, Shilu

    2015-01-01

    The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98-336 and 42-127 for younger and older groups, respectively. The excess costs in 2012-13 prices are estimated to range between AU$51,000-184,000 (0-64) and AU$27,000-84,000 (65+). By 2060, these estimates will increase to 229-2300 and 145-1188 at a cost of between AU$120,000-1,200,000 and AU$96,000-786,000 for the respective age groups. Improvements in climate change mitigation and adaptation measures are likely to generate synergistic health co-benefits and reduce the impact on frontline health services.

  7. Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios

    NASA Astrophysics Data System (ADS)

    Toloo, Ghasem (Sam); Hu, Wenbiao; Fitzgerald, Gerry; Aitken, Peter; Tong, Shilu

    2015-08-01

    The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98-336 and 42-127 for younger and older groups, respectively. The excess costs in 2012-13 prices are estimated to range between AU$51,000-184,000 (0-64) and AU$27,000-84,000 (65+). By 2060, these estimates will increase to 229-2300 and 145-1188 at a cost of between AU$120,000-1,200,000 and AU$96,000-786,000 for the respective age groups. Improvements in climate change mitigation and adaptation measures are likely to generate synergistic health co-benefits and reduce the impact on frontline health services.

  8. Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios.

    PubMed

    Toloo, Ghasem Sam; Hu, Wenbiao; FitzGerald, Gerry; Aitken, Peter; Tong, Shilu

    2015-01-01

    The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98-336 and 42-127 for younger and older groups, respectively. The excess costs in 2012-13 prices are estimated to range between AU$51,000-184,000 (0-64) and AU$27,000-84,000 (65+). By 2060, these estimates will increase to 229-2300 and 145-1188 at a cost of between AU$120,000-1,200,000 and AU$96,000-786,000 for the respective age groups. Improvements in climate change mitigation and adaptation measures are likely to generate synergistic health co-benefits and reduce the impact on frontline health services. PMID:26245139

  9. EMS transports patients to clinics--seeks to relieve ED crowding.

    PubMed

    2010-07-01

    With most EDs overcrowded and with no relief in sight, ED managers will take all the help they can get. In some areas of the country, the local EMS providers are looking to offer some relief by transporting less urgent patients to alternative sites such as urgent care clinics. EDs assist in the development of program protocols and processes. ED nurses are considered for consultation on whether a patient can appropriately be seen in a less urgent setting. EMS providers must be trained on the requirements patients must fulfill to be transported to an ED PMID:20608479

  10. Constitutive disease resistance requires EDS1 in the Arabidopsis mutants cpr1 and cpr6 and is partially EDS1-dependent in cpr5.

    PubMed

    Clarke, J D; Aarts, N; Feys, B J; Dong, X; Parker, J E

    2001-05-01

    The systemic acquired resistance (SAR) response in Arabidopsis is characterized by the accumulation of salicylic acid (SA), expression of the pathogenesis-related (PR) genes, and enhanced resistance to virulent bacterial and oomycete pathogens. The cpr (constitutive expressor of PR genes) mutants express all three SAR phenotypes. In addition, cpr5 and cpr6 induce expression of PDF1.2, a defense-related gene associated with activation of the jasmonate/ethylene-mediated resistance pathways. cpr5 also forms spontaneous lesions. In contrast, the eds1 (enhanced disease susceptibility) mutation abolishes race-specific resistance conferred by a major subclass of resistance (R) gene products in response to avirulent pathogens. eds1 plants also exhibit increased susceptibility to virulent pathogens. Epistasis experiments were designed to explore the relationship between the cpr- and EDS1-mediated resistance pathways. We found that a null eds1 mutation suppresses the disease resistance phenotypes of both cpr1 and cpr6. In contrast, eds1 only partially suppresses resistance in cpr5, leading us to conclude that cpr5 expresses both EDS1-dependent and EDS1-independent components of plant disease resistance. Although eds1 does not prevent lesion formation on cpr5 leaves, it alters their appearance and reduces their spread. This phenotypic difference is associated with increased pathogen colonization of cpr5 eds1 plants compared to cpr5. The data allow us to place EDS1 as a necessary downstream component of cpr1- and cpr6-mediated responses, but suggest a more complex relationship between EDS1 and cpr5 in plant defense.

  11. 78 FR 39345 - ACS Wireless, Inc.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-01

    ... COMMISSION ACS Wireless, Inc.; Notice of Application AGENCY: Securities and Exchange Commission (``Commission...''). Summary of Application: ACS Wireless, Inc. (``ACS Wireless'') seeks an order under section 3(b)(2) of the..., owning, holding or trading in securities. ACS Wireless is primarily engaged in providing...

  12. 21 CFR 888.1240 - AC-powered dynamometer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered dynamometer. 888.1240 Section 888.1240...) MEDICAL DEVICES ORTHOPEDIC DEVICES Diagnostic Devices § 888.1240 AC-powered dynamometer. (a) Identification. An AC-powered dynamometer is an AC-powered device intended for medical purposes to...

  13. 21 CFR 886.4440 - AC-powered magnet.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered magnet. 886.4440 Section 886.4440 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4440 AC-powered magnet. (a) Identification. An AC-powered magnet is an AC-powered device that generates a magnetic field intended to find and...

  14. 21 CFR 886.1630 - AC-powered photostimulator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered photostimulator. 886.1630 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1630 AC-powered photostimulator. (a) Identification. An AC-powered photostimulator is an AC-powered device intended to provide light stimulus...

  15. 21 CFR 886.1850 - AC-powered slitlamp biomicroscope.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered slitlamp biomicroscope. 886.1850... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1850 AC-powered slitlamp biomicroscope. (a) Identification. An AC-powered slitlamp biomicroscope is an AC-powered device that is...

  16. 21 CFR 886.4440 - AC-powered magnet.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false AC-powered magnet. 886.4440 Section 886.4440 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4440 AC-powered magnet. (a) Identification. An AC-powered magnet is an AC-powered device that generates a magnetic field intended to find and...

  17. 21 CFR 886.4440 - AC-powered magnet.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false AC-powered magnet. 886.4440 Section 886.4440 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4440 AC-powered magnet. (a) Identification. An AC-powered magnet is an AC-powered device that generates a magnetic field intended to find and...

  18. 21 CFR 886.4440 - AC-powered magnet.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false AC-powered magnet. 886.4440 Section 886.4440 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4440 AC-powered magnet. (a) Identification. An AC-powered magnet is an AC-powered device that generates a magnetic field intended to find and...

  19. 21 CFR 886.4440 - AC-powered magnet.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false AC-powered magnet. 886.4440 Section 886.4440 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4440 AC-powered magnet. (a) Identification. An AC-powered magnet is an AC-powered device that generates a magnetic field intended to find and...

  20. A Review of Visiting Policies in Intensive Care Units

    PubMed Central

    Khaleghparast, Shiva; Joolaee, Soodabeh; Ghanbari, Behrooz; Maleki, Majid; Peyrovi, Hamid; Bahrani, Naser

    2016-01-01

    Admission to intensive care units is potentially stressful and usually goes together with disruption in physiological and emotional function of the patient. The role of the families in improving ill patients’ conditions is important. So this study investigates the strategies, potential challenges and also the different dimensions of visiting hours’ policies with a narrative review. The search was carried out in scientific information databases using keywords “visiting policy”, “visiting hours” and “intensive care unit” with no time limitation on accessing the published studies in English or Farsi. Of a total of 42 articles, 22 conformed to our study objectives from 1997 to 2013. The trajectory of current research shows that visiting in intensive care units has, since their inception in the 1960s, always considered the nurses’ perspectives, patients’ preferences and physiological responses, and the outlook for families. However, little research has been carried out and most of that originates from the United States, Europe and since 2010, a few from Iran. It seems that the need to use the research findings and emerging theories and practices is necessary to discover and challenge the beliefs and views of nurses about family-oriented care and visiting in intensive care units. PMID:26755480