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  1. Success of Elective Cholecystectomy Treatment Plans After ED Visit

    PubMed Central

    Bingener, Juliane; Thomsen, Kristine M.; McConico, Andrea; Hess, Erik P.; Habermann, Elizabeth B.

    2014-01-01

    Introduction Differentiation between patients with acute cholecystitis and patients with severe biliary colic can be challenging. Patients with undiagnosed acute cholecystitis can incur repeat emergency department (ED) visits, which is resource intensive. Methods Billing records from 2000 – 2013 of all adults who visited the ED in the 30 days preceding their cholecystectomy were analyzed. Patients who were discharged from the ED and underwent elective cholecystectomy were compared to those who were discharged and returned to the ED within 30 days. T-tests, chi-square tests and multivariable analysis were utilized as appropriate. Results From 2000 - 2013, 3138 patients (34%) presented to the ED within 30 days prior to surgery, 63% were women, mean age 51 years, and of those 1625 were directly admitted from the ED for cholecystectomy while 1513 patients left the ED to return for an elective cholecystectomy. Patients who were discharged were younger (mean age 49 vs 54 yrs, p<0.001) and had shorter ED stays (5.9 vs 7.2 hrs, p<0.001) than the patients admitted immediately. Of the discharged patients, 303 (20%) returned to the ED within 30 days to undergo urgent cholecystectomy. Compared to patients with successful elective cholecystectomy after the ED visit, those who failed the pathway were more likely to have an ASA score > 3 and were <40 or ≥60 compared to the successful group. Conclusions One in five patients failed the elective cholecystectomy pathway after ED discharge, leading to additional patient distress and use of resources. Further risk factor assessment may help design efficient care pathways. PMID:25043530

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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…

  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. Unscheduled-Return-Visits after an Emergency Department (ED) Attendance and Clinical Link between Both Visits in Patients Aged 75 Years and Over: A Prospective Observational Study

    PubMed Central

    Pereira, Laurent; Choquet, Christophe; Perozziello, Anne; Wargon, Mathias; Juillien, Gaelle; Colosi, Luisa; Hellmann, Romain; Ranaivoson, Michel; Casalino, Enrique

    2015-01-01

    Background Predictors of unscheduled return visits (URV), best time-frame to evaluate URV rate and clinical relationship between both visits have not yet been determined for the elderly following an ED visit. Methods We conducted a prospective-observational study including 11,521 patients aged ≥75-years and discharged from ED (5,368 patients (53.5%)) or hospitalized after ED visit (6,153 patients). Logistic Regression and time-to-failure analyses including Cox proportional model were performed. Results Mean time to URV was 17 days; 72-hour, 30-day and 90-day URV rates were 1.8%, 6.1% and 10% respectively. Multivariate analysis indicates that care-pathway and final disposition decisions were significantly associated with a 30-day URV. Thus, we evaluated predictors of 30-day URV rates among non-admitted and hospitalized patient groups. By using the Cox model we found that, for non-admitted patients, triage acuity and diagnostic category and, for hospitalized patients, that visit time (day, night) and diagnostic categories were significant predictors (p<0.001). For URV, we found that 25% were due to closely related-clinical conditions. Time lapses between both visits constituted the strongest predictor of closely related-clinical conditions. Conclusion Our study shows that a decision of non-admission in emergency departments is linked with an accrued risk of URV, and that some diagnostic categories are also related for non-admitted and hospitalized subjects alike. Our study also demonstrates that the best time frame to evaluate the URV rate after an ED visit is 30 days, because this is the time period during which most URVs and cases with close clinical relationships between two visits are concentrated. Our results suggest that URV can be used as an indicator or quality. PMID:25853822

  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. 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…

  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. PMID:27625723

  13. 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…

  14. 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.

  15. One Year Medical Outcomes and ED Recidivism Following ED Observation for Cocaine-Associated Chest Pain

    PubMed Central

    Cunningham, Rebecca; Walton, Maureen A.; Weber, Jim Edward; O'Broin, Samantha; Tripathi, Shanti P; Maio, Ronald F.; Booth, Brenda M.

    2010-01-01

    Chest pain is the most common complaint among cocaine users who present to the ED seeking care and many hospital resources are applied to stratify cocaine users in regard to future cardiac morbidity and mortality. Little is known about the longitudinal cardiac and non cardiac medical outcomes of cocaine users who have been stratified to an ED observation period following their ED visit. Objectives to examine one-year cardiac outcomes in a low-intermediate risk sample of patients with cocaine- associated chest pain in an urban ED, as well as to examine ED recidivism one year for cardiac and non-cardiac complaints. Methods Prospective consecutive cohort study of patients (18–60 years) who presented to an urban Level 1 ED with cocaine-associated chest pain and were risk stratified to low-intermediate cardiac risk. Exclusion criteria: EKG suggestive of AMI, elevated serum cardiac markers, history of AMI or CABG, hemodynamic instability, unstable angina. Baseline interviews using validated measures of health functioning, and substance use were conducted during CPOU stay, and 3, 6, and 12 months. ED utilization during the study year was abstracted from medical chart. Zero-Inflated Poisson regression analyses were conducted to predict recurrent ED visits. Results 219 participants (73% participation) were enrolled, 65% returned to the ED post index visit; 23% returned for chest pain, of these 66% had a positive cocaine urine screen. No patient had an AMI within the one year follow up period. Patients with continued cocaine use were more likely to have a recurrent ED visit (p<0.001) but these repeat visits were most often related to musculoskeletal pain (21%), and injury (30%) rather than potential cardiac complaints. Conclusions Patients with cocaine-associated chest pain who are low to intermediate cardiac risk and complete a CPOU protocol have less then 1% rate of MI in the subsequent 12-months. PMID:18824277

  16. 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

  17. Variation in Charges for Emergency Department Visits Across California

    PubMed Central

    Hsia, Renee Y; Antwi, Yaa Akosa

    2014-01-01

    Objective Previous studies have shown that charges for inpatient and clinic procedures vary substantially; however, there is scant data on variation in charges for emergency department (ED) visits. Outpatient ED visits are typically billed using CPT-coded levels to standardize the intensity of services received, providing an ideal element on which to evaluate charge variation. Thus, we sought to analyze the variation in charges for each level of ED visits, and examine whether hospital and market-level factors could help predict these charges. Methods Using 2011 charge data provided by every non-federal California hospital to the Office of Statewide Health Planning and Development, we analyzed the variability in charges for each level of ED visits and used linear regression to assess whether hospital and market characteristics could explain the variation in charges. Results Charges for each ED visit level varied widely; for example, charges for a level 4 visit ranged from $275 to $6,662. Government hospitals charged significantly less than non-profit hospitals, while hospitals that paid higher wages, served higher proportions of Medicare and Medicaid patients, and were located in areas with high costs of living charged more. Overall our models explained only 30–41% of the between-hospital variation in charges for each level of ED visits. Conclusions Our findings of extensive charge variation in ED visits add to the literature in demonstrating the lack of systematic charge setting in the U.S. healthcare system. These widely varying charges affect the hospital bills of millions of uninsured patients and insured patients seeking care out-of-network, and continue to play a role in many aspects of healthcare financing. PMID:24888673

  18. 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…

  19. WarpVisit

    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.

  20. 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.

  1. 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

  2. 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

  3. The Relationship between Same-Day Access and Continuity in Primary Care and Emergency Department Visits

    PubMed Central

    Cordasco, Kristina M.; Chow, Adam

    2015-01-01

    We examined how emergency department (ED) visits for potentially preventable, mental health, and other diagnoses were related to same-day access and provider continuity in primary care using administrative data from 71,296 patients in 22 VHA clinics over a three-year period. ED visits were categorized as non-emergent; primary care treatable; preventable; not preventable; or mental health-related. We conducted multi-level regression models adjusted for patient and clinic factors. More same-day access significantly predicted fewer non-emergent and primary care treatable ED visits while continuity was not significantly related to any type of ED visit. Neither measure was related to ED visits for mental health problems. PMID:26332981

  4. Could your ED meet a 15-minute service pledge?

    PubMed

    2003-01-01

    Patients dissatisfied with long waits is one of the most pressing problems that emergency department (ED) managers must address, and there is a trend of EDs offering service guarantees to patients to obtain higher satisfaction scores. At participating EDs, patients are offered letters of apology, movie passes, or a free visit if the guarantee isn't met. Census increased dramatically after the guarantee programs were implemented. To ensure the guarantees are met, additional nursing staff or ED beds may need to be added. PMID:12515111

  5. 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. PMID:26205070

  6. Health Care Utilization before and after an Outpatient Emergency Department Visit in Older People

    PubMed Central

    Horney, Carolyn; Schmader, Kenneth; Sanders, Linda L.; Heflin, Mitchell; Ragsdale, Luna; McConnell, Eleanor; Hocker, Michael; Hastings, S. Nicole

    2010-01-01

    Background Older adults in the U.S. receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization has not been adequately studied in this population. Objectives The goal of this study were to examine the relationships between health care use before and after an ED visit among older adults. Methods This retrospective cohort study examined health care use among 308 patients ≥ 65 years old discharged from a university-affiliated ED. Proportional-hazards models were used to assess the relationship between pre-ED health care use (primary care physician (PCP), specialist, ED and hospital) and risk of return ED visits. Results Older ED patients in this study had visited other types of providers frequently in the previous year (median number of primary care physician (PCP) and specialist visits = 4). Patients who used the ED on 2 or more occasions in the previous year were found to have visited their PCP more often than those without frequent ED use (median number of visits 7.0 vs 4.0, p<.001). Despite more PCP use in this population, frequent ED use was associated with increased risk of a repeat ED visit (HR 2.20, 95% CI 1.15–4.21), in models adjusted for demographics and health status. Conclusion Older adults who use the ED are also receiving significant amounts of care from other sources; simply providing additional access to care may not improve outcomes for these vulnerable individuals. PMID:21216555

  7. 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

  8. 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

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

    PubMed Central

    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 counties in Georgia which have a community health center clinic site vs. counties without a CHC presence. METHODS We analyzed data from 100% of ED visits occurring in 117 rural (non-metropolitan statistical area [MSA]) counties in Georgia from 2003-2005. Counties were classified as having a CHC presence if a federally funded (Section 330) community health center had a primary care delivery site in that county throughout the study period. The main outcome measure was uninsured ED visit rates among the uninsured (all-cause ED visits and visits for ambulatory care sensitive conditions). Poisson regression models were used to examine the relationship between ED rates and presence of a CHC. To assure that the effects were unique to the uninsured population, we ran similar analyses on insured ED visits. FINDINGS Counties without a community health center primary care clinic site had 33% higher rates of uninsured all-cause ED visits per 10,000 uninsured population compared with non-CHC counties (rate ratio=1.33, 95% CI=1.11-1.59). Higher ED visit rates remained significant (RR=1.21, 95% CI=1.02-1.42) after adjustment for percent of population below poverty level, percent black, and number of hospitals. Uninsured ED visit rates were also higher for various categories of diagnoses, but remained statistically significant on multivariate analysis only for ambulatory care sensitive conditions (adjusted RR=1.22, 95% CI=1.01-1.47). No such relationship was found for ED visit rates of insured patients (RR=1.06, 95% CI=0.92-1.22). CONCLUSIONS Absence of a community health center is associated with a substantial excess in uninsured ED visits in

  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. PMID:11781909

  11. Emergency Department Visits by Adults for Psychiatric Medication Adverse Events

    PubMed Central

    Hampton, Lee M.; Daubresse, Matthew; Chang, Hsien-Yen; Alexander, G. Caleb; Budnitz, Daniel S.

    2015-01-01

    IMPORTANCE In 2011, an estimated 26.8 million US adults used prescription medications for mental illness. OBJECTIVE To estimate the numbers and rates of adverse drug event (ADE) emergency department (ED) visits involving psychiatric medications among US adults between January 1, 2009, and December 31, 2011. DESIGN AND SETTING Descriptive analyses of active, nationally representative surveillance of ADE ED visits using the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance system and of drug prescribing during outpatient visits using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. PARTICIPANTS Medical records from national probability samples of ED and outpatient visits by adults 19 years or older were reviewed and analyzed. EXPOSURES Antidepressants, antipsychotics, lithium salts, sedatives and anxiolytics, and stimulants. MAIN OUTCOMES AND MEASURES National estimates of ADE ED visits resulting from therapeutic psychiatric medication use and of psychiatric medication ADE ED visits per 10 000 outpatient visits at which psychiatric medications were prescribed. RESULTS From 2009 through 2011, there were an estimated 89 094 (95% CI, 68 641–109 548) psychiatric medication ADE ED visits annually, with 19.3% (95% CI, 16.3%–22.2%) resulting in hospitalization and 49.4% (95% CI, 46.5%–52.4%) involving patients aged 19 to 44 years. Sedatives and anxiolytics, antidepressants, antipsychotics, lithium salts, and stimulants were implicated in an estimated 30 707 (95% CI, 23 406–38 008), 25 377 (95% CI, 19 051–31 704), 21 578 (95% CI, 16 599–26 557), 3620 (95% CI, 2311–4928), and 2779 (95% CI, 1764–3794) respective ADE ED visits annually. Antipsychotics and lithium salts were implicated in 11.7 (95% CI, 10.1–13.2) and 16.4 (95% CI, 13.0–19.9) ADE ED visits per 10 000 outpatient prescription visits, respectively, compared with 3.6 (95% CI, 3.2–4.1) for sedatives

  12. 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

  13. Pre-Emergency-Department Care-Seeking Patterns Are Associated with the Severity of Presenting Condition for Emergency Department Visit and Subsequent Adverse Events: A Timeframe Episode Analysis

    PubMed Central

    Yang, Nan-Ping; Lai, K. Robert; Huang, Hsin-Tsung

    2015-01-01

    Background Many patients treated in Emergency Department (ED) visits can be treated at primary or urgent care sectors, despite the fact that a number of ED visitors seek other forms of care prior to an ED visit. However, little is known regarding how the pre-ED activity episodes affect ED visits. Objectives We investigated whether care-seeking patterns involve the use of health care services of various types prior to ED visits and examined the associations of these patterns with the severity of the presenting condition for the ED visit (EDVS) and subsequent events. Methods This retrospective observational study used administrative data on beneficiaries of the universal health care insurance program in Taiwan. The service type, treatment capacity, and relative diagnosis were used to classify pre-ED visits into 8 care types. Frequent pattern analysis was used to identify sequential care-seeking patterns and to classify 667,183 eligible pre-ED episodes into patterns. Generalized linear models were developed using generalized estimating equations to examine the associations of these patterns with EDVS and subsequent events. Results The results revealed 17 care-seeking patterns. The EDVS and likelihood of subsequent events significantly differed among patterns. The ED severity index of patterns differ from patterns seeking directly ED care (coefficients ranged from -0.05 to 0.13), and the odds-ratios for the likelihood of subsequent ED visits and hospitalization ranged from 1.18 to 1.86 and 1.16 to 2.84, respectively. Conclusions The pre-ED care-seeking patterns differ in severity of presenting condition and subsequent events that may represent different causes of ED visit. Future health policy maker may adopt different intervention strategies for targeted population to reduce unnecessary ED visit effectively. PMID:26030278

  14. Motor Vehicle Collision-Related Emergency Department Visits by Older Adults in the United States

    PubMed Central

    Platts-Mills, Timothy F.; Hunold, Katherine M.; Esserman, Denise A.; Sloane, Philip D.; McLean, Samuel A.

    2012-01-01

    Objectives Motor vehicle collisions (MVCs) are the second most common cause of non-fatal injury among U.S. adults age 65 years and older. However, the frequency of emergency department (ED) visits, disposition, pain locations, and pain severity for older adults experiencing MVCs have not previously been described. The authors sought to determine these characteristics using information from two nationally representative data sets. Methods Data from the 2008 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (NEDS), and the National Hospital Ambulatory Medical Care Survey (NHAMCS), were used to estimate MVC-related ED visits and ED disposition for patients 65 years and older. NHAMCS data from 2004 through 2008 were used to further characterize MVC-related ED visits. Results In 2008, the NEDS contained 28,445,564 patient visits, of which 760,356 (2.7%) were due to MVCs. The NHAMCS contained 34,134 patient visits, of which 1,038 (3.0%) were due to MVCs. National estimates of MVC-related ED visits by patients 65 years and older in 2008 are 226,000 (95% CI = 210,000 to 240,000), for NEDS and 270,000 (95% CI = 185,000 to 355,000) for NHAMCS. Most older adults with MVC-related ED visits were sent home from the ED (proportion discharged NEDS 78%, 95% CI 78% to 79%; NHAMCS 77%, 95% CI 66% to 86%). During the years 2004 through 2008, of MVC-related ED visits by older adults not resulting in hospital admission, moderate or severe pain was reported in 61% (95% CI = 52% to 70%) of those with recorded pain scores. Older patients sent home after MVC-related ED visits were less likely than younger patients to receive analgesics (35%, 95% CI 26% to 43% vs. 47%, 95% CI 44% to 50%) during their ED evaluations, or as discharge prescriptions (52%, 95% CI 41% to 62% vs. 65%, 95% CI = 61% to 68%). Conclusions In 2008, adults age 65 years or older made more than 200,000 MVC-related ED visits. Approximately 80% of these visits were discharged home from the ED

  15. The Sustained Visitation Program.

    ERIC Educational Resources Information Center

    Gatto, Joseph A.

    1979-01-01

    A sustained visitation program was initiated between the Los Angeles Unified School District and the Los Angeles County Museum of Art. The program enables selected students to visit the museum on a regular basis for one semester, during which time they study, photograph, and videotape museum life and artifacts. (KC)

  16. Home Visiting Handbook.

    ERIC Educational Resources Information Center

    Jefferson County Public Schools, Lakewood, CO.

    This handbook describes the home visiting program of the Jefferson County, Colorado public schools, in which teacher assistants, under supervision of the head teacher, visit parents of the children they are responsible for in the preschool center. Section I is an overview of the goals and purpose of the program. Section II describes the program in…

  17. 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.

  18. Inside Home Visiting Programs.

    ERIC Educational Resources Information Center

    Powell, Douglas R.

    1993-01-01

    Examines the wide variation that exists among home visiting programs in their content, theory, and operation, outlining the theoretical goals and operational dimensions of such programs. Numerous home visiting programs that focus on parents of young children are highlighted. Observes that few programs have been rigorously evaluated using the…

  19. 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…

  20. 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…

  1. ED, heal thyself.

    PubMed

    Becker, Nora V; Friedman, Ari B

    2014-02-01

    Emergency department (ED) wait times have continued to worsen despite receiving considerable attention for more than 2 decades and despite the availability of a variety of methods to restructure care in a more streamlined fashion. This article offers an economic framework that abstracts away from the details of operations research to understand the fundamental disincentives to improving wait times. Hospitals that reduce wait times are financially penalized if they must provide more uncompensated care as a result. Pending changes under the Patient Protection and Affordable Care Act are considered. We find that the likely effect of the Patient Protection and Affordable Care Act's insurance expansion is to reduce this penalty for improving ED wait times. Consequently, mandating adoption of solutions to ED crowding may be unnecessary and counterproductive. If the insurance expansion is insufficient to fully solve the problem, the hospital value-based purchasing initiative should adopt wait times as a goal in its next iteration. PMID:24332901

  2. 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

  3. Well-child visits

    MedlinePlus

    ... listening to heart, breath, and stomach sounds) Heart sounds Infantile reflexes and deep tendon reflexes as the child gets older Neonatal jaundice -- first few visits only Palpation Percussion Standard ophthalmic exam Temperature measurement (see also normal body temperature ) Immunization information: ...

  4. [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

  5. 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

  6. United States Emergency Department Visits Coded for Intimate Partner Violence

    PubMed Central

    Davidov, Danielle M.; Larrabee, Hollynn; Davis, Stephen M.

    2015-01-01

    Background Limited information exists about medical treatment for victims of intimate partner violence (IPV) Objective Our aim was to estimate the number of emergency department (ED) visits and subsequent hospitalizations that were assigned a code specific to IPV and to describe the clinical and sociodemographic features of this population. Methods Data from the Nationwide Emergency Department Sample from 2006–2009 were analyzed. Cases with an external cause of injury code of E967.3 (battering by spouse or partner) were abstracted. Results From 2006–2009, there were 112,664 visits made to United States EDs with an e-code for battering by a part-ner or spouse. Most patients were female (93 %) with a mean age of 35 years. Patients were significantly more likely to reside in communities with the lowest median income quar-tile and in the Southern United States. Approximately 5% of visits resulted in hospital admission. The mean charge for treat-and-release visits was $1904.69 and $27,068.00 for hospitalizations. Common diagnoses included superficial injuries and contusions, skull/face fractures, and complications of pregnancy. Females were more likely to experience superficial injuries and contusions, and males were more likely to have open wounds of the head, neck, trunk, and extremities. Conclusions From 2006 to 2009, there were approximately 28,000 ED visits per year with an e-code specific to IPV. Although a minority, 7% of these visits were made by males, which has not been reported previously. Future prospective research should confirm the unique demographic and geographic features of these visits to guide development of targeted screening and intervention strategies to mitigate IPV and further characterize male IPV visits. PMID:25282121

  7. 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

  8. California Emergency Department Visit Rates For Medical Conditions Increased While Visit Rates For Injuries Fell, 2005–11

    PubMed Central

    Hsia, Renee Y.; Nath, Julia B.; Baker, Laurence C.

    2015-01-01

    The emergency department (ED) is the source of most hospital admissions, cares for patients with no other point of access to the health care system, receives advanced care referrals from primary care physicians, and provides surveillance data on injuries, infectious disease, violence, and adverse drug events. Understanding the changes in the profile of disease in the ED can inform emergency services administration and planning as well as provide insight into the public’s health. We analyzed the trends in the diagnoses seen in California EDs from 2005–11, finding that while the ED visit rate for injuries decreased by 0.7 percent, the rate of ED visits for non-injury diagnoses rose 13.4 percent. We also found a rise in symptom-related diagnoses, such as abdominal pain, along with nervous system disorders, gastrointestinal disease, and mental illness. These trends point out the increasing importance of EDs in providing care for complex medical cases, as well as the changing nature of illness in the population needing immediate medical attention. PMID:25847645

  9. Why Pediatric Patients with Cancer Visit the Emergency Department: United States, 2006-2010

    PubMed Central

    Mueller, Emily L; Sabbatini, Amber; Gebremariam, Achamyeleh; Mody, Rajen; Sung, Lillian; Macy, Michelle L

    2014-01-01

    BACKGROUND Little is known about emergency department (ED) use among pediatric patients with cancer. We explored reasons prompting emergency department (ED) visits and factors associated with hospital admission. PROCEDURE A retrospective cohort analysis of pediatric ED visits from 2006-2010 using the Nationwide Emergency Department Sample, the largest all-payer database of United States ED visits. Pediatric patients with cancer (ages ≤19 years) were identified using Clinical Classification Software. Proportion of visits and disposition for the top ten-ranking non-cancer diagnoses were determined. Weighted multivariate logistic regression was performed to analyze factors associated with admission versus discharge. RESULTS There were 294,289 ED visits by pediatric patients with cancer in the US over the study period. Fever and fever with neutropenia (FN) were the two most common diagnoses, accounting for almost 20% of visits. Forty-four percent of pediatric patients with cancer were admitted to the same hospital, with admission rates up to 82% for FN. Risk factors for admission were: FN (odds ratio (OR) 8.58; 95% confidence interval (CI) 5.97-12.34); neutropenia alone (OR 7.28; 95% CI 5.08-10.43), ages 0-4 years compared with 15-19 years (OR 1.19; 95% CI 1.08-1.31) and highest median household income ZIP code (OR 1.27; 95% CI 1.08-1.49) compared with lowest. “Self-pay” visits had lower odds of admission (OR 0.42; 95% CI 0.35-0.51) compared with public payer. CONCLUSION FN was the most common reason for ED visits among pediatric patients with cancer and is the condition most strongly associated with admission. Socioeconomic factors appear to influence ED disposition for this population. PMID:25345994

  10. 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

  11. 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

  12. 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

  13. Frequency of ED revisits and death among older adults after a fall

    PubMed Central

    Liu, Shan W.; Obermeyer, Ziad; Chang, Yuchiao; Shankar, Kalpana N.

    2016-01-01

    Introduction Falls among older adults (aged ≥65 years) are the leading cause of both injury deaths and emergency department (ED) visits for trauma. We examine the characteristics and prevalence of older adult ED fallers as well as the recurrent ED visit and mortality rate. Methods This was a retrospective analysis of a cohort of elderly fall patients who presented to the ED between 2005 and 2011 at two urban, level-1 trauma, teaching hospitals with approximately 80,000-95,000 annual visits. We examined the frequency of ED revisits and death at 3 days, 7 days, 30 days, and 1 year controlling for certain covariates. Results Our cohort included 21,340 patients. The average age was 78.6. An increasing proportion of patients revisited the ED over the course of a year, ranging from 2% of patients at 3 days to 25% at 1 year. Death rates increased from 1.2% at 3 days to 15% at 1 year. 10,728 (50.2%) patients returned to the ED at some point during our 7-year study period and 36% of patients had an ED revisit or death within 1 year. In multivariate logistic regression, male sex and comorbidities were associated with ED revisits and death. Conclusion Over a third of older adult ED fall patients had an ED revisit or died within one year. Falls are one of the geriatric syndromes that contribute to frequent ED revisits and death rates. Future research should determine whether falls increase the risk of such outcomes and how to prevent future fall and death. PMID:25983268

  14. Assessment of the Framingham risk factors among ED patients with newly diagnosed atrial fibrillation

    PubMed Central

    Barrett, Tyler W.; Storrow, Alan B.; Jenkins, Cathy A.; Harrell, Frank E.; Amdahl, John; Russ, Stephan; Slovis, Corey M.; Darbar, Dawood

    2010-01-01

    Study Objective Atrial fibrillation (AF) is often first diagnosed in the emergency department (ED) and accounts for nearly 1% of all ED visits. Our objective was to assess the Framingham Heart Study risk score for AF development in ED patients with newly diagnosed AF. Methods We systematically reviewed the electronic medical records of ED patients with newly diagnosed AF between August 2005 and July 2008. We measured the frequency of the Framingham Heart Study predictors and calculated each patient's risk score. Results During the 3-year study period, 914 patients had 1228 ED visits. New AF was diagnosed in 296 (32%) patients. Among these patients, 107 (36%) were female, 127 (43%) had prior ED visits since 2003, 189 (64%) were taking hypertension medications and 170 (57.4%) had previous electrocardiograms with measurable PR intervals. The median PR interval was 166 ms (151 to 180) and 60% of available PR intervals were ≥160 ms. The median (Interquartile range) age, body mass index, and systolic blood pressure were 66 years (53 to 77), 27 (23 to 31), and 134 mm Hg (118 to 151), respectively. Median risk score was 7 (3 to 9) indicating high predicted risk. Heart failure and cardiac murmurs were previously diagnosed in 45 (15%) and 32 (11%) of these patients, respectively. Conclusions The Framingham risk factors for AF are commonly encountered among ED patients with newly diagnosed AF. The ED might provide an opportunity to identify patients at high risk for AF and refer them for primary prevention interventions. PMID:21208770

  15. 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)

  16. Congressman Clyburn Visit

    ScienceCinema

    Cody, Tom

    2012-06-14

    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.

  17. 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.

  18. Home Weatherization Visit

    ScienceCinema

    Chu, Steven

    2013-05-29

    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.

  19. 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…

  20. 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

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

    PubMed

    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

  2. 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.

  3. 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

  4. Winter Temperature Inversions and Emergency Department Visits for Asthma in Salt Lake County, Utah, 2003–2008

    PubMed Central

    Beck, Celeste; Graham, Randall; Packham, Steven C.; Traphagan, Monica; Giles, Rebecca T.; Morgan, John G.

    2012-01-01

    Background: Winter temperature inversions—layers of air in which temperature increases with altitude—trap air pollutants and lead to higher pollutant concentrations. Previous studies have evaluated associations between pollutants and emergency department (ED) visits for asthma, but none have considered inversions as independent risk factors for ED visits for asthma. Objective: We aimed to assess associations between winter inversions and ED visits for asthma in Salt Lake County, Utah. Methods: We obtained electronic records of ED visits for asthma and data on inversions, weather, and air pollutants for Salt Lake County, Utah, during the winters of 2003 through 2004 to 2007 through 2008. We identified 3,425 ED visits using a primary diagnosis of asthma. We used a time-stratified case-crossover design, and conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to estimate rate ratios of ED visits for asthma in relation to inversions during a 4-day lag period and prolonged inversions. We evaluated interactions between inversions and weather and pollutants. Results: After adjusting for dew point and mean temperatures, the OR for ED visits for asthma associated with inversions 0–3 days before the visit compared with no inversions during the lag period was 1.14 (95% CI: 1.00, 1.30). The OR for each 1-day increase in the number of inversion days during the lag period was 1.03 (95% CI: 1.00, 1.07). Associations were only apparent when PM10 and maximum and mean temperatures were above median levels. Conclusions: Our results provide evidence that winter inversions are associated with increased rates of ED visits for asthma. PMID:22784691

  5. Determining the rate of follow-up after hospital emergency department visits for dental conditions

    PubMed Central

    Meyer, Beau; Adkins, Eric; Finnerty, Nathan M; Robinson, Fonda G

    2016-01-01

    Background Emergency department (ED) visits for dental reasons continue to impact EDs nationwide. This investigation determined the rate of follow-up in an emergency dental clinic (EDC) after hospital ED visits for nontraumatic dental conditions. Methods This prospective investigation reports the number of patients who presented to an ED for nontraumatic dental conditions and the rate of follow-up at an EDC. Upon ED discharge, patients were provided instructions to follow-up for low-cost care at the EDC. Telephone contact was attempted following failed referrals. Descriptive statistics were reported for comparing referral sources and demographic trends. Results Two hundred and forty-seven referrals were made and 31% followed up for definitive treatment at the EDC. More referrals were made on weekends than on weekdays. Failed referrals were unreachable by telephone in 75% of cases. Tooth extraction was the most common treatment rendered in the EDC. Of the ED patients who accessed EDC care, 14% became comprehensive patients in the EDC’s regular dental clinic. Conclusion Less than one-third of ED referrals to the EDC followed up for definitive care when provided an opportunity to do so, and 75% of referrals were unreachable by telephone in the week following the ED dental visit. PMID:27099530

  6. Timing of Emergency Department Visits for Childhood Asthma after Initial Inhaled Corticosteroid Use

    PubMed Central

    Zhang, Shun; Holloway, Kelvin; Tyler-Hill, Yasmin

    2015-01-01

    Abstract Inhaled corticosteroids can prevent acute exacerbations and emergency visits when used as part of a chronic care plan for long-term control of asthma, but low patient adherence and inadequate provider prescribing (clinical inertia) can limit these benefits. State Medicaid programs are a major source of insurance coverage for low-income children, paying for medications and preventive care, as well as bearing the cost of adverse outcomes for common chronic conditions in childhood, such as asthma. This study measured the incidence and timing of emergency department (ED) visits in the first 90 days after an initial inhaled corticosteroid prescription (ICS-Rx) among 43,156 Medicaid-enrolled children with a diagnosis of asthma in 14 southern states in 2007. One in 5 children (19.6%) with asthma had at least 1 ED visit in the first 90 days after initial ICS-Rx; 10% of these visits occurred within the first 48 hours, and 25% occurred within the first week. Continued ICS-Rx use was associated with lower risk of an ED visit. There were no racial differences in the ED visit rates. Initial ICS-Rx for Medicaid-enrolled children is a warning flag for short-term risk of asthma-related ED visits, whereas continued ICS-Rx use is protective for at least 90 days. Primary care follow-up may be needed within the first 2 days after initial ICS-Rx to prevent adverse outcomes. Medicaid programs could use claims data for surveillance of adherence to guideline-concordant therapy and for sentinel events marking windows of a higher risk for ED visits. Population Health Management 2015;18:54–60. PMID:25046059

  7. 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

  8. 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.

  9. 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 ...

  10. Community paramedics fill gaps, take load off EDs.

    PubMed

    2014-03-01

    In a continuing effort to ease demand on busy EDs, some communities are coming up with new ways to leverage paramedics. Under a three-year pilot program in Raleigh, NC, a select group of paramedics with added training are being used to assess patients with mental health or addiction problems and transfer them to alternative facilities when appropriate. In Robbinsdale, MN, a community paramedicine program is filling in care gaps for patients with chronic diseases and other complaints who are at risk for repeat ED visits or inpatient hospitalizations. * Administrators of the Raleigh, NC, program say that in 2013, paramedics diverted more than 300 patients to alternative facilities. Of these, only 20% to 25% need further transport to the hospital. * Every time the NC paramedics divert a patient from the ED to an alternative facility, they return an estimated 14 bed-hours back to the ED. * In addition to responding to patients with non-urgent needs, the Robbinsdale, MN, community paramedicine program is a referral source for ED physicians who are concerned about follow-up care for patients who have presented to the ED with medical problems that require ongoing attention. PMID:24640290

  11. Emergency Department Charges for Asthma-Related Outpatient Visits by Insurance Status

    PubMed Central

    Wang, Tiffany; Srebotnjak, Tanja; Brownell, Julia; Hsia, Renee Y.

    2014-01-01

    Though Americans make 1.8 million asthma-related outpatient visits to the emergency department (ED) annually, little is known about the episodic charges for asthma care in the ED. We therefore sought to assess the bills patients could face for acute asthma incidents by examining hospital charges for asthma-related outpatient ED visits. We performed a nationwide, cross-sectional study of 2.9 million weighted asthma-related outpatient ED visits from 2006–2008 using data from the Medical Expenditure Panel Survey. We found that the average charge for an outpatient ED visit was $1,502 (95% CI $1,493–$1,511). The charges did not vary significantly by insurance group but did increase significantly with age. Our results indicate that the financial burden of ED care for asthma may take a severe toll on low-income populations who have limited ability to pay, especially patients who must pay undiscounted charges, including the uninsured and those on high-deductible health plans. PMID:24509034

  12. 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

  13. Influence of Climate on Emergency Department Visits for Syncope: Role of Air Temperature Variability

    PubMed Central

    Galli, Andrea; Barbic, Franca; Borella, Marta; Costantino, Giorgio; Perego, Francesca; Dipaola, Franca; Casella, Francesco; Duca, Pier Giorgio; Diedrich, Andrè; Raj, Satish; Robertson, David; Porta, Alberto; Furlan, Raffaello

    2011-01-01

    Background Syncope is a clinical event characterized by a transient loss of consciousness, estimated to affect 6.2/1000 person-years, resulting in remarkable health care and social costs. Human pathophysiology suggests that heat may promote syncope during standing. We tested the hypothesis that the increase of air temperatures from January to July would be accompanied by an increased rate of syncope resulting in a higher frequency of Emergency Department (ED) visits. We also evaluated the role of maximal temperature variability in affecting ED visits for syncope. Methodology/Principal Findings We included 770 of 2775 consecutive subjects who were seen for syncope at four EDs between January and July 2004. This period was subdivided into three epochs of similar length: 23 January–31 March, 1 April–31 May and 1 June–31 July. Spectral techniques were used to analyze oscillatory components of day by day maximal temperature and syncope variability and assess their linear relationship. There was no correlation between daily maximum temperatures and number of syncope. ED visits for syncope were lower in June and July when maximal temperature variability declined although the maximal temperatures themselves were higher. Frequency analysis of day by day maximal temperature variability showed a major non-random fluctuation characterized by a ∼23-day period and two minor oscillations with ∼3- and ∼7-day periods. This latter oscillation was correlated with a similar ∼7-day fluctuation in ED visits for syncope. Conclusions/Significance We conclude that ED visits for syncope were not predicted by daily maximal temperature but were associated with increased temperature variability. A ∼7-day rhythm characterized both maximal temperatures and ED visits for syncope variability suggesting that climate changes may have a significant effect on the mode of syncope occurrence. PMID:21818372

  14. 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

  15. ACOs: time for ED managers to get involved, shape how their departments will add value.

    PubMed

    2011-06-01

    Even with a proposed rule outlining how accountable care organizations (ACO) will be structured under fee-for-service Medicare, emergency medicine experts are concerned about how ACOs will impact patient access to the ED. Further, some see a clear need to beef-up case management staff, while others say ED managers need to get involved with ACO-development now so their interests and concerns are represented. Under a proposed rule unveiled by the Department of Health and Human Services, a handful of quality indicators will require the tracking of ED visits related to certain ambulatory care-sensitive conditions; experts say it could be a challenge for ED staff to differentiate between appropriate and inappropriate use of the ED. EDs that figure out how to contribute value under the ACO mission will be better positioned to prosper under the new model. The ACO model is likely to add considerable complexity to billing and reimbursement. PMID:21675150

  16. 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. PMID:25911437

  17. 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

  18. 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,…

  19. What Is Ag-Ed?

    ERIC Educational Resources Information Center

    Lindley, Judy

    Ag-Ed is an agricultural education project aimed at upper primary students, held in conjunction with the Toowoomba Show (similar to a county fair) in Queensland, Australia. The program achieves its purpose of helping children understand the impact and relevance that agriculture has on their everyday lives through two components, an Ag-Ed day and a…

  20. 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

  1. Sensing kuuki among visiting nurses.

    PubMed

    Shimamura, Atsuko; Suwa, Sayuri; Tsujimura, Mayuko

    2016-04-01

    This study aimed to explore how visiting nurses in Japan sense Kuuki (mood or atmosphere) in the homes of patients and families. Participants were 15 Japanese visiting nurses with experience sensing kuuki in homes of patients and families. Data were collected through two 90 min focus group interviews with experienced visiting nurses, and a qualitative content analysis was performed. The qualitative analysis showed that experienced visiting nurses sensed kuuki in eight ways. Kuuki differs based on type of illness, state of health and number of visits. Sensitivity to kuuki is thought to be linked to understanding of patient and family feelings, changes in the physical condition of patients and evaluation of nursing care delivery. Perception of kuuki also contributes to care planning especially on the very first home visit and when visiting terminally ill patients. PMID:27184700

  2. 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

  3. 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…

  4. Single Visit versus Multiple Visit Root Canal Therapy

    PubMed Central

    Singla, Rajesh; Marwah, Nikhil; Dutta, Samir

    2008-01-01

    Aim: The purpose of this study was to determine clinical success rate of single visit verses multiple visit root canal treatment in cariously exposed vital primary molars. Material& methods: 40 children in age group of 4 to 7 years were divided equally into two treatment groups and recall visits were carried out after one week, one month and three months and six months. Results: Statistically no significant difference was found. Conclusion: Multiple visit and single visit root canal treatment demonstrated almost equal success but most important aspect for success in pulpectomy cases is the indication of each case and then its subsequent treatment, be it multiple or single visit root canal treatment. PMID:25206084

  5. 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

  6. 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

  7. 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. PMID:11992333

  8. Dispelling myths about emergency department use: majority of Medicaid visits are for urgent or more serious symptoms.

    PubMed

    Sommers, Anna S; Boukus, Ellyn R; Carrier, Emily

    2012-07-01

    Contrary to conventional wisdom that Medicaid patients often use hospital emergency departments (EDs) for routine care, the majority of ED visits by nonelderly Medicaid patients are for symptoms suggesting urgent or more serious medical problems, according to a new national study by the Center for Studying Health System Change (HSC). About 10 percent of nonelderly Medicaid patient ED visits are for nonurgent symptoms, compared with about 7 percent for privately insured nonelderly people. Nonetheless, there are clearly opportunities to develop less-costly care options than emergency departments for both nonelderly Medicaid and privately insured patients. To reduce ED use, policy makers might consider how to encourage development of care settings that can quickly handle a high volume of potentially urgent medical problems. Policy makers may want to focus initially on conditions that account for high ED volume that could likely be treated in less resource-intensive settings. For example, diagnoses of acute respiratory and other common infections in children and injuries together account for about 53 percent of ED visits by children aged 0 to 12 covered by Medicaid and almost 60 percent of ED visits by privately insured children aged 0 to 12. While some infections and injuries will be too serious to treat elsewhere, lower-cost settings that can provide a moderate intensity of care and urgent response time likely could reduce emergency department use. PMID:22787720

  9. School's in Session: Visitation Day.

    ERIC Educational Resources Information Center

    Hulbert, Barbara T.

    1997-01-01

    Describes a parent program at Dryden Middle School in New York in which parents attend school for the entire day with their children. Includes information on parent orientation, structure of the visit, and students' reactions to parental visitation. Notes the importance of publicity, preparation, organization, and follow-up activities for program…

  10. STS-124 crew visits Stennis

    NASA Technical Reports Server (NTRS)

    2008-01-01

    NASA's John C. Stennis Space Center Deputy Director Gene Goldman (center) welcomed members of the STS-124 Discovery space shuttle crew during their July 23 visit to the center. Crew members who visited Stennis were (l to r) Pilot Ken Ham, Mission Specialist Karen Nyberg, Kelly, and Mission Specialists Ron Garan and Mike Fossum.

  11. 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…

  12. Effects of Using a Neuroeducational Intervention to Enhance Perseverance for Online EdD and EdS Students

    ERIC Educational Resources Information Center

    Cadle, Charles R.

    2013-01-01

    Developing and maintaining a "completion mindset" is a necessary mental condition for online educational doctorate (EdD) and educational specialist (EdS) students to obtain their advanced degrees. The purpose of this research study was to examine the effect of a neuroeducational intervention on a volunteer convenience sample of EdD and…

  13. 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

  14. 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

  15. Demographic Comparison of Burn Emergency Only Visits and Admissions in an Urban Burn Center.

    PubMed

    Kowal-Vern, Areta; Bokhari, Faran; Poulakidas, Stathis

    2016-01-01

    There are few publications about demographics of Emergency Department (ED) burn patient visits. The purpose of this study was to compare ED only burn patients with admitted patients in an urban burn center. This was a retrospective review (1999 to 2014) of a burn unit patient registry. Patients were seen either in the Emergency Room or Trauma Bay (ED-TB) by staff, who determined whether the patient required admission or not. During this period, of the 5936 burn injury ED-TB encounters, there were 3754 (63%) admissions and 2182 (37%) ED-TB only (evaluation and discharge) visits. The median age was 30 years, and the %TBSA in the ED-TB only versus admitted patients was 1% vs 4% TBSA, P < .0001. Both groups had mainly scalding injuries in the kitchen. The majority of the ED-TB only patients presented with upper extremity burns (40%), whereas admitted patients had burns in multiple areas (49%). Most of the ED-TB only patients (73%) came to the hospital themselves, 23% were transferred from other hospitals, and 2% each, direct from the scene and clinic. In contrast, 53% of admitted patients were transferred from other hospitals, 29% came in on their own, and 11% were brought in direct from the scene, or from the burn clinic (7%), P = .0001. This review suggests that the main reason for non-admission of ED-TB only patients was the severity of injury; ED-TB only patients had a significantly less severe %TBSA (P < .0001), and fewer comorbidities compared to admitted patients. PMID:25423441

  16. Crohn's Disease: The First Visit

    PubMed Central

    Farraye, Francis A.

    2011-01-01

    A Crohn's disease patient's first visit to a new practice is the optimal time to collect important clinical data and identify appropriate therapies. A methodologic approach to this visit is crucial. The focus of this visit should be on preparing the patient for the initiation of treatment, with particular attention to the necessary steps prior to the use of immunosuppressive and biologic agents. This paper is intended to provide recommendations and a checklist for the initial assessment and evaluation of patients with Crohn's disease. PMID:21528042

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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…

  2. 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

  3. 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...

  4. 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 ...

  5. 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.

  6. 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…

  7. AGU Members Visit Capitol Hill

    NASA Astrophysics Data System (ADS)

    Von Holle, Kate

    2007-06-01

    More than 200 scientists and engineers from around the United States convened in Washington, D.C., on 1-2 May 2007 to participate in the annual Science Engineering and Technology (SET) Congressional Visits Day (CVD). The AGU Office of Public Affairs frequently helps to arrange for members' visits to their congressional delegations, but CVD is a unique event during which AGU members can team up with a larger group of scientists and engineers to promote federal funding of scientific research.

  8. 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.

  9. 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…

  10. 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

  11. 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

  12. 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

  13. 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…

  14. 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

  15. Virtual visits for Parkinson disease

    PubMed Central

    Venkataraman, Vinayak; Donohue, Sean J.; Biglan, Kevin M.; Wicks, Paul

    2014-01-01

    Summary We sought to characterize recommendations and feedback of patients with Parkinson disease, each offered a free telemedicine consultation with a specialist. Visits consisted of history, neurologic examination, and recommendations. Midway through the program, patients were asked to complete an online satisfaction survey. From August 2012 to May 2013, 55 patients in 5 states (mean age 67.8 years) participated, with 80% of visits conducted from their home. Patients with Parkinson disease were recommended to exercise (86%), change current medication (63%), and add new medication (53%). Thirty-three of 35 consecutive patients completed a survey. Patient satisfaction exceeded 90% for virtually all aspects of the visit measured. Providing care to patients in their homes via telemedicine is feasible, results in changes to care, and is well-received. PMID:24790799

  16. Grandparent Visitation Rights: Successful Acquisition of Court-Ordered Visitation

    ERIC Educational Resources Information Center

    Henderson, Tammy L.

    2005-01-01

    The author examined 65 cases in which grandparents successfully acquired court-ordered visitation with their grandchildren to understand how courts shape family development and how social scientists might support families who are engaged in legal disputes. Using grounded theory methods, two categories explained grandparents' success at acquiring…

  17. 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. PMID:21683915

  18. 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/.

  19. Redesigning physician compensation and improving ED performance.

    PubMed

    Finkelstein, Jeff; Lifton, James; Capone, Claudio

    2011-06-01

    Redesigning a physician compensation system in the emergency department (ED) should include goals of improving quality, productivity, and patient satisfaction. Tips for hospital administrators: A contemporary ED information system is needed to ensure that the ED is essentially a paperless operation. Transparency, internally and externally, is essential. ED physicians should perform as individuals, yet as members of a team. Incentives, especially incentive compensation, should strike a balance between individual and team performance. PMID:21692383

  20. Screening for Violence Risk Factors Identifies Young Adults at Risk for Return Emergency Department Visit for Injury

    PubMed Central

    Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra

    2014-01-01

    Introduction: Homicide is the second leading cause of death among youth aged 15–24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED) visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. Methods: This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18–24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3–5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a) aggression, b) perceived likelihood of violence, c) recent violent behavior, d) peer behavior, e) community exposure to violence, and f) positive future outlook. At 12 months following the initial ED visit, the participants' medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chi-square and logistic regression analyses. Results: Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants' average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first visit, return

  1. 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

  2. 10 CFR 25.35 - Classified visits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Classified visits. 25.35 Section 25.35 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Classified Visits § 25.35 Classified visits. (a) The number of classified visits must be held to a minimum. The licensee, certificate holder, applicant for a...

  3. 10 CFR 25.35 - Classified visits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Classified visits. 25.35 Section 25.35 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Classified Visits § 25.35 Classified visits. (a) The number of classified visits must be held to a minimum. The licensee, certificate holder, applicant for a...

  4. 10 CFR 25.35 - Classified visits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Classified visits. 25.35 Section 25.35 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Classified Visits § 25.35 Classified visits. (a) The number of classified visits must be held to a minimum. The licensee, certificate holder, applicant for a...

  5. 10 CFR 25.35 - Classified visits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Classified visits. 25.35 Section 25.35 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Classified Visits § 25.35 Classified visits. (a) The number of classified visits must be held to a minimum. The licensee, certificate holder, applicant for a...

  6. 10 CFR 25.35 - Classified visits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Classified visits. 25.35 Section 25.35 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Classified Visits § 25.35 Classified visits. (a) The number of classified visits must be held to a minimum. The licensee, certificate holder, applicant for a...

  7. 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...

  8. The Visiting Teacher in Texas Public Schools.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin. Div. of Guidance Services.

    This brochure sketches the range of services provided by visiting teachers in the Texas Public Schools and offers suggestions for establishing a visiting teacher program in other school systems. The rationale for the visiting teacher program is outlined first followed by an explanation of who the visiting teacher is. Twenty functions of the…

  9. 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...

  10. Identification of high-risk patients with acute coronary syndrome using point-of-care echocardiography in the ED.

    PubMed

    Frenkel, Oron; Riguzzi, Christine; Nagdev, Arun

    2014-06-01

    Stratifying risk of patients with acute coronary syndrome (ACS) in the emergency department (ED) remains a frequent challenge. When ST-elevation criteria are absent, current recommendations rely upon insensitive and time-intensive methods such as the electrocardiogram and cardiac enzyme testing. Here, we report on a series of cases, where emergency physicians used a simplified model for identifying regional wall motion abnormalities by point-of-care echocardiography in patients presenting with chest pain to the ED. With the use of a simplified model described herein, high-risk patients with ACS were identified rapidly in a cohort usually difficult to risk stratify. PMID:24745875

  11. School Visits: The Author's Viewpoint.

    ERIC Educational Resources Information Center

    Miles, Betty; Avi

    1987-01-01

    Two authors of children's books discuss the elements of a successful school visit, including how to select and contact an author; fees; choosing dates; having books available; planning collaboratively with authors, principals, teachers, and parents; organizing the schedule; the author as critic; publicity; travel plans; autographs; and follow-up.…

  12. 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…

  13. 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…

  14. Emergency department visits, ambulance calls, and mortality associated with an exceptional heat wave in Sydney, Australia, 2011: a time-series analysis

    PubMed Central

    2012-01-01

    Background From January 30-February 6, 2011, New South Wales was affected by an exceptional heat wave, which broke numerous records. Near real-time Emergency Department (ED) and ambulance surveillance allowed rapid detection of an increase in the number of heat-related ED visits and ambulance calls during this period. The purpose of this study was to quantify the excess heat-related and all-cause ED visits and ambulance calls, and excess all-cause mortality, associated with the heat wave. Methods ED and ambulance data were obtained from surveillance and administrative databases, while mortality data were obtained from the state death registry. The observed counts were compared with the average counts from the same period from 2006/07 through 2009/10, and a Poisson regression model was constructed to calculate the number of excess ED visits, ambulance and deaths after adjusting for calendar and lag effects. Results During the heat wave there were 104 and 236 ED visits for heat effects and dehydration respectively, and 116 ambulance calls for heat exposure. From the regression model, all-cause ED visits increased by 2% (95% CI 1.01-1.03), all-cause ambulance calls increased by 14% (95% CI 1.11-1.16), and all-cause mortality increased by 13% (95% CI 1.06-1.22). Those aged 75 years and older had the highest excess rates of all outcomes. Conclusions The 2011 heat wave resulted in an increase in the number of ED visits and ambulance calls, especially in older persons, as well as an increase in all-cause mortality. Rapid surveillance systems provide markers of heat wave impacts that have fatal outcomes. PMID:22273155

  15. ACS Quicklook PDF products

    NASA Astrophysics Data System (ADS)

    Suchkov, Anatoly

    1999-12-01

    This report details the features of the ACS quicklook PDF products produced by the HST data pipeline. The requirements closely follow the design of paper products recommended by the Data Quality Committee, with appropriate changes required to fully support ACS.

  16. 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

  17. A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010

    PubMed Central

    Macpherson, Alison; Fridman, Liraz; Scolnik, Michal; Corallo, Ashley; Guttmann, Astrid

    2014-01-01

    BACKGROUND: There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits. OBJECTIVE: To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs. METHODS: A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted. RESULTS: The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions. CONCLUSIONS: The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs. PMID:25587234

  18. STS-128 crew visits Stennis

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Astronauts C.J. Sturckow (seated, left) and Pat Forrester (seated, right) sign autographs during their Oct. 7 visit to Stennis Space Center. The astronauts visited the rocket engine testing facility to thank Stennis employees for contributions to their recent STS-128 space shuttle mission. All three of the main engines used on the mission were tested at Stennis. Sturckow served as commander for the STS-128 flight; Forrester was a mission specialist. During a 14-day mission aboard space shuttle discovery, the STS-128 crew delivered equipment and supplies to the International Space Station, including science and storage racks, a freezer to store research samples, a new sleeping compartment and an exercise treadmill. The mission featured three spacewalks to replace experiments and install new equipment at the space station.

  19. Mississippi lieutenant governor visits Stennis

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Stennis Space Center Director Gene Goldman (left) stands with Mississippi Lt. Gov. Phil Bryant at the A-3 Test Stand construction site during an Oct. 1 visit by the state official. During his tour, Bryant was updated on construction of the first large test stand at Stennis since the 1960s. The A-3 stand will be used to conduct simulated high-altitude testing on the next generation of rocket engines that will take humans back to the moon and possibly beyond. In addition to touring Stennis facilities, Bryant visited the INFINITY Science Center construction site, where he was updated on work under way to construct a 72,000-square-foot facility that will showcase the science underpinning the missions of NASA and resident agencies at Stennis.

  20. 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

  1. Mount Sinai leverages smartphone technology, aiming to boost care, coordination of ED patients while also trimming costs.

    PubMed

    2015-05-01

    Mount Sinai Hospital in New York, NY, is using smartphone technology to enhance follow-up calls to senior patients who have visited the ED, and to help provide acute-level care to select patients in their own homes. Investigators are hoping to show that these approaches can improve care and coordination while trimming costs, and they expect that patients will approve of these new approaches as well. While senior patients are still in the ED, nurse coordinators will work with them to load a HIPAA-compliant application to their smartphones so they can conduct face-to-face follow-up calls that meet HIPAA standards. Nurses say the face-to-face communications enhance their ability to assess how patients are doing following their ED visit. The hospital is also testing a program that enables some ED patients who meet inpatient criteria to receive this care in the home setting through the use of a mobile acute care team (MACT). In the case of emergencies, the MACT team relies on community paramedics who will visit the patients' homes and provide care under the direction of MACT physicians who are linked in to these visits via smartphone technology. PMID:25932496

  2. Arctic Visiting Speakers Series (AVS)

    NASA Astrophysics Data System (ADS)

    Fox, S. E.; Griswold, J.

    2011-12-01

    The Arctic Visiting Speakers (AVS) Series funds researchers and other arctic experts to travel and share their knowledge in communities where they might not otherwise connect. Speakers cover a wide range of arctic research topics and can address a variety of audiences including K-12 students, graduate and undergraduate students, and the general public. Host applications are accepted on an on-going basis, depending on funding availability. Applications need to be submitted at least 1 month prior to the expected tour dates. Interested hosts can choose speakers from an online Speakers Bureau or invite a speaker of their choice. Preference is given to individuals and organizations to host speakers that reach a broad audience and the general public. AVS tours are encouraged to span several days, allowing ample time for interactions with faculty, students, local media, and community members. Applications for both domestic and international visits will be considered. Applications for international visits should involve participation of more than one host organization and must include either a US-based speaker or a US-based organization. This is a small but important program that educates the public about Arctic issues. There have been 27 tours since 2007 that have impacted communities across the globe including: Gatineau, Quebec Canada; St. Petersburg, Russia; Piscataway, New Jersey; Cordova, Alaska; Nuuk, Greenland; Elizabethtown, Pennsylvania; Oslo, Norway; Inari, Finland; Borgarnes, Iceland; San Francisco, California and Wolcott, Vermont to name a few. Tours have included lectures to K-12 schools, college and university students, tribal organizations, Boy Scout troops, science center and museum patrons, and the general public. There are approximately 300 attendees enjoying each AVS tour, roughly 4100 people have been reached since 2007. The expectations for each tour are extremely manageable. Hosts must submit a schedule of events and a tour summary to be posted online

  3. 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.

  4. Media campaign educates public on ED overcrowding.

    PubMed

    2004-04-01

    A Tennessee health care system is reducing overcrowding in its EDs with a media campaign that urges patients with nonurgent needs to seek other care options. The campaign has contributed to a 5% decrease in ED volume at one hospital in the first few months. Advertising spots urge patients to go to primary care physicians and urgent care clinics. ED staff help educate patients while treating them for nonurgent needs. PMID:15077530

  5. 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

  6. 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

  7. Test of Filter Wheel Flight Software Update {ACS}

    NASA Astrophysics Data System (ADS)

    Cox, Colin

    2003-07-01

    This test will be run following the installation of a flight software change which will position the filter wheels more accurately. It incorporates an ACS anneal and will substitute for one of the routine anneals that are carried out every four weeks. A series of internal flats will be taken with several filters. The exposures will be just long enough to obtain engineering data concerning the wheel positions. One external earth flat will also be taken to provide visual confirmation that the filter is correctly aligned. In the event of a problem being found, an operations request will be issued to revert to the original software. There are several requirements affecting timing and real-time contact. 1. Visit 1 must be scheduled to start within 12 hours of an SMS boundary. 2. Engineering telemetry contact must be available during visits 4, 5 and 6 3. An uplink opportunity must be available, at least 30 minutes after execution of the test, i.e. completion of visits 4, 5 and 6 {visit 7 should have several orbit gap from the last of 4, 5 and 6. 4. Visit 7 may not proceed, nor may any other ACS observation take place after the start of visit 1 until the uplink opportunity has occurred.

  8. 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...

  9. 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…

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 42 CFR 409.48 - Visits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... care, only one visit may be covered. (4) A visit is initiated with the delivery of covered home health services and ends at the conclusion of delivery of covered home health services. In those circumstances in... 42 Public Health 2 2012-10-01 2012-10-01 false Visits. 409.48 Section 409.48 Public Health...

  15. 42 CFR 409.48 - Visits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... care, only one visit may be covered. (4) A visit is initiated with the delivery of covered home health services and ends at the conclusion of delivery of covered home health services. In those circumstances in... 42 Public Health 2 2011-10-01 2011-10-01 false Visits. 409.48 Section 409.48 Public Health...

  16. 42 CFR 409.48 - Visits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... care, only one visit may be covered. (4) A visit is initiated with the delivery of covered home health services and ends at the conclusion of delivery of covered home health services. In those circumstances in... 42 Public Health 2 2010-10-01 2010-10-01 false Visits. 409.48 Section 409.48 Public Health...

  17. 42 CFR 409.48 - Visits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... care, only one visit may be covered. (4) A visit is initiated with the delivery of covered home health services and ends at the conclusion of delivery of covered home health services. In those circumstances in... 42 Public Health 2 2014-10-01 2014-10-01 false Visits. 409.48 Section 409.48 Public Health...

  18. 42 CFR 409.48 - Visits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... care, only one visit may be covered. (4) A visit is initiated with the delivery of covered home health services and ends at the conclusion of delivery of covered home health services. In those circumstances in... 42 Public Health 2 2013-10-01 2013-10-01 false Visits. 409.48 Section 409.48 Public Health...

  19. 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). PMID:27241347

  20. 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.

  1. 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

  2. Linking pollinator visitation rate and pollen receipt.

    PubMed

    Cayenne Engel, E; Irwin, Rebecca E

    2003-11-01

    The majority of flowering plants require animals for pollination, a critical ecosystem service in natural and agricultural systems. However, quantifying useful estimates of pollinator visitation rates can be nearly impossible when pollinator visitation is infrequent. We examined the utility of an indirect measure of pollinator visitation, namely pollen receipt by flowers, using the hummingbird-pollinated plant, Ipomopsis aggregata (Polemoniaceae). Our a priori hypothesis was that increased pollinator visitation should result in increased pollen receipt by stigmas. However, the relationship between pollinator visitation rate and pollen receipt may be misleading if pollen receipt is a function of both the number of pollinator visits and variation in pollinator efficiency at depositing pollen, especially in the context of variable floral morphology. Therefore, we measured floral and plant characters known to be important to pollinator visitation and/or pollen receipt in I. aggregata (corolla length and width and plant height) and used path analysis to dissect and compare the effect of pollinator visitation rate vs. pollinator efficiency on pollen receipt. Of the characters we measured, pollinator visitation rate (number of times plants were visited multiplied by the mean percentage of flowers probed per visit) had the strongest direct positive effect on pollen receipt, explaining 36% of the variation in pollen receipt. Plant height had a direct positive effect on pollinator visitation rate and an indirect positive effect on pollen receipt. Despite the supposition that floral characters would directly affect pollen receipt as a result of changes in pollinator efficiency, corolla length and width only weakly affected pollen receipt. These results suggest a direct positive link between pollinator visitation rate and pollen receipt across naturally varying floral morphology in I. aggregata. Understanding the relationship between pollinator visitation rate and pollen

  3. 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.

  4. 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

  5. Gall's visit to The Netherlands.

    PubMed

    Eling, Paul; Draaisma, Douwe; Conradi, Matthijs

    2011-04-01

    In March 1805, Franz Joseph Gall left Vienna to start what has become known as his cranioscopic tour. He traveled through Germany, Denmark, and The Netherlands. In this article, we will describe his visit to The Netherlands in greater detail, as it has not yet received due attention. Gall was eager to go to Amsterdam because he was interested in the large collection of skulls of Petrus Camper. Gall presented a series of lectures, reports of which can be found in a local newspaper and in a few books, published at that time. We will summarize this material. We will first outline developments in the area of physiognomy, in particular in The Netherlands, and what the Dutch knew about Gall's doctrine prior to his arrival. We will then present a reconstruction of the contents of the lectures. Finally, we will discuss the reception of his ideas in the scientific community. PMID:21480037

  6. Visits to La Plata Observatory

    NASA Astrophysics Data System (ADS)

    Feinstein, A.

    1985-03-01

    La Plata Observatory will welcome visitors to ESO-La Silla that are willing to make a stop at Buenos Aires on their trip to Chile or on their way back. There is a nice guesthouse at the Observatory that can be used, for a couple of days or so, by astronomers interested in visiting the Observatory and delivering talks on their research work to the Argentine colleagues. No payments can, however, be made at present. La Plata is at 60 km from Buenos Aires. In the same area lie the Instituto de Astronomia y Fisica dei Espacio (IAFE), in Buenos Aires proper, and the Instituto Argentino de Radioastronomia (IAR). about 40 km from Buenos Aires on the way to La Plata. Those interested should contacl: Sr Decano Prof. Cesar A. Mondinalli, or Dr Alejandro Feinstein, Observatorio Astron6mico, Paseo dei Bosque, 1900 La Plata, Argentina. Telex: 31216 CESLA AR.

  7. 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

  8. 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

  9. Child-focused single home visiting.

    PubMed

    Byrd, M E

    1997-10-01

    Home visiting is a central, long-standing, and yet theoretically underdeveloped public health nursing process. The general aim of this study was to expand and refine a preliminary model of home visiting. A stylized field research investigation was conducted in the area of maternal-child health with one nurse in a visiting nurse association in New England. A specific type of home visiting, identified as child focused, emerged, with phases labeled as surveying and designating; selling and scheduling; approaching the home and the visit; entering the home; gaining permission to ask questions and access the infant--starting with the mother's expressed concerns; making the caregiving judgment--asking questions and weighing and examining the infant; and ending the visit. "Haunting and telling" was an additional phase for certain visits. The nurse conducted child-focused home visiting in three patterns. The single pattern is described in this article. Potential maternal, child, interactive, and environmental consequences were identified, as were factors influencing the process of maternal-child home visiting. Social exchange theory emerged as useful in describing how the nurse initiated, maintained, and ended the home visiting process, and in describing attendant client consequences. PMID:9342923

  10. Mechanical Ventilation and ARDS in the ED

    PubMed Central

    Mohr, Nicholas M.; Miller, Christopher N.; Deitchman, Andrew R.; Castagno, Nicole; Hassebroek, Elizabeth C.; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H.

    2015-01-01

    BACKGROUND: There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. METHODS: This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. RESULTS: We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. CONCLUSIONS: Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov PMID:25742126

  11. 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

  12. 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

  13. 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

  14. 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

  15. Expedition 7 Crew Interview: Ed Lu

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Ed Lu of Expedition Seven is seen during a pre-launch interview. He explains why he became interested in space flight. He states that this is a different type of mission and gives his reaction to the Columbia Space Shuttle tragedy. The handover of Expedition six is explained by Ed Lu. The challenges of this mission are also described by Lu. These challenges include working with a crew member reduction from three to two, and the conservation of clothing and consumables. Ed Lu talks about what it is like to work with commander Yuri Malenchenko in space. Finally, Ed Lu states that he will continue scientific experiments in space on calcium loss in bones.

  16. 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.

  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. 'Mystery shoppers' can uncover ED weaknesses.

    PubMed

    2006-12-01

    One veteran "mystery shopper" has uncovered several common ED practices that can hurt patient satisfaction. You can learn from her observations to improve your ED's customer service: Be sure to let all of your patients know how long they might expect to wait before seeing a doctor. Wash your hands where the patient can see you, so they can be confident you are practicing good hygiene. Clearly explain all forms and discharge instructions to help ensure patient compliance. PMID:17209484

  19. 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.

  20. 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

  1. 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…

  2. 28 CFR 540.62 - Institutional visits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 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...

  3. 28 CFR 540.62 - Institutional visits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 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...

  4. 28 CFR 540.62 - Institutional visits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 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...

  5. Visual Spreadsheets in VisIt

    SciTech Connect

    Whitlock, B; Childs, H

    2007-02-05

    The VACET team would like to add visual spreadsheeting capability to the visualization tool VisIt, to make it be a viable tool for current users of AMRVis and ChomboVis. This document describes AMRVis and ChomboVis approaches to visual spreadsheets and describes a proposed visual spreadsheet mechanism for VisIt.

  6. 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…

  7. Economic Evaluation of Home Visiting Programs.

    ERIC Educational Resources Information Center

    Barnett, W. Steven

    1993-01-01

    Reviews important factors relevant to measuring the costs and outcomes of home visiting programs and examines six cost-benefit studies of such programs. Concludes that these studies demonstrate the feasibility of economic evaluation of home visiting and the importance of the insights it can produce. (MDM)

  8. Child-Visiting and Domestic Abuse.

    ERIC Educational Resources Information Center

    Shepard, Melanie

    1992-01-01

    Explains problems with child visiting in cases of domestic abuse. Data on domestic abuse, child care concerns, and child adjustment problems were collected from 25 mothers and 22 fathers at a child visiting program serving separated and abusive families. Psychological abuse of mothers correlated with child adjustment problems. (BB)

  9. 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…

  10. 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,…

  11. 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...

  12. 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...

  13. 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…

  14. 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...

  15. 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.

  16. ACS Symposium Support

    SciTech Connect

    Kenneth D. Jordan

    2010-02-20

    The funds from this DOE grant were used to help cover the travel costs of five students and postdoctoral fellows who attended a symposium on 'Hydration: From Clusters to Aqueous Solutions' held at the Fall 2007 American Chemical Society Meeting in Boston, MA, August 19-23. The Symposium was sponsored by the Physical Chemistry Division, ACS. The technical program for the meeting is available at http://phys-acs.org/fall2007.html.

  17. Clinical and economic characteristics of emergency department visits due to acetaminophen toxicity in the USA

    PubMed Central

    Altyar, Ahmed; Kordi, Lama; Skrepnek, Grant

    2015-01-01

    Objectives To estimate the number of acetaminophen (APAP) toxicity-related emergency department (ED) visits, and to assess their associated clinical and economic burden in the USA from 2006 to 2010. Design Cross-sectional, retrospective, large-scale database study. Setting Non-federal, non-rehabilitation, community EDs in the USA. Participants Inclusion criteria included any listed diagnosis identifying poisoning by aromatic analgesics paracetamol/APAP or associated supplementary code. Generalised linear models were used to investigate the association between outcomes of inpatient admission, mortality, requirement of invasive mechanical ventilation, charges and inpatient lengths of stay based on patient, hospital and clinical characteristics. Results Across the 625.2 million ED visits in the USA from 2006 to 2010, 411 811 APAP-related toxicity ED visits were observed, with 45.5% resulting in inpatient admission, 4.7% requiring invasive mechanical ventilation and 0.6% involving death. Overall, the incidence proportion was 27.10 per 100 000 US population, exceeding 70 per 100 000 at age 2 years and ages 16–18 years. The total national bill was $1.06 billion per year (US$ 2014), and predominantly involved females (65.5%) and intentional self-harm (58.4%), which were notably higher within the 12–20 years age category (female12–20 years=74.8%, intentional self-harm12–20 years=71.4%). Behavioural and mental health comorbidities were relatively common and associated with an increased relative risk of admission and likelihood of charges almost entirely across all age categories of ≥12 years within the multivariable analyses. The number of ED visits did not appreciably change over time, decreasing by <2% from 2006 to 2010 (n=1351). Multivariable results also suggested no consistent change in outcomes across the study's time horizon. Conclusions A substantial public health impact of APAP toxicity-related cases was observed in the US from 2006 to

  18. Evaluation Study of the Exploratory Visit: An Innovative Outreach Activity of the ILGWU's Friendly Visiting Program

    ERIC Educational Resources Information Center

    Wright, Holly; And Others

    1977-01-01

    The exploratory visit to recent retirees, an outreach component of the International Ladies Garment Workers Union Friendly Visiting Program, was evaluated. A post-test only control group effect study revealed exploratory visits were effective in establishing a link between the program and the retiree. (Author)

  19. 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

  20. Brief Intervention for Drug Users Presenting in Emergency Departments (NIDA CTN Protocol 0047: SMART-ED)

    PubMed Central

    Bogenschutz, Michael P.; Donovan, Dennis M.; Mandler, Raul N.; Perl, Harold I.; Forcehimes, Alyssa A.; Crandall, Cameron; Lindblad, Robert; Oden, Neal L.; Sharma, Gaurav; Metsch, Lisa; Lyons, Michael S.; McCormack, Ryan; Konstantopoulos, Wendy Macias; Douaihy, Antoine

    2014-01-01

    IMPORTANCE Medical treatment settings such as Emergency Departments (EDs) present important opportunities to address problematic substance use. Currently, EDs do not typically intervene beyond acute medical stabilization. OBJECTIVE To contrast the effects of a brief intervention with telephone boosters (BI-B) to those of screening, assessment, and referral to treatment (SAR) and minimal screening only (MSO) among drug-using ED patients. DESIGN Between October 2010 and February 2012, 1285 patients were randomized to MSO (n = 431), SAR (n = 427), or BI-B (n = 427). Follow-up assessments were conducted at 3, 6, and 12 months by blinded interviewers. SETTING EDs of six academic hospitals in the U.S. PARTICIPANTS Participants were adult ED patients scoring ≥ 3 on the 10-item Drug Abuse Screening Test (indicating moderate to severe problems related to drug use) and currently using drugs. INTERVENTIONS Following screening, MSO participants received only an informational pamphlet. SAR participants received assessment plus referral to addiction treatment if indicated. BI-B participants received assessment and referral as in SAR, plus a manual-guided counseling session based on motivational interviewing principles and up to 2 “booster” sessions by telephone during the month following the ED visit. MAIN OUTCOMES AND MEASURES Outcomes evaluated at follow-up visits included self-reported days using the patient-defined primary problem drug, days using any drug, days of heavy drinking, and drug use based on analysis of hair samples. RESULTS Follow-up rates were 88%, 86%, and 81% at 3, 6, and 12 months, respectively. There were no significant differences between groups in self-reported days using the primary drug, days using any drug, or heavy drinking days at 3, 6, or 12 months. At the 3-month follow-up, participants in the SAR group had a higher rate of hair samples positive for their primary drug of abuse (265/280, 95%) than did participants in the MSO group (253/287, 88

  1. Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

    PubMed Central

    Crane, Sarah J.; Chaudhry, Rajeev; Ebbert, Jon O.; Ytterberg, Karen; Tulledge-Scheitel, Sidna M.; Stroebel, Robert J.

    2014-01-01

    Abstract Introduction: Secure messages and electronic visits (“e-visits”) through patient portals provide patients with alternatives to face-to-face appointments, telephone contact, letters, and e-mails. Limited information exists on how portal messaging impacts face-to-face visits in primary care. Materials and Methods: We conducted a retrospective cohort study of 2,357 primary care patients who used electronic messaging (both secure messages and e-visits) on a patient portal. Face-to-face appointment frequencies (visits/year) of each patient were calculated before and after the first message in a matched-pairs analysis. We analyzed visit frequencies with and without adjustments for a first message surge in visits, and we examined subgroups of high message utilizers and long-term users. Results: Primary care patients who sent at least one message (secure message or e-visit) had a mean of 2.43 (standard deviation [SD] 2.3) annual face-to-face visits before the first message and 2.47 (SD 2.8) after, a nonsignificant difference (p=0.45). After adjustment for a first message surge in visits, no significant visit frequency differences were observed (mean, 2.35 annual visits per patient both before and after first message; p=0.93). Subgroup analysis also showed no significant change in visit frequency for patients with higher message utilization or for those who had used the messaging feature longer. Conclusions: No significant change in face-to-face visit frequency was observed following implementation of portal messaging. Secure messaging and e-visits through a patient portal may not result in a change of adult primary care face-to-face visits. PMID:24350803

  2. Visit-to-Visit Variability in Blood Pressure Is Related to Late-Life Cognitive Decline.

    PubMed

    Qin, Bo; Viera, Anthony J; Muntner, Paul; Plassman, Brenda L; Edwards, Lloyd J; Adair, Linda S; Popkin, Barry M; Mendez, Michelle A

    2016-07-01

    The association between visit-to-visit variability of blood pressure (BP) and cognitive decline over time remains incompletely understood in a general population of older adults. We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. This prospective cohort study comprised 976 adults who had 3 or 4 visits with BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed cognitive screening tests at ≥2 visits in 1997, 2000, or 2004. Visit-to-visit BP variability was expressed as the SD, coefficient of variation, or as the variation independent of mean BP across visits conducted at a mean interval of 3.2 years. Mean (SD) age at the first cognitive test was 64 (6) years. Using multivariable-adjusted linear mixed-effects models, we found higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% confidence interval] for high versus low tertile of SD variability: standardized composite scores -0.038 standard units (SU)/y [-0.066 to -0.009] and verbal memory -0.041 SU/y [-0.075 to -0.008]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of cognitive function, independent of mean diastolic BP, among adults aged 55 to 64 years but not those ≥65 years. Our results suggest that higher long-term BP visit-to-visit variability is associated with a faster rate of cognitive decline among older adults. PMID:27217401

  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. 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.

  5. Tracking Inner City Substance Users from the ED: How many Contacts Does It Take?

    PubMed Central

    Cunningham, Rebecca; Walton, Maureen A.; Outman, Ryan; Murray, Regan; Booth, Brenda M.

    2009-01-01

    Longitudinal studies of substance users report difficulty in locating and completing 12-month interviews, which may compromise study validity. OBJECTIVE This study examined rates and predictors of contact difficulty and in-person follow-up completion among patients presenting with cocaine-related chest pain to an inner-city ED. We hypothesize less staff effort in contacting patients and lower follow-up rates would bias subsequent substance use analysis by missing those with heavier substance misuse. METHODS 219 patients 19-60 yrs (65% males; 78% African-American) with cocaine related chest pain were interviewed in the ED, and then in person at 3, 6, and 12-months. Demographics, substance use measures, and amount/type of research staff contacts (telephone, letters, home visits, and locating patient during return ED visits) were recorded. Linear regression analyses were conducted to predict quantity of patient contacts for the 12-month follow-up. RESULTS Interview completion rates at 3, 6 and 12-months were: 78%, 82%, and 80%. Average contact attempts to obtain each interview were: 10 at 3-months (range 3-44), 8 at 6-months (1-31), and 8 at 12-months (1-50); 13% of patients required a home visit to complete the 12 month interview. Participants requiring more contact attempts by staff reported frequent binge drinking at baseline (p<.01) and were more likely to report prior mental health treatment (p<.05). Findings demonstrate that substantial staff effort is required to achieve adequate retention over 12- months of patients with substance misuse. Without these extensive efforts participants with a history of binge drinking would be missed at follow-up biasing longitudinal analyses. PMID:18275443

  6. 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

  7. 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.

  8. 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 . ...

  9. A Visit Makes Things Come Alive

    ERIC Educational Resources Information Center

    Munschauer, John L.

    1971-01-01

    The author describes impressions gained from visitations to employers at their expense, which helped him understand the employment scene without preconceived notions. As a result, he was better able to serve the college graduates seeking employment. (CJ)

  10. The changing nature of physicians' office visits.

    PubMed Central

    Mitchell, J B; Schurman, R; Cromwell, J

    1988-01-01

    Although there is a general feeling that, into the early 1980s, overall improvement was occurring in the content and quality of physicians' services, no time-series documentation to date has appeared to support this assumption. This article provides empirical evidence that physicians' office visits were in fact changing over time, though not in ways that one might expect. Rather than involving more diagnostic services, such as laboratory tests and x-rays, the typical office visit had come to include more therapeutic services, especially counseling. This is consistent with the observed increase in time spent with patients: between 1974 and 1981, the average office visit increased in length by nearly one full minute. Multivariate analysis indicates that the typical office visit was changing largely because physicians themselves were changing. Not only were physicians becoming increasingly specialized, but they were also more likely to be female, in group practice, and board-certified. PMID:3182291

  11. 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 ...

  12. 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...

  13. 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

  14. 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.

  15. 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

  16. ROBUST ESTIMATES OF THE ED50

    EPA Science Inventory

    To explore the possibility that robust estimators of location can be adapted to the problem of estimating the ED50 in binary-response bioassay, 10 estimators are compared. A Monte Carlo study is conducted to determine the mean squared errors (MSE) of the estimators. Taking into a...

  17. 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…

  18. 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,…

  19. 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.

  20. AC solar cell

    SciTech Connect

    Schutten, H.P.; Benjamin, J.A.; Lade, R.W.

    1986-03-18

    An AC solar cell is described comprising: a pair of PN junction type solar cells connected in antiparallel between a pair of main terminals; and means for electrically directing light alternatingly without mechanical movement on the PN junctions to generate an alternating potential across the main terminals.

  1. AC 67 Launch Video

    NASA Technical Reports Server (NTRS)

    1987-01-01

    Live footage of the Unmanned Atlas Centaur (AC) 67 launch is presented on March 26, 1987 at the WESH television station in Florida. Lightning is shown after 49 seconds into the flight. The vehicle is totally destroyed due to a cloud-to-ground lightning flash.

  2. Father Attendance in Nurse Home Visitation

    PubMed Central

    Holmberg, John R.; Olds, David L.

    2015-01-01

    Our aim was to examine the rates and predictors of father attendance at nurse home visits in replication sites of the Nurse-Family Partnership (NFP). Early childhood programs can facilitate father involvement in the lives of their children, but program improvements require an understanding of factors that predict father involvement. The sample consisted of 29,109 low-income, first-time mothers who received services from 694 nurses from 80 sites. We conducted mixed-model multiple regression analyses to identify population, implementation, site, and nurse influences on father attendance. Predictors of father attendance included a count of maternal visits (B = 0.12, SE = 0.01, F = 3101.77), frequent contact between parents (B = 0.61, SE = 0.02, F = 708.02), cohabitation (B = 1.41, SE = 0.07, F = 631.51), White maternal race (B = 0.77, SE = 0.06, F = 190.12), and marriage (B = 0.42, SE = 0.08, F = 30.08). Random effects for sites and nurses predicted father-visit participation (2.7 & 6.7% of the variance, respectively), even after controlling for population sociodemographic characteristics. These findings suggest that factors operating at the levels of sites and nurses influence father attendance at home visits, even after controlling for differences in populations served. Further inquiry about these influences on father visit attendance is likely to inform program-improvement efforts. PMID:25521707

  3. Father attendance in nurse home visitation.

    PubMed

    Holmberg, John R; Olds, David L

    2015-01-01

    Our aim was to examine the rates and predictors of father attendance at nurse home visits in replication sites of the Nurse-Family Partnership (NFP). Early childhood programs can facilitate father involvement in the lives of their children, but program improvements require an understanding of factors that predict father involvement. The sample consisted of 29,109 low-income, first-time mothers who received services from 694 nurses from 80 sites. We conducted mixed-model multiple regression analyses to identify population, implementation, site, and nurse influences on father attendance. Predictors of father attendance included a count of maternal visits (B = 0.12, SE = 0.01, F = 3101.77), frequent contact between parents (B = 0.61, SE = 0.02, F = 708.02), cohabitation (B = 1.41, SE = 0.07, F = 631.51), White maternal race (B = 0.77, SE = 0.06, F = 190.12), and marriage (B = 0.42, SE = 0.08, F = 30.08). Random effects for sites and nurses predicted father-visit participation (2.7 & 6.7% of the variance, respectively), even after controlling for population sociodemographic characteristics. These findings suggest that factors operating at the levels of sites and nurses influence father attendance at home visits, even after controlling for differences in populations served. Further inquiry about these influences on father visit attendance is likely to inform program-improvement efforts. PMID:25521707

  4. 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.

  5. Emergency Department Visits at the End of Life of Patients With Terminal Cancer: Pattern, Causes, and Avoidability.

    PubMed

    Alsirafy, Samy A; Raheem, Ahmad A; Al-Zahrani, Abdullah S; Mohammed, Amrallah A; Sherisher, Mohamed A; El-Kashif, Amr T; Ghanem, Hafez M

    2016-08-01

    Frequent emergency department visits (EDVs) by patients with terminal cancer indicates aggressive care. The pattern and causes of EDVs in 154 patients with terminal cancer were investigated. The EDVs that started during working hours and ended by home discharge were considered avoidable. During the last 3 months of life, 77% of patients had at least 1 EDV. In total, 309 EDVs were analyzed. The EDVs occurred out of hour in 67%, extended for an average of 3.6 hours, and ended by hospitalization in 52%. The most common chief complaints were pain (46%), dyspnea (13%), and vomiting (12%). The EDVs were considered avoidable in 19% of the visits. The majority of patients with terminal cancer visit the ED before death, mainly because of uncontrolled symptoms. A significant proportion of EDVs at the end of life is potentially avoidable. PMID:25877944

  6. 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

  7. Managing ecotourism visitation in protected areas

    USGS Publications Warehouse

    Marion, J.L.; Farrell, T.A.

    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.

  8. "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…

  9. Visiting a Museum Together: How To Share a Visit to a Virtual World.

    ERIC Educational Resources Information Center

    Paolini, Paolo; Barbieri, Thimoty; Loiudice, Paolo; Alonzo, Francesca; Zanti, Marco; Gaia, G.

    2000-01-01

    Examines different types of virtual visits to museums and explores different paradigms for providing interactive experiences while visiting virtual museums. Describes one example of an experimental environment, WebTalk, which has been used in the MST (Museum of Science and Technology) in Milan, Italy. (LRW)

  10. 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.

  11. 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.

  12. Syncope risk stratification in the ED.

    PubMed

    Dipaola, Franca; Costantino, Giorgio; Solbiati, Monica; Barbic, Franca; Capitanio, Chiara; Tobaldini, Eleonora; Brunetta, Enrico; Zamunér, Antonio Roberto; Furlan, Raffaello

    2014-09-01

    Syncope may be the final common presentation of a number of clinical conditions spanning benign (i.e. neurally-mediated syncope) to life-threatening diseases (i.e. cardiac syncope). Hospitalization rate after a syncopal episode is high. An effective risk stratification is crucial to identify patients at risk of poor prognosis in the short term period to avoid unnecessary hospital admissions. The decision to admit or discharge a syncope patient from the ED is often based on the physician's clinical judgment. In recent years, several prognostic tools (i.e. clinical prediction rules and risk scores) have been developed to provide emergency physicians with accurate guidelines for hospital admission. At present, there are no compelling evidence that prognostic tools perform better than physician's clinical judgment in assessing the short-term outcome of syncope. However, the risk factors characterizing clinical prediction rules and risk scores may be profitably used by emergency doctors in their decision making, specifically whenever a syncope patient has to be discharged from ED or admitted to hospital. Patients with syncope of undetermined etiology, who are characterized by an intermediate-high risk profile after the initial evaluation, should be monitored in the ED. Indeed, data suggest that the 48h following syncope are at the highest risk for major adverse events. A new tool for syncope management is represented by the Syncope Unit in the ED or in an outpatient setting. Syncope Unit may reduce hospitalization and length of hospital stay. However, further studies are needed to clarify whether syncope patients' prognosis can be also improved. PMID:24811585

  13. 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

  14. 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.

  15. Earth and space scientists Visit Capitol Hill

    NASA Astrophysics Data System (ADS)

    O'Riordan, Catherine

    AGU's Office of Public Affairs organizes frequent opportunities for members to meet with Congress. Recently AGU members participated in two events: an annual Congressional Visits Day and the Coalition for National Science Funding congressional reception.Over 200 scientists and engineers met with key legislators and their staffs on Capitol Hill in Washington, D.C. as part of the 10th annual Science, Engineering, and Technology Congressional Visits Day (CVD) held on 10-11 May. In their meetings, participants advocated this year's CVD theme: Federally funded research secures our nation's future.

  16. 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.

  17. Can a poison center overdose guideline safely reduce pediatric emergency department visits for unintentional β-blocker ingestions?

    PubMed

    Hickey, Colleen N; Mycyk, Mark B; Wahl, Michael S

    2012-09-01

    Poisoning is a leading cause cause for injury and death in pediatric patients. For this reason, β-blocker ingestion has been an indication for emergency department (ED) referral and evaluation in pediatric patients even though significant clinical effects are uncommonly reported. We sought to determine whether an evidence-based triage guideline developed jointly by the American Association of Poison Control Centers, American Academy of Clinical Toxicology, and American College of Medical Toxicology safely reduces unnecessary pediatric ED visits after unintentional small dose β-blocker overdose. This was a prospective study of patients aged 0-6 years with a β-blocker ingestion managed by a regional poison center pre and postimplementation of the triage guideline. One hundred fifty-three cases met inclusion criteria. Before implementation of an evidence-based triage guideline for out-of-hospital management, 52 (67%) cases were referred for ED evaluation, and 26 (33%) cases were recommended for home observation. After guideline implementation, 38 (51%) cases were referred for ED evaluation, and 37 (49%) were recommended for home observation. No deaths occurred in either group. The triage guideline was accurately followed by poison center staff in 96% of cases after implementation. An out-of-hospital triage guideline for pediatric β-blocker overdose was accurately followed by poison center staff and safely reduced unnecessary ED referrals with a 50% increase in home observation. PMID:21192245

  18. 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. PMID:25087527

  19. 22 CFR 125.5 - Exemptions for plant visits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.5 Exemptions for plant visits. (a) A... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Exemptions for plant visits. 125.5 Section 125... course of a classified plant visit by a foreign person, provided: The classified visit has itself...

  20. 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…

  1. 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...

  2. 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...

  3. 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...

  4. 22 CFR 125.5 - Exemptions for plant visits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 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. 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

  6. Federally Qualified Health Center Use Among Dual Eligibles: Rates Of Hospitalizations And Emergency Department Visits

    PubMed Central

    Wright, Brad; Potter, Andrew J.; Trivedi, Amal

    2016-01-01

    People who are eligible for both Medicare and Medicaid, known as “dual eligibles,” disproportionately are members of racial or ethnic minority groups. They face barriers accessing primary care, which in turn increase the risk of potentially preventable hospitalizations and emergency department (ED) visits for ambulatory care–sensitive conditions. Federally qualified health centers provide services known to address barriers to primary care. We analyzed 2008–10 Medicare data for elderly and nonelderly disabled dual eligibles residing in Primary Care Service Areas with nearby federally qualified health centers. Among our findings: There were fewer hospitalizations for ambulatory care–sensitive conditions among blacks and Hispanics who used these health centers than among their counterparts who did not use them (16 percent and 13 percent fewer, respectively). Use of the health centers was also associated with 3 percent and 12 percent fewer hospitalizations for ambulatory care–sensitive conditions among nonelderly disabled blacks and Hispanics, respectively. These findings suggest that federally qualified health centers can reduce disparities in preventable hospitalizations for some dual eligibles. However, further efforts are needed to reduce preventable ED visits among dual eligibles receiving care in the health centers. PMID:26153309

  7. Tax Ramifications for the Visiting Professor.

    ERIC Educational Resources Information Center

    Henry, Robert J.

    1984-01-01

    The uncertainty of the tax treatment of faculty accepting a temporary visiting position that becomes indefinite is discussed, and related issues including salary differentials, salary types such as fellowships, traveling and living expenses, home residence considerations, and related tax benefits are outlined. (MSE)

  8. 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…

  9. Home Kits, Home Visits, and More!

    ERIC Educational Resources Information Center

    Gorter-Reu, Maralee S.; Anderson, Jean Marie

    1998-01-01

    The Home Kit/Home Visit Program--designed for children needing reinforcement of basic concepts and knowledge of colors, shapes, numbers, letter recognition, and letter-sound correspondence--is proving successful in encouraging parent involvement in first-graders' learning of basic skills. Parents are provided with home learning kits to guide their…

  10. 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

  11. 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 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH... governed by the provisions on contact with news media (see subpart E of this part). A media...

  12. Visit to China and the USSR.

    ERIC Educational Resources Information Center

    Dudley, E. Samuel

    During the summer of 1984, 30 speech communication professors and their spouses visited Shanghai, Beijing, Moscow, and Leningrad, spending three or four days in each city. In each of the four communist cities, they met with professors and administrators for long briefings and discussions about communication. One of the first things the Americans…

  13. Finnish Students' Perceptions of a Visiting Professor.

    ERIC Educational Resources Information Center

    Haussler, Susan C.; Paavilainen, Eija; Astedt-Kurki, Paivi

    2003-01-01

    Finnish nursing students (n=31) evaluated their experience with a visiting Fulbright professor. Students were satisfied with course content, teaching methods, and information about the U.S. health care system. They thought the professor should have been more knowledgeable about Finnish culture, education, and health care. (Contains 15 references.)…

  14. 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…

  15. 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.

  16. EDS coal liquefaction process development. Phase V. EDS Consolidation Program: flushing and blowdown system design

    SciTech Connect

    1984-01-01

    The flushing and blowdown system of an EDS plant provides the means of removing viscous coal products and slurry streams from plant vessels and lines. In addition, it provides the flushing oil needed during normal operations for purging instruments in slurry service, for flushing slurry pump and slurry agitator seals, and for flushing slurry safety valve inlet lines. It contains a blowdown system for collecting material from washing operations, including the transport of the collected material to slop tankage. The rerun options for depleting the inventory of collected slop are a related aspect of the flushing and blowdown system design although specific equipment for handling slop is not part of the flushing and blowdown system facilities. This report documents the results of a study which evaluates the flushing and blowdown requirements for a commercial-scale EDS plant. The work was conducted as part of the EDS Consolidation Program. The design recommendations represent a consolidation of learnings accrued during previous phases of the EDS Project including results obtained from ECLP operations, from the ECLP Test Program, and from past EDS Study Design preparations. 1 reference, 4 figures, 2 tables.

  17. Sexuality Talk During Adolescent Health Maintenance Visits

    PubMed Central

    Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.

    2015-01-01

    Importance Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. Objective To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Design, Setting, and Participants Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Main Outcomes and Measures Total time per visit during which sexuality issues were discussed. Results One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant

  18. 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

  19. 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

  20. Floral visitation by the Argentine ant reduces bee visitation and plant seed set.

    PubMed

    Hanna, Cause; Naughton, Ida; Boser, Christina; Alarcón, Ruben; Hung, Keng-Lou James; Holway, David

    2015-01-01

    Ants often visit flowers, but have only seldom been documented to provide effective pollination services. Floral visitation by ants can also compromise plant reproduction in situations where ants interfere with more effective pollinators. Introduced ants may be especially likely to reduce plant reproductive success through floral visitation, but existing experimental studies have found little support for this hypothesis. Here, we combine experimental and observational approaches to examine the importance of floral visitation by the nonnative Argentine ant (Linepithema humile) on plant species native to Santa Cruz Island, California, USA. First, we determine how L. humile affects floral visitor diversity, bee visitation rates, and levels of pollen limitation for the common, focal plant species island morning glory (Calystegia macrostegia ssp. macrostegia). Second, we assess the broader ecological consequences of floral visitation by L. humile by comparing floral visitation networks between invaded and uninvaded sites. The Argentine ant and native ants both visited island morning glory flowers, but L. humile was much more likely to behave aggressively towards other floral visitors and to be the sole floral occupant. The presence of L. humile in morning glory flowers reduced floral visitor diversity, decreased rates of bee visitation, and increased levels of pollen limitation. Network comparisons between invaded and uninvaded. sites revealed differences in both network structure and species-level attributes. In. invaded sites, floral visitors were observed on fewer plant species, ants had a higher per-plant interaction strength relative to that of other visitors, and interaction strengths between bees and plants were weaker. These results illustrate that introduced ants can negatively affect plant reproduction and potentially disrupt pollination services at an ecosystem scale. PMID:26236907

  1. 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 ...

  2. EFFECTS OF ETHANE DIMETHANESULFONATE (EDS) ON ADULT AND IMMATURE RABBIT LEYDIG CELLS: COMPARISON WITH EDS-TREATED RAT LEYDIG CELLS

    EPA Science Inventory

    Ethane-dimethanesulfonate (EDS) has been shown to selectively kill Leydig cells and depress testosterone production in adult rats. ecent study has shown that immature rat leydig cells are less sensitive to EDS exposure. here is evidence that the rabbit metabolizes EDS to methane ...

  3. 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. PMID:26713065

  4. 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

  5. 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.

  6. ED navigators steer patients to appropriate providers.

    PubMed

    2012-03-01

    At Presbyterian Healthcare Services in Albuquerque, NM, emergency department navigators refer patients with minor ailments to primary care providers or urgent care centers. All patients are triaged by nurse in ED. - Appropriate patients are sent to the hospital's Lean Track area where they are evaluated by a physician or mid-level provider. - Patients who can safely be treated in 12-24 hours are referred to the navigator, who obtains an appointment for them with a primary care provider or urgent care center. PMID:22423392

  7. 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.

  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. 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

  11. The predictability of consumer visitation patterns

    PubMed Central

    Krumme, Coco; Llorente, Alejandro; Cebrian, Manuel; Pentland, Alex ("Sandy"); Moro, Esteban

    2013-01-01

    We consider hundreds of thousands of individual economic transactions to ask: how predictable are consumers in their merchant visitation patterns? Our results suggest that, in the long-run, much of our seemingly elective activity is actually highly predictable. Notwithstanding a wide range of individual preferences, shoppers share regularities in how they visit merchant locations over time. Yet while aggregate behavior is largely predictable, the interleaving of shopping events introduces important stochastic elements at short time scales. These short- and long-scale patterns suggest a theoretical upper bound on predictability, and describe the accuracy of a Markov model in predicting a person's next location. We incorporate population-level transition probabilities in the predictive models, and find that in many cases these improve accuracy. While our results point to the elusiveness of precise predictions about where a person will go next, they suggest the existence, at large time-scales, of regularities across the population. PMID:23598917

  12. The predictability of consumer visitation patterns

    NASA Astrophysics Data System (ADS)

    Krumme, Coco; Llorente, Alejandro; Cebrian, Manuel; Pentland, Alex ("Sandy"); Moro, Esteban

    2013-04-01

    We consider hundreds of thousands of individual economic transactions to ask: how predictable are consumers in their merchant visitation patterns? Our results suggest that, in the long-run, much of our seemingly elective activity is actually highly predictable. Notwithstanding a wide range of individual preferences, shoppers share regularities in how they visit merchant locations over time. Yet while aggregate behavior is largely predictable, the interleaving of shopping events introduces important stochastic elements at short time scales. These short- and long-scale patterns suggest a theoretical upper bound on predictability, and describe the accuracy of a Markov model in predicting a person's next location. We incorporate population-level transition probabilities in the predictive models, and find that in many cases these improve accuracy. While our results point to the elusiveness of precise predictions about where a person will go next, they suggest the existence, at large time-scales, of regularities across the population.

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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…

  18. 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.

  19. 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

  20. 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…

  1. Visit of the Federal President of Germany

    ScienceCinema

    None

    2011-04-25

    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.

  2. 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

  3. A home visit program for CAPD.

    PubMed

    Warmington, V

    1996-01-01

    In the U.K. in the last five years a reassessment of the central role of the hospital has taken place, with a fundamental shift in care for people with increased dependencies to community settings. For patients using peritoneal dialysis a need has been realized for a home-visiting service by specialist renal nurses who can manage and coordinate the program of care, thus reducing the strain on hospital resources. In addition, the provision of a community nurse to visit the patient at home means that ongoing education and training can be undertaken in a suitable learning environment. The home-visiting program creates an opportunity to develop an holistic care plan using strategies of general health promotion as well as practical nursing care. This paper highlights the experiences of a pioneering model of community continuous ambulatory peritoneal dialysis care in the South London. Auditing of this unusually funded post has shown significant reductions in peritonitis, exit-site infections, and hospital admissions in this growing patient population. PMID:8728249

  4. Toward Population Impact from Home Visiting

    PubMed Central

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

    2013-01-01

    Although some home-visiting programs have proven effective with the families they serve, no program has yet demonstrated an impact at the population level. We describe the Durham Connects (DC) initiative, which aims to achieve population impact by coalescing community agencies to serve early-intervention goals through a Preventive System Of Care and by delivering a universal, short-term, postnatal nurse home-visiting program. The home-visitor delivers brief intervention, assesses family needs in 12 domains, and connects the family with community resources to address individualized family needs. Evaluation of DC occurred through a population randomized controlled trial of all 4,777 births in Durham, NC, over an 18-month period. DC was implemented with high penetration and high fidelity. Impact evaluation indicated that by age 6 months, DC infants had 18 percent fewer emergency room visits and 80 percent fewer overnights in the hospital than did control families. We conclude that population impact is achievable if a program attends to challenges of community partnership, universal reach and assessment, rigorous evaluation, and models for sustaining funding. PMID:23526864

  5. 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. PMID:24505864

  6. 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

  7. Violence prevention training for ED staff.

    PubMed

    Martindell, Denise

    2012-09-01

    The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, and birthing centers, as well as some abortion facilities, must file information on medical errors. Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafetyauthority.org. For the original article discussed in this column or for other articles on patient safety, click on "Patient Safety Advisories" and then "Advisory Library" in the left-hand navigation menu. PMID:22932056

  8. 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.

  9. 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.

  10. Thermionic triode generates ac power

    NASA Technical Reports Server (NTRS)

    Kniazzeh, A. G. F.; Scharz, F. C.

    1970-01-01

    Electrostatic grid controls conduction cycle of thermionic diode to convert low dc output voltages to high ac power without undesirable power loss. An ac voltage applied to the grid of this new thermionic triode enables it to convert heat directly into high voltage electrical power.

  11. Automated ac galvanomagnetic measurement system

    NASA Technical Reports Server (NTRS)

    Szofran, F. R.; Espy, P. N.

    1985-01-01

    An automated, ac galvanomagnetic measurement system is described. Hall or van der Pauw measurements in the temperature range 10-300 K can be made at a preselected magnetic field without operator attendance. Procedures to validate sample installation and correct operation of other system functions, such as magnetic field and thermometry, are included. Advantages of ac measurements are discussed.

  12. 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

  13. 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.

  14. 'Pot Tourists' Linked to Surge in Colorado ER Visits

    MedlinePlus

    ... Visits Many out-of-state users overindulge with marijuana, particularly the edible version, researcher says To use ... have visited Colorado to sample the state's legal marijuana haven't been able to handle their high, ...

  15. 19 CFR 181.74 - Verification visit procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... generates a reliable receipt, to the CBP officer who gave the notification provided for in § 181.73 of this... otherwise cooperate during the verification visit shall mean that the verification visit never took...

  16. 19 CFR 181.74 - Verification visit procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... generates a reliable receipt, to the CBP officer who gave the notification provided for in § 181.73 of this... otherwise cooperate during the verification visit shall mean that the verification visit never took...

  17. 78 FR 29704 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-21

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of Public Meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  18. 76 FR 59659 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of public meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  19. 75 FR 28785 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-24

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of Partially Closed Meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT), National Institute of Standards...

  20. 76 FR 29195 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-20

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of Public Meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  1. 77 FR 59592 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of public meeting. ] SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  2. 78 FR 292 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-03

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of Public Meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  3. 75 FR 60082 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-29

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of Public Meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT), National Institute of Standards and...

  4. 78 FR 57839 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of public meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  5. 77 FR 32570 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-01

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of public meeting. SUMMARY: The Visiting Committee on Advanced Technology (VCAT or Committee), National Institute of Standards...

  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, 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...

  8. 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...

  9. 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...

  10. 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

  11. 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

  12. 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

  13. 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…

  14. A Climate of Trust: A Visit to Two Swedish Schools.

    ERIC Educational Resources Information Center

    Nordgren, R. D.

    This paper describes a Florida educator's visit to two Swedish schools for students aged 16 to 19. The educator spent 2 days visiting Duveholmsskolan in Katrineholm (about 70 miles west of Stockholm) and 3 days visiting Wargentinsskolan in Ostersund (situated 350 miles north of Stockholm and about 200 miles south of the Arctic Circle) observing…

  15. 42 CFR 405.2416 - Visiting nurse services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Visiting nurse services. 405.2416 Section 405.2416... Health Center Services § 405.2416 Visiting nurse services. (a) Visiting nurse services are covered if: (1... are furnished by a registered nurse, licensed practical nurse, or licensed vocational nurse who...

  16. Parental Visiting in Foster Care: Law and Practice.

    ERIC Educational Resources Information Center

    Proch, Kathleen; Howard, Jeanne

    1984-01-01

    Reviews the specific provisions of state and federal statutes relating to parental visiting, contrasts provisions with those in several model acts, discusses the purpose of visiting as reflected in the statutes, and concludes with recommendations for statutory reform practices offering a compromise between terminating parents' visiting rights and…

  17. Parent-Child Interaction during Foster Care Visits.

    ERIC Educational Resources Information Center

    Haight, Wendy L.; Black, James E.; Workman, Cindy L; Tata, Lakshmi

    2001-01-01

    The case-based research discussed in this article describes the variety of strategies mothers and young children spontaneously used to negotiate the complexities of foster care visits. Mothers and children displayed a variety of responses to visits, particularly separating at the end of visits. (Author)

  18. 48 CFR 52.236-27 - Site Visit (Construction).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Site Visit (Construction....236-27 Site Visit (Construction). As prescribed in 36.523, insert a provision substantially the same as the following: Site Visit (Construction) (FEB 1995) (a) The clauses at 52.236-2, Differing...

  19. 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…

  20. 77 FR 48992 - Tobacco Product Manufacturing Facility Visits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... to current good manufacturing practice, or hazard analysis and critical control point methodology... HUMAN SERVICES Food and Drug Administration Tobacco Product Manufacturing Facility Visits AGENCY: Food... Manufacturing Facility Visits. This program is intended to give FDA staff an opportunity to visit...

  1. 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

  2. Association Between Apple Consumption and Physician Visits

    PubMed Central

    Davis, Matthew A.; Bynum, Julie P.W.; Sirovich, Brenda E.

    2015-01-01

    IMPORTANCE Fruit consumption is believed to have beneficial health effects, and some claim, “An apple a day keeps the doctor away.” OBJECTIVE To examine the relationship between eating an apple a day and keeping the doctor away. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of a nationally representative sample of the noninstitutionalized US adult population. A total of 8728 adults 18 years and older from the 2007–2008 and 2009–2010 National Health and Nutrition Examination Survey completed a 24-hour dietary recall questionnaire and reported that the quantity of food they ate was reflective of their usual daily diet. EXPOSURES Daily apple eaters (consuming the equivalent of at least 1 small apple daily, or 149 g of raw apple) vs non–apple eaters, based on the reported quantity of whole apple consumed during the 24-hour dietary recall period. MAIN OUTCOMES AND MEASURES The primary outcome measure was success at “keeping the doctor away,” measured as no more than 1 visit (self-reported) to a physician during the past year; secondary outcomes included successful avoidance of other health care services (ie, no overnight hospital stays, visits to a mental health professional, or prescription medications). RESULTS Of 8399 eligible study participants who completed the dietary recall questionnaire, we identified 753 adult apple eaters (9.0%)—those who typically consume at least 1 small apple per day. Compared with the 7646 non–apple eaters (91.0%), apple eaters had higher educational attainment, were more likely to be from a racial or ethnic minority, and were less likely to smoke (P < .001 for each comparison). Apple eaters were more likely, in the crude analysis, to keep the doctor (and prescription medications) away: 39.0% of apple eaters avoided physician visits vs 33.9%of non–apple eaters (P = .03). After adjusting for sociodemographic and health-related characteristics, however, the association was no longer statistically significant

  3. 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

  4. 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

  5. Ceres: Dawn visits a warm wet planet

    NASA Astrophysics Data System (ADS)

    McCord, T.

    2014-04-01

    Ceres likely contains considerable water, has differentiated, possesses a silicate core and water mantle, and has experienced major dimensional, thermal and chemical changes over its history, making it more a planet than an asteroid [1]. These factors created the present day body, its interior structure and composition, and its surface properties, which Dawn will visit. Here, I will summarize our current understanding of Ceres and suggest what Dawn will find, building on earlier attempts [2]. 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 current surface and hidden Ceres' secrets.

  6. Joint Effects of Ambient Air Pollutants on Pediatric Asthma Emergency Department Visits in Atlanta, 1998–2004

    PubMed Central

    Winquist, Andrea; Kirrane, Ellen; Klein, Mitch; Strickland, Matthew; Darrow, Lyndsey A.; Sarnat, Stefanie Ebelt; Gass, Katherine; Mulholland, James; Russell, Armistead; Tolbert, Paige

    2016-01-01

    Background Because ambient air pollution exposure occurs as mixtures, consideration of joint effects of multiple pollutants may advance our understanding of air pollution health effects. Methods We assessed the joint effect of air pollutants in selected combinations (representative of oxidant gases, secondary, traffic, power plant, and criteria pollutants; constructed using combinations of criteria pollutants and fine particulate matter (PM2.5) components) on pediatric asthma emergency department (ED) visits in Atlanta during 1998–2004. Joint effects were assessed using multi-pollutant Poisson generalized linear models controlling for time trends, meteorology and daily non-asthma upper respiratory ED visit counts. Rate ratios (RR) were calculated for the combined effect of an interquartile-range increment in each pollutant’s concentration. Results Increases in all of the selected pollutant combinations were associated with increases in warm-season pediatric asthma ED visits [e.g., joint effect rate ratio=1.13 (95% confidence interval 1.06–1.21) for criteria pollutants (including ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, and PM2.5)]. Cold-season joint effects from models without non-linear effects were generally weaker than warm-season effects. Joint effect estimates from multi-pollutant models were often smaller than estimates calculated based on single-pollutant model results, due to control for confounding. Compared with models without interactions, joint effect estimates from models including first-order pollutant interactions were largely similar. There was evidence of non-linear cold-season effects. Conclusions Our analyses illustrate how consideration of joint effects can add to our understanding of health effects of multi-pollutant exposures, and also illustrate some of the complexities involved in calculating and interpreting joint effects of multiple pollutants. PMID:25045931

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Why do geriatric patients visit otorhinolaryngology?

    PubMed

    Özler, Gül Soylu; Yengil, Erhan

    2016-06-01

    The number and proportion of people more than 65 years old in the population are increasing with the rise in life expectancy. This study was designed to investigate the otolarygologic needs and visits of geriatric patients. We conducted a retrospective study that included all patients ≥65 years of age who visited the otolaryngology department between 8 a.m. and 4 p.m. during 1 year. Age, gender, main complaint, and clinical diagnosis were noted on a chart and analyzed. In 2012, a total of 19,875 patients attended the otolaryngology department between 8 a.m. and 4 p.m., of whom 418 (2.1%) were aged ≥65 years. The most common complaints were ear and hearing disorders (24.2%), epistaxis(15.3%), balance disorders (15.1%), pharyngotonsillar pathologies (14.8%), and head and facial trauma (9.6%). This study shows that the changing patient population will change the type and frequencies of pathologies seen in general otolaryngology practices. Geriatric patients need a targeted approach to their diseases because they have special issues unique to their population. PMID:27304440

  13. 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.

  14. 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

  15. MedEdPORTAL: Educational Scholarship for Teaching

    ERIC Educational Resources Information Center

    Reynolds, Robby J.; Candler, Christopher S.

    2008-01-01

    MedEdPORTAL is an online publication service provided at no charge by the Association of American Medical Colleges (AAMC). The intent is to promote collaboration and educational scholarship by helping educators publish and share educational resources. With MedEdPORTAL, users can quickly locate high-quality, peer-reviewed teaching materials in both…

  16. 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…

  17. 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…

  18. Medicare Home Visit Program Associated With Fewer Hospital And Nursing Home Admissions, Increased Office Visits.

    PubMed

    Mattke, Soeren; Han, Dan; Wilks, Asa; Sloss, Elizabeth

    2015-12-01

    Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. Such programs combine a comprehensive geriatric assessment by a clinician during a home visit with referrals to community providers and health plan resources to address uncovered issues. We evaluated UnitedHealth Group's HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants' numbers of office visits--chiefly to specialists--increased 2-6 percent (depending on the comparison group). The program's effects on emergency department use were mixed. These results indicate that a thorough home-based clinical assessment of a member's health and home environment combined with referral services can support aging in place, promote physician office visits, and preempt costly institutional care. PMID:26643635

  19. 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…

  20. Ac traction gets on track

    SciTech Connect

    O`Connor, L.

    1995-09-01

    This article describes inverter-based ac traction systems which give freight locomotives greater adhesion, pulling power, and braking capacity. In the 1940s, dc traction replaced the steam engine as a source of train propulsion, and it has ruled the freight transportation industry ever since. But now, high-performance ac-traction systems, with their unprecedented levels of pulling power and adhesion, are becoming increasingly common on America`s freight railroads. In thousands of miles of demonstration tests, today`s ac-traction systems have outperformed traditional dc-motor driven systems. Major railroad companies are convinced enough of the benefits of ac traction to have integrated it into their freight locomotives.

  1. 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.

  2. 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.

  3. Predictors of violence following Emergency Department visit for cocaine-related chest pain.

    PubMed

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

    2009-01-01

    This study examined 1-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=19-60). Baseline rates of past year violent victimization and perpetration history were: 38% and 30%, respectively. During the 12-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 were 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 binge

  4. 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

  5. Nine years of DentEd--a global perspective on dental education.

    PubMed

    Reynolds, P A; Eaton, K A; Paganelli, C; Shanley, D

    2008-08-23

    This paper describes the three successive and successful DentEd projects, funded by the European Union, that established a productive thematic network which identified common content within the dental curriculum. It then developed an agreed professional profile, with a defined set of competences and a modular curriculum for all new dental graduates based on the European Credit Transfer System and trends in learning and assessment. The three phases took nine years to complete. Phase one investigated all aspects of dental undergraduate education and included over 30 visits to different dental schools by teams of dental educators. Phase two built on this work and included further visits to dental schools. Phase three refined the competency framework that had been developed in phase two and culminated in a global dental conference which finalised position papers on all aspects of dental education. The work and recommendations of the ICT in dental education group are considered in detail in the paper. The projects provided the stimulus for a number of European and international collaborations, including the web-based International Federation of Dental Education and Associations (IFDEA) Knowledge Centre and the International Virtual Dental School (IVIDENT), both of which aim to make increasingly sophisticated ICT-based educational material available worldwide and to promote international understanding. PMID:18724340

  6. Well Baby Visits: Screening and Health Promotion

    PubMed Central

    Rourke, James T. B.; Rourke, Leslie L.

    1985-01-01

    Traditional child care consists of periodic health examinations and treatment for episodic illness. It is important to ensure that prevention, detection and early treatment of developmental problems are always done, especially in children with frequent illnesses. Educational and psychosocial factors, nutrition and physical assessment must also be stressed to promote child and family health. The authors have developed flow sheets for screening visits at age two weeks to two years, to check growth, nutrition, education, parenting, behavior, development, symptoms, examination procedures, and assessment. The sheets are a memory and charting aid in a busy office, allow other office staff to participate, and can be modified to suit the practice and the patient. PMID:21274145

  7. 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.

  8. US petroleum production mission visits Middle East

    SciTech Connect

    McQueen, C.

    1984-08-06

    To help US petroleum executives promote American equipment and technical expertise, the Commerce Department is sponsoring a petroleum production trade mission, November 26-December 11, to Egypt, Saudi Arabia, Oman, and Iraq - four Middle East countries where petroleum is the lifeline of the economy and a sector targeted for further investment. Participation affords US executives access to key officials, agents, and private buyers, and is especially valuable to new-to-market companies that experience difficulty in arranging individual travel and business appointments. The author summarizes the market for petroleum equipment and services in each of the countries to be visited. Business representatives interested in taking advantage of this trade/investment opportunity in the Middle East should contact: Thomas H. Shugart, Project Coordinator, US Department of Commerce, 1100 Commerce St., Room 7A5, Dallas, Texas, telephone 214-767-0546.

  9. Short term visits for collaborative research

    NASA Astrophysics Data System (ADS)

    Horie, Yasuyuki

    1994-12-01

    Two Russian scientists were invited to spend six months at North Carolina State University, Raleigh, NC, to develop and promote individual research interactions that are of mutual benefits in the field of shock compression chemistry. The principal results of their visits are: (1) up-to-date reviews and evaluations not only of their own research activities, but also of Russian publications since 1986; (2) a comparative study of U.S. and Russian approaches to the modeling of heterogeneous continual; and (3) the development of a new computational technique to analyze and interpret the mesoscale response of heterogeneous media to shock loading. A further extension of the third project will be continued at one of the home institutions in Russia under the auspices of the program titled 'Industrial Partnering with the New Independent States of the Former Soviet Union.'

  10. Lupus cerebritis after visiting a tanning salon.

    PubMed

    Geara, Abdallah S; Torbey, Estelle; El-imad, Badiaa

    2009-01-01

    A 53-year-old female was admitted to the intensive care unit for lupus cerebritis; she had a 15-year history of stable lupus. Over the prior 1 to 2 months, the patient visited a tanning salon and this triggered the exacerbation of lupus. Her initial symptoms were cutaneous in the form of an erythematous rash. Within 2 weeks she started to have headaches and was admitted for seizure and psychosis. Ultraviolet A exposure in the tanning salon is known to exacerbate lupus by modulation of the immune system at the level of the skin. It has also been found that ultraviolet light can lead to the formation of antinuclear antibodies. This case illustrates the need to emphasize the danger of the tanning salon to patients with systemic lupus erythematous; the risk is not only cutaneous, it can also be systemic. PMID:20001946

  11. [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

  12. Postanesthesia care unit visitation decreases family member anxiety.

    PubMed

    Carter, Amy J; Deselms, JoAnn; Ruyle, Shelley; Morrissey-Lucas, Marcella; Kollar, Suzie; Cannon, Shelly; Schick, Lois

    2012-02-01

    Despite advocacy by professional nursing organizations, no randomized controlled trials (RCTs) have evaluated the response of family members to a visit with an adult patient during a postanesthesia care unit (PACU) stay. Therefore, the purpose of this RCT was to evaluate the impact of a brief PACU visitation on the anxiety of family members. The study was conducted in a phase I PACU of a large community-based hospital. Subjects were designated adult family members or significant others of an adult PACU patient who had undergone general anesthesia. A pretest-posttest RCT design was used. The dependent variable was the change in anxiety scores of the visitor after seeing his or her family member in the PACU. Student t test (unpaired, two tailed) was used to determine if changes in anxiety scores (posttest score-pretest score) were different for the PACU visit and no visit groups. A total of 45 participants were studied over a 3-month period, with N=24 randomly assigned to a PACU visit and N=21 assigned to usual care (no PACU visit). Participants in the PACU visit group had a statistically significant (P=.0001) decrease in anxiety after the visitation period (-4.11±6.4); participants in the usual care group (no PACU visit) had an increase in anxiety (+4.47±6.6). The results from this study support the value and importance of PACU visitation for family members. PMID:22264615

  13. 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

  14. Having a patient advocate dedicated to the ED.

    PubMed

    2008-02-01

    The ED at St. Mary's Hospital in Tucson, AZ, has its own departmental patient advocate. This new staff position saves a lot of time for the rest of the team members. Here are some of the functions a patient advocate can perform in your ED: proactively prevent problems and satisfy delivery of care needs in a timelier manner to avoid complaints; train the ED staff in customer service and communication techniques; communicate with outside clinics to support uninsured or underinsured patients who don't have primary care physicians. PMID:18447293

  15. 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. PMID:12317381

  16. 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.

  17. 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.

  18. 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

  19. Influence of Urbanicity and County Characteristics on the Association between Ozone and Asthma Emergency Department Visits in North Carolina

    PubMed Central

    Rappold, Ana G.; Davis, J. Allen; Richardson, David B.; Waller, Anna E.; Luben, Thomas J.

    2014-01-01

    Background: Air pollution epidemiologic studies, often conducted in large metropolitan areas because of proximity to regulatory monitors, are limited in their ability to examine potential associations between air pollution exposures and health effects in rural locations. Methods: Using a time-stratified case-crossover framework, we examined associations between asthma emergency department (ED) visits in North Carolina (2006–2008), collected by a surveillance system, and short-term ozone (O3) exposures using predicted concentrations from the Community Multiscale Air Quality (CMAQ) model. We estimated associations by county groupings based on four urbanicity classifications (representative of county size and urban proximity) and county health. Results: O3 was associated with asthma ED visits in all-year and warm season (April–October) analyses [odds ratio (OR) = 1.019; 95% CI: 0.998, 1.040; OR = 1.020; 95% CI: 0.997, 1.044, respectively, for a 20-ppb increase in lag 0–2 days O3]. The association was strongest in Less Urbanized counties, with no evidence of a positive association in Rural counties. Associations were similar when adjusted for fine particulate matter in copollutant models. Associations were stronger for children (5–17 years of age) compared with other age groups, and for individuals living in counties identified with poorer health status compared with counties that had the highest health rankings, although estimated associations for these subgroups had larger uncertainty. Conclusions: Associations between short-term O3 exposures and asthma ED visits differed by overall county health and urbanicity, with stronger associations in Less Urbanized counties, and no positive association in Rural counties. Results also suggest that children are at increased risk of O3-related respiratory effects. Citation: Sacks JD, Rappold AG, Davis JA Jr, Richardson DB, Waller AE, Luben TJ. 2014. Influence of urbanicity and county characteristics on the association

  20. 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

  1. SSF Terra-FM1 Ed3A

    Atmospheric Science Data Center

    2016-07-13

    SSF Terra-FM1 Ed3A Project Title:  CERES Discipline:  Clouds Radiation Budget ...   Reverb Tutorial Subset/Visualization Tool: CERES Order Tool Subset Data:  CERES Search and Subset Tool (HDF4 & ...

  2. SSF Aqua-FM3 Ed3A

    Atmospheric Science Data Center

    2016-07-13

    SSF Aqua-FM3 Ed3A Project Title:  CERES Discipline:  Clouds Radiation Budget ...   Reverb Tutorial Subset/Visualization Tool: CERES Order Tool Subset Data:  CERES Search and Subset Tool (HDF4 & ...

  3. 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 ...

  4. 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

  5. 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…

  6. Rethinking the Ed.D., or What's in a Name?

    ERIC Educational Resources Information Center

    Townsend, Barbara K.

    This paper traces the development of the Ed.D., explores the purposes the degree serves, and assesses its value. The creation of the degree stemmed largely from the reluctance of faculty in Arts and Sciences to offer the Ph.D. in professional schools. The one thing most Ed.D. programs have in common is that it is supposed to be an applied or…

  7. 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…

  8. A Compassionate Visitation Program for Church Homebound Elders.

    PubMed

    Emblen, Julia Quiring

    2016-01-01

    Homebound elders are vulnerable to decreased quality of life, related to their social and emotional isolation. This article discusses development of a Compassionate Visitation Program in the faith community, including recruitment and training of visitors, assessment of visitees and their environment, and structure and record-keeping of visits. PMID:27295235

  9. 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…

  10. 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…

  11. 19 CFR 181.74 - Verification visit procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... visit in Canada or Mexico pursuant to § 181.72(a)(3)(iii) of this part, CBP shall obtain the written...) Postponement of visit in Canada or Mexico. Following receipt of the notification provided for in § 181.73...

  12. 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…

  13. 19 CFR 181.74 - Verification visit procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 2 2012-04-01 2012-04-01 false Verification visit procedures. 181.74 Section 181.74 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) NORTH AMERICAN FREE TRADE AGREEMENT Origin Verifications and Determinations § 181.74 Verification visit procedures....

  14. Child Care in East Germany: A Visit after the Fall.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    1990-01-01

    Describes contrasts in the author's visits to East and West Berlin in 1972 and 1990. Discusses visits to child care centers in East and West Germany in 1990 and concludes with speculation about the future of child care services in a reunited Germany. (DR)

  15. 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…

  16. School Visits to Natural History Museums: Teaching or Enriching?

    ERIC Educational Resources Information Center

    Tal, Tali; Morag, Orly

    2007-01-01

    This article describes a 3-year study of school visits to four natural history museums and addresses the research agenda with regard to out-of-school learning. More specifically, the findings focus on the "process of learning" in museums. Comprehensive data collection allowed for an analysis of patterns of guided visits, the way the scientific…

  17. 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…

  18. 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....

  19. 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....

  20. 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....

  1. 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....

  2. 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....

  3. 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…

  4. U.S.A. Plant Visits, 1977-1978.

    ERIC Educational Resources Information Center

    Department of Commerce, Washington, DC.

    This government publication provides a partial listing of plant visits available to business groups, especially international visitors. Each listing gives a short description of the industry, the address, visiting hours, person to contact, and a telephone number. The list is arranged alphabetically by state and city. Included is an industry…

  5. Inside Home Visits: A Collaborative Look at Process and Quality.

    ERIC Educational Resources Information Center

    Roggman, Lori A.; Boyce, Lisa K.; Cook, Gina A.; Jump, Vonda K.

    2001-01-01

    Assessed home visit quality in an Early Head Start program using measures developed in collaboration with program staff. Found that parent ratings were high, indicating customer satisfaction with home visiting. Families perceived by staff as improving the most had home visitors observed as most effective at engaging parents and involving parent…

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  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. 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

  12. 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…

  13. 26 CFR 521.114 - Visiting professors or teachers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 19 2014-04-01 2010-04-01 true Visiting professors or teachers. 521.114 Section 521.114 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS... Denmark and of Danish Corporations § 521.114 Visiting professors or teachers. Under Article XIV of...

  14. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 19 2014-04-01 2010-04-01 true Visiting professors or teachers. 509.115 Section... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a) General. Pursuant to Article XII of the convention, a professor or teacher, a nonresident alien who is...

  15. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  16. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  17. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  20. 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…

  1. Who Drops out of Early Head Start Home Visiting Programs?

    ERIC Educational Resources Information Center

    Roggman, Lori A.; Cook, Gina A.; Peterson, Carla A.; Raikes, Helen H.

    2008-01-01

    Research Findings: Early Head Start home-based programs provide services through weekly home visits to families with children up to age 3, but families vary in how long they remain enrolled. In this study of 564 families in home-based Early Head Start programs, "dropping out" was predicted by specific variations in home visits and certain family…

  2. 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…

  3. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 19 2013-04-01 2010-04-01 true Visiting professors or teachers. 509.115 Section... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a) General. Pursuant to Article XII of the convention, a professor or teacher, a nonresident alien who is...

  4. 26 CFR 509.115 - Visiting professors or teachers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 19 2012-04-01 2010-04-01 true Visiting professors or teachers. 509.115 Section... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.115 Visiting professors or teachers. (a) General. Pursuant to Article XII of the convention, a professor or teacher, a nonresident alien who is...

  5. 26 CFR 521.114 - Visiting professors or teachers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 19 2011-04-01 2010-04-01 true Visiting professors or teachers. 521.114 Section 521.114 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS... Denmark and of Danish Corporations § 521.114 Visiting professors or teachers. Under Article XIV of...

  6. 26 CFR 521.114 - Visiting professors or teachers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 19 2012-04-01 2010-04-01 true Visiting professors or teachers. 521.114 Section 521.114 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS... Denmark and of Danish Corporations § 521.114 Visiting professors or teachers. Under Article XIV of...

  7. 26 CFR 521.114 - Visiting professors or teachers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 19 2013-04-01 2010-04-01 true Visiting professors or teachers. 521.114 Section 521.114 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS... Denmark and of Danish Corporations § 521.114 Visiting professors or teachers. Under Article XIV of...

  8. 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

  9. 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

  10. Use of ED and Hospital Services for Patients with Acute Leukemia after Induction Therapy: One year Follow-Up

    PubMed Central

    Bryant, Ashley Leak; Deal, Allison M.; Walton, AnnMarie; Wood, William; Muss, Hyman; Mayer, Deborah K.

    2016-01-01

    Previous studies have documented use of health care services by oncology patients in the Emergency Department (ED), but little is known about the utilization of health services of patients with acute leukemia after induction therapy. The aim of this study was to examine chief reasons for ED and hospital use by patients newly diagnosed with acute leukemia patients after induction therapy up to one year after discharge. A retrospective, longitudinal study of all visits to the ED or unplanned hospital admissions at a single institution for patients with acute leukemia was conducted. Inclusion criteria were patients ≥18 years of age at time of diagnosis, a confirmed diagnosis of AML or ALL, and received and discharged from induction treatment between 2007–2010. Donabedian’s structure-process-outcome framework guided this study examining health services utilization and assessing patient outcomes. 80 patients met the inclusion criteria; 52 had AML and 28 had ALL; median age was 48 (range: 18–76) and 29% (n=23) were non-Caucasian. 70% (n=56) were discharged from induction in remission. 81% (n=65) had at least 1 ED or hospitalization event, and 44% (n=35) had 2 or more events. Of 137 events in 65 patients, the most common reason was neutropenic fever/infection (55%), bleeding (12%), and GI problems (11%). Mean number of events for ALL was 2.43 compared to 1.33 for AML patients (p=0.02), and 2.23 for <50 years of age compared to 1.20 for those older (p=0.002). 20 patients died within one year of diagnosis. Findings from this study can help inform health services delivery and utilization among patients with acute leukemia after induction therapy. Oncology providers can anticipate discharge needs and enhance follow-up care for those at higher risk for problems needing hospitalization. PMID:25711944

  11. Danger zone: battered mothers and their families in supervised visitation.

    PubMed

    Parker, Tracee; Rogers, Kellie; Collins, Meghan; Edleson, Jeffrey L

    2008-11-01

    Supervised visitation centers (SVCs) have developed rapidly across the United States. Increasingly, courts are restricting contact between abusive intimate partners and their children by ordering visitation or exchanges to occur at SVCs. This article describes some of the key lessons the authors learned over 18 months of planning and then another 18 months of implementation at a SVC developed specifically to serve families for whom domestic violence was their primary reason for referral. The authors have organized their experiences around five major themes: (a) battered women in supervised visitation, (b) how battering continues during supervised visitation, (c) how rules at the SVC evolved over the first 18 months of implementation, (d) the importance of well-trained visit monitors, and (e) the need to embed SVCs within a larger context of coordinated community responses to domestic violence. PMID:18809847

  12. 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.

  13. 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

  14. 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

  15. Simple Equipment for Imaging AC.

    ERIC Educational Resources Information Center

    Kamata, Masahiro; Anayama, Takayuki

    2003-01-01

    Presents an effective way to demonstrate the difference between direct current and alternating current using red and green LEDs. Describes how to make a tool that shows how an AC voltage changes with time using the afterimage effect of the LEDs. (Author/NB)

  16. 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.

  17. Energy saving in ac generators

    NASA Technical Reports Server (NTRS)

    Nola, F. J.

    1980-01-01

    Circuit cuts no-load losses, without sacrificing full-load power. Phase-contro circuit includes gate-controlled semiconductor switch that cuts off applied voltage for most of ac cycle if generator idling. Switch "on" time increases when generator is in operation.

  18. Predictors of Provider-Patient Visit Frequency During Hemodialysis

    PubMed Central

    Slinin, Yelena; Guo, Haifeng; Li, Suying; Liu, Jiannong; Morgan, Benjamin; Ensrud, Kristine; Gilbertson, David T.; Collins, Allan J.; Ishani, Areef

    2013-01-01

    Background/Aims In 2004, the Centers for Medicare & Medicaid Services tied reimbursement for outpatient hemodialysis services to number of times per month providers see their dialysis patients, resulting in increased provider-patient visit frequency. Greater provider-patient visit frequency is associated with lower hospitalization risk for hemodialysis patients. Determinants of visit frequency are uncertain. We aimed to identify patient, provider, and dialysis facility characteristics associated with provider visit frequency. Methods This retrospective cohort study used United States Renal Data System (USRDS) data for point-prevalent patients receiving in-center hemodialysis on January 1, 2006 (n = 144,860). Patient characteristics were defined January 1-June 30, 2006, and provider-patient visit frequency (< 4 vs. ≥ 4 visits/month) July 1-December 31, 2006. Patient characteristics were obtained from the USRDS. Provider data were obtained from the American Medical Association Physician Master File. We determined longitudinal associations between patient, provider, and facility characteristics and provider-patient visit frequency using logistic regression. Results Patient characteristics independently associated with greater provider-patient visit frequency included older age, African American race, longer dialysis duration, higher comorbidity score, Medicaid eligibility, urban residence, better compliance with dialysis, and more hospital days during run-in. Provider characteristics associated with greater provider-patient visit frequency included more years in practice, graduation from a foreign medical school, shorter distance between provider office and dialysis unit, and caring for more dialysis patients; facility characteristics included free-standing, independent status. Conclusion After the Medicare reimbursement policy change, several patient, provider, and facility characteristics were independently associated with greater dialysis provider-patient visit

  19. Bringing your child to visit a very ill sibling

    MedlinePlus

    ... support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force ... Deshler J. Family-centered care in the pediatric intensive care unit. In: Fuhrman BP and Zimmerman JJ, eds. Pediatric ...

  20. Visit-to-visit blood pressure variability and classes of antihypertensive agents; associations with artery remodeling and the risk of stroke.

    PubMed

    Nagai, Michiaki; Dote, Keigo; Kato, Masaya; Sasaki, Shota; Oda, Noboru; Kagawa, Eisuke; Nakano, Yoshinori; Yamane, Aya; Kubo, Yumiko; Higashihara, Tasuku; Miyauchi, Shunsuke; Harada, Wakako

    2016-01-01

    Recent studies have shown that visit-to-visit blood pressure (BP) variability was emerging as an independent risk factor for stroke. Although the mechanism is not fully understood, artery remodeling would be closely associated with the relationship between visit-to-visit BP variability and stroke. In addition, the class of antihypertensive agents is suggested to be an important determinant of visit-to-visit BP variability. This review article summarizes the recent literature on these topics. In the elderly hypertensives, strict BP control using calcium channel blockade would play a crucial role to prevent stroke via reducing the visit-to-visit BP variability. PMID:26561058

  1. Factors influencing hospital admissions and emergency department visits among children with complex chronic conditions: a qualitative study of parents' and providers' perspectives.

    PubMed

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

    2014-03-01

    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. 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…

  3. 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…

  4. 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

  5. A nationwide study of children and adolescents with pneumonia who visited Emergency Department in South Korea in 2012

    PubMed Central

    Lee, Chang Hyu; Won, Youn Kyoung; Roh, Eui-Jung; Suh, Dong In

    2016-01-01

    Purpose Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. Methods We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ≤18 years who were diagnosed with pneumonia between January and December 2012. Results Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). Conclusion Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia. PMID:27186220

  6. Voltage controller/current limiter for ac

    NASA Technical Reports Server (NTRS)

    Wu, T. T.

    1980-01-01

    Circuit protects ac power systems for overload failures, limits power surge and short-circuit currents to 150 percent of steady state level, regulates ac output voltage, and soft starts loads. Limiter generates dc error signal in response to line fluctuations and dumps power when overload is reached. Device is inserted between ac source and load.

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. Epidemiology of dental emergency visits to an urban children's hospital.

    PubMed

    Zeng, Y; Sheller, B; Milgrom, P

    1994-01-01

    All 1482 emergency room dental visits to Seattle's Children's Hospital and Medical Center from 1982 to 1991 were studied to evaluate trends in patients seeking care: 60% of visits were for trauma, the remainder for infection or other reasons. The number of visits was 2.1 times greater in 1991 than in 1982. Comparing the periods of 1982-1987 and 1988-1991, there was an increase in the proportion of infection-related visits from 30.5 to 43.5% of all visits. Spring/summer and weekends had the highest volume. More males (61.2%) than females received care. The largest number of visits (47.9%) occurred between 6:00 PM and midnight. Nearly two-thirds (62%) of children did not have a usual source of medical care; 30.2% of children had no medical insurance, and 21.5% received Medicaid benefits. Medicaid patients were twice as likely to be seen for infection as for trauma. Among the uninsured, there was no difference in the rates of trauma or infection. Non-Caucasian patients were twice as likely to be seen for infection as Caucasians. Infection visits were for pulpitis (32.1%), and periapical and gingival abscess (53.5%). Trauma patients were younger (66 months) than infection patients (89 months). Trauma was primarily to the maxillary anterior teeth (70.1%) and upper lip and gingiva (12.1%). Common agents for trauma were furniture, bicycles, and sports. PMID:7854948

  13. [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. PMID:22880498

  14. Authentic Field-Based Learning Experiences for EdD Students

    ERIC Educational Resources Information Center

    Hershberger, Jane Boag

    2009-01-01

    This EPP examines the problem of EdD coursework not having sufficient connection to the work that EdD students will eventually assume as leaders of school districts or other educational systems. It reviews literature critical of EdD programs and websites of educational administration professional organizations with recommended curriculum for EdD…

  15. 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

  16. 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.

  17. ac-resistance-measuring instrument

    SciTech Connect

    Hof, P.J.

    1981-04-22

    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.

  18. ED quality performance moves into the public reporting arena.

    PubMed

    2010-09-01

    As an ED manager, you face the growing challenge of your performance data being shared with the public and with hospital administration. Be sure to share the good news with your administration, so they can use it to help market the hospital. When adverse rankings appear, you have two options: Seek additional resources to improve performance, or challenge the data. Use an automated system to access"real-time"data on your department's performance, so you will always be ready to defend your ED. PMID:20853578

  19. 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.

  20. 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

  1. 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. PMID:12762523

  2. Automated SEM-EDS GSR Analysis for Turkish Ammunitions

    NASA Astrophysics Data System (ADS)

    Cakir, Ismail; Uner, H. Bulent

    2007-04-01

    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.

  3. The Emotional Reaction to Classroom Visitation and Peer Coaching.

    ERIC Educational Resources Information Center

    Eisenbach, Regina; Curry, Renee R.

    1999-01-01

    Classroom observation evokes feelings of fear and vulnerability, but the method can have developmental value for faculty. Visits by colleagues from other disciplines and supportive relationships with peer coaches can help improve teaching techniques and teacher quality. (SK)

  4. Regular Doctor Visits Can Help Spot Colon Cancer

    MedlinePlus

    ... 159699.html Regular Doctor Visits Can Help Spot Colon Cancer Early detection improves likelihood of survival, researchers ... increases the odds you'll be screened for colon cancer, a new study says. Colon cancer is ...

  5. Smokey Visits Station Flight Control Room - Duration: 14 minutes.

    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...

  6. 75 FR 106 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-04

    ... National Institute of Standards and Technology Visiting Committee on Advanced Technology AGENCY: National Institute of Standards and Technology, Department of Commerce. ACTION: Notice of public meeting. SUMMARY... Committee on Advanced Technology (VCAT), National Institute of Standards and Technology (NIST), will...

  7. 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

  8. 76 FR 2662 - Visiting Committee on Advanced Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ...The Visiting Committee on Advanced Technology (VCAT), National Institute of Standards and Technology (NIST), will meet Tuesday, February 1, 2011, from 8:30 a.m. to 5 p.m. and Wednesday, February 2, 2011, from 8:30 a.m. to 2 p.m. The Visiting Committee on Advanced Technology is composed of fifteen members appointed by the Director of NIST who are eminent in such fields as business, research,......

  9. Acute Effects of Outdoor Air Pollution on Emergency Department Visits Due to Five Clinical Subtypes of Coronary Heart Diseases in Shanghai, China

    PubMed Central

    Xie, Juan; He, Mingzhen; Zhu, Weiying

    2014-01-01

    Background Air pollution can be a contributing cause to the development and exacerbation of coronary heart disease (CHD), but there is little knowledge about the acute effects of air pollution on different clinical subtypes of CHD. Methods We conducted a time-series study to investigate the association of air pollution (particulate matter with an aerodynamic diameter < 10 µm [PM10], sulfur dioxide [SO2], and nitrogen dioxide [NO2]) on emergency department (ED) visits due to five different subtypes of CHD in Shanghai, China, from 2010 to 2012. We applied an over-dispersed Poisson generalized addictive model to analyze the associations after controlling for the seasonality, day of the week, and weather conditions. Results We identified a total of 47 523 ED visits for CHD. A 10-µg/m3 increase in the present-day concentrations of PM10, SO2, and NO2 was associated with respective increases of 1.10% (95% confidence interval [CI] 0.33%–1.87%), 0.90% (95% CI −0.14%–1.93%), and 1.44% (95% CI 0.63%–2.26%) for total ED visits for CHD. These associations varied greatly by clinical type, with strong effects on sudden cardiac death, moderate effects on acute myocardial infarction and angina, weak effects on ischemic cardiomyopathy, and no effect on occult CHD. The associations were stronger among people aged 65 years or more than in younger individuals and in the cool season versus the warm one. Conclusions Outdoor air pollution may have different effects of air pollution on 5 subtypes of CHD. Our results might be useful for the primary prevention of various subtypes of CHD exacerbated by air pollution. PMID:24998952

  10. 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.

  11. [The evaluation of preoperative anesthetic visit in our hospital].

    PubMed

    Adachi, Y; Watanabe, K; Satoh, T

    1999-09-01

    The preoperative visit by an anesthetist has been thought to be important for the assessment of patient and to communicate with them. However, there are few reports on the visit in Japan until now. The effect of preoperative anesthetic visit in our hospital was estimated by interviewing patients just before surgery who had received a visit by their anesthetist. The answers from sequential 346 scheduled surgical patients for 8 weeks were obtained. Only 72 patients were able to recall the name of their anesthetists. About half of patients believed that anesthetist just had put the patient to sleep and relieved them from pain. We measured the number of treatments each patient could remember that had been explained by the anesthetist on the visit, and found it was unexpectedly small at the interview. These data suggest that our preoperative visit may not be satisfying in view of making good relationship between patients and anesthetists, and educating patients for recent anesthesia. We should make an effort to educate the patients about up-to-date and reasonable anesthesia. PMID:10513187

  12. Implementation of a pet visitation program in critical care.

    PubMed

    Giuliano, K K; Bloniasz, E; Bell, J

    1999-06-01

    We have no quantitative research data to document that these visits are actually helpful to patients in any measurable way, although we certainly hope to have some soon. However, observations of staff members and evaluations from participants in the program have been quite positive thus far. The program has been in place for more than 2 years, and about 30 pets have visited so far, including 28 dogs and 2 cats. Implementing a pet visitation program for critically ill patients affords healthcare providers the opportunity to offer a unique and humanistic therapeutic intervention to appropriate patients. Although it is a time-consuming endeavor, it has been well received by those patients and families that have participated in pet visits. Critically ill patients are often denied many simple pleasures because they are in physiological crisis. Such patients experience loneliness, isolation, depression, and lack of emotional support. Pet visitation is one way to address these common problems of ICU patients. For this reason, pet visitation will remain a therapeutic option for the support of our critically ill patients. PMID:10661091

  13. 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.…

  14. 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…

  15. Weck Ed. Weck Educational Development Program. Final Performance Report.

    ERIC Educational Resources Information Center

    Coplin, Jennifer; And Others

    This document includes a final performance report and evaluation report from the Weck Ed program, through which job-linked adult basic education and General Educational Development (GED) test preparation courses that were jointly developed by the company Pilling Weck and Durham Technical Community College were offered to Pilling Weck employees on…

  16. 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…

  17. Lifeworld and Textualism: Reassembling the Researcher/ed and "Others"

    ERIC Educational Resources Information Center

    Payne, Phillip G.

    2005-01-01

    This response to McKenzie's "post-post" concerns about environmental education research draws upon empirical, conceptual, anecdotal, metaphorical, imaged and poetic means to help the researcher "reassemble" the researcher/ed by attending to her/his relational body and embodiment of various, often hegemonic, socially constructed environmental…

  18. Prediction of College Student Dropouts Using EDS Scores.

    ERIC Educational Resources Information Center

    Witherspoon, A. D.; Long, Carolyn K.; Chubick, Jennifer D.

    1999-01-01

    To identify college students at risk for dropping out, scores on the Environmental Deprivation Scale (EDS) given six quarters earlier were studied. Students who had graduated at follow-up had lower scores than those who had dropped out. Examination of items showed types of support lacking for at-risk students. (EMK)

  19. 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.

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. Institutionalizing Environmental Scanning in the ED QUEST Process.

    ERIC Educational Resources Information Center

    Morrison, James L.

    An environmental scanning system is structured to identify and evaluate trends, events, and emerging issues. QUEST represents the quick environmental scanning technique, and an ED QUEST process enables an educational organization to clarify its future and define its options. This paper describes how an educational organization can establish an…

  5. 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)…

  6. Merging Career and Ex Ed Centers: A Perspective.

    ERIC Educational Resources Information Center

    Shea, Denise Dwight

    1995-01-01

    Career centers in universities are increasingly being merged with other student employment programs, such as internship and cooperative education programs. Experiential education (ex ed) is poised to become the largest service component of the new merged services. Discusses values to students, employers, and career services professionals. (JPS)

  7. Indiana AdvancED/NCA District Accreditation Study

    ERIC Educational Resources Information Center

    Boles, Sterling M.

    2012-01-01

    The purpose of this study was to examine the perceived strengths and limitations of the AdvancED/NCA district model of accreditation. Indiana public school superintendent, principal, and teacher results were examined in order to determine effective systems model improvement efforts. The survey results of district-accredited staff members from…

  8. SSF1deg-Day Terra Ed4

    Atmospheric Science Data Center

    2016-06-08

    ... and Order:  Reverb   Reverb Tutorial Subset/Visualization Tool:  CERES Order Tool Search and Order:  ASDC Order ... Documents:  Detailed CERES SSF1deg-lite Product Information Data Products Catalog: DPC_SSF1deg-Day_Ed4_R5V1 ...

  9. SSF1deg-Day Aqua Ed4

    Atmospheric Science Data Center

    2016-06-08

    ... and Order:  Reverb   Reverb Tutorial Subset/Visualization Tool:  CERES Order Tool Search and Order:  ASDC Order ... Documents:  Detailed CERES SSF1deg-lite Product Information Data Products Catalog: DPC_SSF1deg-Day_Ed4_R6V1 ...

  10. Visit the MedlinePlus Search Cloud | NIH MedlinePlus the Magazine

    MedlinePlus

    ... please turn Javascript on. Visit the MedlinePlus Search Cloud Past Issues / Winter 2011 Table of Contents Free, ... Visit the new MedlinePlus Visit the MedlinePlus search cloud, featuring the top 100 search terms of the ...

  11. Assessing the Deployment of Home Visiting: Learning from a State-Wide Survey of Home Visiting Programs.

    PubMed

    Fischer, Robert L; Anthony, Elizabeth R; Lalich, Nina; Nevar, Ann; Bakaki, Paul; Koroukian, Siran

    2016-03-01

    Objectives Large-scale planning for health and human services programming is required to inform effective public policy as well as deliver services to meet community needs. The present study demonstrates the value of collecting data directly from deliverers of home visiting programs across a state. This study was conducted in response to the Patient Protection and Affordable Care Act, which requires states to conduct a needs assessment of home visiting programs for pregnant women and young children to receive federal funding. In this paper, we provide a descriptive analysis of a needs assessment of home visiting programs in Ohio. Methods All programs in the state that met the federal definition of home visiting were included in this study. Program staff completed a web-based survey with open- and close-ended questions covering program management, content, goals, and characteristics of the families served. Results Consistent with the research literature, program representatives reported great diversity with regard to program management, reach, eligibility, goals, content, and services delivered, yet consistently conveyed great need for home visiting services across the state. Conclusions Results demonstrate quantitative and qualitative assessments of need have direct implications for public policy. Given the lack of consistency highlighted in Ohio, other states are encouraged to conduct a similar needs assessment to facilitate cross-program and cross-state comparisons. Data could be used to outline a capacity-building and technical assistance agenda to ensure states can effectively meet the need for home visiting in their state. PMID:26576591

  12. Ac electrode diagnostics in ac-operated metal halide lamps

    NASA Astrophysics Data System (ADS)

    Luijks, G. M. J. F.; van Esveld, H. A.; Nijdam, S.; Weerdesteijn, P. A. M.

    2008-07-01

    A diagnostic technique is presented to determine the electrode work function in ac-operated metal halide lamps. The heart of the experimental set-up is a high-speed photodiode array detector, which is able to follow real-time variations of electrode tip temperature and near-electrode plasma emissions in ac-operated experimental YAG lamps, enabling discrimination between the anode and cathode effects. Electrode tip temperature ripples have been measured for 100 Hz square wave operation and simulated with an existing electrode model. By using the electrode work function as main fit parameter for the simulations it is found that the measured cooling effect of the electrode tip in a NaTlDy-iodide lamp is caused by a gas-phase emitter effect of Dy. It is concluded that Dy coverage of the electrode tip causes an effective work function reduction of 0.3 eV at 100 Hz square wave operation, considerably less than the 1.0 eV reduction measured earlier for dc operation.

  13. Ambient ozone concentration and emergency department visits for panic attacks.

    PubMed

    Cho, Jaelim; Choi, Yoon Jung; Sohn, Jungwoo; Suh, Mina; Cho, Seong-Kyung; Ha, Kyoung Hwa; Kim, Changsoo; Shin, Dong Chun

    2015-03-01

    The effect of ambient air pollution on panic disorder in the general population has not yet been thoroughly elucidated, although the occurrence of panic disorder in workers exposed to organic solvents has been reported previously. We investigated the association of ambient air pollution with the risk of panic attack-related emergency department visits. Using health insurance claims, we collected data from emergency department visits for panic attacks in Seoul, Republic of Korea (2005-2009). Daily air pollutant concentrations were obtained using automatic monitoring system data. We conducted a time-series study using a generalized additive model with Poisson distribution, which included spline variables (date of visit, daily mean temperature, and relative humidity) and parametric variables (daily mean air pollutant concentration, national holiday, and day of the week). In addition to single lag models (lag1 to lag3), cumulative lag models (lag0-1 to lag0-3) were constructed using moving-average concentrations on the days leading up to the visit. The risk was expressed as relative risk (RR) per one standard deviation of each air pollutant and its 95% confidence interval (95% CI). A total of 2320 emergency department visits for panic attacks were observed during the study period. The adjusted RR of panic attack-related emergency department visits was 1.051 (95% CI, 1.014-1.090) for same-day exposure to ozone. In cumulative models, adjusted RRs were 1.068 (1.029-1.107) in lag0-2 and 1.074 (1.035-1.114) in lag0-3. The ambient ozone concentration was significantly associated with emergency department visits for panic attacks. PMID:25669697

  14. 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

  15. 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;

  16. The AC photovoltaic module is here!

    NASA Astrophysics Data System (ADS)

    Strong, Steven J.; Wohlgemuth, John H.; Wills, Robert H.

    1997-02-01

    This paper describes the design, development, and performance results of a large-area photovoltaic module whose electrical output is ac power suitable for direct connection to the utility grid. The large-area ac PV module features a dedicated, integrally mounted, high-efficiency dc-to-ac power inverter with a nominal output of 250 watts (STC) at 120 Vac, 60 H, that is fully compatible with utility power. The module's output is connected directly to the building's conventional ac distribution system without need for any dc wiring, string combiners, dc ground-fault protection or additional power-conditioning equipment. With its advantages, the ac photovoltaic module promises to become a universal building block for use in all utility-interactive PV systems. This paper discusses AC Module design aspects and utility interface issues (including islanding).

  17. 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

  18. 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

  19. 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.

  20. 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

  1. Single event AC - DC electrospraying

    NASA Astrophysics Data System (ADS)

    Stachewicz, U.; Dijksman, J. F.; Marijnissen, J. C. M.

    2008-12-01

    Electrospraying is an innovative method to deposit very small amounts of, for example, biofluids (far less than 1 p1) that include DNA or protein molecules. An electric potential is applied between a nozzle filled with liquid and a counter electrode placed at 1-2 millimeter distance from the nozzle. In our set-up we use an AC field superposed on a DC field to control the droplet generation process. Our approach is to create single events of electrospraying triggered by one single AC pulse. During this pulse, the equilibrium meniscus (determined by surface tension, static pressure and the DC field) of the liquid changes rapidly into a cone and subsequently into a jet formed at the cone apex. Next, the jet breaks-up into fine droplets and the spraying stops. The meniscus returns to its equilibrium shape again. So far we obtained a stable and reproducible single event process for ethanol and ethylene glycol with water using glass pipettes. The results will be used to generate droplets on demand in a controlled way and deposit them on a pre-defined place on the substrate.

  2. Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios

    PubMed Central

    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

  3. 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.

  4. 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

  5. VisIt Version 2.0.1

    2010-06-01

    VisIt is an interactive parallel visualization and graphical analysis tool for viewing scientific data on UNIX and PC platforms, Users can quickly generate visualizations from their data, animate them through time, manipulate them, and save the resulting images for presentations, VisIt contains a rich set of visualization features so that you can view your data in a variety of ways. It can be used to visualize scalar and vector fields defined on two and threemore » dimensional (2D and 3D) structured and unstructured meshes. VisIt was designed to handle very large data set sizes in the terascale range and yet can also handle small data sets in kilobyte range.« less

  6. Coyote visits at scent stations in relation to home range

    SciTech Connect

    Harris, C.E.; Knowlton, F.F.

    1986-01-01

    Response of free-franging coyotes (Canis latrans) to scent stations was studied in southeastern Idaho and southern Texas to examine relationships between the scent-station survey technique and coyote home range. Coyotes with radio transmitters were intensively monitored to determine movement and spatial use patterns for comparison with coyote visitations to artificial scent stations. Coyotes more frequently visited scent stations on the periphery or outside their home ranges than within them, probably because resident coyotes avoided scent stations (novel stimuli) in the very familiar core areas of their home ranges and were more likely to investigate them when encountered on the periphery or outside of them. Hence, scent stations may receive more visits from transient or dispersing individuals than from residents. 55 refs., 4 tabs.

  7. Modeling Common Cause Failures of Thrusters on ISS Visiting Vehicles

    NASA Technical Reports Server (NTRS)

    Haught, Megan

    2014-01-01

    This paper discusses the methodology used to model common cause failures of thrusters on the International Space Station (ISS) Visiting Vehicles. The ISS Visiting Vehicles each have as many as 32 thrusters, whose redundancy makes them susceptible to common cause failures. The Global Alpha Model (as described in NUREG/CR-5485) can be used to represent the system common cause contribution, but NUREG/CR-5496 supplies global alpha parameters for groups only up to size six. Because of the large number of redundant thrusters on each vehicle, regression is used to determine parameter values for groups of size larger than six. An additional challenge is that Visiting Vehicle thruster failures must occur in specific combinations in order to fail the propulsion system; not all failure groups of a certain size are critical.

  8. Modeling Common Cause Failures of Thrusters on ISS Visiting Vehicles

    NASA Technical Reports Server (NTRS)

    Haught, Megan; Duncan, Gary

    2014-01-01

    This paper discusses the methodology used to model common cause failures of thrusters on the International Space Station (ISS) Visiting Vehicles. The ISS Visiting Vehicles each have as many as 32 thrusters, whose redundancy and similar design make them susceptible to common cause failures. The Global Alpha Model (as described in NUREG/CR-5485) can be used to represent the system common cause contribution, but NUREG/CR-5496 supplies global alpha parameters for groups only up to size six. Because of the large number of redundant thrusters on each vehicle, regression is used to determine parameter values for groups of size larger than six. An additional challenge is that Visiting Vehicle thruster failures must occur in specific combinations in order to fail the propulsion system; not all failure groups of a certain size are critical.

  9. Visiting Congress: Can AGU Members Make a Difference?

    NASA Astrophysics Data System (ADS)

    Basu, Sunanda

    2006-03-01

    Having recently discovered the value of a Congressional Visit experience, I would like to invite other AGU members to participate in the 2006 Science Engineering and Technology Congressional Visits Day (CVD), 28-29 March 2006. My experience at an AGU CVD last fall taught me that participating in the policy process and visiting your Congressional delegation can make a difference. On 14 September 2005, I was part of a group of more than 70 scientists that fanned out to meet members of Congress and their staffs as part of a CVD organized by the Coalition for National Science Funding (CNSF). CNSF is an alliance of more than 100 organizations, including AGU, that supports the goal of increasing national investment in the U.S. National Science Foundation's (NSF) research and education programs.

  10. Characteristics of Breastfeeding Discussions at the Initial Prenatal Visit

    PubMed Central

    Demirci, Jill R.; Bogen, Debra L.; Holland, Cynthia; Tarr, Jill A.; Rubio, Doris; Li, Jie; Nemecek, Marianne; Chang, Judy C.

    2014-01-01

    Objective To describe the observed characteristics of first prenatal visit breastfeeding discussions between obstetric providers and their pregnant patients. Methods This analysis was part of a larger study involving 69 providers and 377 patients attending their initial prenatal visits at a single clinic. Audio recordings and transcripts from the first 172 visits (including 36 obstetric-gynecology residents, six nurse midwives and five nurse practitioners) were reviewed for breastfeeding discussion occurrence, timing, and initiator of discussions, and adherence to American College of Obstetricians and Gynecologists (the College) prenatal breastfeeding guidelines. Descriptive statistics were used to characterize the sample and frequency of breastfeeding discussions. Logistic regression and chi-square tests were used to examine patterns in women's breastfeeding discussion preferences and discussion occurrence. Conversations were qualitatively analyzed for breastfeeding content. Results Breastfeeding discussions were infrequent (29% of visits), brief (m=39 seconds), and most often initiated by clinicians in an ambivalent manner. Sixty-nine percent of breastfeeding discussions incorporated any College breastfeeding recommendations. Breastfeeding was significantly more likely to be discussed by certified nurse midwives (CNMs) than residents (OR 24.54, 95% CI: 3.78-159.06; p<0.01), and CNMs tended to engage patients in more open discussions. Women indicating a preference for breastfeeding discussions at the first visit (n=19) were more likely to actually have the discussion (p<0.001). Conclusion Observed breastfeeding education at the first prenatal visit was suboptimal. The causes and effect of this deficiency on breastfeeding outcomes remains an important point of investigation. PMID:24201684

  11. Emergency department visits during an Olympic gold medal television broadcast

    PubMed Central

    Redelmeier, Donald A; Vermeulen, Marian J

    2011-01-01

    Background Practice pattern variations are often attributed to physician decision-making with no accounting for patient preferences. Objective To test whether a mass media television broadcast unrelated to health was associated with changes in the rate and characteristics of visits for acute emergency care. Design Time-series analysis of emergency department visits for any reason. Subjects Population-based sample of all patients seeking emergency care in Ontario, Canada. Measures The broadcast day was defined as the Olympic men’s gold medal ice hockey game final. The control days were defined as the 6 Sundays before and after the broadcast day. Results A total of 99 447 visits occurred over the 7 Sundays, of which 13 990 occurred on the broadcast day. Comparing the broadcast day with control days, we found no significant difference in the hourly rate of visits before the broadcast (544 vs 537, p = 0.41) or after the broadcast (647 vs 639, p = 0.55). In contrast, we observed a significant reduction in hourly rate of visits during the broadcast (647 vs 783, p < 0.001), equal to an absolute decrease of 409 patients, a relative decrease of 17% (95% confidence interval 13–21), or about 136 fewer patients per hour. The relative decrease during the broadcast was particularly large for adult men with low triage severity. The greatest reductions were for patients with abdominal, musculoskeletal or traumatic disorders. Conclusion Mass media television broadcasts can influence patient preferences and thereby lead to a decrease in emergency department visits. PMID:21915235

  12. 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. PMID:18689224

  13. 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. PMID:18198764

  14. Remotely operated welding systems for EdF plant maintenance

    SciTech Connect

    Thapon, G. ); Blight, J.; Durand, B. )

    1992-01-01

    With the objective of improving weld quality, reducing outage times, and minimizing integrated dose, Electricite de France (EdF) and Comex Nucleaire (CxN) have developed a number of advanced remotely controlled welding systems. Three such developments are described, two having been used operationally and the third being qualified for use in the coming months. The three developments involve replacing pressurizes heaters, replacing fuel charge head sleeves, and real-time interactive welding.

  15. The implementation of Mask-Ed: reflections of academic participants.

    PubMed

    Reid-Searl, Kerry; Levett-Jones, Tracy; Cooper, Simon; Happell, Brenda

    2014-09-01

    This paper profiles the findings from a study that explored the perspectives and experiences of nurse educators who implemented a novel simulation approach termed Mask-Ed. The technique involves the educator wearing a silicone mask and or body parts and transforming into a character. The premise of this approach is that the masked educator has domain specific knowledge related to the simulation scenario and can transmit this to learners in a way that is engaging, realistic, spontaneous and humanistic. Nurse educators charged with the responsibility of implementing Mask-Ed in three universities were invited to participate in the study by attending an introductory workshop, implementing the technique and then journaling their experiences, insights and perspectives over a 12 month period. The journal entries were then thematically analysed. Key themes were categorised under the headings of Preparation, Implementation and Impact; Reflexivity and Responsiveness; Student Engagement and Ownership; and Teaching and Learning. Mask-Ed is a simulation approach which allows students to interact with the 'characters' in humanistic ways that promote person-centred care and therapeutic communication. This simulation approach holds previously untapped potential for a range of learning experiences, however, to be effective, adequate resourcing, training, preparation and practice is required. PMID:24906681

  16. 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.

  17. Lean-driven solutions slash ED wait times, LOS.

    PubMed

    2012-12-01

    The ED at The Aroostook Medical Center (TAMC) in Presque Isle, ME, is a level II trauma center. It is the largest in the region, with only 89 beds. It has undergone a transformation in recent months, with average wait times to see a provider going from four to five hours down to less than five minutes, and the left-without-being-seen (LWBS) rate has been slashed from a high of 7% down to less than 1%. The hospital says the improvements are the result of lean-driven, staff-designed solutions, coupled with administrative engagement and oversight. And administrators say more improvements are on the way in 2013 when a hospital-wide workgroup will try to clear away obstacles and inefficiencies from the hospital admissions process. To tackle long wait times among patients with lower triage levels, the ED instituted a fast-track system, manned by mid-level providers and a tech or LPN. Responsibilities for charge nurses have been redesigned so that they have the power to monitor and facilitate patient flow. The ED has initiated more point-of-care testing so that nurses and techs can conduct many routine tests on their own. While the lean model relies on staff-driven solutions, administrators make the difference when it comes to sustaining changes and minimizing employee resistance. PMID:23214229

  18. 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

  19. 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

  20. 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