Minnesota urban partnership agreement national evaluation : content analysis test plan.

DOT National Transportation Integrated Search

2009-11-17

This report presents the content analysis test plan for the Minnesota Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The Minnesota UPA projects focus on reducing congestion by employing ...

Minnesota urban partnership agreement national evaluation : cost benefit analysis test plan.

DOT National Transportation Integrated Search

2009-11-17

This report presents the cost benefit analysis test plan for the Minnesota Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The Minnesota UPA projects focus on reducing congestion by emplo...

Integrated corridor management initiative : demonstration phase evaluation – Dallas corridor performance analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Corridor Performance Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM ...

Integrated corridor management initiative : demonstration phase evaluation – San Diego corridor performance analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Corridor Performance Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

Impact of local/short haul operations on driver fatigue : focus group summary and analysis

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Institutional and Organizational Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstrati...

Integrated corridor management initiative : demonstration phase evaluation - Dallas decision support system analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Decision Support System (DSS) Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration....

Integrated corridor management initiative : demonstration phase evaluation – Dallas technical capability analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM ...

Interim analysis report : model deployment of a regional, multi-modal 511 traveler information system

DOT National Transportation Integrated Search

2004-02-17

This document presents the results of the analysis of baseline, or "pre-enhancement," data describing the operation of the existing 511 telephone traveler information system operated by the Arizona Department of Transportation (ADOT). The model deplo...

Who breaches the four-hour emergency department wait time target? A retrospective analysis of 374,000 emergency department attendances between 2008 and 2013 at a type 1 emergency department in England.

PubMed

Bobrovitz, Niklas; Lasserson, Daniel S; Briggs, Adam D M

2017-11-02

The four-hour target is a key hospital emergency department performance indicator in England and one that drives the physical and organisational design of the ED. Some studies have identified time of presentation as a key factor affecting waiting times. Few studies have investigated other determinants of breaching the four-hour target. Therefore, our objective was to describe patterns of emergency department breaches of the four-hour wait time target and identify patients at highest risk of breaching. This was a retrospective cohort study of a large type 1 Emergency department at an NHS teaching hospital in Oxford, England. We analysed anonymised individual level patient data for 378,873 emergency department attendances, representing all attendances between April 2008 and April 2013. We examined patient characteristics and emergency department presentation circumstances associated with the highest likelihood of breaching the four-hour wait time target. We used 374,459 complete cases for analysis. In total, 8.3% of all patients breached the four-hour wait time target. The main determinants of patients breaching the four-hour wait time target were hour of arrival to the ED, day of the week, patient age, ED referral source, and the types of investigations patients receive (p < 0.01 for all associations). Patients most likely to breach the four-hour target were older, presented at night, presented on Monday, received multiple types of investigation in the emergency department, and were not self-referred (p < 0.01 for all associations). Patients attending from October to February had a higher odds of breaching compared to those attending from March to September (OR 1.63, 95% CI 1.59 to 1.66). There are a number of independent patient and circumstantial factors associated with the probability of breaching the four-hour ED wait time target including patient age, ED referral source, the types of investigations patients receive, as well as the hour, day, and month of arrival to the ED. Efforts to reduce the number of breaches could explore late-evening/overnight staffing, access to diagnostic tests, rapid discharge facilities, and early assessment and input on diagnostic and management strategies from a senior practitioner.

An Analysis of Self-Efficacy Perceptions of Physical Education and Sport Teacher Candidates and Other Teacher Candidates on Teaching Profession

ERIC Educational Resources Information Center

Ozer, Tugce; Demirel, Duygu H.

2017-01-01

Aim of this research is to identify the self-efficacy perception levels of teacher candidates studying at department of Physical Education and Sport and other teaching departments towards teaching profession, to present whether these the self-efficacy perceptions differ or not depending on independent variables acquired from the personal…

Maryland State Department of Education: Analysis of the Voluntary State Curriculum (VSC) in Science Grades Pre-K-8

ERIC Educational Resources Information Center

Achieve, Inc., 2005

2005-01-01

In response to a proposal request from the state, Achieve reviewed the draft of Maryland's Pre-K-8 Voluntary State Curriculum (VSC) in Science (dated May 2004). This preliminary report summarizes their findings and also reflects the discussion that followed their presentation to representatives of the Maryland State Department of Education on…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sprik, Samuel; Kurtz, Jennifer M; Ainscough, Christopher D

In this presentation, the National Renewable Energy Laboratory presented aggregated analysis results on the performance of existing hydrogen stations, including performance, operation, utilization, maintenance, safety, hydrogen quality, and cost. The U.S. Department of Energy funds technology validation work at NREL through its National Fuel Cell Technology Evaluation Center (NFCTEC).

Integrated corridor management initiative : demonstration phase evaluation – San Diego benefit-cost analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Benefit-Cost Analysis (BCA) for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM project...

Ocular related emergencies in Zagreb University Hospital Centre--ten month analysis.

PubMed

Skegro, Ivan; Kordić, Rajko; Kuzman, Tomislav; Perić, Sanja; Kutija, Marija Barisić; Jandroković, Sonja; Jukić, Tomislav

2013-04-01

To determine number, demographic characteristics and presenting symptoms of patients admitted to Emergency ophthalmologic department of Zagreb University hospital centre. Prospective analysis of data of 743 patients admitted to Emergency ophthalmologic department of University hospital centre Zagreb during period of 10 month. Main presenting symptoms at admission were red eye, pain and foreign body sensation. 64% of all patients admitted to emergency unit were male. Almost 40% of them were between 20 and 40 years of age. In female population majority is between 50 and 60 years old (19.33%). The study shows that the most frequent reason for admission in emergency ophthalmic unit is red eye, pain and foreign body sensation. These symptoms were present most frequently in young male patients. Considering fact of their working ability, data can suggest that they don't comply with occupational safety measures. Further research in this direction is needed.

Analysis of Energy Consumption and Possibilities of Thermal-Modernization in Residential Buildings in Poland Case Study: The Town of Zielona Góra

NASA Astrophysics Data System (ADS)

Alsabry, A.; Truszkiewicz, P.; Szymański, K.; Łaskawiec, K.; Rojek, Ł.

2017-12-01

The article presents an analysis of buildings belonging the Department of Public Utilities and Housing in Zielona Góra. The research was based on a set of questions for building operators. The questionnaires consisted of 30 questions concerning general and detailed information about the buildings. In order to clearly present the results, this article includes data only about residential and residential-commercial buildings. Forty building built in different periods were selected for analysis.

Human resources management for a hospital pharmacy department.

PubMed

Chase, P A

1989-06-01

The concepts of human resources management (HRM) are presented, and the application of HRM concepts to a hospital pharmacy department is described. Low salaries and poor working conditions had precipitated a mass exodus of pharmacists from a 650-bed, tertiary-care medical center. The newly hired director of pharmacy sought to rebuild the department by developing a three-stage HRM model consisting of needs forecasting, performance management, and advanced management systems. In the needs-forecasting stage, the strengths and weaknesses of departmental programs were determined through analysis of existing standards of practice, situational analysis, and financial analyses; the strengths and weaknesses of departmental employees were determined through the use of talent inventories, turnover analysis, analysis of time and leave records, reevaluation of the department's job classifications, performance and productivity evaluations, and productivity evaluations, and development of a philosophy of practice and mission statement. Needs and problems were addressed by examining each existing program and developing new policies and procedures, performance standards, quality assurance mechanisms, and productivity expectations. Personnel needs and problems were addressed by designing a system of differentiated career ladders, contracting with pharmacists for career moves, developing the skills of currently employed pharmacists, and implementing a succession planning model. The model has been in place for approximately three years and is beginning to yield the desired results. Application of HRM concepts to a hospital pharmacy department appears to have been successful in improving employee morale and in helping the department to meet goals of expanded and improved services.

Analysis of pathology department Web sites and practical recommendations.

PubMed

Nero, Christopher; Dighe, Anand S

2008-09-01

There are numerous customers for pathology departmental Web sites, including pathology department staff, clinical staff, residency applicants, job seekers, and other individuals outside the department seeking department information. Despite the increasing importance of departmental Web sites as a means of distributing information, no analysis has been done to date of the content and usage of pathology department Web sites. In this study, we analyzed pathology department Web sites to examine the elements present on each site and to evaluate the use of search technology on these sites. Further, we examined the usage patterns of our own departmental Internet and internet Web sites to better understand the users of pathology Web sites. We reviewed selected departmental pathology Web sites and analyzed their content and functionality. Our institution's departmental pathology Web sites were modified to enable detailed information to be stored regarding users and usage patterns, and that information was analyzed. We demonstrate considerable heterogeneity in departmental Web sites with many sites lacking basic content and search features. In addition, we demonstrate that increasing the traffic of a department's informational Web sites may result in reduced phone inquiries to the laboratory. We propose recommendations for pathology department Web sites to maximize promotion of a department's mission. A departmental pathology Web site is an essential communication tool for all pathology departments, and attention to the users and content of the site can have operational impact.

Infrastructure Analysis Tools: A Focus on Cash Flow Analysis (Presentation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Melaina, M.; Penev, M.

2012-09-01

NREL has developed and maintains a variety of infrastructure analysis models for the U.S. Department of Energy. Business case analysis has recently been added to this tool set. This presentation focuses on cash flow analysis. Cash flows depend upon infrastructure costs, optimized spatially and temporally, and assumptions about financing and revenue. NREL has incorporated detailed metrics on financing and incentives into the models. Next steps in modeling include continuing to collect feedback on regional/local infrastructure development activities and 'roadmap' dynamics, and incorporating consumer preference assumptions on infrastructure to provide direct feedback between vehicles and station rollout.

Cost Analysis of Online Courses. AIR 2000 Annual Forum Paper.

ERIC Educational Resources Information Center

Milam, John H., Jr.

This paper presents a complex, hybrid, method of cost analysis of online courses, which incorporates data on expenditures; student/course enrollment; departmental consumption/contribution; space utilization/opportunity costs; direct non-personnel costs; computing support; faculty/staff workload; administrative overhead at the department, dean, and…

Uniform Food Service Management System.

DTIC Science & Technology

The study report contains an analysis of the management of food service within the Office of the Secretary of Defense and the military departments...Procedures and organizations which inhibit an optimum food service management system are discussed. Recommendations are made for the establishment of...a uniform food service management system in the Department of Defense which will be responsive to present day requirements in food service operations

The Role of Information in the Strategic Management Process.

ERIC Educational Resources Information Center

Hayward, Tim; Broady, Judith E.

1995-01-01

Presents research on the use of external information in the strategic management of retail banks in the United Kingdom. Explores the organizational role of the environmental analysis department, the character of business environment analysis, and the nature of information used in strategic management and its perceived importance. (Author/AEF)

Defining the Technology Transition Manager within the Acquisition Framework of the Department of Defense

DTIC Science & Technology

2010-03-01

80 Discussion ...methods used to construct the survey questionnaire and discuss the data analysis methodology. Chapter IV will present the analysis of the data...2 provides a snapshot of the similarities and differences across various studies on new product development. The subsequent paragraphs will discuss

The impact of educational interventions on attitudes of emergency department staff towards patients with substance-related presentations: a quantitative systematic review.

PubMed

Gonzalez, Miriam; Clarke, Diana E; Pereira, Asha; Boyce-Gaudreau, Krystal; Waldman, Celeste; Demczuk, Lisa; Legare, Carol

2017-08-01

Visits to emergency departments for substance use/abuse are common worldwide. However, emergency department health care providers perceive substance-using patients as a challenging group to manage which can lead to negative attitudes. Providing education or experience-based exercises may impact positively on behaviors towards this patient population. Whether staff attitudes are similarly impacted by knowledge acquired through educational interventions remains unknown. To synthesize available evidence on the relationship between new knowledge gained through substance use educational interventions and emergency department health care providers' attitudes towards patients with substance-related presentations. Health care providers working in urban and rural emergency departments of healthcare facilities worldwide providing care to adult patients with substance-related presentations. Quantitative papers examining the impact of substance use educational interventions on health care providers' attitudes towards substance using patients. Experimental and non-experimental study designs. Emergency department staff attitudes towards patients presenting with substance use/abuse. A three-step search strategy was conducted in August 2015 with a search update in March 2017. Studies published since 1995 in English, French or Spanish were considered for inclusion. Two reviewers assessed studies for methodological quality using critical appraisal checklists from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Reviewers agreed on JBI-MAStARI methodological criteria a study must meet in order to be included in the review (e.g. appropriate use of statistical analysis). The data extraction instrument from JBI-MAStARI was used. As statistical pooling of the data was not possible, the findings are presented in narrative form. A total of 900 articles were identified as relevant for this review. Following abstract and full text screening, four articles were selected and assessed for methodological quality. One article met methodological criteria for inclusion in the review: use of random assignment and comparable study groups and measurement outcomes in a reliable and consistent manner. The included study was a cluster randomized controlled trial. Participants were emergency medicine residents with a mean age of 30 years. The study assessed the impact of a skills-based educational intervention on residents' attitudes, knowledge and practice towards patients with alcohol problems. While knowledge and practice behaviors improved one year following the intervention, there were no significant differences between groups on attitudinal measures. Employing educational interventions to improve the attitudes of emergency department staff towards individuals with drug and alcohol related presentations is not supported by evidence.

Technical efficiency of Shiraz school of medicine in research and education domains: a data envelopment analysis.

PubMed

Delavari, Somayeh; Rezaee, Rita; Hatam, Nahid; Delavari, Sajad

2016-01-01

Efficiency evaluation of universities and faculties is one of the tools that help managers to identify the departments' strengths and weakness. The main objective of the present research was to measure and compare the technical efficiency of Shiraz school of medicine departments using Data Envelopment Analysis (DEA) technique. This cross-sectional and retrospective study was performed on clinical and non-clinical departments in research and education domains over the period of 2006 to 2011. Different inputs and outputs were considered for research and educational domain separately. Efficiency was measured based on the observed optimal performance. Findings showed that pathology and anatomy departments achieved the score of 100 in technical efficiency in education during 2006 to 2011. During this period, parasitology, psychiatric and pediatrics department's achieved the score of 100 for technical efficiency in research domain. The lowest mean of relative educational efficiency belonged to orthopedic department; as to relative research efficiency, the lowest mean was shown in orthopedics and genetics departments. The mean technical efficiency of non-medical departments in education and research domain was 91.93 and 76.08, respectively, while the mean technical efficiency of the clinical department in educational and research fields was 91.02 and 82.23, respectively. Using multiple input and output in DEA technique provided a comprehensive evaluation of efficiency in Shiraz school of medicine departments. The DEA could successfully estimate the technical efficiency of the departments in research and educational fields. Moreover, the deficiency in each department was found; this could help them to plan for improvement.

Biometric identification standards research

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Air Quality Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM projects being...

Virginia Bridge Information Systems Laboratory.

DOT National Transportation Integrated Search

2014-06-01

This report presents the results of applied data mining of legacy bridge databases, focusing on the Pontis and : National Bridge Inventory databases maintained by the Virginia Department of Transportation (VDOT). Data : analysis was performed using a...

ARC-2009-ACD09-0063-001

NASA Image and Video Library

2009-04-16

Aeronautics Technical Seminar: Dr. Elisabeth Pate-Cornell, Burt and Deedee McMurtry professor and chair of the Department of Management Science and Engineering at Stanford University presents 'Lessons Learned in Applying Engineering Risk Analysis'.

ARC-2009-ACD09-0063-002

NASA Image and Video Library

2009-04-16

Aeronautics Technical Seminar: Dr. Elisabeth Pate-Cornell, Burt and Deedee McMurtry professor and chair of the Department of Management Science and Engineering at Stanford University presents 'Lessons Learned in Applying Engineering Risk Analysis'.

ARC-2009-ACD09-0063-005

NASA Image and Video Library

2009-04-16

Aeronautics Technical Seminar: Dr. Elisabeth Pate-Cornell, Burt and Deedee McMurtry professor and chair of the Department of Management Science and Engineering at Stanford University presents 'Lessons Learned in Applying Engineering Risk Analysis'.

ARC-2009-ACD09-0063-004

NASA Image and Video Library

2009-04-16

Aeronautics Technical Seminar: Dr. Elisabeth Pate-Cornell, Burt and Deedee McMurtry professor and chair of the Department of Management Science and Engineering at Stanford University presents 'Lessons Learned in Applying Engineering Risk Analysis'.

ARC-2009-ACD09-0063-003

NASA Image and Video Library

2009-04-16

Aeronautics Technical Seminar: Dr. Elisabeth Pate-Cornell, Burt and Deedee McMurtry professor and chair of the Department of Management Science and Engineering at Stanford University presents 'Lessons Learned in Applying Engineering Risk Analysis'.

Effect of Additional Incentives for Aviation Biofuels: Results from the Biomass Scenario Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vimmerstedt, Laura J; Newes, Emily K

2017-12-05

The National Renewable Energy Laboratory supported the Department of Energy, Bioenergy Technologies Office, with analysis of alternative jet fuels in collaboration with the U.S. Department of Transportation, Federal Aviation Administration. Airlines for America requested additional exploratory scenarios within FAA analytic framework. Airlines for America requested additional analysis using the same analytic framework, the Biomass Scenario Model. The results were presented at a public working meeting of the California Air Resources Board on including alternative jet fuel in the Low Carbon Fuel Standard on March 17, 2017 (https://www.arb.ca.gov/fuels/lcfs/lcfs_meetings/lcfs_meetings.htm). This presentation clarifies and annotates the slides from the public working meeting, andmore » provides a link to the full data set. NREL does not advocate for or against the policies analyzed in this study.« less

Effect of Additional Incentives for Aviation Biofuels: Results from the Biomass Scenario Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vimmerstedt, Laura J; Newes, Emily K

The National Renewable Energy Laboratory supported the Department of Energy, Bioenergy Technologies Office, with analysis of alternative jet fuels in collaboration with the U.S. Department of Transportation, Federal Aviation Administration. Airlines for America requested additional exploratory scenarios within FAA analytic framework. Airlines for America requested additional analysis using the same analytic framework, the Biomass Scenario Model. The results were presented at a public working meeting of the California Air Resources Board on including alternative jet fuel in the Low Carbon Fuel Standard on March 17, 2017 (https://www.arb.ca.gov/fuels/lcfs/lcfs_meetings/lcfs_meetings.htm). This presentation clarifies and annotates the slides from the public working meeting, andmore » provides a link to the full data set. NREL does not advocate for or against the policies analyzed in this study.« less

Bragg-cell receiver study

NASA Technical Reports Server (NTRS)

Wilson, Lonnie A.

1987-01-01

Bragg-cell receivers are employed in specialized Electronic Warfare (EW) applications for the measurement of frequency. Bragg-cell receiver characteristics are fully characterized for simple RF emitter signals. This receiver is early in its development cycle when compared to the IFM receiver. Functional mathematical models are derived and presented in this report for the Bragg-cell receiver. Theoretical analysis is presented and digital computer signal processing results are presented for the Bragg-cell receiver. Probability density function analysis are performed for output frequency. Probability density function distributions are observed to depart from assumed distributions for wideband and complex RF signals. This analysis is significant for high resolution and fine grain EW Bragg-cell receiver systems.

Health effects of the September 2009 dust storm in Sydney, Australia: did emergency department visits and hospital admissions increase?

PubMed

Merrifield, Alistair; Schindeler, Suzanne; Jalaludin, Bin; Smith, Wayne

2013-04-16

During September 2009, a large dust storm was experienced in Sydney, New South Wales, Australia. Extremely high levels of particulate matter were recorded, with daily average levels of coarse matter (<10 μm) peaking over 11,000 μg/m3 and fine (<2.5 μm) over 1,600 μg/m3. We conducted an analysis to determine whether the dust storm was associated with increases in all-cause, cardiovascular, respiratory and asthma-related emergency department presentations and hospital admissions. We used distributed-lag Poisson generalized models to analyse the emergency department presentations and hospital admissions adjusted for pollutants, humidity, temperature and day of week and seasonal effects to obtain estimates of relative risks associated with the dust storm. The dust storm period was associated with large increases in asthma emergency department visits (relative risk 1.23, 95% confidence interval 1.10-1.38, p < 0.01), and to a lesser extent, all emergency department visits (relative risk 1.04, 95% confidence interval 1.03-1.06, p < 0.01) and respiratory emergency department visits (relative risk 1.20, 95% confidence interval 1.15-1.26, p < 0.01). There was no significant increase in cardiovascular emergency department visits (p = 0.09) or hospital admissions for any reason. Age-specific analyses showed the dust storm was associated with increases in all-cause and respiratory emergency department visits in the ≥65 year age group; the ≤5 year group had higher risks of all-cause, respiratory and asthma-related emergency department presentations. We recommend public health measures, especially targeting asthmatics, should be implemented during future dust storm events.

Health effects of the September 2009 dust storm in Sydney, Australia: did emergency department visits and hospital admissions increase?

PubMed Central

2013-01-01

Background During September 2009, a large dust storm was experienced in Sydney, New South Wales, Australia. Extremely high levels of particulate matter were recorded, with daily average levels of coarse matter (<10 μm) peaking over 11,000 μg/m3 and fine (<2.5 μm) over 1,600 μg/m3. We conducted an analysis to determine whether the dust storm was associated with increases in all-cause, cardiovascular, respiratory and asthma-related emergency department presentations and hospital admissions. Methods We used distributed-lag Poisson generalized models to analyse the emergency department presentations and hospital admissions adjusted for pollutants, humidity, temperature and day of week and seasonal effects to obtain estimates of relative risks associated with the dust storm. Results The dust storm period was associated with large increases in asthma emergency department visits (relative risk 1.23, 95% confidence interval 1.10-1.38, p < 0.01), and to a lesser extent, all emergency department visits (relative risk 1.04, 95% confidence interval 1.03-1.06, p < 0.01) and respiratory emergency department visits (relative risk 1.20, 95% confidence interval 1.15-1.26, p < 0.01). There was no significant increase in cardiovascular emergency department visits (p = 0.09) or hospital admissions for any reason. Age-specific analyses showed the dust storm was associated with increases in all-cause and respiratory emergency department visits in the ≥65 year age group; the ≤5 year group had higher risks of all-cause, respiratory and asthma-related emergency department presentations. Conclusions We recommend public health measures, especially targeting asthmatics, should be implemented during future dust storm events. PMID:23587335

[Animal drugs quality status and reason analysis].

PubMed

Ding, Qing; Qiu, Ya-jing; Fang, Ke-hui; Hu, Hao-bin; Wu, Yue

2015-11-01

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.

Cartographic standards to improve maps produced by the Forest Inventory and Analysis program

Treesearch

Charles H. (Hobie) Perry; Mark D. Nelson

2009-01-01

The Forest Service, U.S. Department of Agriculture's Forest Inventory and Analysis (FIA) program is incorporating an increasing number of cartographic products in reports, publications, and presentations. To create greater quality and consistency within the national FIA program, a Geospatial Standards team developed cartographic design standards for FIA map...

Performance Management in the French System of Secondary-Teacher Training

ERIC Educational Resources Information Center

Tchibozo, Guy

2005-01-01

The present study focuses on performance analysis and performance management in teacher training in France. After a brief summary of the French system of secondary-teacher training, determinants affecting performance are analyzed. The analysis shows that three determinants--the number of external competitors, the size of a department and the…

Data envelopment analysis with upper bound on output to measure efficiency performance of departments in Malaikulsaleh University

NASA Astrophysics Data System (ADS)

Abdullah, Dahlan; Suwilo, Saib; Tulus; Mawengkang, Herman; Efendi, Syahril

2017-09-01

The higher education system in Indonesia can be considered not only as an important source of developing knowledge in the country, but also could create positive living conditions for the country. Therefore it is not surprising that enrollments in higher education continue to expand. However, the implication of this situation, the Indonesian government is necessarily to support more funds. In the interest of accountability, it is essential to measure the efficiency for this higher institution. Data envelopment analysis (DEA) is a method to evaluate the technical efficiency of production units which have multiple input and output. The higher learning institution considered in this paper is Malikussaleh University located in Lhokseumawe, a city in Aceh province of Indonesia. This paper develops a method to evaluate efficiency for all departments in Malikussaleh University using DEA with bounded output. Accordingly, we present some important differences in efficiency of those departments. Finally we discuss the effort should be done by these departments in order to become efficient.

Acute health problems in African refugees: ten years' experience in a Swiss emergency department.

PubMed

Pfortmueller, Carmen A; Graf, Fabienne; Tabbara, Malek; Tabarra, Malek; Lindner, Gregor; Zimmermann, Heinz; Exadaktylos, Aristomenis K

2012-09-01

Over the last two decades, the total number of applications from Africans for asylum in the countries of the European Union has increased from 578,000 to more than 2.9 million. About 20 % (7,196/36,100) of the asylum seekers in Switzerland originate from Africa. The disease profile of African asylum seekers is remarkably different from that of the native population in the country of application. We have therefore conducted an analysis of African asylum seekers presenting themselves to our emergency department. In a retrospective analysis, the central patient registry database was searched for patients originating from Africa admitted from 1 January 2000 to 30 November 2011 and labelled as "Asylbewerber" (asylum seeker) or "Flüchtling" (refugee). Three thousand six hundred and seventy-five African asylum seekers were admitted to our emergency department between 2000 and 2010. Thirty-four percent (n = 1,247) were female and 66 % (n = 2,426) male. Eighty percent (n = 1,940) of the men and 70 % (n = 823) of the women were younger than 40 years. Most of our patients originated from Algeria (n = 612). Forty-five percent (n = 1,628) of all patients presented with internal medical problems, 40 % (n = 1,487) with injuries. 3.5 % (n = 130) of all patients presented with psychiatric problems. Admission for psychiatric problems increased steadily from 2 % (n = 4) in 2001 to 10 % (n = 35) in 2011. The causes of presentation are manifold, including internal medical problems and injuries. Admissions for psychiatric problems are increasing. Establishing simple screening scores for somatization should be a key priority in providing more focused treatment in emergency departments.

Multi Objective Decision Analysis for Assignment Problems

DTIC Science & Technology

2011-03-01

needed data or try to get data from related databases. 2.3.8 Deterministic Analysis In order to determine an overall score for each...The views expressed in this thesis are those of the author and do not reflect the official policy or position of the Turkish Air...DECISION ANALYSIS FOR ASSIGNMENT PROBLEMS THESIS Presented to the Faculty Department of Operational Sciences Graduate School of

Student Response to Hypermedia in the Lecture Theatre: A Case Study.

ERIC Educational Resources Information Center

Conway, Damian

The Computer Science Department at Monash University (Victoria, Australia) recently began presenting lectures using projection of a hypertext system, HyperLecture, running on a notebook computer as the primary medium. This paper presents a statistical analysis of student reactions to this approach, focusing on the effects, as perceived by the…

Comparative cost analysis of inpatient integrative medicine-Results of a pilot study.

PubMed

Ostermann, Thomas; Lauche, Romy; Cramer, Holger; Dobos, Gustav

2017-06-01

Costs of integrative treatment alone and in comparison with other treatment approaches have scarcely been reported in the past. This study presents results of a comparative cost analysis of an inpatient integrative medicine treatment costs. Data from 2006 for inpatients referred to a Department of Integrative Medicine in Germany were used. Case-related treatment costs were calculated, and transformed into Casemix-Indices and revenues per DRG. Costs were compared between departments at the same hospital and between different hospitals using univariate statistics and Chi-Square tests. In total 1253 inpatients (81.4% female, 61.1±14.4years) were included in the current analysis. Most patients were treated for diseases of the musculoskeletal system (57.2%), followed by diseases of the digestive system (11.4%), and diseases of the nervous system (10.4%). The department received an additional payment for most of the patients (88.0%), which led to an effective appreciation of 10.8% per case compared to the standardized Casemix-Index. In-house comparisons with other departments found the department in close vicinity to the departments of Internal medicine with regards to CMI and mean revenue, however the Patient Clinical Complexity Level was significantly lower in the Integrative medicine department. The interhospital comparison revealed comparable Casemix-Index and DRG-revenue, however the additional payment increased the mean revenue significantly. Modern integrative in-patient treatment is mostly cost-equivalent to conventional treatment. Cost effectiveness studies should be considered to further investigate the potential of integrative in patient treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Signaling Crosstalk: A Live in Situ Analysis of the Temporal and Spatial Regulation of Key Pathways in Human Breast Cancer Progression

DTIC Science & Technology

2007-05-01

BODY: Revised Specific Aim 1: Elucidate the biochemistry of stratifin within the context of normal mammary gland development and homeostasis...keratinocyte proliferation and lack of differentiation into keratin squames. The excessive skin thickening closes the mouths of pups, resulting in suffocation ...the Department of Molecular and Cell Biology Honours Research Symposium - Gave a poster presentation at the Department of Comparative Biochemistry

Competitive Advantage, Uncertainty, and Weapons Procurement: Striking Balance for the Future

DTIC Science & Technology

2009-05-02

position of the Department of the Army, Department of Defense, or the U.S. Government. COMPETITIVE ADVANTAGE , UNCERTAINTY, AND WEAPONS PROCUREMENT: STRIKING...Competitive Advantage , Uncertainty, and Weapons Procurement: Striking Balance for the Future 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...the right balance of investments all leading to a sustained competitive advantage . This paper presents an analysis of how effective this overhaul has

Ceramic transactions: Fractography of glasses and ceramics III. Volume 64

DOE Office of Scientific and Technical Information (OSTI.GOV)

Varner, J.R.; Frechette, V.D.; Quinn, G.D.

1996-12-31

Reports are presented from the Third Annual Conference on the Fractography of Glasses and Ceramics. Topics include ceramics fracture mode, damage analysis, defect origin, deformation, crack evolution, and the use of laser raman spectroscopy for analysis of residual surface strains. Individual projects have been processed separately for the United States Department of Energy databases.

Regional Traffic Incident Management Programs : Implementation Guide

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Air Quality Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM projects ...

Machine learning in updating predictive models of planning and scheduling transportation projects

DOT National Transportation Integrated Search

1997-01-01

A method combining machine learning and regression analysis to automatically and intelligently update predictive models used in the Kansas Department of Transportations (KDOTs) internal management system is presented. The predictive models used...

Traffic conflict techniques for safety and operations : observers manual

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Institutional and Organizational Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. T...

Ohio traffic crash facts, 2007

DOT National Transportation Integrated Search

2008-05-07

The Ohio Department of Public Safety is pleased to present the 2007 Ohio Traffic Crash : Facts Book, an in-depth highway safety statistical profile and analysis compiled from : data supplied by law enforcement agencies from across the state. : This a...

Ohio traffic crash facts, 2008

DOT National Transportation Integrated Search

2009-07-01

The Ohio Department of Public Safety is pleased to present the 2008 Ohio Traffic Crash : Facts Book, an in-depth highway safety statistical profile and analysis compiled from : data supplied by law enforcement agencies from across the state. This ann...

Ohio traffic crash facts, 2009

DOT National Transportation Integrated Search

2010-11-01

The Ohio Department of Public Safety is pleased to present the 2009 Ohio Traffic Crash Facts Book, an in-depth highway safety statistical profile and analysis compiled from data supplied by law enforcement agencies from across the state. This annual ...

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

PubMed

Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

Reciprocal Allocation Method in Service Departments. The Case of a Production Enterprise

NASA Astrophysics Data System (ADS)

Papaj, Ewelina

2017-12-01

The main aim of this article is to indicate the role of reciprocal allocation method in the process of costs calculation. In the environment of nowadays companies, often taking very complex organisational forms, the existence of service departments becomes of great importance. Although, as far as management accounting processes are concerned, which lead to identifying the product cost, the service departments' costs come out to be of minor importance. This article means to prove that the service departments' costs and their reliable settlement are a desirable source of information about the products. This work consists of two parts. First of them features theoretical considerations and a critical analysis of subject literature. In the latter part, the service departments' costs calculation will be presented, basing on reciprocal services in a production enterprise from chemical industry.

Direct cost analysis of intensive care unit stay in four European countries: applying a standardized costing methodology.

PubMed

Tan, Siok Swan; Bakker, Jan; Hoogendoorn, Marga E; Kapila, Atul; Martin, Joerg; Pezzi, Angelo; Pittoni, Giovanni; Spronk, Peter E; Welte, Robert; Hakkaart-van Roijen, Leona

2012-01-01

The objective of the present study was to measure and compare the direct costs of intensive care unit (ICU) days at seven ICU departments in Germany, Italy, the Netherlands, and the United Kingdom by means of a standardized costing methodology. A retrospective cost analysis of ICU patients was performed from the hospital's perspective. The standardized costing methodology was developed on the basis of the availability of data at the seven ICU departments. It entailed the application of the bottom-up approach for "hotel and nutrition" and the top-down approach for "diagnostics," "consumables," and "labor." Direct costs per ICU day ranged from €1168 to €2025. Even though the distribution of costs varied by cost component, labor was the most important cost driver at all departments. The costs for "labor" amounted to €1629 at department G but were fairly similar at the other departments (€711 ± 115). Direct costs of ICU days vary widely between the seven departments. Our standardized costing methodology could serve as a valuable instrument to compare actual cost differences, such as those resulting from differences in patient case-mix. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Analysis of the Database of Theses and Dissertations from DME/UFSCAR about Astronomy Education

NASA Astrophysics Data System (ADS)

Rodrigues Ferreira, Orlando; Voelzke, Marcos Rincon

2013-11-01

The paper presents a brief analysis of the "Database of Theses and Dissertations about Astronomy Education" from the Department of Teaching Methodology (DME) of the Federal University of São Carlos(UFSCar). This kind of study made it possible to develop new analysis and statistical data, as well as to conduct a rating of Brazilian institutions that produce academic work in the area.

Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department.

PubMed

Ngo, Stephanie; Shahsahebi, Mohammad; Schreiber, Sean; Johnson, Fred; Silberberg, Mina

2017-11-09

This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p < 0.001) and a decrease of 9.5 h in emergency department length of stay per average visit per patient (p<0.001). There was no significant effect on the number of hospitalizations or hospital length of stay. This intervention demonstrated a correlation with reducing emergency department use in patients with behavioral health issues, but no correlation with reducing hospital utilization. This under-researched approach of integrating medical records at point-of-care could serve as a model for better emergency department management of behavioral health patients.

Economic analysis of wood- or bark-fired systems

Treesearch

T. H. Ellis

1978-01-01

The Tennessee Valley Authority, in cooperation with the U.S. Department of Agriculture and the Forest Products Research Society, is preparing three slide-tape presentations to help people evaluate wood- and bark fueled boiler systems as alternatives to ones using oil, gas, or coal. The first two presentations cover equipment selection and estimation of fuel values; the...

Wireless Laptops in English Classrooms: A SWOT Analysis from Singapore

ERIC Educational Resources Information Center

Towndrow, Phillip A.; Vaish, Viniti

2009-01-01

This paper presents illustrative findings from a one-year pilot study undertaken in the English department of a high school in Singapore that was in the first year of implementing a one-to-one wireless laptop programme. The findings show that learning was often constrained by lecture-style presentations and overt test preparation. Despite…

Workload and casemix in Cape Town emergency departments.

PubMed

Wallis, Lee A; Twomey, Michele

2007-12-01

Little is known about the nature of patients presenting to emergency departments (EDs) in South Africa. This study aimed to provide evidence on ED usage in Cape Town by studying patients at four community health centre (CHC) EDs, with details of the severity of their presentation and their disposal. A total of 16,392 patients presented in this 8-week prospective observational study, and 15,681 were included in the descriptive data analysis. One-quarter were children. There were clear and predictable peaks in attendance after 1600 hr and at weekends, with a steady stream of patients presenting overnight. Case severity was evenly distributed between emergency, urgent and routine care. Nearly 10% of patients were referred on to a higher level of care. The data from this study present a model for staffing and resource allocation. It has implications for the provision of emergency care in CHC EDs.

Current and planned shared service arrangements in Wisconsin local and tribal health departments.

PubMed

Madamala, Kusuma; Young, Nancy; Young, Dustin; Giese, Lieske; Brandenberg, Terry; Zahner, Susan

2014-01-01

The objective of this study was to explore current and future use of shared service arrangements as a management strategy to increase capacity to provide public health essential services in Wisconsin. An online cross-sectional survey of 99 local and tribal health departments in Wisconsin was conducted. Select variables from the 2010 Wisconsin Local Health Department Survey were merged. Other data sources included results from a Board of Health governance analysis and the Wisconsin Department of Health Services region data. Descriptive analysis was performed of current and future shared service arrangements and the characteristics of the types of arrangements and agreements in place. Ninety-one of 99 Wisconsin local and tribal health departments responded, yielding a 92% response rate. Seventy-one percent of respondents currently share services with 1 or more other health departments. More frequent arrangements were present in programmatic areas than in departmental operations. Most frequently reported motivators include making better use of resources, providing better services, and responding to program requirements. Extensive qualitative comments indicate arrangements accomplished what the local health department hoped it would with perceived gains in efficiency and effectiveness. There is widespread use of shared services among health departments in Wisconsin. Extensive qualitative comments suggest participant satisfaction with what the arrangements have accomplished. Motivating factors in developing the arrangements and limited mention of expiration dates suggest continued study of how these arrangements may evolve. Further examination of shared services as a potential mechanism to advance service effectiveness and efficiency is needed.

A retrospective review of required projects in systems-based practice in a single anesthesiology residency: a 10-year experience.

PubMed

Sakai, Tetsuro; Emerick, Trent D; Patel, Rita M

2015-09-01

The Accreditation Council for Graduate Medical Education has emphasized in its core competencies and more recently, in its Milestones Project, that residents understand the importance of systems-based practice (SBP). The objectives of the study are to evaluate the quality of residents' SBP projects and to determine the degrees that were subsequently implemented. A retrospective educational observational study. A university-based anesthesiology training institution. One hundred forty-nine anesthesiology residents in their final (postgraduate year 4) year of training who completed SBP projects for the last 10 years (2004-2013). A structured SBP course was provided for postgraduate year 4 anesthesiology residents with deadlines set such as project identification, data collection, and proposal draft. Each resident's written SBP proposal received inputs by 2 members of the department executive steering committee. The SBP projects concluded with oral presentations by each resident to the department executive steering committee, who provided overall scores. All SBP projects were categorized into 7 categories: safety initiatives, economic analysis, process analysis, policy change recommendations, education initiatives, teamwork/communication, and operating room efficiency. Evaluation scores using a Likert scale (1-9, where 9 is the best) were analyzed. The rate of implementation of project ideas within the department based on the presentations to the executive committee was examined. Of 149 projects, policy change recommendations was the most frequently chosen category (46 projects; 30.9%), followed by process analysis (36 projects; 24.2%). The overall evaluation score was 7.6 ± 0.6 (mean ± SD). A total of 53 projects (35.6%) were implemented in the department. There was no statistical difference between SBPs with implementation vs SBPs without implementation in terms of evaluation scores, year of the presentation, or categories. This SBP project has given residents the opportunity to participate in a hospital system change aiming to improve efficiency and safety. Copyright © 2015 Elsevier Inc. All rights reserved.

[Oncological emergencies in the emergency department].

PubMed

Cimpoeşu, Diana; Dumea, Mihaela; Durchi, Simona; Apostoae, F; Olaru, G; Ciolan, Mioara; Popa, O; Corlade-Andrei, Mihaela

2011-01-01

to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED. we performed a retrospective study on nonrandomized consecutive cases. The lot analysis included 1315 oncological patients admitted in the Emergency Department of the Clinical Emergency Hospital "St. Spiridon" Iaşi, in the period June 1st, 2009 - May 31st, 2010. 23.12% of the patients had high suspicion of neoplasia at the first visit to the ED. 67.07% of patients were in metastatic stage disease located as follows: liver metastasis 37.59%, lung metastasis 18.36%, lymph node metastasis 13, 29%. After processing the data there were found statistically significant correlations between the age of patients and the documented/suspected diagnosis of neoplasia (p = 0.01) in the sense that a neoplasia diagnosis in emergency was more frequent in people of young age. It should be mentioned that other studies rarely mention first diagnosis of neoplasia in emergency department with presence of complications. 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with neoplasia and those with high-suspicion neoplasia first diagnosed in the ED.

Impact of environmental justice analysis on transportation planning.

DOT National Transportation Integrated Search

2011-12-30

This report presents the findings of a study sponsored by the Georgia Department of Transportation (GDOT): Impact of Environmental Justice (EJ) on Transportation Planning. The objectives of the study were to determine the state of the practice of EJ ...

Ohio traffic crash facts, 2010

DOT National Transportation Integrated Search

2011-10-01

The Ohio Department of Public Safety is pleased to present the 2010 Ohio Traffic Crash Facts Book, an in-depth highway safety profile and analysis compiled from data supplied by law enforcement agencies across the state. This annual report provides a...

Development of the North American cargo securement standard

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Benefit-Cost Analysis (BCA) for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM pr...

Estimating the financial resources needed for local public health departments in Minnesota: a multimethod approach.

PubMed

Riley, William; Briggs, Jill; McCullough, Mac

2011-01-01

This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.

Diagnostic and referral intervals for Manitoba women with epithelial ovarian cancer - the Manitoba Ovarian Cancer Outcomes (MOCO) study group: a retrospective cross-sectional study

PubMed Central

Love, Allison J.; Lambert, Pascal; Turner, Donna; Lotocki, Robert; Dean, Erin; Popowich, Shaundra; Altman, Alon D.; Nachtigal, Mark W.

2017-01-01

Background: Epithelial ovarian cancer has the highest mortality of all gynecologic cancers. The poor survival rates are often attributed to the advanced stage at which most of these cancers are detected. We sought to examine the effects of patient demographics, comorbidities and presenting symptoms on diagnostic and referral intervals by location of first presentation (emergency department v. elsewhere) and to identify factors that affect these intervals. Methods: We performed a retrospective analysis of chart and medical record data for ovarian cancers, with the exceptions of sex cord and germ cell tumours, diagnosed between 2004 and 2010 in Manitoba, Canada. Data were collected on baseline characteristics, time to diagnosis and referral, number and type of physician visits and emergency department visits. Results: The final cohort consisted of 601 patients. Sixty-three percent of patients received their diagnosis within 60 days of initial presentation, and 75.2% had their cancer diagnosed within 2 physician encounters. The median diagnostic interval for all stages of patients presenting to the emergency department was 7 days, compared with 55 days for patients presenting elsewhere. Early stage patients not presenting to the emergency department had their diagnosis a median of 34.0 days later than patients with advanced disease (95% confidence interval [CI] 22.22 to 45.69, p < 0.0001). The presence of some symptoms was associated with shortened diagnostic intervals. Patients with serous, clear-cell or endometrioid histotypes were less likely to have first presentation beginning in the emergency department (odds ratio [OR] 0.40, 95% CI 0.24 to 0.64, p = 0.0001; OR 0.28, 95% CI 0.14 to 0.59, p = 0.007) than those with unclassified epithelial histotype. Interpretation: For this group of patients, the main factor associated with diagnostic and referral intervals is presentation to the emergency department. These patients likely required more urgent attention for their more symptomatic disease, leading to quicker diagnosis and referral patterns, despite poorer prognosis. PMID:28401127

Policy and Evidence: A Critical Analysis of the Year 1 Phonics Screening Check in England

ERIC Educational Resources Information Center

Grundin, Hans U.

2018-01-01

This paper aims to present a critical analysis of the Year 1 Phonics Screening Check (PSC), with special focus on the relationship between the UK Department for Education's policy-making and the evidence considered in the process of developing and evaluating the PSC. The reports from the in-house Standards and Testing Agency and from commissioned…

Evaluation of the Defense Economic Analysis Council (DEAC) and Its Role in Promoting Economic Analysis in the Department of Defense

DTIC Science & Technology

1976-12-01

economic analysts’ familiarity with the principles of economics appears to be of secondary concern to DoD management. Management has deemed desirous, in...and the operational requirements of the present staff. To management, the need for economic analysts to be familiar with the principles of economics is

Cite Globally, Analyze Locally: Citation Analysis from a Local Latin American Studies Perspective

ERIC Educational Resources Information Center

Schadl, Suzanne M.; Todeschini, Marina

2015-01-01

This citation analysis examines the use of Spanish- and Portuguese-language books and articles in PhD dissertations on Latin America at the University of New Mexico between 2000 and 2009. Two sets of data are presented: The first identifies the use of Spanish- and Portuguese-language books and articles across 17 academic departments; and the…

Using digital photogrammetry to conduct an anthropometric analysis of wheelchair users.

PubMed

Barros, Helda Oliveira; Soares, Marcelomárcio

2012-01-01

This study deals with using digital photogrammetry to make an anthropometric analysis of wheelchair users. To analyse the data, Digita software was used, which was made available by means of the agreement of the Design Department of the Federal University of Pernambuco--Brazil--with the Department of Ergonomics of the Technical University of Lisbon--Portugal. Data collection involved a random sample of 18 subjects and occurred in the Biomechanics Laboratory of the Maurice of Nassau Faculty, located in Recife, Pernambuco. The methodology applied comprises the steps of Ergonomic Assessment, Configuration of the Data Base, Taking Digital Photographs, Digitalising the Coordinates and Presentation of Results. 15 structural variables related to static anthropometry were analysed, and 4 functional range variables relating to dynamic anthropometry. The results were presented by analysing personal data, classified by gender, ethnicity and age; by functional analysis of the sample, classified by clinical diagnosis, results of assessing the joints, results of the evaluation through motion and postural evaluation; and of the analysis of the anthropometric sample, which indicated for each variable the number of people, the mean, the standard deviation, and the minimum, median and maximum values.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zoller, J.N.; Rosen, R.S.; Holliday, M.A.

With the publication of a Request for Recommendations and Advance Notice of Intent in the November 10, 1994 Federal Register, the Department of Energy initiated a program to assess alternative strategies for the long-term management or use of depleted uranium hexafluoride. This Request was made to help ensure that, by seeking as many recommendations as possible, Department management considers reasonable options in the long-range management strategy. The Depleted Uranium Hexafluoride Management Program consists of three major program elements: Engineering Analysis, Cost Analysis, and an Environmental Impact Statement. This Technology Assessment Report is the first part of the Engineering Analysis Project,more » and assesses recommendations from interested persons, industry, and Government agencies for potential uses for the depleted uranium hexafluoride stored at the gaseous diffusion plants in Paducah, Kentucky, and Portsmouth, Ohio, and at the Oak Ridge Reservation in Tennessee. Technologies that could facilitate the long-term management of this material are also assessed. The purpose of the Technology Assessment Report is to present the results of the evaluation of these recommendations. Department management will decide which recommendations will receive further study and evaluation.« less

National Disability Registers Report on Causes of Intellectual Disability in Taiwan: 2000-2007

ERIC Educational Resources Information Center

Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling; Kang, Shih-Wan

2009-01-01

The main purposes of the present analysis were to describe the causes of intellectual disability (ID) and examine its overtime change from 2000 to 2007 in Taiwan. Data of the present study mainly come from the public web-access information which collected by the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan. Data were…

Nystagmus-based approach to vertebrobasilar stroke presenting as vertigo without initial neurologic signs.

PubMed

Kim, Min-Beom; Boo, Sung Hyun; Ban, Jae Ho

2013-01-01

We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke. The patients who presented with isolated acute spontaneous vertigo with spontaneous nystagmus (acute vestibular syndrome) at the Emergency Department were retrospectively analyzed. They were referred to the Otolaryngology Department due to the absence of neurologic signs or even of imaging abnormalities after the initial examination at the Emergency Department. Various clinical features, including presenting symptoms, delayed neurologic signs, the site of infarction, and videonystagmographic (VNG) findings were analyzed. Of the 468 cases of acute vestibular syndrome, 23 (4.9%) cases of radiologically proven vertebrobasilar stroke were identified. Of the 23 patients, 17 (74%) showed aggravation of vertigo or delayed neurologic signs during the admission. In the analysis of VNG, 11 (48%) cases of direction-changing gaze-evoked nystagmus, 7 (30%) cases of fixation failure in the caloric test, 6 (27%) cases of periodic alternating nystagmus, and 4 (17%) cases of atypical head-shaking nystagmus were presented. Stroke occurred in the cerebellum (n=18, 78%), medulla (n=4, 17%), and pons (n=1, 4%). In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not. Copyright © 2013 S. Karger AG, Basel.

Clinical and financial implications of emergency department visits for synthetic marijuana.

PubMed

Rowley, Eric; Benson, David; Tiffee, Aaron; Hockensmith, Adam; Zeng, Henry; Jones, Glenn N; Musso, Mandi W

2017-10-01

Many users believe that synthetic cannabinoids offer a safe and legal means of getting high. However, spikes in emergency department visits have been associated with use of synthetic cannabinoids. The purpose of the current study was to document emergency department visits from three large hospitals in one metropolitan area over a two month period. This was a retrospective chart review examining 218 patients presenting to three inner city emergency departments between March and April 2014. Data collected included demographic information, information regarding ED diagnosis and treatment, signs and symptoms, ancillary testing, ED disposition, and cost of the medical treatment. The majority of patients (75.7%) were discharged after ED workup, but 12.4% were admitted for medical treatment and 11.5% were admitted for psychiatric treatment. Ten patients (4.6%) were admitted to the ICU. Symptoms experienced most frequently include: hypertension, tachycardia, agitation, drowsiness, nausea, and confusion. Cluster analysis revealed four symptom clusters of individuals presenting after using synthetic cannabinoids: 1) confusion, hostility, agitation, 2) nausea, vomiting, abdominal pain, 3) drowsiness, and 4) the absence of these symptoms. This study has three important findings. First, significant ED resources are being used to treat individuals presenting due to effects of synthetic cannabis. Second, synthetic cannabis is not a benign substance. Third, while the hostile and agitated user is generally presented in the media, this study finds significant heterogeneity in presentation. Further research is needed to fully understand the implications of synthetic cannabinoid use. Copyright © 2017 Elsevier Inc. All rights reserved.

Patterns of 'at-home' alcohol-related injury presentations to emergency departments.

PubMed

Bunker, Naomi; Woods, Cindy; Conway, Jane; Barker, Ruth; Usher, Kim

2017-01-01

This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of <0·05 as statistically significant. Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the 'other' location, 36·14% 'at home', 13·00% on the street and 9·78% at licensed premises. Of these, males (n = 2635; 59%) represented a higher proportion than females (n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner (n = 510), 59·5% occurred 'at home'. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. © 2016 John Wiley & Sons Ltd.

Incident Management : Successful Practices : A Cross-Cutting Study : Improving Mobility And Saving Lives

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Traveler Response Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM pro...

San Francisco urban partnership agreement, national evaluation : cost benefit analysis test plan.

DOT National Transportation Integrated Search

2011-06-01

This report presents the test plan for collecting and analyzing cost and benefit data for the San Francisco Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The San Francisco UPA projects ...

[Adverse events in general surgery. A prospective analysis of 13,950 consecutive patients].

PubMed

Rebasa, Pere; Mora, Laura; Vallverdú, Helena; Luna, Alexis; Montmany, Sandra; Romaguera, Andreu; Navarro, Salvador

2011-11-01

Adverse event (AE) rates in General Surgery vary, according to different authors and recording methods, between 2% and 30%. Six years ago we designed a prospective AE recording system to change patient safety culture in our Department. We present the results of this work after a 6 year follow-up. The AE, sequelae and health care errors in a University Hospital surgery department were recorded. An analysis of each incident recorded was performed by a reviewer. The data was entered into data base for rapid access and consultation. The results were routinely presented in Departmental morbidity-mortality sessions. A total of 13,950 patients had suffered 11,254 AE, which affected 5142 of them (36.9% of admissions). A total of 920 patients were subjected to at least one health care error (6.6% of admissions). This meant that 6.6% of our patients suffered an avoidable AE. The overall mortality at 5 years in our department was 2.72% (380 deaths). An adverse event was implicated in the death of the patient in 180 cases (1.29% of admissions). In 49 cases (0.35% of admissions), mortality could be attributed to an avoidable AE. After 6 years there tends to be an increasingly lower incidence of errors. The exhaustive and prospective recording of AE leads to changes in patient safety culture in a Surgery Department and helps decrease the incidence of health care errors. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

Democracy (In)Action: A Critical Policy Analysis of New York City Public School Closings by Teachers, Students, Administrators, and Community Members

ERIC Educational Resources Information Center

Kretchmar, Kerry

2014-01-01

In this article, I serve as a secretary for the critical policy analysis presented by hundreds of teachers, parents, students, and community members during 19 public hearings on school closures in New York City. In testimony at hearings, community members rejected the narrow, statistical approach they felt the Department of Education was using to…

The Effect of Motion Analysis Activities in a Video-Based Laboratory in Students' Understanding of Position, Velocity and Frames of Reference

ERIC Educational Resources Information Center

Koleza, Eugenia; Pappas, John

2008-01-01

In this article, we present the results of a qualitative research project on the effect of motion analysis activities in a Video-Based Laboratory (VBL) on students' understanding of position, velocity and frames of reference. The participants in our research were 48 pre-service teachers enrolled in Education Departments with no previous strong…

Consultation behaviour of doctor-shopping patients and factors that reduce shopping.

PubMed

Ohira, Yoshiyuki; Ikusaka, Masatomi; Noda, Kazutaka; Tsukamoto, Tomoko; Takada, Toshihiko; Miyahara, Masahito; Funakoshi, Hiraku; Basugi, Ayako; Keira, Katsunori; Uehara, Takanori

2012-04-01

To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping. Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping. A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P < 0.001). Logistic regression analysis selected the following factors as independent determinants of the cessation of doctor shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01). Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors. © 2010 Blackwell Publishing Ltd.

Energy conservation and money savings through the use of diesel-powered trucks.

DOT National Transportation Integrated Search

1980-01-01

This report presents an analysis of the potential energy and money savings to be achieved from the increased use of class 7, diesel-powered, 4-yard dump trucks by the Department. The technical differences between diesel and gasoline power plants are ...

Developing intelligent transportation systems using the national ITS archetecture: an executive edition for senior transportation managers

DOT National Transportation Integrated Search

2012-07-01

This report presents the Cost Benefit Analysis Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (LAC CRD) under the United States Department of Transportation (U.S. DOT) Congestion Reduction Demonstra...

The Literacy Practices of Law Enforcement

ERIC Educational Resources Information Center

Seawright, Leslie

2012-01-01

This dissertation investigates police report writing at the Jackson Police Department in Northwest Arkansas. It presents three primary research questions which are addressed through qualitative methods of interview, observation, and discourse analysis: (1) In what ways does police training address report writing?; (2) What audience awareness do…

1995 Truck Size and Weight Performance-Based Workshop report : activity 5 : document North American and European experiences

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

Presentations to NSW emergency departments with self-harm, suicidal ideation, or intentional poisoning, 2010-2014.

PubMed

Perera, Jayashanki; Wand, Timothy; Bein, Kendall J; Chalkley, Dane; Ivers, Rebecca; Steinbeck, Katharine S; Shields, Robyn; Dinh, Michael M

2018-05-07

To evaluate population trends in presentations for mental health problems presenting to emergency departments (EDs) in New South Wales during 2010-2014, particularly patients presenting with suicidal ideation, self-harm, or intentional poisoning. This was a retrospective, descriptive analysis of linked Emergency Department Data Collection registry data for presentations to NSW public hospital EDs over five calendar years, 2010-2014. Patients were included if they had presented to an ED and a mental health-related diagnosis was recorded as the principal diagnosis. Rates of mental health-related presentations to EDs by age group and calendar year, both overall and for the subgroups of self-harm, suicidal ideation and behaviour, and intentional poisoning presentations. 331 493 mental health-related presentations to 115 NSW EDs during 2010-2014 were analysed. The presentation rate was highest for 15-19-year-old patients (2014: 2167 per 100 000 population), but had grown most rapidly for 10-14-year-old children (13.8% per year). The combined number of presentations for suicidal ideation, self-harm, or intentional poisoning increased in all age groups, other than those aged 0-9 years; the greatest increase was for the 10-19-year-old age group (27% per year). The rate of mental health presentations to EDs increased significantly in NSW between 2010 and 2014, particularly presentations by adolescents. Urgent action is needed to provide better access to adolescent mental health services in the community and to enhance ED models of mental health care. The underlying drivers of this trend should be investigated to improve mental health care.

Cost comparison and safety of emergency department conscious sedation for the removal of ear foreign bodies.

PubMed

Olson, Michael D; Saw, Jessica; Visscher, Sue L; Balakrishnan, Karthik

2018-07-01

The purpose of this study is to investigate the relative cost and safety of ear foreign body (FB) removal via conscious sedation in the emergency department. A retrospective review of patients presenting from 2000 to 2015 to the emergency department at Mayo Clinic, Rochester, Minnesota was performed. 63 patients requiring sedation for ear foreign body removal were identified. Descriptive data, safety data, and costs were obtained for the study. There were no appreciable differences in patient safety outcomes and otologic outcomes in patients who received sedation in the emergency department or anesthesia in the operating room for FB removal. Cost analysis demonstrated increased cost associated with operating room utilization verses conscious sedation in the emergency department, with the greatest cost increase being in patients evaluated first in the emergency department and then sent to the operating room. Ear foreign body removal in the emergency department is shows a similar safety profile to removal in the operating room, but at a markedly lower cost. Emergency department conscious sedation should be considered a viable option in appropriately selected patients with this common problem given these results. Copyright © 2018. Published by Elsevier B.V.

Demand for Emergency Services Trends in New South Wales Years 2010-2014 (DESTINY): Age and Clinical Factors Associated with Ambulance Transportation to Emergency Departments.

PubMed

Dinh, Michael M; Muecke, Sandy; Berendsen Russell, Saartje; Chalkley, Dane; Bein, Kendall J; Muscatello, David; Nagaraj, Guruprasad; Paoloni, Richard; Ivers, Rebecca

2016-01-01

The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data on presentations to designated EDs across NSW. Patients that presented to EDs by ambulance between January 2010 and December 2014 were included. Patients dead on arrival, transferred from another hospital, or planned ED presentations were excluded. A total of 10.8 million ED attendances were identified of which 2.6 million (23%) were transported to ED by ambulance. The crude rate of ambulance transportations to EDs across all ages increased by 3.0% per annum over the five years with the highest rate observed in those 85 years and over (620.5 presentations per 1,000 population). There was an increase in the proportion of category 1 and 2 (life-threatening or potentially life-threatening) cases from 18.1% to 24.0%. Demand for ambulance services appears to be driven by older patients presenting with higher acuity problems. Alternative models of acute care for elderly patients need to be planned and implemented to address these changes.

Ego Network Analysis of Upper Division Physics Student Survey

NASA Astrophysics Data System (ADS)

Brewe, Eric

2017-01-01

We present the analysis of student networks derived from a survey of upper division physics students. Ego networks focus on the connections that center on one person (the ego). The ego networks in this talk come from a survey that is part of an overall project focused on understanding student retention and persistence. The theory underlying this work is that social and academic integration are essential components to supporting students continued enrollment and ultimately graduation. This work uses network analysis as a way to investigate the role of social and academic interactions in retention and persistence decisions. We focus on student interactions with peers, on mentoring interactions with physics department faculty, and on engagement in physics groups and how they influence persistence. Our results, which are preliminary, will help frame the ongoing research project and identify ways in which departments can support students. This work supported by NSF grant #PHY 1344247.

Western U.S.-Canada crossborder case study : activity 2 : task D : conduct regional and local trucking case studies

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

A qualitative assessment of the role of shippers and others in driver compliance with federal safety regulations

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Decision Support System Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM pr...

Race and acute abdominal pain in a pediatric emergency department.

PubMed

Caperell, Kerry; Pitetti, Raymond; Cross, Keith P

2013-06-01

To investigate the demographic and clinical factors of children who present to the pediatric emergency department (ED) with abdominal pain and their outcomes. A review of the electronic medical record of patients 1 to 18 years old, who presented to the Children's Hospital of Pittsburgh ED with a complaint of abdominal pain over the course of 2 years, was conducted. Demographic and clinical characteristics, as well as visit outcomes, were reviewed. Subjects were grouped by age, race, and gender. Results of evaluation, treatment, and clinical outcomes were compared between groups by using multivariate analysis and recursive partitioning. There were 9424 patient visits during the study period that met inclusion and exclusion criteria. Female gender comprised 61% of African American children compared with 52% of white children. Insurance was characterized as private for 75% of white and 37% of African American children. A diagnosis of appendicitis was present in 1.9% of African American children and 5.1% of white children. Older children were more likely to be admitted and have an operation associated with their ED visit. Appendicitis was uncommon in younger children. Constipation was commonly diagnosed. Multivariate analysis by diagnosis as well as recursive partitioning analysis did not reflect any racial differences in evaluation, treatment, or outcome. Constipation is the most common diagnosis in children presenting with abdominal pain. Our data demonstrate that no racial differences exist in the evaluation, treatment, and disposition of children with abdominal pain.

[The Pro-ABEn project: contributions and reflexions for a marketing strategy for the association].

PubMed

Silva, Isília Aparecida; Felli, Vanda Elisa Andres; Ciampone, Maria Helena Trench

2002-01-01

In the present study, an internal analysis of the Brazilian Association of Nursing (ABEn) was carried out in order to identify the representations of the members of the national and regional management departments of ABEn, regarding this association. The objective was to gather subsidies for the planning and implementation of a project aiming at institutional empowerment. The scenarios for data collection were the regional and national management departments, as well as all the members available from the each regional section and two members from the national office. Data collection was done through a form, which was answered by 15 sections during the period between 1997 and 2002. The analysis of the empirical data material was done in two ways. The first analysis was based on the Discourse of the Collective Subject--DCS, and the second through Institutional Analysis. The representations of the subjects interviewed could be identified, enabling the planning of marketing strategies for ABEn.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Plemons, R.E.; Hopwood, W.H. Jr.; Hamilton, J.H.

For a number of years the Oak Ridge Y-12 Plant Laboratory has been analyzing coal predominately for the utilities department of the Y-12 Plant. All laboratory procedures, except a Leco sulfur method which used the Leco Instruction Manual as a reference, were written based on the ASTM coal analyses. Sulfur is analyzed at the present time by two methods, gravimetric and Leco. The laboratory has two major endeavors for monitoring the quality of its coal analyses. (1) A control program by the Plant Statistical Quality Control Department. Quality Control submits one sample for every nine samples submitted by the utilitiesmore » departments and the laboratory analyzes a control sample along with the utilities samples. (2) An exchange program with the DOE Coal Analysis Laboratory in Bruceton, Pennsylvania. The Y-12 Laboratory submits to the DOE Coal Laboratory, on even numbered months, a sample that Y-12 has analyzed. The DOE Coal Laboratory submits, on odd numbered months, one of their analyzed samples to the Y-12 Plant Laboratory to be analyzed. The results of these control and exchange programs are monitored not only by laboratory personnel, but also by Statistical Quality Control personnel who provide statistical evaluations. After analysis and reporting of results, all utilities samples are retained by the laboratory until the coal contracts have been settled. The utilities departments have responsibility for the initiation and preparation of the coal samples. The samples normally received by the laboratory have been ground to 4-mesh, reduced to 0.5-gallon quantities, and sealed in air-tight containers. Sample identification numbers and a Request for Analysis are generated by the utilities departments.« less

Comparative study of the clinical presentation of Legionella pneumonia and other community-acquired pneumonias.

PubMed

Sopena, N; Sabrià-Leal, M; Pedro-Botet, M L; Padilla, E; Dominguez, J; Morera, J; Tudela, P

1998-05-01

The aim of this study was to compare the clinical, biological, and radiologic features of presentation in the emergency ward of community-acquired pneumonia (CAP) by Legionella pneumophila (LP) and other community-acquired bacterial pneumonias to help in early diagnosis of CAP by LP. Three hundred ninety-two patients with CAP were studied prospectively in the emergency department of a 600-bed university hospital. Univariate and multivariate analyses were performed to compare epidemiologic and demographic data and clinical, analytical, and radiologic features of presentation in 48 patients with CAP by LP and 125 patients with CAP by other bacterial etiology (68 by Streptococcus pneumoniae, 41 by Chlamydia pneumoniae, 5 by Mycoplasma pneumoniae, 4 by Coxiella burnetii, 3 by Pseudomonas aeruginosa, 2 by Haemophilus influenzae, and 2 by Nocardia species. Univariate analysis showed that CAP by LP was more frequent in middle-aged, male healthy (but alcohol drinking) patients than CAP by other etiology. Moreover, the lack of response to previous beta-lactamic drugs, headache, diarrhea, severe hyponatremia, and elevation in serum creatine kinase (CK) levels on presentation were more frequent in CAP by LP, while cough, expectoration, and thoracic pain were more frequent in CAP by other bacterial etiology. However, multivariate analysis only confirmed these differences with respect to lack of underlying disease, diarrhea, and elevation in the CK level. We conclude that detailed analysis of features of presentation of CAP allows suspicion of Legionnaire's disease in the emergency department. The initiation of antibiotic treatment, including a macrolide, and the performance of rapid diagnostic techniques are mandatory in these cases.

National survey on dose data analysis in computed tomography.

PubMed

Heilmaier, Christina; Treier, Reto; Merkle, Elmar Max; Alkhadi, Hatem; Weishaupt, Dominik; Schindera, Sebastian

2018-05-28

A nationwide survey was performed assessing current practice of dose data analysis in computed tomography (CT). All radiological departments in Switzerland were asked to participate in the on-line survey composed of 19 questions (16 multiple choice, 3 free text). It consisted of four sections: (1) general information on the department, (2) dose data analysis, (3) use of a dose management software (DMS) and (4) radiation protection activities. In total, 152 out of 241 Swiss radiological departments filled in the whole questionnaire (return rate, 63%). Seventy-nine per cent of the departments (n = 120/152) analyse dose data on a regular basis with considerable heterogeneity in the frequency (1-2 times per year, 45%, n = 54/120; every month, 35%, n = 42/120) and method of analysis. Manual analysis is carried out by 58% (n = 70/120) compared with 42% (n = 50/120) of departments using a DMS. Purchase of a DMS is planned by 43% (n = 30/70) of the departments with manual analysis. Real-time analysis of dose data is performed by 42% (n = 21/50) of the departments with a DMS; however, residents can access the DMS in clinical routine only in 20% (n = 10/50) of the departments. An interdisciplinary dose team, which among other things communicates dose data internally (63%, n = 76/120) and externally, is already implemented in 57% (n = 68/120) departments. Swiss radiological departments are committed to radiation safety. However, there is high heterogeneity among them regarding the frequency and method of dose data analysis as well as the use of DMS and radiation protection activities. • Swiss radiological departments are committed to and interest in radiation safety as proven by a 63% return rate of the survey. • Seventy-nine per cent of departments analyse dose data on a regular basis with differences in the frequency and method of analysis: 42% use a dose management software, while 58% currently perform manual dose data analysis. Of the latter, 43% plan to buy a dose management software. • Currently, only 25% of the departments add radiation exposure data to the final CT report.

Shapley value-based multi-objective data envelopment analysis application for assessing academic efficiency of university departments

NASA Astrophysics Data System (ADS)

Abing, Stephen Lloyd N.; Barton, Mercie Grace L.; Dumdum, Michael Gerard M.; Bongo, Miriam F.; Ocampo, Lanndon A.

2018-02-01

This paper adopts a modified approach of data envelopment analysis (DEA) to measure the academic efficiency of university departments. In real-world case studies, conventional DEA models often identify too many decision-making units (DMUs) as efficient. This occurs when the number of DMUs under evaluation is not large enough compared to the total number of decision variables. To overcome this limitation and reduce the number of decision variables, multi-objective data envelopment analysis (MODEA) approach previously presented in the literature is applied. The MODEA approach applies Shapley value as a cooperative game to determine the appropriate weights and efficiency score of each category of inputs. To illustrate the performance of the adopted approach, a case study is conducted in a university in the Philippines. The input variables are academic staff, non-academic staff, classrooms, laboratories, research grants, and department expenditures, while the output variables are the number of graduates and publications. The results of the case study revealed that all DMUs are inefficient. DMUs with efficiency scores close to the ideal efficiency score may be emulated by other DMUs with least efficiency scores.

simuwatt - A Tablet Based Electronic Auditing Tool

DOE Office of Scientific and Technical Information (OSTI.GOV)

Macumber, Daniel; Parker, Andrew; Lisell, Lars

2014-05-08

'simuwatt Energy Auditor' (TM) is a new tablet-based electronic auditing tool that is designed to dramatically reduce the time and cost to perform investment-grade audits and improve quality and consistency. The tool uses the U.S. Department of Energy's OpenStudio modeling platform and integrated Building Component Library to automate modeling and analysis. simuwatt's software-guided workflow helps users gather required data, and provides the data in a standard electronic format that is automatically converted to a baseline OpenStudio model for energy analysis. The baseline energy model is calibrated against actual monthly energy use to ASHRAE Standard 14 guidelines. Energy conservation measures frommore » the Building Component Library are then evaluated using OpenStudio's parametric analysis capability. Automated reporting creates audit documents that describe recommended packages of energy conservation measures. The development of this tool was partially funded by the U.S. Department of Defense's Environmental Security Technology Certification Program. As part of this program, the tool is being tested at 13 buildings on 5 Department of Defense sites across the United States. Results of the first simuwatt audit tool demonstration are presented in this paper.« less

The polity of academic medicine: a critical analysis of autocratic governance.

PubMed

Willing, Steven J; Gunderman, Richard B; Cochran, Philip L; Saxton, Todd

2004-12-01

How should academic radiology departments be governed? This question has rarely been directly addressed in the radiology literature. The dominant model of administration in present-day academic departments differs from that typically seen in private group practices. Whereas private group practices tend to follow a democratic model whereby key decisions must be supported by a majority of the partners, in academic institutions, medical school deans and department chairs generally possess great latitude in strategic and operational decision making. This article considers arguments for and against "top-down" governance in academia. The rationale supporting this form of governance is weak, and the best evidence from the fields of management and organizational behavior suggests it may in fact be detrimental.

Uncovering factors affecting use of the emergency department for less urgent health problems in urban and rural areas.

PubMed

Hodgins, Marilyn J; Wuest, Judith

2007-09-01

People who access the emergency department for less urgent health problems have been described as inappropriate users of the health-care system.Yet little is known about the factors precipitating such use and how these differ based on location of the emergency department. In this descriptive-correlational study guided by Andersen's Model of Health Services Use, 1612 people who presented to an emergency department with a less urgent health problem were interviewed. Analysis revealed rural/urban differences in the characteristics of patients, nature of the problems, actions taken, and factors precipitating the visit. Despite its popularity, the predictive capabilities of Andersen's model were limited in explaining use of self-treatment or willingness to wait for treatment. The findings show that an emergency department's roles and functions vary according to its location. Such insights provide direction for developing services that respond to the needs of people with less urgent health problems that are cognizant of geographic location.

Drug therapeutic failures in emergency department patients. A university hospital experience.

PubMed

Franceschi, Alessandro; Tuccori, Marco; Bocci, Guido; Vannozzi, Francesca; Di Paolo, Antonello; Barbara, Cecilia; Lastella, Marianna; Blandizzi, Corrado; Del Tacca, Mario

2004-01-01

Drug therapeutic failure (DTF) could be considered as an adverse drug reaction in which the expected drug effects do not occur following a prescribed pharmacological treatment, including any clinical event that could be related to a low prescribed dose or lack of compliance. DTFs are responsible for increasing disease length, hospitalisation time and social costs, with the worsening of patient quality of life. The aims of the present study are: (1) to estimate the frequency of DTFs among cases of adverse drug events referred to the emergency department; (2) to identify drug classes implicated in DTFs; (3) to analyse the putative causes underlying DTFs. Data presented in this paper were obtained from the Pronto Soccorso and Adverse Drug Events (PSADE) study carried out to analyse drug-related emergency department admissions in several Italian hospitals. Patients, admitted to the emergency department throughout two periods of 10 days each, were interviewed to gain information on their medical status and drug intake during the last two weeks. The present study analysed the patient questionnaires collected in the emergency department of Pisa University Hospital. Among 123 recorded cases of adverse drug event, 41 cases (19:22 male:female ratio; age range: 17-98 years, median age: 75 years) were identified as suspect DTF, resulting in a frequency of 33.33%. A statistical analysis was performed to evaluate the influence of two variables, class of patient age and number of drugs assumed, on DTFs. In accordance with the present findings, showing that the number of drugs assumed by a patient may increase the risk of DTF more than advanced age (odds ratio: 1.371, P<0.02; 1.295, P<0.03, respectively), the prescription of pharmacological combinations might be proposed as a main risk factor for DTF occurrence. In conclusion, our results suggest that DTFs represent an important cause of emergency department admission, particularly in elderly subjects treated with pharmacological associations.

Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 7 : truck costs and truck size and weight regulations

DOT National Transportation Integrated Search

2012-07-01

This report presents the Cost Benefit Analysis Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (LAC CRD) under the United States Department of Transportation (U.S. DOT) Congestion Reduction Demonstra...

Cost-Benefit Analysis of Forbearances. Executive Summary.

ERIC Educational Resources Information Center

USA Group, Inc., Indianapolis, IN.

This report presents findings and recommendations resulting from a study on the costs and benefits of a Department of Education policy of encouraging lenders of student loans to grant forbearances to borrowers who experience temporary financial hardship but do not satisfy the specific conditions required for government-prescribed deferments. The…

Listening to More Voices: Why Being Heard Matters

ERIC Educational Resources Information Center

Elisha-Primo, Iris; Sandler, Simone; Goldfrad, Keren

2015-01-01

This article examines various voices in a triangulated needs analysis project aimed at reevaluating the curriculum of a graduate level EAP program. Previous work (Elisha-Primo, et al., 2010) presented students' voices; this article focuses on department chairpersons and graduate advisors, and graduate EFL instructors with respect to the perceived…

Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 10 : enforcement and truck size and weight regulations

DOT National Transportation Integrated Search

2012-04-01

This report presents the Content Analysis Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (CRD) under the United States Department of Transportation (U.S. DOT) Urban Partnership Agreement (UPA) Progr...

Economic Conditions May Contribute to Increased Violence toward Children: A Nationwide Population-Based Analysis of Pediatric Injuries in Taiwanese Emergency Departments.

PubMed

Liu, Yueh-Ping; Hsu, Ren-Jun; Wu, Mei-Hwan; Peng, Chun-Chih; Chang, Shu-Ting; Lei, Wei-Te; Yeh, Tzu-Lin; Liu, Jui-Ming; Lin, Chien-Yu

2018-01-23

Childhood injuries are unfortunately common. Analysis procedures may assist professionals who work with children with developing preventive measures for protecting children's wellness. This study explores the causes of pediatric injuries presenting to an emergency department in Taiwan. This nationwide, population-based study was conducted using data from the National Health Insurance Research Database of Taiwan (NHIRD). Patients aged <18 years were identified from approximately one million individuals listed in the NHIRD. We followed up with these patients for nine years and analyzed the causes of injuries requiring presentation to an emergency department. Variables of interest were age, sex, injury mechanisms, and temporal trends. A total of 274,028 children were identified in our study. Between 2001 and 2009, the leading causes of pediatric injuries treated in emergency departments were motor vehicle injuries, falls, and homicide. The overall incidence of injuries declined over the course of the study because of reductions in motor vehicle accidents and falls. The incidence of homicide increased during the study period, particularly between 2007 and 2009. A moderately inverse correlation between homicide rate and economic growth was observed (correlation coefficient: -0.613, p = 0.041). There was a general decline in pediatric injuries between 2001 and 2009. Public policy changes, including motorcycle helmet laws and increases in alcohol taxes, may have contributed to this decline. Unfortunately, the incidence of homicide increased over the course of the study. Ongoing financial crises may have contributed to this increase. Multidisciplinary efforts are required to reduce homicide and reinforce the importance of measures that protect children against violence.

Brookhaven highlights, October 1978-September 1979. [October 1978 to September 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1979-01-01

These highlights present an overview of the major research and development achievements at Brookhaven National Laboratory from October 1978 to September 1979. Specific areas covered include: accelerator and high energy physics programs; high energy physics research; the AGS and improvements to the AGS; neutral beam development; heavy ion fusion; superconducting power cables; ISABELLE storage rings; the BNL Tandem accelerator; heavy ion experiments at the Tandem; the High Flux Beam Reactor; medium energy physics; nuclear theory; atomic and applied physics; solid state physics; neutron scattering studies; x-ray scattering studies; solid state theory; defects and disorder in solids; surface physics; the Nationalmore » Synchrotron Light Source ; Chemistry Department; Biology Department; Medical Department; energy sciences; environmental sciences; energy technology programs; National Center for Analysis of Energy Systems; advanced reactor systems; nuclear safety; National Nuclear Data Center; nuclear materials safeguards; Applied Mathematics Department; and support activities. (GHT)« less

Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data.

PubMed

Owens, Christabel; Hansford, Lorraine; Sharkey, Siobhan; Ford, Tamsin

2016-03-01

Presentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood. To examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter. Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm. Participants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received 'treatment as usual', i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle. The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted. © The Royal College of Psychiatrists 2016.

Ion-pairing in aqueous CaCl 2 and RbBr solutions. Simultaneous structural refinement of XAFS and XRD data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pham, Thai V.; Fulton, John L.

2013-01-22

We present a new methodology involving the simultaneous refinement of both x-ray absorption and x-ray diffraction spectra (X-ray Absorption/Diffraction Structural Refinement,XADSR), to study hydration and ion pair structure of CaCl 2 and RbBr salts in concentrated aqueous solutions. The XADSR analysis includes the XAFS spectra analysis of both the cation and anion as a probe of their short-range structure with an XRD spectral analysis as a probe of the global structural. Together they deliver a comprehensive picture of the cation and anion hydration, the contact ion pair (CIP) structure and the solvent-separated ion pair (SSIP) structure. XADSR analysis of 6.0more » m aqueous CaCl 2 reveals that there are an insignificant number of Ca 2+-Cl- CIP’s, but there are approximately 3.4 SSIP’s separated by about 4.99 Å. In contrast XADSR analysis of aqueous RbBr yields about 0.7 pair CIP at a bond length 3.51 Å. The present work demonstrates a new approach for a direct co-refinement of XRD and XAFS spectra in a simple and reliable fashion, opening new opportunities for analysis in various disordered and crystalline systems. This work was supported by the U.S. Department of Energy (DOE), Office of Basic Energy Sciences, Division of Chemical Sciences, Geosciences and Biosciences. Pacific Northwest National Laboratory (PNNL) is operated for the U.S. Department of Energy by Battelle.« less

European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14.

PubMed

Uter, W; Amario-Hita, J C; Balato, A; Ballmer-Weber, B; Bauer, A; Belloni Fortina, A; Bircher, A; Chowdhury, M M U; Cooper, S M; Czarnecka-Operacz, M; Dugonik, A; Gallo, R; Giménez-Arnau, A; Johansen, J D; John, S M; Kieć-Świerczyńska, M; Kmecl, T; Kręcisz, B; Larese Filon, F; Mahler, V; Pesonen, M; Rustemeyer, T; Sadowska-Przytocka, A; Sánchez-Pérez, J; Schliemann, S; Schuttelaar, M L; Simon, D; Spiewak, R; Valiukevičienė, S; Weisshaar, E; White, I R; Wilkinson, S M

2017-09-01

Contact allergy is a common condition and can severely interfere with daily life or professional activities. Due to changes in exposures, such as introduction of new substances, new products or formulations and regulatory intervention, the spectrum of contact sensitization changes. To evaluate the current spectrum of contact allergy to allergens present in the European baseline series (EBS) across Europe. Retrospective analysis of data collected by the European Surveillance System on Contact Allergies (ESSCA, www.essca-dc.org) in consecutively patch-tested patients, 2013/14, in 46 departments in 12 European countries. Altogether, 31 689 patients were included in the analysis. Compared to a similar analysis in 2004, the prevalence of contact allergy to methylisothiazolinone went up to around 20% in several departments. In comparison, contact allergy to the metals nickel, cobalt and chromium remained largely stable, at 18.1%, 5.9% and 3.2%, respectively, similar to mostly unchanged prevalence with fragrance mix I, II and Myroxylon pereirae (balsam of Peru) at 7.3%, 3.8% and 5.3%, respectively. In the subgroup of departments diagnosing (mainly) patients with occupational contact dermatitis, the prevalence of work-related contact allergies such as epoxy resin or rubber additives was found to be increased, compared to general dermatology departments. Continuous surveillance of contact allergy based on network data offers the identification of time trends or persisting problems, and thus enables focussing in-depth research (subgroup analyses, exposure analysis) on areas where it is needed. © 2017 European Academy of Dermatology and Venereology.

Defense Health Care Reform: DOD Needs Further Analysis of the Size, Readiness, and Efficiency of the Medical Force

DTIC Science & Technology

2016-09-01

Department of Defense Instruction 7041.3, Economic Analysis for Decisionmaking (Nov. 7, 1995); and Department of Defense Financial Management...2013 data. • Primary-Care Analysis : The Study examined the ratio of enrolled beneficiaries to primary-care providers, and found that the MHS was... Financial Accounting Standards 4; Department of Defense Instruction 7041.3, Economic Analysis for Decisionmaking (Nov. 7, 1995); and Department of Defense

Risk factors for hospital re-presentation among older adults following fragility fractures: a systematic review and meta-analysis.

PubMed

Mathew, Saira A; Gane, Elise; Heesch, Kristiann C; McPhail, Steven M

2016-09-12

Older adults hospitalized with fragility fractures are at high risk of negative events that can culminate in re-presentations to hospital emergency departments or readmissions to hospital. This systematic review aimed to identify patient, clinical, or hospital-related factors that are identifiable at the index admission and that may be associated with re-presentations to hospital emergency departments or hospital readmissions in older adults following fragility fractures. Four electronic databases (PubMed, CINAHL, Embase, and Scopus) were searched. A suite of search terms identified peer-reviewed English-language articles that examined potential correlates of hospital re-presentation in older adults (mean age ≥ 65 years) who were discharged from hospital following treatment for fragility fractures. A three-stage screening process (titles, abstracts, full text) was conducted by two researchers independently. Participant characteristics, study design, potential correlates examined, analyses, and findings were extracted for studies included in the review. Quality and risk of bias were assessed with the Effective Public Health Practice Project Quality Assessment Tool. The strength of evidence was incorporated into a best evidence synthesis, and meta-analysis was conducted where effect pooling was possible. Eleven of 35 eligible studies were categorized as high quality studies. These studies reported that age, higher Cumulative Illness Rating scores, American Society of Anesthesiologists scores > 3, longer length of stay, male sex, cardiovascular disease, low post-operative hemoglobin, kidney disease, dementia and cancer were factors identified at the index admission that were predictive of subsequent re-presentation to hospital. Age was the only predictor for which pooling of effects across studies was possible: pooling was conducted for re-presentation ≤ 30 days (pooled OR, 1.27; 95 % CI, 1.14-1.43) and > 30 days (pooled OR, 1.23; 95 % CI, 1.01-1.50). The best-evidence synthesis, in addition to the meta-analysis, identified a range of factors that may have utility in guiding clinical practice and policy guidelines for targeted interventions to reduce the need for re-presentation to hospital among this frail clinical population. The paucity of studies investigating re-presentations to hospital emergency departments without admission was an important gap in the literature identified in this review. Key limitations were exclusion of non-English language studies and grey literature. PROSPERO CRD42015019379 .

Comparing emergency department presentations among children with cerebral palsy with general childhood presentations: a data linkage study.

PubMed

Meehan, Elaine; Williams, Katrina; Reid, Susan M; Freed, Gary L; Babl, Franz E; Sewell, Jillian R; Vidmar, Suzanna; Donath, Susan; Reddihough, Dinah S

2017-11-01

The aims of this study were to estimate the proportion of emergency department presentations attributable to children with cerebral palsy (CP), investigate the frequency of emergency department presentations in a CP cohort, and compare emergency department presentations among children with CP with those of other children. This was a retrospective cohort study. The Victorian Cerebral Palsy Register was linked to the Victorian Emergency Minimum Dataset. Data on emergency department presentations for the CP cohort occurring between 2007 and 2014 and population control data were obtained. The CP cohort (n=1748) had 7015 emergency department presentations during the 7-year period, accounting for 0.4% of the 1.69 million age-specific presentations during that time. The number of annual presentations per 1000 children rose with increasing CP severity. Compared with presentations among the general population, higher proportions of presentations among the CP cohort were preceded by ambulance arrivals (27% vs 8%), triaged as urgent (66% vs 32%), and required hospital admission (38% vs 12%). The marked differences in presentations between the CP cohort and the general population in the proportions that were urgent and required ambulance arrivals and hospital admissions was an important finding. Strategies to ensure appropriate use of services, including encouragement to seek earlier assistance from primary care providers, may prevent problems escalating to the need for urgent care. Children with cerebral palsy (CP) account for 0.4% of childhood emergency department presentations. More emergency department presentations among children with CP require ambulance arrival. More CP emergency department presentations are urgent and require hospital admission. Traditional emergency department triage scales seem less accurate for this group. © 2017 Mac Keith Press.

Analysis of Installed Measures and Energy Savings for Single-Family Residential Better Buildings Projects

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heaney, M.; Polly, B.

2015-04-30

This report presents an analysis of data for residential single-family projects reported by 37 organizations that were awarded federal financial assistance (cooperative agreements or grants) by the U.S. Department of Energy’s Better Buildings Neighborhood Program.1 The report characterizes the energy-efficiency measures installed for single-family residential projects and analyzes energy savings and savings prediction accuracy for measures installed in a subset of those projects.

Cohort study of oncologic emergencies in patients with head and neck cancer.

PubMed

Reyes-Gibby, Cielito C; Melkonian, Stephanie C; Hanna, Ehab Y; Yeung, Sai-Ching J; Lu, Charles; Chambers, Mark S; Banala, Srinivas R; Gunn, Gary B; Shete, Sanjay S

2017-06-01

Treatments for head and neck squamous cell carcinoma (HNSCC) are associated with toxicities that lead to emergency department presentation. We utilized data from an ongoing prospective cohort of newly diagnosed, previously untreated patients (N = 298) with HNSCC to evaluate the association between clinical and epidemiologic factors and risk for and frequency of emergency department presentation. Time to event was calculated from the date of treatment initiation to emergency department presentation, date of death, or current date. Frequency of emergency department presentation was the sum of emergency department visits during the follow-up time. History of hypertension, normal/underweight body mass index (BMI), and probable depression predicted increased risk for emergency department presentation. BMI and severe pain were associated with higher frequency of emergency department presentations. Clinical and epidemiologic factors can help predict patients with HNSCC who will present to the emergency department. Such knowledge may improve treatment-related patient outcomes and quality of life. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1195-1204, 2017. © 2017 Wiley Periodicals, Inc.

Rates and features of methamphetamine-related presentations to emergency departments: An integrative literature review.

PubMed

Jones, Rikki; Woods, Cindy; Usher, Kim

2018-07-01

To review the clinical impact methamphetamine has on emergency departments by assessing the available research on the rates and features of methamphetamine-related presentations. Globally, methamphetamine availability, distribution and use have rapidly increased. As a result, the number of methamphetamine-related presentations to emergency departments has also increased. In this context, it is timely to review the rate and features of methamphetamine-related presentations to understand the impact of methamphetamine on emergency departments and facilitate the allocation of services, staff and resources. An integrative literature review. This study presents an integrated literature review, following the systematic review process as outlined in the PRISMA flow chart. Several databases were searched using a combination of search terms. Articles were measured against inclusion and exclusion criteria, and the final ten articles were subjected to quality appraisal and outcomes reported. Methamphetamine accounted for 2.3% or less of all emergency departments presentations. The majority of methamphetamine users presenting to emergency departments were males, with a mean age 31-37. Methamphetamine-related presentations to emergency departments were more likely to present with trauma, psychosis, and be placed on 24-hr psychiatric hold. Methamphetamine-related presentations were more likely to present with agitation, aggression and homicidal behaviour and present to emergency departments out of hours and accompanied by police compared with other emergency departments substance-related presentations. Several important themes were highlighted in this review that has an impact on emergency departments services, resources and staff. Understanding the rate and patterns of methamphetamine-related presentations can help to provide evidence for policy development and staff education in emergency departments. Methamphetamine-related presenters are more aggressive and agitated and more likely to be brought in by police. There is a need for policy development and staff training around these issues and further research in this area using stronger study designs. © 2018 John Wiley & Sons Ltd.

Diagnostic accuracy of contrast enhanced ultrasound in patients with blunt abdominal trauma presenting to the emergency department: a systematic review and meta-analysis.

PubMed

Zhang, Zhongheng; Hong, Yucai; Liu, Ning; Chen, Yuhao

2017-06-30

We aimed to investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in evaluating blunt abdominal trauma for patients presenting to the emergency department. Electronic search of Scopus and Pubmed was performed from inception to September 2016. Human studies investigating the diagnostic accuracy of CEUS in identifying abdominal solid organ injuries were included. Risk of bias was assessed using the QUADAS tool. A total of 10 studies were included in the study and 9 of them were included for meta-analysis. The log(DOR) values ranged from 3.80 (95% CI: 2.81-4.79) to 8.52 (95% CI: 4.58-12.47) in component studies. The combined log(DOR) was 6.56 (95% CI: 5.66-7.45). The Cochran's Q was 11.265 (p = 0.793 with 16 degrees of freedom), and the Higgins' I 2 was 0%. The CEUS had a sensitivity of 0.981 (95% CI: 0.868-0.950) and a false positive rate of 0.018 (95% CI: 0.010-0.032) for identifying parenchymal injuries, with an AUC of 0.984. CEUS performed at emergency department had good diagnostic accuracy in identifying abdominal solid organ injuries. CEUS can be recommended in monitoring solid organ injuries, especially for patients managed with non-operative strategy.

Verifying Operational and Developmental Air Force Weather Cloud Analysis and Forecast Products Using Lidar Data from Department of Energy Atmospheric Radiation Measurement (ARM) Sites

NASA Astrophysics Data System (ADS)

Hildebrand, E. P.

2017-12-01

Air Force Weather has developed various cloud analysis and forecast products designed to support global Department of Defense (DoD) missions. A World-Wide Merged Cloud Analysis (WWMCA) and short term Advected Cloud (ADVCLD) forecast is generated hourly using data from 16 geostationary and polar-orbiting satellites. Additionally, WWMCA and Numerical Weather Prediction (NWP) data are used in a statistical long-term (out to five days) cloud forecast model known as the Diagnostic Cloud Forecast (DCF). The WWMCA and ADVCLD are generated on the same polar stereographic 24 km grid for each hemisphere, whereas the DCF is generated on the same grid as its parent NWP model. When verifying the cloud forecast models, the goal is to understand not only the ability to detect cloud, but also the ability to assign it to the correct vertical layer. ADVCLD and DCF forecasts traditionally have been verified using WWMCA data as truth, but this might over-inflate the performance of those models because WWMCA also is a primary input dataset for those models. Because of this, in recent years, a WWMCA Reanalysis product has been developed, but this too is not a fully independent dataset. This year, work has been done to incorporate data from external, independent sources to verify not only the cloud forecast products, but the WWMCA data itself. One such dataset that has been useful for examining the 3-D performance of the cloud analysis and forecast models is Atmospheric Radiation Measurement (ARM) data from various sites around the globe. This presentation will focus on the use of the Department of Energy (DoE) ARM data to verify Air Force Weather cloud analysis and forecast products. Results will be presented to show relative strengths and weaknesses of the analyses and forecasts.

[Strategic planning: an important economic action for German hospitals].

PubMed

Wiese, Christoph H R; Zink, Wolfgang; Russo, Sebastian G

2011-11-01

In medical systems, economic issues and means of action are in the course of dwindling human (physicians and nurses) and financial resources are more important. For this reason, physicians must understand basic economic principles. Only in this way, there may be medical autonomy from social systems and hospital administrators. The current work is an approach to present a model for strategic planning of an anesthesia department. For this, a "strengths", "weaknesses", "opportunities", and "threats" (SWOT) analysis is used. This display is an example of an exemplary anaesthetic department. © Georg Thieme Verlag Stuttgart · New York.

The integrated microbial genome resource of analysis.

PubMed

Checcucci, Alice; Mengoni, Alessio

2015-01-01

Integrated Microbial Genomes and Metagenomes (IMG) is a biocomputational system that allows to provide information and support for annotation and comparative analysis of microbial genomes and metagenomes. IMG has been developed by the US Department of Energy (DOE)-Joint Genome Institute (JGI). IMG platform contains both draft and complete genomes, sequenced by Joint Genome Institute and other public and available genomes. Genomes of strains belonging to Archaea, Bacteria, and Eukarya domains are present as well as those of viruses and plasmids. Here, we provide some essential features of IMG system and case study for pangenome analysis.

Emergency Department Presentations following Tropical Cyclone Yasi.

PubMed

Aitken, Peter; Franklin, Richard Charles; Lawlor, Jenine; Mitchell, Rob; Watt, Kerrianne; Furyk, Jeremy; Small, Niall; Lovegrove, Leone; Leggat, Peter

2015-01-01

Emergency departments see an increase in cases during cyclones. The aim of this study is to describe patient presentations to the Emergency Department (ED) of a tertiary level hospital (Townsville) following a tropical cyclone (Yasi). Specific areas of focus include changes in: patient demographics (age and gender), triage categories, and classification of diseases. Data were extracted from the Townsville Hospitals ED information system (EDIS) for three periods in 2009, 2010 and 2011 to coincide with formation of Cyclone Yasi (31 January 2011) to six days after Yasi crossed the coast line (8 February 2012). The analysis explored the changes in ICD10-AM 4-character classification and presented at the Chapter level. There was a marked increase in the number of patients attending the ED during Yasi, particularly those aged over 65 years with a maximum daily attendance of 372 patients on 4 Feb 2011. The most marked increases were in: Triage categories--4 and 5; and ICD categories--diseases of the skin and subcutaneous tissue (L00-L99), and factors influencing health care status (Z00-Z99). The most common diagnostic presentation across all years was injury (S00-T98). There was an increase in presentations to the ED of TTH, which peaked in the first 24-48 hours following the cyclone and returned to normal over a five-day period. The changes in presentations were mostly an amplification of normal attendance patterns with some altered areas of activity. Injury patterns are similar to overseas experience.

The Department of Defense Acquisition Workforce: Background, Analysis, and Questions for Congress

DTIC Science & Technology

2016-07-29

The Department of Defense Acquisition Workforce: Background, Analysis, and Questions for Congress Moshe Schwartz Specialist in Defense... Acquisition Kathryn A. Francis Analyst in Government Organization and Management Charles V. O’Connor U.S. Department of Defense Fellow July 29, 2016...Congressional Research Service 7-5700 www.crs.gov R44578 The Department of Defense Acquisition Workforce: Background, Analysis, and Questions

Family presence preference when patients are receiving resuscitation in an accident and emergency department.

PubMed

Hung, Maria S Y; Pang, Samantha M C

2011-01-01

This paper is a report of a study to illuminate the experience of family members whose relatives survived the resuscitation in an accident and emergency department, and their preferences with regard to being present. Family presence during resuscitation can offer benefits to both patient and family members, and large healthcare organizations support and recommend offering the option for their presence. However, many staff believe that this is too distressing or traumatic for families and that they would interfere with the resuscitation process. An interpretive phenomenological approach was used to collect data in 2007-2008 with 18 family members of patients who survived life-sustaining interventions in an accident and emergency department in Hong Kong. Audio-recorded interviews were transcribed verbatim for thematic analysis and verified with the participants in second interviews. None of the family members was present in resuscitation room during the life-sustaining interventions, and five entered the room after the patients' condition was stable. The majority indicated a strong preference to be present if given the option. Three interrelated themes emerged: (i) emotional connectedness, (ii) knowing the patient, and (iii) perceived (in)appropriateness, with 10 subthemes representing affective, rational and contextual determinants of family presence preferences. The interplay of these determinants and how they contributed to strong or weak preference for family presence was analysed. Variations among the contributing determinants to each family member's preference to be present were revealed. Appropriate nursing interventions, policy and guidelines should be developed to meet individualized needs during such critical and life-threatening moments in accident and emergency departments. © 2010 Blackwell Publishing Ltd.

Study of Scientific Production of Community Medicines' Department Indexed in ISI Citation Databases.

PubMed

Khademloo, Mohammad; Khaseh, Ali Akbar; Siamian, Hasan; Aligolbandi, Kobra; Latifi, Mahsoomeh; Yaminfirooz, Mousa

2016-10-01

In the scientometric, the main criterion in determining the scientific position and ranking of the scientific centers, particularly the universities, is the rate of scientific production and innovation, and in all participations in the global scientific development. One of the subjects more involved in repeatedly dealt with science and technology and effective on the improvement of health is medical science fields. In this research using scientometric and citation analysis, we studied the rate of scientific productions in the field of community medicine, which is the numbers of articles published and indexed in ISI database from 2000 to 2010. This study is scientometric using the survey and analytical citation. The study samples included all of the articles in the ISI database from 2000 to 2010. For the data collection, the advance method of searching was used at the ISI database. The ISI analyses software and descriptive statistics were used for data analysis. Results showed that among the five top universities in producing documents, Tehran University of Medical Sciences with 88 (22.22%) documents are allocated to the first rank of scientific products. M. Askarian with 36 (90/9%) published documents; most of the scientific outputs in Community medicine, in the international arena is the most active author in this field. In collaboration with other writers, Iranian departments of Community Medicine with 27 published articles have the greatest participation with scholars of English authors. In the process of scientific outputs, the results showed that the scientific process was in its lowest in the years 2000 to 2004, and while the department of Community medicine in 2009 allocated most of the production process to itself. Iranian Journal of Public Health and Saudi Medical Journal each of them had 16 articles which had most participation rate in the publishing of community medicine's department. On the type of carrier, community medicine's department by presentation of 340(85.86%) articles had presented most of their scientific productions in the format of article, also in the field of community medicine outputs, article entitled: "Iron loading and erythrophagocytosis increase ferroportin 1 (FPN1) expression in J774 macrophages"(1) with 81 citations ranked first in cited articles. Subject areas of occupational health with 70 articles and subject areas of general medicine with 69 articles ranked the most active research areas in the Production of community medicine's department. the obtained data showed the much growth of scientific production. The Tehran University of medical Sciences ranked the first in publishing articles in community medicine's department and with most collaboration with community medicine department of England writers in this field and most writers will present their works in paper format.

Study of Scientific Production of Community Medicines’ Department Indexed in ISI Citation Databases

PubMed Central

Khademloo, Mohammad; Khaseh, Ali Akbar; Siamian, Hasan; Aligolbandi, Kobra; Latifi, Mahsoomeh; Yaminfirooz, Mousa

2016-01-01

Background: In the scientometric, the main criterion in determining the scientific position and ranking of the scientific centers, particularly the universities, is the rate of scientific production and innovation, and in all participations in the global scientific development. One of the subjects more involved in repeatedly dealt with science and technology and effective on the improvement of health is medical science fields. In this research using scientometric and citation analysis, we studied the rate of scientific productions in the field of community medicine, which is the numbers of articles published and indexed in ISI database from 2000 to 2010. Methods: This study is scientometric using the survey and analytical citation. The study samples included all of the articles in the ISI database from 2000 to 2010. For the data collection, the advance method of searching was used at the ISI database. The ISI analyses software and descriptive statistics were used for data analysis. Results: Results showed that among the five top universities in producing documents, Tehran University of Medical Sciences with 88 (22.22%) documents are allocated to the first rank of scientific products. M. Askarian with 36 (90/9%) published documents; most of the scientific outputs in Community medicine, in the international arena is the most active author in this field. In collaboration with other writers, Iranian departments of Community Medicine with 27 published articles have the greatest participation with scholars of English authors. In the process of scientific outputs, the results showed that the scientific process was in its lowest in the years 2000 to 2004, and while the department of Community medicine in 2009 allocated most of the production process to itself. Iranian Journal of Public Health and Saudi Medical Journal each of them had 16 articles which had most participation rate in the publishing of community medicine’s department. On the type of carrier, community medicine’s department by presentation of 340(85.86%) articles had presented most of their scientific productions in the format of article, also in the field of community medicine outputs, article entitled: “Iron loading and erythrophagocytosis increase ferroportin 1 (FPN1) expression in J774 macrophages”(1) with 81 citations ranked first in cited articles. Subject areas of occupational health with 70 articles and subject areas of general medicine with 69 articles ranked the most active research areas in the Production of community medicine’s department. Conclusion: the obtained data showed the much growth of scientific production. The Tehran University of medical Sciences ranked the first in publishing articles in community medicine’s department and with most collaboration with community medicine department of England writers in this field and most writers will present their works in paper format. PMID:28077896

Waiving Away High School Graduation Rate Accountability? Policy Brief

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2012

2012-01-01

In November 2011, eleven states submitted applications to the U.S. Department of Education (ED) for waivers from key provisions of the No Child Left Behind Act. Although the waiver process presents an opportunity to strengthen college and career readiness among the nation's high school students, this analysis by the Alliance for Excellent…

Head Start Impact Study. Technical Report

ERIC Educational Resources Information Center

Puma, Michael; Bell, Stephen; Cook, Ronna; Heid, Camilla; Shapiro, Gary; Broene, Pam; Jenkins, Frank; Fletcher, Philip; Quinn, Liz; Friedman, Janet; Ciarico, Janet; Rohacek, Monica; Adams, Gina; Spier, Elizabeth

2010-01-01

This Technical Report is designed to provide technical detail to support the analysis and findings presented in the "Head Start Impact Study Final Report" (U.S. Department of Health and Human Services, January 2010). Chapter 1 provides an overview of the Head Start Impact Study and its findings. Chapter 2 provides technical information on the…

Forest health monitoring: national status, trends, and analysis 2013

Treesearch

Kevin M. Potter; Barbara L. Conkling

2015-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Forest health monitoring: National status, trends, and analysis 2012

Treesearch

Kevin M. Potter; Barbara L. Conkling

2014-01-01

The annual national report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation Monitoring...

Forest Health Monitoring: national status, trends, and analysis 2014

Treesearch

Kevin M. Potter; Barbara L. Conkling

2015-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Forest health monitoring: national status, trends, and analysis 2011

Treesearch

Kevin M. Potter; Barbara L. Conkling

2013-01-01

The annual national report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation Monitoring...

Forest health monitoring: national status, trends, and analysis 2016

Treesearch

Kevin M. Potter; Barbara L. Conkling

2017-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introducesnew techniques for analyzing forest health data, and summarizes results of recently completed...

Forest Health Monitoring: national status, trends, and analysis 2010

Treesearch

Kevin M. Potter; Barbara L. Conkling

2013-01-01

The annual national report of the Forest Health Monitoring Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation Monitoring...

Federal Overreach and Common Core. White Paper No. 133

ERIC Educational Resources Information Center

Evers, Williamson M.

2015-01-01

This report provides the historical background and interpretive analysis needed to understand controversies surrounding Common Core and its associated tests. In this report, Williamson M. Evers presents a revised and expanded version of his expert report for "Jindal v. United States Department of Education et al.," No. 14-CV- 534 (M.D.…

Environmental Conservation. The Oil and Gas Industries, Volume One.

ERIC Educational Resources Information Center

National Petroleum Council, Washington, DC.

Prepared in response to a Department of the Interior request, this report is a comprehensive study of environmental conservation problems as they relate to or have impact on the petroleum industry. It contains the general comments and conclusions of The National Petroleum Council based on an analysis of detailed data. For presentation of key…

Let's Talk School Business.

ERIC Educational Resources Information Center

Meglis, Edward, Jr.

Ways in which to stimulate an in-depth analysis of school finances are presented. The text is intended for a wide audience and can be utilized as a college-level text or as supplemental material. Nine chapters discuss a variety of topics of interest to public administrators: politics and school finance, including overviews of departments of…

A Critical Race Case Analysis of Black Undergraduate Student Success at an Urban University

ERIC Educational Resources Information Center

Harper, Shaun R.; Smith, Edward J.; Davis, Charles H. F., III

2018-01-01

Presented in this article is a case study of Black students' enrollment, persistence, and graduation at Cityville University, an urban commuter institution. We combine quantitative data from the University's Office of Institutional Research and the U.S. Department of Education with qualitative insights gathered in interviews with students,…

Women's Work: Up From .878: Report on the DOT Research Project.

ERIC Educational Resources Information Center

Witt, Mary; Naherny, Patricia K.

The document presents results of a research project that reviewed, analyzed, and assessed the United States Department of Labor's Dictionary of Occupational Titles (DOT) in terms of its analysis of traditional female occupations. The current edition of the DOT assesses the tasks of 21,741 salaried occupations, and assigns to each a…

Forest health monitoring: national status, trends, and analysis 2017

Treesearch

Kevin M. Potter; Barbara L. Conkling

2018-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Service Area Market Analysis: Focus on Industry and Occupation.

ERIC Educational Resources Information Center

Front Range Community Coll., Westminster, CO.

This report presents occupation and industry data (statewide and service area specific) for the purpose of assessing external forces in order to provide information to help guide policymaking at Front Range Community College. The report contains tables that display statewide occupational trends as published by the Colorado Department of Labor and…

Professional Development of University Educators in ESD: A Study from Pedagogical Styles

ERIC Educational Resources Information Center

Callejas Restrepo, Maria Mercedes; Blanco-Portela, Norka; Ladino-Ospina, Yolanda; Tuay Sigua, Rosa Nidia; Vargas, Kenneth Ochoa

2017-01-01

Purpose: The aim of this paper is to present a vision for university educator professional development, based on self-analysis of pedagogical styles and production of knowledge about the practices that promote education for sustainable development (ESD). Design/methodology/approach: The "STSE" course is part of the department's…

The Teacher and His Staff: Differentiating Teaching Roles. Report of the 1968 Regional TEPS Conferences.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. National Commission on Teacher Education and Professional Standards.

This book contains 10 papers selected from those presented at the 1968 regional conferences of the NEA National Commission on Teacher Education and Professional Standards (NCTEPS) on differentiated staffing: "Teacher Education: Analysis and Recommendations," John Macdonald, chairman, Department of Education, Sir George Williams Univ.; "New…

The Influence of Management on the Cost of Fire Protection

ERIC Educational Resources Information Center

Donahue, Amy K.

2004-01-01

An important and unresolved issue central to the study of government performance is how the actions of managers and the nature of organizations affect the cost of public services. This paper presents an empirical analysis of fire departments that estimates the influence of managerial choices on per capita spending within a simultaneous public…

Analysis and design of on-grade reinforced concrete track support structures

NASA Technical Reports Server (NTRS)

Mclean, F. G.; Williams, R. D.; Greening, L. R.

1972-01-01

For the improvement of rail service, the Department of Transportation, Federal Rail Administration, is sponsoring a test track on the Atchison, Topeka, and Santa Fe Railway. The test track will contain nine separate rail support structures, including one conventional section for control and three reinforced concrete structures on grade, one slab and two beam sections. The analysis and design of these latter structures was accomplished by means of the finite element method, NASTRAN, and is presented.

Presentations for hypoglycemia associated with diabetes mellitus to emergency departments in a Canadian province: A database and epidemiological analysis.

PubMed

Alexiu, Chris J; Chuck, Anderson; Jelinski, Susan E; Rowe, Brian H

2017-08-01

The prevalence of diabetes mellitus was reportedly 9% in 2014, making it one of the most common global chronic conditions. Hypoglycemia is an important complication of diabetes treatment. The objective of this study was to quantify and characterize hypoglycemia presentations associated with type 1 or 2 diabetes made to emergency departments (EDs) by adults in a Canadian province. A retrospective cohort study was conducted using reliable administrative data from Alberta for a five-year period (2010/11-2014/15). Records of interest were those with an ICD-10-CA diagnosis of diabetes-associated hypoglycemia (e.g., E10.63). A descriptive analysis was conducted. Data extraction yielded 7835 presentations by 5884 patients. The majority (56.2%) of presentations were made by males, median patient age was 62, and 60.5% had type 2 diabetes. These episodes constituted 0.08% of presentations to Alberta EDs. The annual rate of presentations decreased by 11.8% during the five-year period. Most presentations (63.4%) involved transportation to ED via ambulance. Median length-of-stay was four hours. For 27.5% of presentations, an X-ray was obtained. Most hypoglycemic episodes (65.2%) were considered to be moderate, while 34.3% were considered to be severe. Diabetes-associated hypoglycemia presentations to Alberta EDs are more commonly made by patients with type 2 diabetes, who are more likely to be transported via ambulance and also admitted. Each year, approximately one percent of Albertans with diabetes presented with a hypoglycemia episode; however, knowledge of the variation across regions can guide a strategy for improved care. Copyright © 2017 Elsevier B.V. All rights reserved.

Age-related variation in primary care-type presentations to emergency departments.

PubMed

Freed, Gary; Gafforini, Sarah; Carson, Norman

2015-08-01

A significant amount of attention has been paid to the increase in emergency department (ED) presentations in Australia. Questions have arisen regarding whether all of those presenting to the ED are actually in need of true emergency services. Under-standing the characteristics of those patients who may be cared for in non-emergency settings is important for future health system strategies. The aim of this study was to identify age-related variation in primary care type emergency department (ED) presentations over time. A secondary analysis of data from the Victorian emergency minimum dataset (VEMD) between 2002-13 was conducted. The main outcomes were patterns of primary care type ED presentations for different ages groups over time, age-specific patterns of specific primary care type exclusion criteria and primary care type ED presentations by residents from aged care facilities. The proportion of triage category 4 or 5 ED presentations that met the criteria for a primary care type visit was greatest in the 0-4-year age group and tended to decrease as the age of the patient increased. Triage category 4 or 5 presentation by ambulance was uncommon in the younger age groups, surpassed 10% in the 50-54-year age group, and was >70% for those aged >90 years. The greater proportion of residential aged care facility patients who arrived by ambulance resulted in a much smaller proportion of primary care type visits. There are marked differences by age in the proportion of triage category 4 or 5 ED presentations that met the criteria for primary care type visits. These results indicate it was primarily younger patients who presented to the ED with non-urgent conditions. Most might be able to safely receive care in a primary care setting.

Treatment of Non-ST Elevation Myocardial Infarction: A Process Analysis of Patient and Program Factors in a Teaching Hospital.

PubMed

Shepple, Benjamin I; Thistlethwaite, William A; Schumann, Christopher L; Akosah, Kwame O; Schutt, Robert C; Keeley, Ellen C

2016-09-01

As part of a quality improvement project, we performed a process analysis to evaluate how patients presenting with type 1 non-ST elevation myocardial infarction (STEMI) are diagnosed and managed early after the diagnosis has been made. We performed a retrospective chart review and collected detailed information regarding the timing of the first 12-lead electrocardiogram, troponin order entry and first positive troponin result, administration of anticoagulation and antiplatelet medications, and referral for coronary angiography to identify areas of treatment variability and delay. A total of 242 patients with type 1 non-STEMI were included. The majority of patients received aspirin early after presentation to the emergency department; however, there was significant variability in the time from presentation to administration of other medications, including anticoagulation and P2Y12 therapy, even after an elevated troponin level was documented in the chart. Lack of a standardized non-STEMI admission order set, inconsistency regarding whether the emergency department physician or the cardiology admitting team order these medications after the diagnosis is made, and per current protocol, the initial call regarding the patient made to the cardiology fellow, not the admitting house staff, were identified as possible contributors to the delay. Patients who presented during "nighttime" hours had higher rates of atypical symptoms (P = 0.036) and longer delays to coronary angiography (46.5 versus 24 hours, P < 0.001) even in those deemed intermediate to high risk. A process analysis revealed considerable variation in non-STEMI treatment in our teaching hospital and identified specific areas for quality improvement measures.

Cost Analysis of Selected Patient Categories within a Dermatology Department Using an ABC Approach

PubMed Central

Papadaki, Šárka; Popesko, Boris

2016-01-01

Background: Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. Methods: The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. Results: The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Conclusions: Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the hospital management. Based on the analysis results, it is possible to standardize activities and performance appraisal (Benchmarking), and provide all necessary information for hospital budgeting practices, especially Activity-Based Budgeting (ABB). PMID:26755477

Cost Analysis of Selected Patient Categories Within A Dermatology Department Using an ABC Approach.

PubMed

Papadaki, Šárka; Popesko, Boris

2015-11-17

Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the hospital management. Based on the analysis results, it is possible to standardize activities and performance appraisal (Benchmarking), and provide all necessary information for hospital budgeting practices, especially Activity-Based Budgeting (ABB).

A Gender Bias Habit-Breaking Intervention Led to Increased Hiring of Female Faculty in STEMM Departments.

PubMed

Devine, Patricia G; Forscher, Patrick S; Cox, William T L; Kaatz, Anna; Sheridan, Jennifer; Carnes, Molly

2017-11-01

Addressing the underrepresentation of women in science is a top priority for many institutions, but the majority of efforts to increase representation of women are neither evidence-based nor rigorously assessed. One exception is the gender bias habit-breaking intervention (Carnes et al., 2015), which, in a cluster-randomized trial involving all but two departmental clusters ( N = 92) in the 6 STEMM focused schools/colleges at the University of Wisconsin - Madison, led to increases in gender bias awareness and self-efficacy to promote gender equity in academic science departments. Following this initial success, the present study compares, in a preregistered analysis, hiring rates of new female faculty pre- and post-manipulation. Whereas the proportion of women hired by control departments remained stable over time, the proportion of women hired by intervention departments increased by an estimated 18 percentage points ( OR = 2.23, d OR = 0.34). Though the preregistered analysis did not achieve conventional levels of statistical significance ( p < 0.07), our study has a hard upper limit on statistical power, as the cluster-randomized trial has a maximum sample size of 92 departmental clusters. These patterns have undeniable practical significance for the advancement of women in science, and provide promising evidence that psychological interventions can facilitate gender equity and diversity.

Improving hospital bed occupancy and resource utilization through queuing modeling and evolutionary computation.

PubMed

Belciug, Smaranda; Gorunescu, Florin

2015-02-01

Scarce healthcare resources require carefully made policies ensuring optimal bed allocation, quality healthcare service, and adequate financial support. This paper proposes a complex analysis of the resource allocation in a hospital department by integrating in the same framework a queuing system, a compartmental model, and an evolutionary-based optimization. The queuing system shapes the flow of patients through the hospital, the compartmental model offers a feasible structure of the hospital department in accordance to the queuing characteristics, and the evolutionary paradigm provides the means to optimize the bed-occupancy management and the resource utilization using a genetic algorithm approach. The paper also focuses on a "What-if analysis" providing a flexible tool to explore the effects on the outcomes of the queuing system and resource utilization through systematic changes in the input parameters. The methodology was illustrated using a simulation based on real data collected from a geriatric department of a hospital from London, UK. In addition, the paper explores the possibility of adapting the methodology to different medical departments (surgery, stroke, and mental illness). Moreover, the paper also focuses on the practical use of the model from the healthcare point of view, by presenting a simulated application. Copyright © 2014 Elsevier Inc. All rights reserved.

Proceedings of the 5th Symposium on applied surface analysis

NASA Astrophysics Data System (ADS)

Grant, J. T.

1984-04-01

The 5th Symposium on Applied Surface Analysis was held at the University of Dayton, 8-10 June 1983. This Symposium was held to meet a need, namely to show the transition between basic surface science research and applications of this research to areas of Department of Defense interest. Areas receiving special attention at this Symposium were chemical bonding and reactions at metal-semiconductors interfaces, surface analysis and the tribological processes of ion implanted materials, microbeam analysis and laser ionization of sputtered neutrals. Other topics discussed included adsorption, adhesion, corrosion, wear and thin films. Approximately 110 scientists active in the field of surface analysis participated in the Symposium. Four scientists presented invited papers at the Symposium. There were 29 contributed presentations. The proceedings of the Symposium are being published in a special issue of the journal, Applications of Surface Science, by North-Holland Publishing Company.

Mathematics and Statistics Research Department progress report, period ending June 30, 1982

DOE Office of Scientific and Technical Information (OSTI.GOV)

Denson, M.V.; Funderlic, R.E.; Gosslee, D.G.

1982-08-01

This report is the twenty-fifth in the series of progress reports of the Mathematics and Statistics Research Department of the Computer Sciences Division, Union Carbide Corporation Nuclear Division (UCC-ND). Part A records research progress in analysis of large data sets, biometrics research, computational statistics, materials science applications, moving boundary problems, numerical linear algebra, and risk analysis. Collaboration and consulting with others throughout the UCC-ND complex are recorded in Part B. Included are sections on biology, chemistry, energy, engineering, environmental sciences, health and safety, materials science, safeguards, surveys, and the waste storage program. Part C summarizes the various educational activities inmore » which the staff was engaged. Part D lists the presentations of research results, and Part E records the staff's other professional activities during the report period.« less

Mathematics and statistics research department. Progress report, period ending June 30, 1981

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lever, W.E.; Kane, V.E.; Scott, D.S.

1981-09-01

This report is the twenty-fourth in the series of progress reports of the Mathematics and Statistics Research Department of the Computer Sciences Division, Union Carbide Corporation - Nuclear Division (UCC-ND). Part A records research progress in biometrics research, materials science applications, model evaluation, moving boundary problems, multivariate analysis, numerical linear algebra, risk analysis, and complementary areas. Collaboration and consulting with others throughout the UCC-ND complex are recorded in Part B. Included are sections on biology and health sciences, chemistry, energy, engineering, environmental sciences, health and safety research, materials sciences, safeguards, surveys, and uranium resource evaluation. Part C summarizes the variousmore » educational activities in which the staff was engaged. Part D lists the presentations of research results, and Part E records the staff's other professional activities during the report period.« less

The First NASA Advanced Composites Technology Conference, part 1

NASA Technical Reports Server (NTRS)

Davis, John G., Jr. (Compiler); Bohon, Herman L. (Compiler)

1991-01-01

Papers are presented from the conference. The ACT program is a multiyear research initiative to achieve a national goal of technology readiness before the end of the decade. Conference papers recorded results of research in the ACT program on new materials development and processing, innovative design concepts, analysis development and validation, cost effective manufacturing methodology, and cost tracking and prediction procedures. Papers presented on major applications programs approved by the Department of Defense are also included.

Cost Of Compliance On Munitions Consolidation From Lualualei To West Loch

DTIC Science & Technology

2017-12-01

from the perspective of the Department of Defense in order to capture all costs and benefits associated with the Army and Navy, the main stakeholders...weaknesses of the available alternative options. The model identifies tangible costs and benefits to estimate a net present value for each option. To...the robustness of the average net present value and to show the probability of net costs exceeding the net benefits . The analysis conducted in this

Analysis of Fat Intake Based on the US Department of ...

EPA Pesticide Factsheets

EPA released the final report, Analysis of Fat Intake Based on USDA’s 1994-1996, 1998 Continuing Survey of Food Intakes by Individuals (CSFII, Final Report). For this report, the EPA conducted an analysis of fat consumption across the U.S. population based on data derived from the U.S. Department of Agriculture's 1994-96, 1998 Continuing Survey of Food Intakes by Individuals (CSFII) and EPA's Food Commodity Intake Database (FCID). Percentiles of fat consumption were calculated on the basis of total mass and on a per-unit body-weight basis for 12 food categories and 98 demographic cohorts. In addition, dietary breakdown and fat intake percentiles were calculated for a subset of the sample population whose consumption of animal fats exceeded the 90th percentile within its age group. Many chemicals found in the environment tend to accumulate in fatty tissue. Assessing risks from these chemicals requires knowledge of dietary habits and the amount of fat present in various types of foods.

Forensic patients in the emergency department: Who are they and how should we care for them?

PubMed

Filmalter, Celia J; Heyns, T; Ferreira, R

2017-10-16

Patients who suffer violent, crime related injuries are likely to seek medical assistance in emergency departments. Forensic patients may not disclose the cause of their injuries leading to the impairment of evidence. We explored healthcare providers' perceptions of forensic patients and how they should be cared for. The perceptions of physicians and nurses regarding the profiles and care of forensic patients were explored in three urban emergency departments. The data were collected through a talking wall and analysed collaboratively, with the participants, using content analysis. Healthcare providers in emergency departments differentiated between living and deceased forensic patients. Healthcare providers identified living forensic patients as victims of sexual assault, assault, gunshots and stab wounds, and abused children. Deceased patients included patients that were dead on arrival or died in the emergency departments. Healthcare providers acknowledged that evidence should be collected, preserved and documented. Every trauma patient in the emergency department should be treated asa forensic patient until otherwise proven. If healthcare providers are unable to identify forensic patients and collect the evidence present, the patients' human right to justice will be violated. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Microbiología, sensibilidad antibiótica y factores asociados a bacteriemia en la prostatitis aguda].

PubMed

Ferré, C; Llopis, F; Jacob, J

2016-08-01

The aim of the study was to analyze the characteristics of patients with acute prostatitis presenting to the Emergency Department, the microbiological findings, antibiotic susceptibility, and bacteraemia associated factors. Observational and cohort study with prospective follow-up including patients with acute prostatitis presenting to the Emergency Department from January-December 2012. Data were collected for demographic variables, comorbidities, microbiological findings, antibiotic treatment and outcome. Two hundred and forty one episodes of acute prostatitis were included. Mean age was 62.9 ± 16 years, a history of prostate adenoma was reported in 54 cases (22.5%) and prior manipulation of the lower urinary tract in 40 (17%). Mean symptoms duration was 3.38 ± 4.04 days, voiding symptoms were present in 176 cases (73%) and fever in 154 (64%). Seventy patients (29%) were admitted to the hospital and 3 died. From 216 urine cultures, 128 were positive (59%) and 24 (17.6%) out of 136 blood cultures. Escherichia coli was the main pathogen (58.6% of urine cultures and 64% of blood cultures) with resistant strains to fluoroquinolones, cotrimoxazole and amoxicillin/clavulanic in 27.7%, 22.9% and 27.7% of cases respectively. In the univariate analysis, only chills were associated to bacteraemia (p=0.013). At 30-day follow-up, patients with bacteraemia returned more frequently to the Emergency Department (p=0.037) and were more often admitted to the hospital (p=0.003). Patients with acute prostatitis discharged from the Emergency Department need clinical follow-up and monitoring of microbiological findings in order to assure an adequate antibiotic treatment. Return to Emergency Department and admission to the hospital were significantly more frequent among patients with bacteraemia.

Collaboration and patient safety at an emergency department - a qualitative case study.

PubMed

Pedersen, Anna Helene Meldgaard; Rasmussen, Kurt; Grytnes, Regine; Nielsen, Kent Jacob

2018-03-19

Purpose The purpose of this paper is to examine how conflicts about collaboration between staff at different departments arose during the establishment of a new emergency department and how these conflicts affected the daily work and ultimately patient safety at the emergency department. Design/methodology/approach This qualitative single case study draws on qualitative semi-structured interviews and participant observation. The theoretical concepts "availability" and "receptiveness" as antecedents for collaboration will be applied in the analysis. Findings Close collaboration between departments was an essential precondition for the functioning of the new emergency department. The study shows how a lack of antecedents for collaboration affected the working relation and communication between employees and departments, which spurred negative feelings and reproduced conflicts. This situation was seen as a potential threat for the safety of the emergency patients. Research limitations/implications This study presents a single case study, at a specific point in time, and should be used as an illustrative example of how contextual and situational factors affect the working environment and through that patient safety. Originality/value Few studies provide an in-depth investigation of what actually takes place when collaboration between professional groups goes wrong and escalates, and how problems in collaboration may affect patient safety.

Lessons learned from curriculum changes and setting curriculum objectives at the University of Pennsylvania's Earth and Environmental Science Department

NASA Astrophysics Data System (ADS)

Dmochowski, J. E.

2009-12-01

Recent restructuring of the University of Pennsylvania’s curriculum, including a revised multi-disciplinary Environmental Studies major and a proposed Environmental Science major has led to several changes, including a mandatory junior research seminar. Feedback from students indicates that a more structured curriculum has helped guide them through the multi-disciplinary Environmental Studies major. The addition of mandatory courses in Statistics, Geographical and Environmental Modeling, as well as Economics and Policy has ensured that students have important skills needed to succeed after graduation. We have compiled a curriculum objective matrix to clarify both the broad and focused objectives of our curriculum and how each course helps to fulfill these objectives. An important aspect of both majors is the Senior Thesis. The junior research seminar was recently revised to help students prepare for their thesis research. Topic selection, library research, data presentation, basic research methods, advisor identification, and funding options are discussed. Throughout the course, faculty from within the department lecture about their research and highlight opportunities for undergraduates. In one assignment, students are given a few types of datasets and asked to present the data and error analysis in various formats using different software (SPSS and Excel). The final paper was a research proposal outlining the student’s Senior Thesis. Based on both the university and instructor written course evaluations, students felt they benefited most from writing their senior thesis proposal; doing assignments on data analysis, library research and critical analysis; and the faculty research lectures. The lessons learned in restructuring this flexible major and providing a research seminar in the junior year may benefit other departments considering such changes.

Lessons Learned from the Frenchman Flat Flow and Transport Modeling External Peer Review

NASA Astrophysics Data System (ADS)

Becker, N. M.; Crowe, B. M.; Ruskauff, G.; Kwicklis, E. M.; Wilborn, B.

2011-12-01

The objective of the U.S. Department of Energy's Underground Test Area Program program is to forecast, using computer modeling, the contaminant boundary of radionuclide transport in groundwater at the Nevada National Security Site that exceeds the Safe Drinking Water Act after 1000 yrs. This objective is defined within the Federal Facilities Agreement and Consent Order between the Department of Energy, Department of Defense and State of Nevada Division of Environmental Protection . At one of the Corrective Action Units, Frenchman Flat, a Phase I flow and transport model underwent peer review in 1999 to determine if the model approach, assumptions and results adequate to be used as a decision tool as a basis to negotiate a compliance boundary with Nevada Division of Environmental Protection. The external peer review decision was that the model was not fully tested under a full suite of possible conceptual models, including boundary conditions, flow mechanisms, other transport processes, hydrological framework models, sensitivity and uncertainty analysis, etc. The program went back to collect more data, expand modeling to consider other alternatives that were not adequately tested, and conduct sensitivity and uncertainty analysis. A second external peer review was held in August 2010. Their conclusion that the new Frenchman Flat flow and transport modeling analysis were adequate as a decision tool and that the model was ready to advance to the next step in the Federal Facilities Agreement and Consent Order strategy. We will discuss the processes to changing the modeling that occurred between the first and second peer reviews, and then present the second peer review general comments. Finally, we present the lessons learned from the total model acceptance process required for federal regulatory compliance.

Hanford Works monthly report, October 1952

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1952-11-20

this document presents a summary of work and progress at the Hanford Engineer works for October 1952. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Works monthly report, December 1952

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1953-01-23

This document presents a summary of work and progress at the Hanford Engineer Works for December 1952. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Works monthly report, February 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1953-03-18

This document presents a summary of work and progress at the Hanford Engineer Works for February 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Service departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Works monthly report, September 1952

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1952-10-20

This document presents a summary of work and progress at the Hanford Engineer Works for September 1952. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

A Pilot Cost-Effectiveness Analysis of the Economic and Educational Impact of the Mountain-Plains Education and Economic Development Program, Inc. A Research Study for Department of Health, Education and Welfare, National Institute of Education. Revised May 1976.

ERIC Educational Resources Information Center

Stromsdorfer, Ernst W.; Moayed-Dadkhah, Kamran

Presenting a cost-benefit analysis of the Mountain-Plains Career Education Program (a family based program for the economically deprived in the mountain plains states operating out of Glasgow Air Force Base in Montana) and the methodological basis for a full and more detailed study, this evaluation includes: (1) discussion of theoretical issues…

Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study.

PubMed

Pepe, Giuseppe; Castelli, Matteo; Nazerian, Peiman; Vanni, Simone; Del Panta, Massimo; Gambassi, Francesco; Botti, Primo; Missanelli, Andrea; Grifoni, Stefano

2011-03-17

Delayed neuropsychological sequelae (DNS) commonly occur after recovery from acute carbon monoxide (CO) poisoning. The preventive role and the indications for hyperbaric oxygen therapy in the acute setting are still controversial. Early identification of patients at risk in the Emergency Department might permit an improvement in quality of care. We conducted a retrospective study to identify predictive risk factors for DNS development in the Emergency Department. We retrospectively considered all CO-poisoned patients admitted to the Emergency Department of Careggi University General Hospital (Florence, Italy) from 1992 to 2007. Patients were invited to participate in three follow-up visits at one, six and twelve months from hospital discharge. Clinical and biohumoral data were collected; univariate and multivariate analysis were performed to identify predictive risk factors for DNS. Three hundred forty seven patients were admitted to the Emergency Department for acute CO poisoning from 1992 to 2007; 141/347 patients participated in the follow-up visit at one month from hospital discharge. Thirty four/141 patients were diagnosed with DNS (24.1%). Five/34 patients previously diagnosed as having DNS presented to the follow-up visit at six months, reporting a complete recovery. The following variables (collected before or upon Emergency Department admission) were associated to DNS development at one month from hospital discharge in the univariate analysis: CO exposure duration >6 hours, a Glasgow Coma Scale (GCS) score <9, seizures, systolic blood pressure <90 mmHg, elevated creatine phosphokinase concentration and leukocytosis. There was no significant correlation with age, sex, voluntary exposure, headache, transient loss of consciousness, GCS between 14 and 9, arterial lactate and carboxyhemoglobin concentration. The multivariate analysis confirmed as independent prognostic factors GCS <9 (OR 7.15; CI 95%: 1.04-48.8) and leukocytosis (OR 3.31; CI 95%: 1.02-10.71). Our study identified several potential predictive risk factors for DNS. Treatment algorithms based on an appropriate risk-stratification of patients in the Emergency Department might reduce DNS incidence; however, more studies are needed. Adequate follow-up after hospital discharge, aimed at correct recognition of DNS, is also important.

Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study

PubMed Central

2011-01-01

Background Delayed neuropsychological sequelae (DNS) commonly occur after recovery from acute carbon monoxide (CO) poisoning. The preventive role and the indications for hyperbaric oxygen therapy in the acute setting are still controversial. Early identification of patients at risk in the Emergency Department might permit an improvement in quality of care. We conducted a retrospective study to identify predictive risk factors for DNS development in the Emergency Department. Methods We retrospectively considered all CO-poisoned patients admitted to the Emergency Department of Careggi University General Hospital (Florence, Italy) from 1992 to 2007. Patients were invited to participate in three follow-up visits at one, six and twelve months from hospital discharge. Clinical and biohumoral data were collected; univariate and multivariate analysis were performed to identify predictive risk factors for DNS. Results Three hundred forty seven patients were admitted to the Emergency Department for acute CO poisoning from 1992 to 2007; 141/347 patients participated in the follow-up visit at one month from hospital discharge. Thirty four/141 patients were diagnosed with DNS (24.1%). Five/34 patients previously diagnosed as having DNS presented to the follow-up visit at six months, reporting a complete recovery. The following variables (collected before or upon Emergency Department admission) were associated to DNS development at one month from hospital discharge in the univariate analysis: CO exposure duration >6 hours, a Glasgow Coma Scale (GCS) score <9, seizures, systolic blood pressure <90 mmHg, elevated creatine phosphokinase concentration and leukocytosis. There was no significant correlation with age, sex, voluntary exposure, headache, transient loss of consciousness, GCS between 14 and 9, arterial lactate and carboxyhemoglobin concentration. The multivariate analysis confirmed as independent prognostic factors GCS <9 (OR 7.15; CI 95%: 1.04-48.8) and leukocytosis (OR 3.31; CI 95%: 1.02-10.71). Conclusions Our study identified several potential predictive risk factors for DNS. Treatment algorithms based on an appropriate risk-stratification of patients in the Emergency Department might reduce DNS incidence; however, more studies are needed. Adequate follow-up after hospital discharge, aimed at correct recognition of DNS, is also important. PMID:21414211

Presentations to Emergency Departments for COPD: A Time Series Analysis.

PubMed

Rosychuk, Rhonda J; Youngson, Erik; Rowe, Brian H

2016-01-01

Background. Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by progressive dyspnea and acute exacerbations which may result in emergency department (ED) presentations. This study examines monthly rates of presentations to EDs in one Canadian province. Methods. Presentations for COPD made by individuals aged ≥55 years during April 1999 to March 2011 were extracted from provincial databases. Data included age, sex, and health zone of residence (North, Central, South, and urban). Crude rates were calculated. Seasonal autoregressive integrated moving average (SARIMA) time series models were developed. Results. ED presentations for COPD totalled 188,824 and the monthly rate of presentation remained relatively stable (from 197.7 to 232.6 per 100,000). Males and seniors (≥65 years) comprised 52.2% and 73.7% of presentations, respectively. The ARIMA(1,0, 0) × (1,0, 1)12 model was appropriate for the overall rate of presentations and for each sex and seniors. Zone specific models showed relatively stable or decreasing rates; the North zone had an increasing trend. Conclusions. ED presentation rates for COPD have been relatively stable in Alberta during the past decade. However, their increases in northern regions deserve further exploration. The SARIMA models quantified the temporal patterns and can help planning future health care service needs.

Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial

PubMed Central

2014-01-01

Background Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despite the existence of several high quality clinical practice guidelines, internationally and in Australia, research shows inconsistent implementation of these recommendations. The aim of this trial is to test the effectiveness of a targeted, theory- and evidence-informed implementation intervention to increase the uptake of three key clinical recommendations regarding the emergency department management of adult patients (18 years of age or older) who present following mild head injuries (concussion), compared with passive dissemination of these recommendations. The primary objective is to establish whether the intervention is effective in increasing the percentage of patients for which appropriate post-traumatic amnesia screening is performed. Methods/design The design of this study is a cluster randomised trial. We aim to include 34 Australian 24-hour emergency departments, which will be randomised to an intervention or control group. Control group departments will receive a copy of the most recent Australian evidence-based clinical practice guideline on the acute management of patients with mild head injuries. The intervention group will receive an implementation intervention based on an analysis of influencing factors, which include local stakeholder meetings, identification of nursing and medical opinion leaders in each site, a train-the-trainer day and standardised education and interactive workshops delivered by the opinion leaders during a 3 month period of time. Clinical practice outcomes will be collected retrospectively from medical records by independent chart auditors over the 2 month period following intervention delivery (patient level outcomes). In consenting hospitals, eligible patients will be recruited for a follow-up telephone interview conducted by trained researchers. A cost-effectiveness analysis and process evaluation using mixed-methods will be conducted. Sample size calculations are based on including 30 patients on average per department. Outcome assessors will be blinded to group allocation. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612001286831 (date registered 12 December 2012). PMID:25012235

The Multilevel Mixed Intact Group Analysis: A Mixed Method to Seek, Detect, Describe, and Explain Differences Among Intact Groups

ERIC Educational Resources Information Center

Schoonenboom, Judith

2016-01-01

Educational innovations often involve intact subgroups, such as school classes or university departments. In small-scale educational evaluation research, typically involving 1 to 20 subgroups, differences among these subgroups are often neglected. This article presents a mixed method from a qualitative perspective, in which differences among…

Final Report - Cloud-Based Management Platform for Distributed, Multi-Domain Networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chowdhury, Pulak; Mukherjee, Biswanath

2017-11-03

In this Department of Energy (DOE) Small Business Innovation Research (SBIR) Phase II project final report, Ennetix presents the development of a solution for end-to-end monitoring, analysis, and visualization of network performance for distributed networks. This solution benefits enterprises of all sizes, operators of distributed and federated networks, and service providers.

The Implementation of a Cost Effectiveness Analyzer for Web-Supported Academic Instruction: An Example from Life Science

ERIC Educational Resources Information Center

Cohen, Anat; Nachmias, Rafi

2012-01-01

This paper describes implementation of a quantitative cost effectiveness analyzer for Web-supported academic instruction that was developed in our University. The paper presents the cost effectiveness analysis of one academic exemplary course in Life Science department and its introducing to the course lecturer for evaluation. The benefits and…

Job Analysis Techniques for Restructuring Health Manpower Education and Training in the Navy Medical Department. Attachment 1. Radiation QPCB Task Sort for Radiation.

ERIC Educational Resources Information Center

Technomics, Inc., McLean, VA.

This publication is Attachment 1 of a set of 16 computer listed QPCB task sorts, by career level, for the entire Hospital Corps and Dental Technician fields. Statistical data are presented in tabular form for a detailed listing of job duties in radiation. (BT)

Inspiring Creativity in Urban School Leaders: Lessons from the Performing Arts

ERIC Educational Resources Information Center

Kaimal, Girija; Drescher, Jon; Fairbank, Holly; Gonzaga, Adele; White, George P.

2014-01-01

This paper presents an analysis of how guided engagement with the arts can provide leadership lessons for school leaders and administrators. The study was conducted as part of two projects funded by the School Leadership Program (SLP) grants from the U.S. Department of Education. The principal interns and practicing school leaders participated in…

An Analysis of Insulated Concrete Forms for use in Sustainable Military Construction

DTIC Science & Technology

2014-03-27

CONSTRUCTION THESIS Presented to the Faculty Department of Systems and Engineering Management Graduate School of Engineering and Management...which fit together and are filled with reinforced concrete to construct the exterior wall systems of a building. By design, this material provides a...Forms with Rebar .............................................................. 12 Figure 3. Cut outs of ICF wall systems

A Decision Analysis Tool for the Source Selection Process

DTIC Science & Technology

2006-03-01

THE SOURCE SELECTION PROCESS THESIS Presented to the Faculty Department of Systems and Engineering Management Graduate School of...Engineering and Management Air Force Institute of Technology Air University Air Education and Training Command In Partial Fulfillment of...the Requirements for the Degree of Master of Science in Engineering Management John R. Trumm, BS Captain, USAF March 2006

Effect of Time Management on the Job Satisfaction and Motivation of Teacher Educators: A Narrative Analysis

ERIC Educational Resources Information Center

Sahito, Zafarullah; Vaisanen, Pertti

2017-01-01

The present study was conducted to investigate the relationship between time management, job satisfaction and motivation among teacher educators in university departments, institutes and faculties of education in the Sindh province of Pakistan. Using an interview approach, the researchers recorded the professional stories of 40 teacher educators.…

Basic sciences agonize in Turkey!

NASA Astrophysics Data System (ADS)

Akdemir, Fatma; Araz, Asli; Akman, Ferdi; Durak, Rıdvan

2016-04-01

In this study, changes from past to present in the departments of physics, chemistry, biology and mathematics, which are considered as the basic sciences in Turkey, are shown. The importance of basic science for the country emphasized and the status of our country was discussed with a critical perspective. The number of academic staff, the number of students, opened quotas according to years for these four departments at universities were calculated and analysis of the resulting changes were made. In examined graphics changes to these four departments were similar. Especially a significant change was observed in the physics department. Lack of jobs employing young people who have graduated from basic science is also an issue that must be discussed. There are also qualitative results of this study that we have discussed as quantitative. Psychological problems caused by unemployment have become a disease among young people. This study was focused on more quantitative results. We have tried to explain the causes of obtained results and propose solutions.

Emergency Department Care in the Postpartum Period: California Births, 2009-2011.

PubMed

Batra, Priya; Fridman, Moshe; Leng, Mei; Gregory, Kimberly D

2017-11-01

To use population data to identify patient characteristics associated with a postpartum maternal emergency department visit within 90 days of discharge after birth. This retrospective cross-sectional study analyzed linked maternal discharge and emergency department data for all live California births from 2009 to 2011. The primary outcome was at least one emergency department visit within 90 days of hospital discharge after birth. Secondary outcomes included three or more visits within 90 days ("high utilization") and inpatient readmission. Independent variables included demographics (age, race or ethnicity, payer, income) and clinical characteristics (length of stay, antepartum complications, mode of delivery, and severe maternal morbidity at delivery). Multilevel logistic regression identified variables associated study outcomes; we validated the predictive model with a split-sample approach and receiver operating characteristic curve analysis. Of 1,071,232 deliveries included, 88,674 women (8.3%) visited the emergency department at least once in the 90 days after delivery discharge. Emergency department use was significantly associated with Medicaid insurance (adjusted odds ratio [OR] 2.15, 95% CI 2.08-2.21), age younger than 20 years (adjusted OR 2.08, 95% CI 1.98-2.19), severe maternal morbidity at delivery (adjusted OR 1.58, 95% CI 1.49-1.71), antepartum complications (adjusted OR 1.46, 95% CI 1.42-1.50), and cesarean delivery (adjusted OR 1.40, 95% CI 1.37-1.44). Approximately one fifth of visits occurred within 4 days of discharge, and more than half were within 3 weeks. High utilizers comprised 0.5% of the entire sample (5,171 women) and only 1.2% of women presenting for emergency department care were readmitted. Receiver operating curve model analysis using the validation sample supported predictive accuracy for postpartum emergency department use (area under the curve=0.95). One in 12 California women visited the emergency department in the first 90 days after postpartum discharge. Women at increased risk for postpartum emergency department use per our validated model (eg, low income, birth complications) may benefit from earlier scheduled postpartum visits.

Epidemiology of fishing related upper extremity injuries presenting to the emergency department in the United States.

PubMed

Gil, Joseph A; Elia, Gregory; Shah, Kalpit N; Owens, Brett D; Got, Christopher

2018-04-16

Fishing injuries commonly affect the hands. The goal of this study was to quantify the incidence of fishing-related upper extremity injuries that present to emergency departments in the United States. We examined the reported cases of fishing-related upper extremity injuries in the National Electronic Injury Surveillance System database. Analysis was performed based on age, sex and the type of injury reported. The national incidence of fishing-related upper extremity injuries was 119.6 per 1 million person-years in 2014. The most common anatomic site for injury was the finger (63.3%), followed by the hand (20.3%). The most common type of injury in the upper extremity was the presence of a foreign body (70.4%). The incidence of fishing-related upper extremity injuries in males was 200 per 1 million person-years, which was significantly higher than the incidence in females (41 per 1 million person-years). The incidence of fishing-related upper extremity injuries that present to the Emergency Department was 120 per 1 million person-years. The incidence was significantly higher in males. With the widespread popularity of the activity, it is important for Emergency Physicians and Hand Surgeons to understand how to properly evaluate and manage these injuries.

Combating substance misuse: competences and preparation of special education department students.

PubMed

Al-Zboon, Eman

2017-01-14

This study examines Jordanian special education department students' competences and preparation relating to combating substance misuse (SM). Thematic analysis was performed on data from interviews with 150 students. Some participants denied the possibility of addiction among students with disabilities, and presented negative attitudes toward their role in combating SM. In general, the participants displayed low levels of professionalism relating to combating SM, and the results revealed that they felt that their preparation programme had been inadequate and they desired more courses that related to combating SM. These results suggest that Jordanian Universities should emphasise the role of teachers in a preventive approach to SM.

Washington State reorganization: more of the story.

PubMed

Gebbie, K M

1997-01-01

The creation of a new Department of Health in Washington State in 1989 provided an opportunity for analysis of the many forces beyond the pressure of interest groups leading to such a change. Interviews with key actors from executive and legislative branches of state government, local government, and interested health organizations were conducted to uncover the full scope considered for the new department, and the interactions that led to the final, narrower entity. A process model based on these findings is presented as a useful tool for those seeking to improve public health at the state level through changes in the organizational units responsible for health activities.

Application of the FTA and ETA Method for Gas Hazard Identification for the Performance of Safety Systems in the Industrial Department

NASA Astrophysics Data System (ADS)

Ignac-Nowicka, Jolanta

2018-03-01

The paper analyzes the conditions of safe use of industrial gas systems and factors influencing gas hazards. Typical gas installation and its basic features have been characterized. The results of gas threat analysis in an industrial enterprise using FTA error tree method and ETA event tree method are presented. Compares selected methods of identifying hazards gas industry with respect to the scope of their use. The paper presents an analysis of two exemplary hazards: an industrial gas catastrophe (FTA) and an explosive gas explosion (ETA). In both cases, technical risks and human errors (human factor) were taken into account. The cause-effect relationships of hazards and their causes are presented in the form of diagrams in the drawings.

Ergonomic evaluation of a wheelchair for transfer of disabled passengers at a large airport.

PubMed

Rohmert, W; Löwenthal, I; Rückert, A

1990-01-01

Transferring disabled passengers to the aircraft, both arriving and departing, is one passenger service at a big airport. We use different ergonomic research methods (registration of heart rate, AET job analysis as well as a standardized questionnaire) to evaluate the present wheelchair design. Due to e.g. the high wheelchair backrest, the forces needed to handle the chair and other facts, the current wheelchair causes a strain bottleneck. The results of the AET analysis and the rating of the perceived exertion confirm this finding. A redesigned wheelchair based on ergonomic principles, which reduces stress on the employees and offers more comfort to disabled passengers, is presented.

Hanford Atomic Products Operation monthly report, January 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-02-21

This document presents a summary of work and progress at the Hanford Engineer Works for January 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical Design, and Project Sections. Costs for the various departments are presented in the Financial department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report for April 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-05-23

This document presents a summary of work and progress at the Hanford Engineer Works for April 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Monthly report Hanford Atomic Products Operation, July 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-08-20

This document presents a summary of work and progress at the Hanford Engineer Works for July 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services Departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, August 1956

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1956-09-28

This document presents a summary of work and progress at the Hanford Engineer Works for August 1956. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Sciences, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report for May 1956

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1956-06-21

This document presents a summary of work and progress at the Hanford Engineer Works for May, 1956. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, March 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-04-23

This document presents a summary of work and progress at the Hanford Engineer Works for March 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Service departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, September 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-10-27

This document presents a summary of work and progress at the Hanford Engineer Works for September 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, June 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-07-26

This document presents a summary of work and progress at the Hanford Engineer Works for June 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, March 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-04-20

This document presents a summary of work and progress at the Hanford Engineer Works for March 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, November 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-12-30

This document presents a summary of work and progress at the Hanford Engineer Works for November 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, August 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-09-27

This document presents a summary of work and progress at the Hanford Engineer Works for August 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Sciences, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, May 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-06-22

This document presents a summary of work and progress at the Hanford Engineer Works for May 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Science, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report for December 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1956-01-30

This document presents a summary of work and progress at the Hanford Engineer Works for December 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, October 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-11-30

This document presents a summary of work and progress at the Hanford Engineer works for October, 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products for Operation monthly report, February 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-03-18

This document presents a summary of work and progress at the Hanford Engineer Works for February 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, May 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-06-23

This document presents a summary of work and progress at the Hanford Engineer Works for May 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, July 1955

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-08-26

This document presents a summary of work and progress at the Hanford Engineer Works for July 1955. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, October 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1953-11-20

This document presents a summary of work and progress at the Hanford Engineer Works for October 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services. Employee and Public Relations, and Community Realmore » Estate and Service departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, May 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This document presents a summary of work and progress at the Hanford Engineer Works for May 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, October 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-11-24

This document presents a summary of work and progress at the Hanford Engineer Works for October 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, December 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1955-01-25

This document presents a summary of work and progress at the Hanford Engineer Works for December 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, July 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1953-08-20

This document presents a summary of work and progress at the Hanford Engineer Works for July 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, August 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-09-17

This document presents a summary of work and progress at the Hanford Engineer Works for August 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department report plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities, and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report for September 1954

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-10-25

This document presents a summary of work and progress at the Hanford Engineer Works for September 1954. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, June 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1953-07-22

This document presents a summary of work and progress at the Hanford Engineer Works for June 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Real Estatemore » and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, December 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1954-01-22

This document presents a summary of work and progress at the Hanford Engineer Works for December 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Hanford Atomic Products Operation monthly report, August 1953

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1953-09-18

This document presents a summary of work and progress at the Hanford Engineer Works for August, 1953. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department`s section summarizes work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical, Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Realmore » Estate and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Analysis of new workers' compensation claims in the Department of Defense civilian workforce, 2000-2012.

PubMed

Nelson, Cameron J L; Bigley, Daniel P; Mallon, Timothy M

2015-03-01

This study of Department of Defense (DoD) civilian employees Workers' Compensation (WC) claims for chargeback year 2000 through 2012 aimed to analyze the frequency, rates, and costs of WC claims representing 5% of the DoD annual personnel budget. A multiyear cross-sectional study of WC claims data identified the top five most frequent causes, natures, and anatomical sites; changes in frequency, worker age, costs, and time were evaluated for trends. The annual frequency and rate of new DoD WC claims decreased over time, whereas costs per new claim have increased. New claim frequencies, rates, and costs aggregated in older age groups. The increasing trend in costs of each claim and the overall program costs presents a need for case management. Analysis of WC claims data is necessary to help target injury prevention efforts and reduce program costs.

The evolution of a teledentistry system within the Department of Defense.

PubMed Central

Rocca, M. A.; Kudryk, V. L.; Pajak, J. C.; Morris, T.

1999-01-01

Total Dental Access (TDA) is the teledentistry project within the Department of Defense. This project enables referring dentists from the US Armed Forces to consult with specialists on the status of a patient. TDA focuses on three areas of dentistry: patient care, continuing education and dentist-laboratory communications. One of the goals of this project is to increase patient access to quality dental care. The other goal is to establish a cost effective telemedicine system. This paper describes the evolution of a teledentistry system, the main features of POTS-based, ISDN-based and Web-based systems used, advantages, disadvantages and cost-effectiveness of these systems. Data has been collected on the frequency of use, technical problems occurred, avoided patient or specialist travel and the total number of consults. A cost-effectiveness analysis has been conducted on the data collected. The results of this analysis will be presented. PMID:10566495

The evolution of a teledentistry system within the Department of Defense.

PubMed

Rocca, M A; Kudryk, V L; Pajak, J C; Morris, T

1999-01-01

Total Dental Access (TDA) is the teledentistry project within the Department of Defense. This project enables referring dentists from the US Armed Forces to consult with specialists on the status of a patient. TDA focuses on three areas of dentistry: patient care, continuing education and dentist-laboratory communications. One of the goals of this project is to increase patient access to quality dental care. The other goal is to establish a cost effective telemedicine system. This paper describes the evolution of a teledentistry system, the main features of POTS-based, ISDN-based and Web-based systems used, advantages, disadvantages and cost-effectiveness of these systems. Data has been collected on the frequency of use, technical problems occurred, avoided patient or specialist travel and the total number of consults. A cost-effectiveness analysis has been conducted on the data collected. The results of this analysis will be presented.

Online patient information from radiation oncology departments is too complex for the general population.

PubMed

Rosenberg, Stephen A; Francis, David M; Hullet, Craig R; Morris, Zachary S; Brower, Jeffrey V; Anderson, Bethany M; Bradley, Kristin A; Bassetti, Michael F; Kimple, Randall J

Nearly two-thirds of cancer patients seek information about their diagnosis online. We assessed the readability of online patient education materials found on academic radiation oncology department Web sites to determine whether they adhered to guidelines suggesting that information be presented at a sixth-grade reading level. The Association of American Medical Colleges Web site was used to identify all academic radiation oncology departments in the United States. One-third of these department Web sites were selected for analysis using a random number generator. Both general information on radiation therapy and specific information regarding various radiation modalities were collected. To test the hypothesis that the readability of these online educational materials was written at the recommended grade level, a panel of 10 common readability tests was used. A composite grade level of readability was constructed using the 8 readability measures that provide a single grade-level output. A mean of 5605 words (range, 2058-12,837) from 30 department Web sites was collected. Using the composite grade level score, the overall mean readability level was determined to be 13.36 (12.83-13.89), corresponding to a collegiate reading level. This was significantly higher than the target sixth-grade reading level (middle school, t (29) = 27.41, P < .001). Online patient educational materials from academic radiation oncology Web sites are significantly more complex than recommended by the National Institutes of Health and the Department of Health and Human Services. To improve patients' comprehension of radiation therapy and its role in their treatment, our analysis suggests that the language used in online patient information should be simplified to communicate the information at a more appropriate level. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Alcohol intoxication in the context of major public holidays, sporting and social events: a time-series analysis in Melbourne, Australia, 2000-2009.

PubMed

Lloyd, Belinda; Matthews, Sharon; Livingston, Michael; Jayasekara, Harindra; Smith, Karen

2013-04-01

To assess the relationship between ambulance attendances, emergency department (ED) presentations and hospital admissions for acute alcohol intoxication and the timing of public holidays, sporting and social events. Time-series analysis was used to explore trends in intoxication in the context of major events. Population of Melbourne, Victoria, Australia between 2000 and 2009. All patients attended by ambulance, presenting to hospital EDs, or admitted to hospital who were classified as acutely alcohol intoxicated. Analysis of daily numbers of presentations for acute alcohol intoxication associated with major events were undertaken, including lead and lag effects. Analyses controlled for day of week and month of year to address temporal and seasonal variations. Alcohol intoxication presentations were significantly elevated the day before all public holidays, with intoxication cases on the day of public holidays only higher on New Year's Day (ambulance 6.57, 95% confidence intervals (CI): 3.4-9.74; ED 3.34, 95% CI: 1.28-5.4) and ANZAC Day (ambulance 3.71, 95% CI: 0.68-6.75). The Australian Football League (AFL) Grand Final (ED 2.37, 95% CI: 0.55-4.19), Commonwealth Games (ED 2.45, 95% CI: 0.6-4.3) and Melbourne Cup Day (ambulance 6.14, 95% CI: 2.42-9.85) represented the sporting events with significant elevations in acute intoxication requiring medical attention. The last working day before Christmas was the only social event where a significant increase in acute intoxication occurred (ambulance 8.98, 95% CI: 6.8-11.15). Acute alcohol intoxication cases requiring ambulance, emergency department and hospital in-patient treatment increase substantially on the day preceding public holidays and other major social events. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Older Adults with Mental Disorders: What Factors Distinguish Those Who Present to Emergency Departments for Mental Health Reasons from Those Who Do Not?

PubMed

Walsh, Patrick G; Currier, Glenn W; Shah, Manish N; Friedman, Bruce

2015-11-01

To identify among older adults with mental disorders factors associated with those who present to emergency departments (EDs) for mental health reasons versus those who do not. The authors conducted a secondary, cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS), which comprises a representative sample of the U.S. civilian noninstitutionalized population. Of the MEPS participants ages 66 and older on December 31 of the survey years 2000-2005, the analysis sample (2,757) included the 177 persons with at least one mental health ED visit and the 2,580 persons with mental disorders without such a visit. The three categories of the Andersen behavioral model for healthcare services utilization-predisposing, enabling, and need factors-were used as the theoretical framework for the independent variables. Logistic regression analysis indicated that four need factors (adjustment disorder [OR: 3.42], psychosis [OR: 2.68], fair perceived physical health status [OR: 2.24], and anxiety disorder [OR: 1.85]) and two predisposing characteristics (widowed and living alone [OR: 1.68] and female [OR: 1.56]) were significantly associated with older adults with mental disorders who present to an ED for mental health reasons. Good perceived mental health status (OR: 0.55) was protective against presenting to an ED. EDs that serve populations with higher proportions of older persons that are women, widowed and living alone, with adjustment disorder, psychosis, anxiety disorders, or fair perceived physical health should expect to have a greater likelihood of older persons visiting the ED for mental health reasons. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Hanford Works monthly report, August 1952

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1952-09-24

This document presents a summary of work and progress at the Hanford Engineer Works for August 1952. The report is divided into sections by department. A plant wide general summary is included at the beginning of the report, after which the departmental summaries begin. The Manufacturing Department reports plant statistics, and summaries for the Metal Preparation, Reactor and Separation sections. The Engineering Department` section summaries work for the Technical, Design, and Project Sections. Costs for the various departments are presented in the Financial Department`s summary. The Medical,Radiological Sciences, Utilities and General Services, Employee and Public Relations, and Community Real Estatemore » and Services departments have sections presenting their monthly statistics, work, progress, and summaries.« less

Calculation of design load for the MOD-5A 7.3 mW wind turbine system

NASA Technical Reports Server (NTRS)

Mirandy, L.; Strain, J. C.

1995-01-01

Design loads are presented for the General Electric MOD-SA wind turbine. The MOD-SA system consists of a 400 ft. diameter, upwind, two-bladed, teetered rotor connected to a 7.3 mW variable-speed generator. Fatigue loads are specified in the form of histograms for the 30 year life of the machine, while limit (or maximum) loads have been derived from transient dynamic analysis at critical operating conditions. Loads prediction was accomplished using state of the art aeroelastic analyses developed at General Electric. Features of the primary predictive tool - the Transient Rotor Analysis Code (TRAC) are described in the paper. Key to the load predictions are the following wind models: (1) yearly mean wind distribution; (2) mean wind variations during operation; (3) number of start/shutdown cycles; (4) spatially large gusts; and (5) spatially small gusts (local turbulence). The methods used to develop statistical distributions from load calculations represent an extension of procedures used in past wind programs and are believed to be a significant contribution to Wind Turbine Generator analysis. Test/theory correlations are presented to demonstrate code load predictive capability and to support the wind models used in the analysis. In addition MOD-5A loads are compared with those of existing machines. The MOD-5A design was performed by the General Electric Company, Advanced Energy Program Department, under Contract DEN3-153 with NASA Lewis Research Center and sponsored by the Department of Energy.

Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

PubMed Central

Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

2013-01-01

Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. Methods and analysis To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. Ethics and dissemination This protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences. PMID:23633423

Presentations to an urban emergency department in Bern, Switzerland associated with acute recreational drug toxicity.

PubMed

Liakoni, Evangelia; Müller, Sabine; Stoller, Adrian; Ricklin, Meret; Liechti, Matthias E; Exadaktylos, Aristomenis K

2017-03-07

Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use. The cases were retrieved using a comprehensive full-text search algorithm of the electronic health records. Isolated ethanol intoxications were excluded. During the study period, 503 of the 157,328 emergency department attendances were directly related to acute toxicity of substances used recreationally. The mean patient age was 33 years (range 16-74), 68% were male. Alcohol co-ingestion was reported in 54% of the cases, and use of more than one recreational drug in 37% of the cases. Most presentations were related to cocaine (29%), cannabis (26%), heroin (20%) and benzodiazepines/sedatives (18%). Urine drug screening immunoassay was available in 277 cases (55%). The most frequently detected substances were cannabis (29%), cocaine (22%), benzodiazepines (21%) and opioids excluding methadone (20%). There were only two intoxications with novel psychoactive substances (NPSs): One with methylone and one with 2,5-dimethoxy-4(n)-propylphenethylamine (2C-P). The majority of patients (58%) displayed impaired consciousness (Glasgow Coma Scale (GCS) <15) upon presentation and/or pre-hospital; 21% were unconscious (GCS <8). Other frequent symptoms were agitation (36%), tachycardia (29%), and anxiety (24%). Severe complications included two fatalities, three acute myocardial infarctions, two intracranial haemorrhages, as well as psychosis and seizures in 71 and 26 cases, respectively. Most medical problems related to recreational drug use were associated with cocaine and cannabis use and were mainly characterised by central nervous system depression, sympathomimetic toxicity and/or psychiatric disorders. Presentations related to acute toxicities of NPSs appear to be uncommon, while prescription drugs were after classical recreational drugs the substances most commonly reported.

Alcopops, taxation and harm: a segmented time series analysis of emergency department presentations.

PubMed

Gale, Marianne; Muscatello, David J; Dinh, Michael; Byrnes, Joshua; Shakeshaft, Anthony; Hayen, Andrew; MacIntyre, Chandini Raina; Haber, Paul; Cretikos, Michelle; Morton, Patricia

2015-05-06

In Australia, a Goods and Services Tax (GST) introduced in 2000 led to a decline in the price of ready-to-drink (RTD) beverages relative to other alcohol products. The 2008 RTD ("alcopops") tax increased RTD prices. The objective of this study was to estimate the change in incidence of Emergency Department (ED) presentations for acute alcohol problems associated with each tax. Segmented regression analyses were performed on age and sex-specific time series of monthly presentation rates for acute alcohol problems to 39 hospital emergency departments across New South Wales, Australia over 15 years, 1997 to 2011. Indicator variables represented the introduction of each tax. Retail liquor turnover controlled for large-scale economic factors such as the global financial crisis that may have influenced demand. Under-age (15-17 years) and legal age (18 years and over) drinkers were included. The GST was associated with a statistically significant increase in ED presentations for acute alcohol problems among 18-24 year old females (0 · 14/100,000/month, 95% CI 0 · 05-0 · 22). The subsequent alcopops tax was associated with a statistically significant decrease in males 15-50 years, and females 15-65 years, particularly in 18-24 year old females (-0 · 37/100,000/month, 95% CI -0 · 45 to -0 · 29). An increase in retail turnover of liquor was positively and statistically significantly associated with ED presentations for acute alcohol problems across all age and sex strata. Reduced tax on RTDs was associated with increasing ED presentations for acute alcohol problems among young women. The alcopops tax was associated with declining presentations in young to middle-aged persons of both sexes, including under-age drinkers.

The Situational Analysis of the Physical State of an ELT Department

ERIC Educational Resources Information Center

Ulum, Ömer Gökhan

2016-01-01

While there are just a limited number of situation analysis studies, there is almost no situation analysis study referring to the physical conditions of an ELT Department. With this in mind, in this paper, the physical state of an ELT department in one of the oldest and rooted universities of Turkey was tried to be analyzed. The picture drawn by…

Checklist of vascular plants of the Department of Ñeembucú, Paraguay

PubMed Central

Egea, Juana De; Peña-Chocarro, Maria; Espada, Cristina; Knapp, Sandra

2012-01-01

Abstract The Department of Ñeembucú is one of the least well-documented areas of eastern Paraguay, and the flora is composed of a mixture of forest and Chaco elements. Regions like Ñeembucú are often considered of lower diversity and interest that more forested regions; this results from both actual species richness figures and from under-collecting due to perception as uninteresting. We present here a checklist of the vascular plants of Ñeembucú, which includes 676 taxa (including infraspecific taxa and collections identified only to genus) in 100 families and 374 genera. Four hundred and thirty nine (439) of these are new records for Ñeembucú and of these, 4 are new published records for Paraguay. Synonyms, distribution details within Paraguay and a voucher specimen or literature record are provided for each taxon, and a brief analysis of the diversity and importance of the flora is presented. PMID:22371688

International cooperation Brazil-Cuba-Haiti: the role of community radios in strengthening social mobilization in the public health context in Haiti.

PubMed

Gomes, Renata Machado Dos Santos; Oliveira, Valdir de Castro

2015-01-01

The present article investigates the role of Haitian community radios in strengthening social mobilization, with the aim of supporting the actions undertaken in the field of public health in Haiti, based on the development of the Workshop for community radios, as part of the Tripartite Cooperation Brazil-Cuba-Haiti. The qualitative methodology is justified because of the study content, an analysis of documents and direct observation, through a case study presented at the Workshop held in the department of Hinches, in Haiti. This meeting was held in the context of the Working Group on Tripartite Communication, under the responsibility of the Health Channel/Fiocruz, in partnership with the Department for Health Promotion and Environmental Prevention of the Ministry of Health and Population of Haiti (DPSPE/MSPP/Haiti), with a proposal to better structure a network of multipliers in health promotion.

Public Spending Efficiency: Institutional Indicators in Primary and Secondary Education. OECD Economics Department Working Papers, No. 543

ERIC Educational Resources Information Center

Gonand, Frederic; Joumard, Isabelle; Price, Robert

2007-01-01

This paper presents composite indicators of the institutional and policy characteristics of educational systems, collated from the questionnaire responses of 26 Member countries. These indicators provide an overview of the institutional framework in the primary and secondary education sector and are constructed so as to be used for the analysis of…

Facilitating practitioner research into strategies for improving communication in classroom groups: Action research and interaction analysis — A reconciliation?

NASA Astrophysics Data System (ADS)

Sadler, Jo; Fawns, Rod

1993-12-01

This study involved collaborative classroom-based observation of student communication and cognition in small groups after the implementation of two management strategies in science departments in several schools. The paper presents the data and provides insights into the conduct of research and teacher development in the midst of educational change.

The Analysis of the Problems the Pre-Service Teachers Experience in Posing Problems about Equations

ERIC Educational Resources Information Center

Isik, Cemalettin; Kar, Tugrul

2012-01-01

The present study aimed to analyse the potential difficulties in the problems posed by pre-service teachers about first degree equations with one unknown and equation pairs with two unknowns. It was carried out with 20 pre-service teachers studying in the Department of Elementary Mathematics Educations at a university in Eastern Turkey. The…

Homophobia and the Transition to Adulthood: A Three Year Panel Study among Belgian Late Adolescents and Young Adults, 2008-2011

ERIC Educational Resources Information Center

Hooghe, Marc; Meeusen, Cecil

2012-01-01

Studies on homophobia among adolescents routinely depart from the assumption that this attitude will be continued into adulthood. However, little research has been conducted on how the transition toward adulthood actually affects homophobia. While earlier studies relied on cross-sectional observations, the present analysis makes use of the Belgian…

Procurement specification color graphic camera system

NASA Technical Reports Server (NTRS)

Prow, G. E.

1980-01-01

The performance and design requirements for a Color Graphic Camera System are presented. The system is a functional part of the Earth Observation Department Laboratory System (EODLS) and will be interfaced with Image Analysis Stations. It will convert the output of a raster scan computer color terminal into permanent, high resolution photographic prints and transparencies. Images usually displayed will be remotely sensed LANDSAT imager scenes.

Universities in Africa: Strategies for Stabilization and Revitalization. World Bank Technical Paper No. 194, Africa Technical Department Series.

ERIC Educational Resources Information Center

Saint, William S.

This publication presents the results of a study on how to overcome the current crisis of quality, relevance and finance in African universities. The analysis developed from the 1988 policy study, "Education in Sub-Saharan Africa," and discussion within the Donors to African Education Working Group on Higher Education. In 12 chapters the…

Combining computer and manual overlays—Willamette River Greenway Study

Treesearch

Asa Hanamoto; Lucille Biesbroeck

1979-01-01

We will present a method of combining computer mapping with manual overlays. An example of its use is the Willamette River Greenway Study produced for the State of Oregon Department of Transportation in 1974. This one year planning study included analysis of data relevant to a 286-mile river system. The product is a "wise use" plan which conserves the basic...

[The characteristic of stomatologic service manpower in Omsk region].

PubMed

Prokop'ev, K A; Ravdugina, T G

2013-01-01

The article considers the network and manpower characteristics of stomatologic service in Omsk oblast during 2006-3011. The results are presented concerning statistical analysis of dynamics of manpower size and staffing of specialists in stomatologic rooms (departments) in state (budget) health institutions. The differences are demonstrated concerning the accessibility of stomatologic care to residents of city and rural regions of oblast.

Information Storage and Retrieval...Reports on Text Analysis, Dynamic Indexing, Feedback Searches, Dictionary Construction and File Organization.

ERIC Educational Resources Information Center

Salton, Gerald; And Others

The present report is the twenty-first in a series describing research in information storage and retrieval conducted by the Department of Computer Science at Cornell University. The report covering work carried out by the SMART project for approximately two years (summer 1970 to summer 1972) is separated into five parts: automatic content…

Job Analysis Techniques for Restructuring Health Manpower Education and Training in the Navy Medical Department. Attachment 9. Laboratory QPCB Task Sort for Medical Laboratory Technology.

ERIC Educational Resources Information Center

Technomics, Inc., McLean, VA.

This publication is Attachment 9 of a set of 16 computer listed QPCB task sorts, by career level, for the entire Hospital Corps and Dental Technician fields. Statistical data are presented in tabular form for a detailed listing of job duties in medical laboratory technology. (BT)

Supply and Demand of Educational Personnel for Wisconsin Public Schools. An Examination of Data Trends, 1997.

ERIC Educational Resources Information Center

Lauritzen, Paul

This report presents 1997 supply and demand information about Wisconsin Public School educational personnel using Wisconsin Department of Public Instruction (DPI) data. The analysis found a large supply of teachers in most subjects. The largest number of new licenses was in fields that already had surplus educators. The number of teachers prepared…

Graduates of Higher Education in the Food and Agricultural Sciences: An Analysis of Supply/Demand Relationship. Volume II--Home Economics.

ERIC Educational Resources Information Center

Coulter, Kyle Jane; Stanton, Marge

Information on the supply of new college graduates seeking home economics-related positions, home economics job openings, and projected levels of employment is presented. Based on a Department of Agriculture manpower assessment project, supply and demand relationships through 1990 were analyzed, and supply data were aggregated by 11 educational…

Three Proposed Data Collection Models for Annual Inventories

Treesearch

Bill Bechtold; Ron McRoberts; Frank Spirek; Chuck Liff

2005-01-01

Three competing data collection models for the U.S. Department of Agriculture Forest Service Forest Inventory and Analysis (FIA) program?s annual inventories are presented. We show that in the presence of panel creep, the model now in place does not meet requirements of an annual inventory system mandated by the 1998 Farm Bill. Two data-collection models that use...

Topical Ketoprofen Versus Placebo in Treatment of Acute Ankle Sprain in the Emergency Department.

PubMed

Serinken, Mustafa; Eken, Cenker; Elicabuk, Hayri

2016-09-01

Topical agents have been shown to be effective in soft tissue injuries and commonly used in outpatient clinics. However, the data regarding topical agents in the emergency department is insufficient, and they are not used often in the emergency department setting. The present study aimed to compare the effect of 2.5% topical ketoprofen (gel form) to placebo in patients presenting with ankle sprain to the emergency department. Patients presenting with ankle sprain composed the study population. Study patients were randomized into 2 study arms: 2.5% ketoprofen gel and placebo administered over a 5-cm area locally. Pain alleviation was measured by visual analog scale at 15 and 30 minutes. A total of 100 patients were included in the final analysis. The median pain reduction in ketoprofen and placebo groups at 15 minutes was 27 (19.8-33.4) and 9 (7.6-17), respectively. The median pain reduction at 30 minutes for both groups was 42 (36-50.8) and 20 (17.6-24.4), respectively. Pain improvement either at 15 minutes (median difference: 16 [9-22]) or 30 minutes (median difference: 21 [15-27]) was better in the ketoprofen group than placebo. There were no adverse effects in either group. Ketoprofen gel was superior to placebo at 30 minutes in alleviating pain secondary to ankle sprain in the ED with a high safety profile. Further studies are needed concerning the effect of ketoprofen gel for long-term effects. Level I, high quality prospective randomized study. © The Author(s) 2016.

Atypical presentations of older adults at the emergency department and associated factors.

PubMed

Limpawattana, Panita; Phungoen, Pariwat; Mitsungnern, Thapanawong; Laosuangkoon, Wannisa; Tansangworn, Natthida

2016-01-01

The objectives were to determine the prevalence of atypical presentations among older adults at the Emergency Department (ED) of a tertiary care hospital and to identify factors associated with these presentations. A retrospective medical record audit was randomly reviewed in 633 patients who were aged ≥ 65 years who attended the ED of Srinagarind Medical School Hospital in 2013. Demographic data were collected and were analyzed using descriptive statistics. Regression analysis was used to analyze the variables associated with the outcomes. The prevalence of an atypical presentation was 28.6% (181/633 cases). The failure to develop fever with a disease known to cause fever was the most common atypical presentation of illness (34.42%). Independent factors associated with atypical presentations were complicated urinary tract infection (UTI) (odds ratios (OR) 4.66, 95% confidence interval (CI) 2.0, 10.84, p=0.00) and a background of dementia (OR 3.48, 95% CI 1.38, 8.77, p=0.008). The prevalence of atypical presentations of older adults at the ED was about a third. The absence of fever with a disease known to cause fever was the most common atypical presentation. Complicated UTI and demented patients were the independent risk factors associated with the atypical presentations. Early awareness of non-specific presentations and applying comprehensive geriatric assessments among older patients at the ED is recommended. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Analysis of accident sequences and source terms at waste treatment and storage facilities for waste generated by U.S. Department of Energy Waste Management Operations, Volume 3: Appendixes C-H

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller, C.; Nabelssi, B.; Roglans-Ribas, J.

1995-04-01

This report contains the Appendices for the Analysis of Accident Sequences and Source Terms at Waste Treatment and Storage Facilities for Waste Generated by the U.S. Department of Energy Waste Management Operations. The main report documents the methodology, computational framework, and results of facility accident analyses performed as a part of the U.S. Department of Energy (DOE) Waste Management Programmatic Environmental Impact Statement (WM PEIS). The accident sequences potentially important to human health risk are specified, their frequencies are assessed, and the resultant radiological and chemical source terms are evaluated. A personal computer-based computational framework and database have been developedmore » that provide these results as input to the WM PEIS for calculation of human health risk impacts. This report summarizes the accident analyses and aggregates the key results for each of the waste streams. Source terms are estimated and results are presented for each of the major DOE sites and facilities by WM PEIS alternative for each waste stream. The appendices identify the potential atmospheric release of each toxic chemical or radionuclide for each accident scenario studied. They also provide discussion of specific accident analysis data and guidance used or consulted in this report.« less

Application of Six Sigma methodology to a diagnostic imaging process.

PubMed

Taner, Mehmet Tolga; Sezen, Bulent; Atwat, Kamal M

2012-01-01

This paper aims to apply the Six Sigma methodology to improve workflow by eliminating the causes of failure in the medical imaging department of a private Turkish hospital. Implementation of the design, measure, analyse, improve and control (DMAIC) improvement cycle, workflow chart, fishbone diagrams and Pareto charts were employed, together with rigorous data collection in the department. The identification of root causes of repeat sessions and delays was followed by failure, mode and effect analysis, hazard analysis and decision tree analysis. The most frequent causes of failure were malfunction of the RIS/PACS system and improper positioning of patients. Subsequent to extensive training of professionals, the sigma level was increased from 3.5 to 4.2. The data were collected over only four months. Six Sigma's data measurement and process improvement methodology is the impetus for health care organisations to rethink their workflow and reduce malpractice. It involves measuring, recording and reporting data on a regular basis. This enables the administration to monitor workflow continuously. The improvements in the workflow under study, made by determining the failures and potential risks associated with radiologic care, will have a positive impact on society in terms of patient safety. Having eliminated repeat examinations, the risk of being exposed to more radiation was also minimised. This paper supports the need to apply Six Sigma and present an evaluation of the process in an imaging department.

Building a Greenway: Using EnviroAtlas in the Classroom. ...

EPA Pesticide Factsheets

In this hypothetical case study, funding to complete a pilot section of a greenway has been granted to a city Parks and Recreation Department. The proposed pilot section is being presented to the city council for review and approval. The proposal was drafted by the Parks and Recreation Department and selected to meet the goals of the Department. Numerous data and maps were used in determining this selection and are included in the proposal. The reader is asked to generate an opinion and justification for supporting or not supporting the proposed route. The Parks and Recreation Department goals include the following:Improve access to and use of parks and green spaces,Enhance habitat for biota,Encourage physical activity and recreational opportunities, particularly for aging populations. This case study is intended to showcase ways in which EnviroAtlas, an interactive web-based tool that combines maps, analysis tools, fact sheets, and downloadable data, can support decision-making. Available data can inform alternatives and help prioritize action at the local, regional, and national level. Such planning efforts also present a unique educational opportunity for students to be introduced to complex problems and learn to analyze and interpret relevant data while being asked to generate recommendations. To support classroom educational curricula on ecosystem services, their societal benefits, and the use of geographic information science.

The life-cycle research productivity of mathematicians and scientists.

PubMed

Diamond, A M

1986-07-01

Declining research productivity with age is implied by economic models of life-cycle human capital investment but is denied by some recent empirical studies. The purpose of the present study is to provide new evidence on whether a scientist's output generally declines with advancing age. A longitudinal data set has been compiled for scientists and mathematicians at six major departments, including data on age, salaries, annual citations (stock of human capital), citations to current output (flow of human capital), and quantity of current output measured both in number of articles and in number of pages. Analysis of the data indicates that salaries peak from the early to mid-60s, whereas annual citations appear to peak from age 39 to 89 for different departments with a mean age of 59 for the 6 departments. The quantity and quality of current research output appear to decline continuously with age.

An intelligent algorithm for optimizing emergency department job and patient satisfaction.

PubMed

Azadeh, Ali; Yazdanparast, Reza; Abdolhossein Zadeh, Saeed; Keramati, Abbas

2018-06-11

Purpose Resilience engineering, job satisfaction and patient satisfaction were evaluated and analyzed in one Tehran emergency department (ED) to determine ED strengths, weaknesses and opportunities to improve safety, performance, staff and patient satisfaction. The paper aims to discuss these issues. Design/methodology/approach The algorithm included data envelopment analysis (DEA), two artificial neural networks: multilayer perceptron and radial basis function. Data were based on integrated resilience engineering (IRE) and satisfaction indicators. IRE indicators are considered inputs and job and patient satisfaction indicators are considered output variables. Methods were based on mean absolute percentage error analysis. Subsequently, the algorithm was employed for measuring staff and patient satisfaction separately. Each indicator is also identified through sensitivity analysis. Findings The results showed that salary, wage, patient admission and discharge are the crucial factors influencing job and patient satisfaction. The results obtained by the algorithm were validated by comparing them with DEA. Practical implications The approach is a decision-making tool that helps health managers to assess and improve performance and take corrective action. Originality/value This study presents an IRE and intelligent algorithm for analyzing ED job and patient satisfaction - the first study to present an integrated IRE, neural network and mathematical programming approach for optimizing job and patient satisfaction, which simultaneously optimizes job and patient satisfaction, and IRE. The results are validated by DEA through statistical methods.

Outdoor pollen is a trigger of child and adolescent asthma emergency department presentations: A systematic review and meta-analysis.

PubMed

Erbas, B; Jazayeri, M; Lambert, K A; Katelaris, C H; Prendergast, L A; Tham, R; Parrodi, M J; Davies, J; Newbigin, E; Abramson, M J; Dharmage, S C

2018-01-13

In the context of increased asthma exacerbations associated with climatic changes such as thunderstorm asthma, interest in establishing the link between pollen exposure and asthma hospital admissions has intensified. Here, we systematically reviewed and performed a meta-analysis of studies on pollen and emergency department (ED) attendance. A search for studies with appropriate search strategy in MEDLINE, EMBASE, Web of Science and CINAHL was conducted. Each study was assessed for quality and risk of bias. The available evidence was summarized both qualitatively and meta-analysed using random-effects models when moderate heterogeneity was observed. Fourteen studies were included. The pollen taxa investigated differed between studies, allowing meta-analysis only of the effect of grass pollen. A statistically significant increase in the percentage change in the mean number of asthma ED presentations (MPC) (pooled results from 3 studies) was observed for an increase in 10 grass pollen grains per cubic metre of exposure 1.88% (95% CI = 0.94%, 2.82%). Time series studies showed positive correlations between pollen concentrations and ED presentations. Age-stratified studies found strongest associations in children aged 5-17 years old. Exposure to ambient grass pollen is an important trigger for childhood asthma exacerbations requiring ED attendance. As pollen exposure is increasingly a problem especially in relation to thunderstorm asthma, studies with uniform measures of pollen and similar analytical methods are necessary to fully understand its impact on human health. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Safety leadership in the teaching laboratories of electrical and electronic engineering departments at Taiwanese Universities.

PubMed

Wu, Tsung-Chih

2008-01-01

Safety has always been one of the principal goals in teaching laboratories. Laboratories cannot serve their educational purpose when accidents occur. The leadership of department heads has a major impact on laboratory safety, so this study discusses the factors affecting safety leadership in teaching laboratories. This study uses a mail survey to explore the perceived safety leadership in electrical and electronic engineering departments at Taiwanese universities. An exploratory factor analysis shows that there are three main components of safety leadership, as measured on a safety leadership scale: safety controlling, safety coaching, and safety caring. The descriptive statistics also reveals that among faculty, the perception of department heads' safety leadership is in general positive. A two-way MANOVA shows that there are interaction effects on safety leadership between university size and instructor age; there are also interaction effects between presence of a safety committee and faculty gender and faculty age. It is therefore necessary to assess organizational factors when determining whether individual factors are the cause of differing perceptions among faculty members. The author also presents advice on improving safety leadership for department heads at small universities and at universities without safety committees.

Development and use of a computer system in a radiotherapy department: SISGRAD.

PubMed

Costa, A; Lalanne, C M; Marcié, S; Leca, M; Rameau, P; Chauvel, P; Héry, M; Lagrange, J L; Verschoore, J

1987-12-01

SISGRAD, the interactive computer system of the Antoine-Lacassagne Cancer Center Radiotherapy Department, has been operational since January 1982. It completes the computerized dosimetry system installed several years earlier and is fully integrated with the institution's central network. SISGRAD is in charge of surveillance of the radiotherapy treatments given by the Center's three radiotherapy units (1400 patients per year); it is also used for administrative purposes in the Department and physically connects all of the Department's operating stations. SISGRAD consists of a series of microcomputers connected to a common mass memory; each microcomputer is used as an intelligent console. SISGRAD was developed to guarantee that the treatments comply with prescriptions, to supply extemporaneous dosimetric data, to improve administrative work, and to supply banks with data for statistical analysis and research. SISGRAD actively intervenes to guarantee treatment quality and helps to improve therapy-related security factors. The present text describes the results of clinical use over a 4-year period. The consequences of integration of the system within the Department are analyzed, with special emphasis being placed on SISGRAD's role in the prevention and detection of errors in treatment prescription and delivery.

Analysis of Total Food Intake and Composition of Individual's ...

EPA Pesticide Factsheets

EPA released the final report, Analysis of Total Food Intake and Composition of Individual’s Diet Based on USDA’s 1994-1996, 98 Continuing Survey of Food Intakes by Individuals (CSFII). The consumption of food by the general population is a significant route of potential exposure to hazardous substances that are present in the environment. For this reason, a thorough analysis of the dietary habits of the American public would aid in the identification of potential exposure pathways. To that end, the EPA developed per capita food intake rates for various food items and food categories using databases developed by the United States Department of Agriculture (USDA). These intake rates were incorporated into EPA's 1997 Exposure Factors Handbook. Since that time, EPA has recommended that the food intake study be updated and expanded to include a more comprehensive analysis of food intake. That analysis is presented in this document. The purpose of this study is to characterize the consumption of food by the people of the United States.

Professional Learning Communities (PLCs) as a Means for School-Based Science Curriculum Change

NASA Astrophysics Data System (ADS)

Browne, Christi L.

The challenge of school-based science curriculum change and educational reform is often presented to science teachers and departments who are not necessarily prepared for the complexity of considerations that change movements require. The development of a Professional Learning Community (PLC) focused on a science department's curriculum change efforts, may provide the necessary tools to foster sustainable school-based curriculum science changes. This research presents a case study of an evolving science department PLC consisting of 10 middle school science teachers from the same middle school and their efforts of school-based science curriculum change. A transformative mixed model case study with qualitative data and deepened by quantitative analysis, was chosen to guide the investigation. Collected data worked to document the essential developmental steps, the occurrence and frequency of the five essential dimensions of successful PLCs, and the influences the science department PLC had on the middle school science department's progression through school-based science curriculum change, and the barriers, struggles and inhibiting actions of the science department PLC. Findings indicated that a science department PLC was unique in that it allowed for a focal science departmental lens of science curriculum change to be applied to the structure and function of the PLC and therefore the process, proceedings, and results were directly aligned to and driven by the science department. The science PLC, while logically difficult to set-up and maintain, became a professional science forum where the middle school science teachers were exposed to new science teaching and learning knowledge, explored new science standards, discussed effects on student science learning, designed and critically analyzed science curriculum change application. Conclusions resulted in the science department PLC as an identified tool providing the ability for science departmental actions to lead to outcomes of science curriculum change improvements with the consideration but not the dictation of the larger school community and state agendas. Thus, the study's results work to fuse previously separated research on general PLCs and curriculum change efforts into a cohesive understanding of the unexplored potential of a science PLC and school-based science curriculum change.

PTSD, cyberbullying and peer violence: prevalence and correlates among adolescent emergency department patients.

PubMed

Ranney, Megan L; Patena, John V; Nugent, Nicole; Spirito, Anthony; Boyer, Edward; Zatzick, Douglas; Cunningham, Rebecca

2016-01-01

Posttraumatic stress disorder (PTSD) is often underdiagnosed and undertreated among adolescents. The objective of this analysis was to describe the prevalence and correlates of symptoms consistent with PTSD among adolescents presenting to an urban emergency department (ED). A cross-sectional survey of adolescents aged 13-17 years presenting to the ED for any reason was conducted between August 2013 and March 2014. Validated self-report measures were used to measure mental health symptoms, violence exposure and risky behaviors. Multivariate logistic regression analysis was performed to determine adjusted differences in associations between symptoms consistent with PTSD and predicted correlates. Of 353 adolescents, 23.2% reported current symptoms consistent with PTSD, 13.9% had moderate or higher depressive symptoms and 11.3% reported past-year suicidal ideation. Adolescents commonly reported physical peer violence (46.5%), cyberbullying (46.7%) and exposure to community violence (58.9%). On multivariate logistic regression, physical peer violence, cyberbullying victimization, exposure to community violence, female gender and alcohol or other drug use positively correlated with symptoms consistent with PTSD. Among adolescents presenting to the ED for any reason, symptoms consistent with PTSD, depressive symptoms, physical peer violence, cyberbullying and community violence exposure are common and interrelated. Greater attention to PTSD, both disorder and symptom levels, and its cooccurring risk factors is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of environmental factors impacting the life cycle cost analysis of conventional and fuel cell/battery-powered passenger vehicles. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This report presents the results of the further developments and testing of the Life Cycle Cost (LCC) Model previously developed by Engineering Systems Management, Inc. (ESM) on behalf of the U.S. Department of Energy (DOE) under contract No. DE-AC02-91CH10491. The Model incorporates specific analytical relationships and cost/performance data relevant to internal combustion engine (ICE) powered vehicles, battery powered electric vehicles (BPEVs), and fuel cell/battery-powered electric vehicles (FCEVs).

[Basic lung ultrasound. Part 2. Parenchymal diseases].

PubMed

de la Quintana Gordon, F B; Nacarino Alcorta, B; Fajardo Pérez, M

2015-01-01

In this second part, an analysis is made of the pathology of lung parenchyma. This text is structured into different sections, including the study of atelectasias, pneumonia and abscess, interstitial/alveolar or Blines patterns, and finally an analysis is made of pulmonary embolism. With this second part, the basic knowledge to develop lung ultrasound in the anesthesia department has been presented. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Stakeholder analysis and mapping as targeted communication strategy.

PubMed

Shirey, Maria R

2012-09-01

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author highlights the importance of stakeholder theory and discusses how to apply the theory to conduct a stakeholder analysis. This article also provides an explanation of how to use related stakeholder mapping techniques with targeted communication strategies.

Why did ISO 9001:2008 system fail to deliver?

PubMed

Langford, Melvyn

2014-02-01

This article is based on an actual investigation undertaken, and summarises the subsequent report's findings and observations. It has been anonymised for obvious reasons. In May 2013 an analysis was undertaken by a multidisciplinary team that compared an NHS Trust estates department's managerial systems against the NHS national recommendations. The conclusions stated that: 'There was a systemic failure across a large number of topics generating intolerable/substantial risks to the organisation, its staff, and patients; this despite the department's managerial systems being accredited to the International Standard ISO 9001:2008'. The natural question raised when presented with this demonstrable and auditable evidence was: 'Why did the ISO 9001:2008 system fail?'

Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: Findings from ACTION-J study.

PubMed

Furuno, Taku; Nakagawa, Makiko; Hino, Kosuke; Yamada, Tomoki; Kawashima, Yoshitaka; Matsuoka, Yutaka; Shirakawa, Osamu; Ishizuka, Naoki; Yonemoto, Naohiro; Kawanishi, Chiaki; Hirayasu, Yoshio

2018-01-01

Self-harm is an important risk factor for subsequent suicide and repetition of self-harm, and a common cause of emergency department presentations. However, there still remains limited evidence on intervention in emergency department settings for individuals who self-harm. This multicentre, randomised controlled trial was conducted at 17 general hospitals in Japan. In total, 914 adult patients admitted to emergency departments for a suicide attempt and had a DSM-IV-TR axis I disorder were randomly assigned to two groups, to receive either assertive case management (intervention) or enhanced usual care (control). Assertive case management was introduced by the case manager during emergency department admissions for suicide attempts, and continued after discharge. Interventions were provided until the end of the study period (for at least 18 months and up to 5 years). The number of overall self-harm episodes per person-year was significantly lower in the intervention group (adjusted incidence risk ratio (IRR) 0.88, 95%CI 0.80-0.96, p=0.0031). Subgroup analysis showed a greater reduction of overall self-harm episodes among patients with no previous suicide attempt at baseline (adjusted IRR 0.73, 95% CI 0.53-0.98, p=0.037). Patients younger than 20 years and patients who self-harmed but were not admitted to an emergency department were excluded. The present study showed that assertive case management following emergency admission for a suicide attempt reduced the incident rate of repeat overall self-harm. Copyright © 2017 Elsevier B.V. All rights reserved.

Ondansetron Oral Dissolve Tab vs. Oral Solution in Children Presenting to the Emergency Department with Gastroenteritis.

PubMed

Thompson, Graham C; Morrison, Ellen L; Chaulk, David; Wobma, Holly; Kwong, Simon; Johnson, David W

2016-11-01

Ondansetron is often used in the emergency department (ED) to promote oral rehydration in children with acute gastroenteritis (AGE), yet medication solutions administered orally may be poorly tolerated in this population. We compared the tolerability of ondansetron oral dissolve tab (ODT) to oral solution (OS) in children presenting to the ED with AGE. Using alternate-day controlled clinical trial design, children aged 3 months to 10 years received either ondansetron ODT or OS. Our primary outcome was early vomiting (within 15 min of drug administration). The secondary outcome was intravenous (i.v.) fluid administration. There were 462/534 eligible children who met study criteria. Demographics, severity, and duration of illness were similar between groups. Using intention-to-treat analysis, early vomiting occurred in 8/209 ODT vs. 19/253 OS children (3.8% vs. 7.5%; odds ratio [OR] 0.49; 95% confidence interval [CI] 0.18-1.21). Using as-treated analysis, 6/222 (2.7%) children receiving ODT experienced early vomiting, compared with 21/221 (9.5%) of the OS group (OR 0.26; 95% CI 0.09-0.70). The proportion of children discharged without i.v. fluids was not different (intention-to-treat: ODT = 91.4% (191/209), OS = 94.1% (238/253), OR 1.49, 95% CI 0.69-3.28; as-treated: ODT = 92.3% (205/222), OS = 93.2% (206/221), OR 0.88, 95% CI 0.40-1.93). Using a conservative intention-to-treat analysis, we found that children presenting to an ED with AGE did not have statistically less early vomiting with ondansetron ODT as compared with OS. However, our as-treated analysis demonstrates that children receiving ondansetron ODT experienced early vomiting approximately one-third as often as those receiving OS. The rate of i.v. fluid administration was no different between groups regardless of the type of analysis used. Copyright © 2016 Elsevier Inc. All rights reserved.

An Audit of Emergency Department Accreditation Based on Joint Commission International Standards (JCI).

PubMed

Hashemi, Behrooz; Motamedi, Maryam; Etemad, Mania; Rahmati, Farhad; Forouzanfar, Mohammad Mehdi; Kaghazchi, Fatemeh

2014-01-01

Despite thousands of years from creation of medical knowledge, it not much passes from founding the health care systems. Accreditation is an effective mechanism for performance evaluation, quality enhancement, and the safety of health care systems. This study was conducted to assess the results of emergency department (ED) accreditation in Shohadaye Tajrish Hospital, Tehran, Iran, 2013 in terms of domesticated standards of joint commission international (JCI) standards. This cohort study with a four-month follow up was conducted in the ED of Shohadaye Tajrish Hospital in 2013. The standard evaluation checklist of Iran hospitals (based on JCI standards) included 24 heading and 337 subheading was used for this purpose. The effective possible causes of weak spots were found and their solutions considered. After correction, assessment of accreditation were repeated again. Finally, the achieved results of two periods were analyzed using SPSS version 20. Quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities had the score of below 50%. The mean of total score for accreditation in ED in the first period was 60.4±30.15 percent and in the second period 68.9±22.9 (p=0.005). Strategic plans, head of department, head nurse, resident physician, responsible nurse for the shift, and personnel file achieved the score of 100%. Of total headings below 50% in the first period just in two cases, collection and analysis of data with growth of 40% as well as competency and capability test for staffs with growth of 17%, were reached to more than 50%. Based on findings of the present study, the ED of Shohadaye Tajrish hospital reached the score of below 50% in six heading of quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities. While, the given score in strategic plans, head of department, head nurse, resident physician, responsible nurse for the shifts, and personnel file was 100%.

Emergency department presentations in infants: Predictors from an Australian birth cohort.

PubMed

Crilly, Julia; Cameron, Cate M; Scuffham, Paul A; Good, Norm; Scott, Rani; Mihala, Gabor; Sweeny, Amy; Keijzers, Gerben

2017-10-01

Infants under 12 months of age are disproportionately represented amongst emergency department (ED) presentations, and infants are more likely to be frequent ED users. This study aimed to describe and identify psychosocial predictors of ED presentation in infants. A prospective birth cohort from Queensland and New South Wales (Environments for Healthy Living) was used to understand infant health service use. Baseline and 12-month questionnaire data pertaining to children born between 2006 and 2011 were used to identify predictors of ED presentation, using multiple regression analysis. Of the 2184 children in the cohort with available baseline and 12-month data, 579 (27%) presented at least once to an ED during their first 12 months of life. Statistically significant predictors of ED presentation in the multivariate analysis included the mother having asthma (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.15-2.39) and a higher Kessler-6 score (a measure of psychological distress) of the primary carer at baseline (OR 1.04, 95% CI 1.01-1.08). Maternal education level was not associated with ED presentations of infants. This study describes maternal and child factors of children who present to the ED in the first year of life. Factors related to an infant's support system were found to be predictors for an ED presentation in the first year of life. This study emphasises the need to review the maternal medical history and psychosocial situation. There may be benefits for health-care practitioners to take the opportunity (such as during routine childhood immunisation) to perform a brief screening tool (such as the Kessler-6) to understand psychological distress experienced by mothers. This may influence the likelihood of a child presenting to an ED within the first 12 months of life. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

A comparison of paediatric soccer, gaelic football and rugby injuries presenting to an emergency department in Ireland.

PubMed

O'Rourke, K P; Quinn, F; Mun, S; Browne, M; Sheehan, J; Cusack, S; Molloy, M

2007-01-01

Children presenting with sport related injuries (SRIs) as a result of soccer, rugby and gaelic football are frequently seen in an emergency medicine (EM) setting in Ireland. A comparison of the demographics of injuries in these three sports has however not previously been performed. The purpose of this study was to provide up-to-date data on the nature of these SRIs. Data was collected retrospectively on all children (<17 years of age), injured in these three sports, presenting to an emergency medicine department over 6 months, and was entered into a database for analysis. Retrospective analysis was performed on 23,000 charts, and 409 SRIs were identified over a 6-month period. None of the children reported using any form of protective gear, and 27% reported a previous presentation to the emergency department with a SRI. Most injuries were as a result of soccer (56%), with 24% occurring in gaelic football, and 20% occurring in rugby. The predominant mechanism of injury was different in each sport, in soccer-falls (38%), in gaelic football-collisions with objects (balls) (37%), and in rugby-collision with persons (55%). Although the predominant type of injury in soccer and gaelic football was a fracture, accounting for 50% and 42% of injuries, respectively, in rugby however, skin/soft tissue injuries presented more commonly, accounting for 44% of injuries. When the general site of injury was investigated, the upper limb accounted for the majority of SRIs in each sport. In the management of SRIs, oral analgesics were prescribed in 50%, however, it was observed that no use was made of topical, intramuscular or rectal analgesic routes of administration. In addition it was observed that RICE/general injury advice was given in only 27%, physiotherapy was requested in 2%, and no injury prevention advice was given to any child. Overall, 8% required admission. The data provided from this study may raise awareness of the nature of SRIs affecting children in each of these three sports, and may be useful in formulating much needed injury prevention strategies.

Knowledge and confidence of Australian emergency department clinicians in managing patients with mental health-related presentations: findings from a national qualitative study

PubMed Central

2013-01-01

Background Mental health related presentations are common in Australian Emergency Departments (EDs). We sought to better understand ED staff knowledge and levels of confidence in treating people with mental health related problems using qualitative methods. Methods This was a qualitative learning needs analysis of Australian emergency doctors and nurses regarding the assessment and management of mental health presentations. Participants were selected for semi-structured telephone interview using criterion-based sampling. Recruitment was via the Australasian College for Emergency Medicine and College of Emergency Nursing Australasia membership databases. Interviews were audio-recorded and transcribed verbatim. Thematic framework analysis was used to identify perceived knowledge gaps and levels of confidence among participants in assessing and managing patients attending EDs with mental health presentations. Results Thirty-six staff comprising 20 doctors and 16 nurses consented to participate. Data saturation was achieved for four major areas where knowledge gaps were reported. These were: assessment (risk assessment and assessment of mental status), management (psychotherapeutic skills, ongoing management, medication management and behaviour management), training (curriculum and rotations), and application of mental health legislation. Participants’ confidence in assessing mental health patients was affected by environmental, staff, and patient related factors. Clinicians were keen to learn more about evidence based practice to provide better care for this patient group. Areas where clinicians felt the least confident were in the effective assessment and management of high risk behaviours, providing continuity of care, managing people with dual diagnosis, prescribing and effectively managing medications, assessing and managing child and adolescent mental health, and balancing the caseload in ED. Conclusion Participants were most concerned about knowledge gaps in risk assessment, particularly for self-harming patients, violent and aggressive patients and their management, and distinguishing psychiatric from physical illness. Staff confidence was enhanced by better availability of skilled psychiatric support staff to assist in clinical decision-making for complex cases and via the provision of a safe ED environment. Strategies to enhance the care of patients with mental health presentations in Australian emergency departments should address these gaps in knowledge and confidence. PMID:23317351

The Department of Energy (DOE) research program in structural analysis of vertical-axis wind turbines

NASA Astrophysics Data System (ADS)

Sullivan, W. N.

The Darrieus-type Vertical Axis Wind Turbine (VAWT) presents a variety of unusual structural problems to designers. The level of understanding of these structural problems governs, to a large degree, the success or failure of today's rotor designs. A survey is presented of the technology available for rotor structural design with emphasis on the DOE research program now underway. Itemizations are included of the major structural issues unique to the VAWT along with discussion of available analysis techniques for each problem area. It is concluded that tools are available to at least approximately address the most important problems. However, experimental data for confirmation is rather limited in terms of volume and the range of rotor configurations tested.

Analysis of BigFoot HDC SymCap experiment N161205 on NIF

NASA Astrophysics Data System (ADS)

Dittrich, T. R.; Baker, K. L.; Thomas, C. A.; Berzak Hopkins, L. F.; Harte, J. A.; Zimmerman, G. B.; Woods, D. T.; Kritcher, A. L.; Ho, D. D.; Weber, C. R.; Kyrala, G.

2017-10-01

Analysis of NIF implosion experiment N161205 provides insight into both hohlraum and capsule performance. This experiment used an undoped High Density Carbon (HDC) ablator driven by a BigFoot x-ray profile in a Au hohlraum. Observations from this experiment include DT fusion yield, bang time, DSR, Tion and time-resolved x-ray emission images around bang time. These observations are all consistent with an x-ray spectrum having significantly reduced Au m-band emission that is present in a standard hohlraum simulation. Attempts to justify the observations using several other simulation modifications will be presented. This work was performed under the auspices of the Department of Energy by Lawrence Livermore National Laboratory under contract DE-AC52-07NA27344.

Quantifying Variations In Multi-parameter Models With The Photon Clean Method (PCM) And Bootstrap Methods

NASA Astrophysics Data System (ADS)

Carpenter, Matthew H.; Jernigan, J. G.

2007-05-01

We present examples of an analysis progression consisting of a synthesis of the Photon Clean Method (Carpenter, Jernigan, Brown, Beiersdorfer 2007) and bootstrap methods to quantify errors and variations in many-parameter models. The Photon Clean Method (PCM) works well for model spaces with large numbers of parameters proportional to the number of photons, therefore a Monte Carlo paradigm is a natural numerical approach. Consequently, PCM, an "inverse Monte-Carlo" method, requires a new approach for quantifying errors as compared to common analysis methods for fitting models of low dimensionality. This presentation will explore the methodology and presentation of analysis results derived from a variety of public data sets, including observations with XMM-Newton, Chandra, and other NASA missions. Special attention is given to the visualization of both data and models including dynamic interactive presentations. This work was performed under the auspices of the Department of Energy under contract No. W-7405-Eng-48. We thank Peter Beiersdorfer and Greg Brown for their support of this technical portion of a larger program related to science with the LLNL EBIT program.

First NASA Advanced Composites Technology Conference, Part 2

NASA Technical Reports Server (NTRS)

Davis, John G., Jr. (Compiler); Bohon, Herman L. (Compiler)

1991-01-01

Presented here is a compilation of papers presented at the first NASA Advanced Composites Technology (ACT) Conference held in Seattle, Washington, from 29 Oct. to 1 Nov. 1990. The ACT program is a major new multiyear research initiative to achieve a national goal of technology readiness before the end of the decade. Included are papers on materials development and processing, innovative design concepts, analysis development and validation, cost effective manufacturing methodology, and cost tracking and prediction procedures. Papers on major applications programs approved by the Department of Defense are also included.

Hydraulic analysis, Paint Creek at State Route 772, Chillicothe, Ohio

USGS Publications Warehouse

Mayo, R.I.; Bartlett, W.P.

1981-01-01

The Ohio Department of Transportation, Division of Highways, proposes to replace a three-span arch, bridge across Paint Creek on South Paint Street in Chillicothe, Ohio with a new deck-type structure resting on four sets of piles and four piers. Profiles of the 10-, 25-, 50- and 100-year floods under present conditions and under conditions modified by constructions of the new bridge are presented in this report. The results indicate that the construction of the new bridge will not cause significant changes in the flood profiles or the areas inundated.

Creating an Early Warning System: Predictors of Dropout in Delaware. REL Mid-Atlantic Technical Assistance Brief. REL MA 1.2.75-10

ERIC Educational Resources Information Center

Uekawa, Kazuaki; Merola, Stacey; Fernandez, Felix; Porowski, Allan

2010-01-01

This Technical Brief presents an historical analysis of key indicators of dropout for Delaware students in grades 9-12. Cut points for key risk indicators of high school dropout for the State of Delaware are provided. Using data provided by the Delaware Department of Education (DDOE), relationships between student dropout and several student…

Genetic Influences on Language, Reading, and Mathematics Skills in a National Sample: An Analysis Using the National Longitudinal Survey of Youth

ERIC Educational Resources Information Center

Hart, Sara A.; Petrill, Stephen A.; Kamp Dush, Claire M.

2010-01-01

Purpose: The present study had two purposes: provide an illustration of use of the National Longitudinal Survey of Youth 1979 Children's (CNLSY; U.S. Department of Labor, 2009) database and use the database to seek convergent evidence regarding the magnitude and significance of genetic effects influencing low and typical performers on measures of…

An Innovative Method for Evaluating Strategic Goals in a Public Agency: Conservation Leadership in the U.S. Forest Service

Treesearch

David N. Bengston; David P. Fan

1999-01-01

This article presents an innovative methodology for evaluating strategic planning goals in a public agency. Computer-coded content analysis was used to evaluate attitudes expressed in about 28,000 on-line news media stories about the U.S. Department of Agriculture Forest Service and its strategic goal of conservation leadership. Three dimensions of conservation...

Systematic use of closed-circuit television in a general practice teaching unit

PubMed Central

Irwin, W. George; Perrott, Jon S.

1981-01-01

We describe use of closed-circuit television in teaching general practice consulting skills in a new central teaching unit of a department of general practice. We explain how the system works, present a simple analysis of student performance in communicating with real and simulated patients and discuss the value of teaching from the consultation with closed-circuit television and video. PMID:7328539

Forest health monitoring: national status, trends, and analysis 2015

Treesearch

Kevin M. Potter; Barbara L. Conkling

2016-01-01

The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi- State regional perspective using a variety of sources, introduces new techniques for analyzing forest health data, and summarizes results of recently completed Evaluation...

Recent Naval Postgraduate School Publications.

DTIC Science & Technology

1980-04-01

Numerical models of ocean circulation and Climate interaction Revs, of Geophis,.and Space Phys., vol. 17, no. 7, p. 1494-1507, (1 979) Haney, R 1...POSTGRADUATE SCHOOL Monterey, California DEPARTMENT OF COMPUTER SCIENCE C06FEBENCE PRESENTATIONS Bradley, G H Enerqy modelling with network optimization...Systems Analysis, Sept., 97 Bradley, G H; Brown, G G Network optimization and defense modeling Center for Nay. Analyses, Arlington, Va., Aug., 1976

Canes Implementation: Analysis of Budgetary, Business, and Policy Challenges

DTIC Science & Technology

2014-12-01

Concept of Operations COTS Commercial Off the Shelf DAG Defense Acquisitions Guidebook DAS Defense Acquisitions System DOD Department of Defense...and Integration NSS National Security Strategy OA Open Architecture OCO Overseas Contingency Operations OEF Operation Enduring Freedom OIF...and software and civilian-type open architecture ( OA ) presents a series of challenges. The purpose of this report is to provide the Navy with a

An assessment of training needs for the lumber manufacturing industry in the eastern United States

Treesearch

Joseph Denig; Scott Page; Yuhua Su; Karen Martinson

2008-01-01

A training needs assessment of the primary forest products industry was conducted for 33 eastern states. his publication presents in detail the statistical analysis of the study. Of the 2,570 lumber manufacturing companies, consisting of firms with more than six employees for the U.S. Department of Labor Standard Industrial Classification Code 2421, the response rate...

On School Bus Safety. Report of the Department of Education to the Governor and the General Assembly of Virginia. House Document No. 10.

ERIC Educational Resources Information Center

Virginia State General Assembly, Richmond. House.

An advisory committee, in response to a 1985 resolution by the Virginia General Assembly, presents this analysis and makes recommendations concerning state school bus safety. The report is divided into eight topics; six appendices comprise three-fourths of the study. "Origin of the Study" states requests to be investigated by the…

What will it take for disease management to demonstrate a return on investment? New perspectives on an old theme.

PubMed

Linden, Ariel Linden

2006-04-01

Disease management programs are expected (and usually contractually required) to reduce total costs in the diseases they manage. To discuss the appropriateness of using utilization indexes in lieu of cost and the importance of reviewing utilization trends to determine whether sufficient opportunity exists for a program to be financially effective; and to conduct an analysis to determine the number of admissions that must be reduced for a program to achieve various levels of return on investment. Descriptive. Historical inpatient cost trends, discharges per 10,000 population, the mean length of stay, and emergency department visits per 10,000 population for acute myocardial infarction, congestive heart failure, asthma, and diabetes mellitus are presented. A "number-needed-to-decrease" analysis is performed to determine the number of admissions or emergency department visits that must be reduced to meet varying levels of return on investment. (1) Hospital days per 10,000 population for these conditions trended downward, while costs during the same period escalated. (2) Discharge and emergency department visit rates per 10,000 population were flat and low during the observation period, while the mean length of stay declined. Results of the number-needed-to-decrease analysis suggest that disease management programs will have to decrease admissions 10% to 30% to cover program fees alone. A review of historical utilization trends and a number-needed-to-decrease analysis should be conducted before disease management program implementation to determine whether sufficient opportunity exists to reduce utilization to levels that will ensure a positive return on investment.

Kayenta Township Building & Safety Department, Tribal Green Building Code Summit Presentation

EPA Pesticide Factsheets

Tribal Green Building Code Summit Presentation by Kayenta Township Building & Safety Department showing how they established the building department, developed a code adoption and enforcement process, and hired staff to carry out the work.

76 FR 30139 - Federal Need Analysis Methodology for the 2012-2013 Award Year

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... DEPARTMENT OF EDUCATION Federal Need Analysis Methodology for the 2012-2013 Award Year AGENCY: Federal Student Aid, Department of Education. ACTION: Notice of revision of the Federal Need Analysis...; 84.268; 84.379]. Federal Need Analysis Methodology for the 2012-2013 award year; Federal Pell Grant...

78 FR 49337 - Direct Grant Programs and Definitions That Apply to Department Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... Department's grant process with the Secretary's policy objectives and allow Department programs to design....210(c) (Quality of the Project Design) (Amended Sec. Sec. 75.209 and 75.210); 6. Authorize program... regulations. We group major issues according to subject. Analysis of Comments and Changes: An analysis of the...

The Relative Efficiency of Departments at a Turkish Engineering College: A Data Envelopment Analysis

ERIC Educational Resources Information Center

Koksal, Gulser; Nalcaci, Burak

2006-01-01

In this study, Data Envelopment Analysis is used to measure relative efficiencies of academic departments of an engineering college. Input and output criteria are determined and measured utilizing the academic personnel performance measurement scheme of the College. New measures are developed to compare departments of different disciplines. The…

Determination of 137Cs and 60Co pollution in the area of the Laguna Verde Nuclear Power Plant, Mexico.

PubMed

Salas Mar, Bernardo

2015-11-01

The project 'Radiological Analysis of Environmental Samples in the Gulf of Mexico and the coast of Quintana Roo', had the aim of identifying and quantifying anthropogenic radionuclides in environmental samples consisting of silt, sand and sea water. This paper presents the results of the radiological analysis of these samples, which was made in the multichannel system for gamma spectrometry with hyperpure germanium detector in the Laboratory of Radiological Analysis of Environmental Samples, located at the Physics Department, Faculty of Sciences, of the Autonomous National University of Mexico (UNAM). The sampled points are along the coast of the contiguous states of Tamaulipas, Veracruz, Tabasco, Campeche, Yucatan and Quintana Roo. This paper presents the qualitative and quantitative concentrations of the main identified anthropogenic radionuclides (60)Co and (137)Cs. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach.

PubMed

Wang, Su-Chen; Tsai, Chi-Cheng; Huang, Shun-Te; Hong, Yu-Jue

2002-12-01

Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

Reduction of radial-head subluxation in children by triage nurses in the emergency department: a cluster-randomized controlled trial

PubMed Central

Dixon, Andrew; Clarkin, Chantalle; Barrowman, Nick; Correll, Rhonda; Osmond, Martin H.; Plint, Amy C.

2014-01-01

Background: Radial-head subluxation is an easily identified and treated injury. We investigated whether triage nurses in the emergency department can safely reduce radial-head subluxation at rates that are not substantially lower than those of emergency department physicians. Methods: We performed an open, noninferiority, cluster-randomized control trial. Children aged 6 years and younger who presented to the emergency department with a presentation consistent with radial-head subluxation and who had sustained a known injury in the previous 12 hours were assigned to either nurse-initiated or physician-initiated treatment, depending on the day. The primary outcome was the proportion of children who had a successful reduction (return to normal arm usage). We used a noninferiority margin of 10%. Results: In total, 268 children were eligible for inclusion and 245 were included in the final analysis. Of the children assigned to receive physician-initiated care, 96.7% (117/121) had a successful reduction performed by a physician. Of the children assigned to receive nurse-treatment care, 84.7% (105/124) had a successful reduction performed by a nurse. The difference in the proportion of successful radial head subluxations between the groups was 12.0% (95% confidence interval [CI] 4.8% to 19.7%). Noninferiority of nurse-initiated radial head subluxation was not shown. Interpretation: In this trial, the rate of successful radial-head subluxation performed by nurses was inferior to the physician success rate. Although the success rate in the nurse-initiated care group did not meet the non-inferiority margin, nurses were able to reduce radial head subluxation for almost 85% of children who presented with probable radial-head subluxation. Trial registration: Clinical Trials.gov, no. NCT00993954. PMID:24664649

An exploration of emergency department presentations related to high heel footwear in Victoria, Australia, 2006-2010.

PubMed

Williams, Cylie M; Haines, Terry P

2014-01-23

Many women are warned against the dangers of wearing high heel footwear however there is limited empirical evidence demonstrating an association between wearing high heel with injury. Gait laboratory testing has found a higher heel height placed the foot in a position that increases the risk of ankle sprain. Women have also been surveyed about wearing high heels and approximately half of those reported inconvenience and pain after wearing a high heel shoe. This study aims to explore emergency department presentations of injuries and the estimated costs that have been directly attributed to wearing high heeled footwear within Victoria, Australia during 2006-2010. The Victorian Emergency Minimum Dataset (VEMD) was searched for all injuries attributed to wearing high heel footwear presenting to emergency departments in Victoria Australia, between the years of 2006-2010. The VEMD produced a report detailing sex, age at presentation, month of presentation, time of day of presentation, day of presentation, location that injury occurred and type of injury for presentation. Monash Health in Victoria Australia, provided emergency department estimates for injury types to calculate an estimated cost of an acute injury related to wearing high heel footwear. There were 240 injuries presenting to Victorian emergency departments directly attributed to wearing high heeled footwear. The majority of people injured were women (n = 236) and all were less than 55 years of age. More injuries presented on a Sunday (n = 83) and more in the 8 am-12 pm time bracket (n = 64). There were also more injuries presenting in the months of November, December and January (n = 80). The most commonly injured body part was the ankle (n = 123). The emergency department estimate of the cost of these injuries over this time-frame was almost $72,000 (mean of $316.72 per presentation). People who wear high heel footwear on weekends appear to be at higher risk for injury that leads to emergency department presentation. However, there was not a large cost associated with emergency department presentations attributable to wearing high heel footwear over a 5 year period.

An exploration of emergency department presentations related to high heel footwear in Victoria, Australia, 2006–2010

PubMed Central

2014-01-01

Background Many women are warned against the dangers of wearing high heel footwear however there is limited empirical evidence demonstrating an association between wearing high heel with injury. Gait laboratory testing has found a higher heel height placed the foot in a position that increases the risk of ankle sprain. Women have also been surveyed about wearing high heels and approximately half of those reported inconvenience and pain after wearing a high heel shoe. This study aims to explore emergency department presentations of injuries and the estimated costs that have been directly attributed to wearing high heeled footwear within Victoria, Australia during 2006–2010. Methods The Victorian Emergency Minimum Dataset (VEMD) was searched for all injuries attributed to wearing high heel footwear presenting to emergency departments in Victoria Australia, between the years of 2006–2010. The VEMD produced a report detailing sex, age at presentation, month of presentation, time of day of presentation, day of presentation, location that injury occurred and type of injury for presentation. Monash Health in Victoria Australia, provided emergency department estimates for injury types to calculate an estimated cost of an acute injury related to wearing high heel footwear. Results There were 240 injuries presenting to Victorian emergency departments directly attributed to wearing high heeled footwear. The majority of people injured were women (n = 236) and all were less than 55 years of age. More injuries presented on a Sunday (n = 83) and more in the 8 am-12 pm time bracket (n = 64). There were also more injuries presenting in the months of November, December and January (n = 80). The most commonly injured body part was the ankle (n = 123). The emergency department estimate of the cost of these injuries over this time-frame was almost $72,000 (mean of $316.72 per presentation). Conclusions People who wear high heel footwear on weekends appear to be at higher risk for injury that leads to emergency department presentation. However, there was not a large cost associated with emergency department presentations attributable to wearing high heel footwear over a 5 year period. PMID:24456691

Application of economic impact analysis to a local public health agency and its "Academic Health Department".

PubMed

Livingood, Wiliiam C; Coughlin, Susan; Bowman, Walter; Bryant, Thomas; Goldhagen, Jeffrey

2007-01-01

Public health systems are stressed by increasing demands and inadequate resources. This study was designed to demonstrate how economic impact analysis can estimate the economic value of a local public health system's infrastructure as well as the economic assets of an "Academic Health Department" model. This study involved the secondary analysis of publicly available data on health department finances and employment using proprietary software specifically designed to assess economic impacts. The health department's impact on the local community was estimated at over 100 million dollars, exceeding the economic impact of other recently studied local industries with no additional costs to local taxpayers.

Federal technology transfer requirements :a focused study of principal agencies approaches with implications for the Department of Homeland Security.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koker, Denise; Micheau, Jill M.

2006-07-01

This report provides relevant information and analysis to the Department of Homeland Security (DHS) that will assist DHS in determining how to meet the requirements of federal technology transfer legislation. These legal requirements are grouped into five categories: (1) establishing an Office of Research and Technology Applications, or providing the functions thereof; (2) information management; (3) enabling agreements with non-federal partners; (4) royalty sharing; and (5) invention ownership/obligations. These five categories provide the organizing framework for this study, which benchmarks other federal agencies/laboratories engaged in technology transfer/transition Four key agencies--the Department of Health & Human Services (HHS), the U.S. Departmentmore » of Agriculture (USDA), the Department of Energy (DOE), and the Department of Defense (DoD)--and several of their laboratories have been surveyed. An analysis of DHS's mission needs for commercializing R&D compared to those agencies/laboratories is presented with implications and next steps for DHS's consideration. Federal technology transfer legislation, requirements, and practices have evolved over the decades as agencies and laboratories have grown more knowledgeable and sophisticated in their efforts to conduct technology transfer and as needs and opinions in the federal sector have changed with regards to what is appropriate. The need to address requirements in a fairly thorough manner has, therefore, resulted in a lengthy paper. There are two ways to find summary information. Each chapter concludes with a summary, and there is an overall ''Summary and Next Steps'' chapter on pages 57-60. For those readers who are unable to read the entire document, we recommend referring to these pages.« less

A prospective cohort study to refine and validate the Panic Screening Score for identifying panic attacks associated with unexplained chest pain in the emergency department

PubMed Central

Foldes-Busque, Guillaume; Denis, Isabelle; Poitras, Julien; Fleet, Richard P; Archambault, Patrick; Dionne, Clermont E

2013-01-01

Introduction Panic-like anxiety (panic attacks with or without panic disorder), a highly treatable condition, is the most prevalent condition associated with unexplained chest pain in the emergency department. Panic-like anxiety may be responsible for a significant portion of the negative consequences of unexplained chest pain, such as functional limitations and chronicity. However, more than 92% of panic-like anxiety cases remain undiagnosed at the time of discharge from the emergency department. The 4-item Panic Screening Score (PSS) questionnaire was derived in order to increase the identification of panic-like anxiety in emergency department patients with unexplained chest pain. Methods and analysis The goals of this prospective cohort study were to (1) refine the PSS; (2) validate the revised version of the PSS; (3) measure the reliability of the revised version of the PSS and (4) assess the acceptability of the instrument among emergency physicians. Eligible and consenting patients will be administered the PSS in a large emergency department. Patients will be contacted by phone for administration of the criterion standard for panic attacks as well as by a standardised interview to collect information for other predictors of panic attacks. Multivariate analysis will be used to refine the PSS. The new version will be prospectively validated in an independent sample and inter-rater agreement will be assessed in 10% of cases. The screening instrument acceptability will be assessed with the Ottawa Acceptability of Decision Rules Instrument. Ethics and dissemination This study protocol has been reviewed and approved by the Alphonse-Desjardins research ethics committee. The results of the study will be presented in scientific conferences and published in peer-reviewed scientific journals. Further dissemination via workshops and a dedicated website is planned. PMID:24163208

77 FR 64385 - Proposed Information Collection (Loan Analysis) Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... forms of information technology. Title: Loan Analysis, VA Form 26-6393. OMB Control Number: 2900-0523... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0523] Proposed Information Collection (Loan Analysis) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans...

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

PubMed

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

2015-01-01

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

Ottawa Ankle Rules and Subjective Surgeon Perception to Evaluate Radiograph Necessity Following Foot and Ankle Sprain

PubMed Central

Pires, RES; Pereira, AA; Abreu-e-Silva, GM; Labronici, PJ; Figueiredo, LB; Godoy-Santos, AL; Kfuri, M

2014-01-01

Background: Foot and ankle injuries are frequent in emergency departments. Although only a few patients with foot and ankle sprain present fractures and the fracture patterns are almost always simple, lack of fracture diagnosis can lead to poor functional outcomes. Aim: The present study aims to evaluate the reliability of the Ottawa ankle rules and the orthopedic surgeon subjective perception to assess foot and ankle fractures after sprains. Subjects and Methods: A cross-sectional study was conducted from July 2012 to December 2012. Ethical approval was granted. Two hundred seventy-four adult patients admitted to the emergency department with foot and/or ankle sprain were evaluated by an orthopedic surgeon who completed a questionnaire prior to radiographic assessment. The Ottawa ankle rules and subjective perception of foot and/or ankle fractures were evaluated on the questionnaire. Results: Thirteen percent (36/274) patients presented fracture. Orthopedic surgeon subjective analysis showed 55.6% sensitivity, 90.1% specificity, 46.5% positive predictive value and 92.9% negative predictive value. The general orthopedic surgeon opinion accuracy was 85.4%. The Ottawa ankle rules presented 97.2% sensitivity, 7.8% specificity, 13.9% positive predictive value, 95% negative predictive value and 19.9% accuracy respectively. Weight-bearing inability was the Ottawa ankle rule item that presented the highest reliability, 69.4% sensitivity, 61.6% specificity, 63.1% accuracy, 21.9% positive predictive value and 93% negative predictive value respectively. Conclusion: The Ottawa ankle rules showed high reliability for deciding when to take radiographs in foot and/or ankle sprains. Weight-bearing inability was the most important isolated item to predict fracture presence. Orthopedic surgeon subjective analysis to predict fracture possibility showed a high specificity rate, representing a confident method to exclude unnecessary radiographic exams. PMID:24971221

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

Measurement properties of the Health Literacy Questionnaire (HLQ) among older adults who present to the emergency department after a fall: a Rasch analysis.

PubMed

Morris, Rebecca L; Soh, Sze-Ee; Hill, Keith D; Buchbinder, Rachelle; Lowthian, Judy A; Redfern, Julie; Etherton-Beer, Christopher D; Hill, Anne-Marie; Osborne, Richard H; Arendts, Glenn; Barker, Anna L

2017-08-29

Health literacy is an important concept associated with participation in preventive health initiatives, such as falls prevention programs. A comprehensive health literacy measurement tool, appropriate for this population, is required. The aim of this study was to evaluate the measurement properties of the Health Literacy Questionnaire (HLQ) in a cohort of older adults who presented to a hospital emergency department (ED) after a fall. Older adults who presented to an ED after a fall had their health literacy assessed using the HLQ (n = 433). Data were collected as part of a multi-centre randomised controlled trial of a falls prevention program. Measurement properties of the HLQ were assessed using Rasch analysis. All nine scales of the HLQ were unidimensional, with good internal consistency reliability. No item bias was found for most items (43 of 44). A degree of overall misfit to the Rasch model was evident for six of the nine HLQ scales. The majority of misfit indicated content overlap between some items and does not compromise measurement. A measurement gap was identified for this cohort at mid to high HLQ score. The HLQ demonstrated good measurement properties in a cohort of older adults who presented to an ED after a fall. The summation of the HLQ items within each scale, providing unbiased information on nine separate areas of health literacy, is supported. Clinicians, researchers and policy makers may have confidence using the HLQ scale scores to gain information about health literacy in older people presenting to the ED after a fall. This study was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000336684 (27 March 2014).

77 FR 17410 - Bottom Mount Combination Refrigerator-Freezers From the Republic of Korea: Final Affirmative...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

..., 2011, the Department issued its Post-Preliminary Analysis of Cross-ownership and its Post- Preliminary Analysis of New Subsidy Allegations. On that date, the Department also issued its Post-Preliminary Analysis... Post-Preliminary Analysis: GOK Preferential Lending Under the Daewoo Workout, and the GOK, LGE, SEC...

A concept for the modernization of underground mining master maps based on the enrichment of data definitions and spatial database technology

NASA Astrophysics Data System (ADS)

Krawczyk, Artur

2018-01-01

In this article, topics regarding the technical and legal aspects of creating digital underground mining maps are described. Currently used technologies and solutions for creating, storing and making digital maps accessible are described in the context of the Polish mining industry. Also, some problems with the use of these technologies are identified and described. One of the identified problems is the need to expand the range of mining map data provided by survey departments to other mining departments, such as ventilation maintenance or geological maintenance. Three solutions are proposed and analyzed, and one is chosen for further analysis. The analysis concerns data storage and making survey data accessible not only from paper documentation, but also directly from computer systems. Based on enrichment data, new processing procedures are proposed for a new way of presenting information that allows the preparation of new cartographic representations (symbols) of data with regard to users' needs.

Epidemiology of Mental Health Attendances at Emergency Departments: Systematic Review and Meta-Analysis

PubMed Central

Rojas-García, Antonio; Clarke, Katherine; Moore, Anna; Whittington, Craig; Stockton, Sarah; Thomas, James; Pilling, Stephen; Raine, Rosalind

2016-01-01

Background The characteristics of Emergency Department (ED) attendances due to mental or behavioural health disorders need to be described to enable appropriate development of services. We aimed to describe the epidemiology of mental health-related ED attendances within health care systems free at the point of access, including clinical reason for presentation, previous service use, and patient sociodemographic characteristics. Method Systematic review and meta-analysis of observational studies describing ED attendances by patients with common mental health conditions. Findings 18 studies from seven countries met eligibility criteria. Patients attending due to mental or behavioural health disorders accounted for 4% of ED attendances; a third were due to self-harm or suicidal ideation. 58.1% of attendees had a history of psychiatric illness and up to 58% were admitted. The majority of studies were single site and of low quality so results must be interpreted cautiously. Conclusions Prevalence studies of mental health-related ED attendances are required to enable the development of services to meet specific needs. PMID:27120350

Increased presentations to emergency departments for asthma associated with rye grass pollen season in inland NSW.

PubMed

Hayden, Timothy J; Muscatello, David J

2011-09-01

This study measured the frequency and geographical extent of peaks in asthma presentations to emergency departments in inland NSW; it assessed the characteristics of patients who presented at peak presentation times during the rye grass pollination season (October-November) and at other times of the year. Data describing over 13 years of daily emergency department presentations with a provisional diagnosis of asthma at nine inland NSW base hospitals were assembled. Days of counts in the top 0.1 percentile for each emergency department were classified as peak asthma count days. While the rye grass pollen season accounts for only 17% of days in the year, 53% of peak asthma count days fell within that period. Patients aged over 14 years represented 74% of visits on peak asthma count days during the pollen season and 50% on peak days at other times of the year. Under the right climatic conditions, rye grass pollen may be responsible for presentations for acute asthma to emergency departments in inland NSW.

Animal-inflicted open wounds in rural Turkey: lessons learned and a proposed treatment algorithm for uncertain scenarios.

PubMed

Sezgin, Billur; Ljohiy, Mbaraka; Akgol Gur, Sultan Tuna

2016-12-01

Uncertainty in the management of animal-inflicted injuries, especially in rural settings, usually results in a general approach to leave all wounds to heal with secondary intention, which can lead to unsightly scarring and functional loss. This study focusus on different circumstances dealt with by plastic surgeons in a rural setting in Turkey and aims to configure what the general approach should be through an analysis of a wide spectrum of patients. Between June 2013 and December 2014, 205 patients who presented to the emergency department for animal-inflicted injuries were retrospectively analysed. Patients who consulted for plastic surgery were included in the analysis to determine which wounds require further attention. Patients with past animal-inflicted injuries who presented to the outpatient plastic surgery clinic with concerns such as non-healing open wounds or cosmetic or functional impairment were also evaluated. Statistical analysis demostrated a significantly lower rate of infection encountered in animal-inflicted open wounds (AIOWs) of patients who consulted for plastic surgery from the emergency department than those who presented to the outpatient clinic (P < 0·05). The main concern in the management of animal-inflicted wounds is their potential for infection, but this does not mean that every wound will be infected. The most important factor is being able to distinguish wounds that have a higher potential for infection and to select the type of wound management accordingly. An algorithm has been proposed as a guidance for the management of AIOWs, which covers the approach towards both domestic and stray animal-inflicted injuries. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

The Ohio Department of Education L10H23 "Critical Analysis of Evolution"; Innovative Lesson Plan or Stealthy Advocacy Tool?

ERIC Educational Resources Information Center

Day, Robert

2006-01-01

This paper will discuss the ongoing controversy surrounding a particular Ohio Department of Education tenth grade lesson plan titled "Critical Analysis of Evolution" (Ohio Department of Education identification L10H23). The lesson professes to encourage students to "critically examine" evidences for and against evolution and…

Morbidity and Mortality Rounds in Liver Transplantation

PubMed Central

Kocabayoglu, Peri; Husen, Martin; Witzke, Oliver; Kribben, Andreas; Saner, Fuat H.; Canbay, Ali; Gerken, Guido; Paul, Andreas

2016-01-01

Background Morbidity and mortality conferences (MMCs) provide powerful opportunities for learning, reflection, and improvement. The current literature gives examples of how MMCs can be designed; however, no systematic review of cases and no original data related to liver transplantation are available. Liver transplantation requires a multidisciplinary approach to case identification, presentation, and analysis. Framework structures that guide case investigation are needed to successfully follow up on outcome measures and provide the basis for quality assessment and transparency in transplant programs. Methods All cases presented at our department's transplant-related MMCs in the years 2014 and 2015 were analyzed. Patient data were collected from our electronic database and meeting minutes. Cases were summarized according to type of transplantation. Liver-related transplant cases were analyzed for in-house deaths and time from death until presentation at an MMC. A literature review was performed, and our center's MMC design was compared with the literature available on conducting MMCs and improving patient safety and quality of care. Results Within 2 years, 15 MMCs were held at our department. 38 cases were discussed of which 25 were liver transplant-related. Most cases were in-house postoperative deaths, mainly due to sepsis or primary non-function. We provide a summary of recommendations for conducting MMCs based on conferences held in our department combined with the literature. Conclusion We present our experience with MMCs held over the past 24 months in consideration of guidelines on MMCs provided in the literature. As there is little conformity to known models for analyzing medical incidents, models for best practice in conduction MMCs are urgently needed. PMID:27722164

Implementing CDIO project-based learning in training of Heat and Power engineers

NASA Astrophysics Data System (ADS)

Boiko, E. A.; Shishmarev, P. V.; Karabarin, D. I.; Yanov, S. R.; Pikalova, A. A.

2017-11-01

This paper presents the experience and current results of CDIO standards implementation in training of bachelors in Heat and Power Engineering at Thermal Power Stations academic department in Siberian Federal University. It provides information on methodology of modernization of educational programs, curricula and programs of disciplines in transition to CDIO project-based learning technology. Preliminary assessment and analysis of lessons learned and scaling perspectives are given.

AMSARA: Accession Medical Standards Analysis and Research Activity. Report of 2006 Attrition and Morbidity Data for 2005 Accessions

DTIC Science & Technology

2007-12-17

and Research Activity (AMSARA) NUMBER Department of Epidemiology Division of Preventive Medicine Walter Reed Army Institute of Research 503 Robert...Hospitalizations, Recruits, Epidemiology, Attrition, Disability, Statistics, Preventive Medicine , Physical Fitness, Motivation, Accession, Waiver, Existing Prior to...an active duty Army enlistee. These findings are presented in abstract form in this report and as a full manuscript submitted to Military Medicine in

Loss of lock analysis : the National Transportation Systems Center : advancing transportation innovation for the public good : U.S. Department of Transportation : Office of Research and Technology : John A. Volpe National Transportation Systems Center : G

DOT National Transportation Integrated Search

2017-03-30

This presentation was given during the GPS-ABC Workshop VI in Washington, DC on March 30, 2017. It provides a summary of loss-of-lock results : of two types in the presence of 10-MHz LTE signals: 1. Interference level for which low-elevation sa...

Job Analysis Techniques for Restructuring Health Manpower Education and Training in the Navy Medical Department. Attachment 4. Clinic QPCB Task Sort for Clinical Physician Assistants--Dermatology, ENT, Opththalmology, Orthopedics, and Urology.

ERIC Educational Resources Information Center

Technomics, Inc., McLean, VA.

This publication is Attachment 4 of a set of 16 computer listed QPCB task sorts, by career level, for the entire Hospital Corps and Dental Technician fields. Statistical data are presented in tabular form for a detailed listing of job duties for clinical physician assistants. (BT)

Job Analysis Techniques for Restructuring Health Manpower Education and Training in the Navy Medical Department. Attachment 5. Biotronics QPCB Task Sort for Cardio-Pulmonary, EEG, EKG, Inhalation Therapy.

ERIC Educational Resources Information Center

Technomics, Inc., McLean, VA.

This publication is Attachment 5 of a set of 16 computer listed QPCB task sorts, by career level, for the entire Hospital Corps and Dental Technician fields. Statistical data are presented in tabular form for a detailed listing of job duties in cardio-pulmonary, EEG, EKG, and inhalation therapy. (BT)

Consortium for Verification Technology Fellowship Report.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sadler, Lorraine E.

2017-06-01

As one recipient of the Consortium for Verification Technology (CVT) Fellowship, I spent eight days as a visiting scientist at the University of Michigan, Department of Nuclear Engineering and Radiological Sciences (NERS). During this time, I participated in multiple department and research group meetings and presentations, met with individual faculty and students, toured multiple laboratories, and taught one-half of a one-unit class on Risk Analysis in Nuclear Arms control (six 1.5 hour lectures). The following report describes some of the interactions that I had during my time as well as a brief discussion of the impact of this fellowship onmore » members of the consortium and on me/my laboratory’s technical knowledge and network.« less

Semi-annual report of the Department of Energy, Office of Environmental Management, Quality Assessment Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greenlaw, P.D.; Minick, S.K.

This Quality Assessment Program (QAP) is designed to test the quality of the environmental measurements being reported to the Department of Energy by its contractors. Since 1976, real or synthetic environmental samples that have been prepared and thoroughly analyzed at the Environmental Measurements Laboratory (EML) have been distributed at first quarterly and then semi-annually to these contractors. Their results, which are returned to EML within 90 days, are compiled with EML`s results and are reported back to the participating contractors 30 days later. This report presents the results from the analysis of the 48th set of environmental quality assessment samplesmore » (QAP XLVIII) that were received on or before June 1, 1998.« less

Does the incidence of pulmonary embolism increase during pregnancy?

PubMed

Howard, Courtney; Howard, Patricia Kunz

2015-01-01

A review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study module for "Systematic Review and Meta-Analysis of Pregnant Patients Investigated for Suspected Pulmonary Embolism in the Emergency Department." The study results showed that there were 25,339 patients evaluated for pulmonary embolism in an emergency department included in the 17 study articles, 2,636 had venous thromboembolism (VTE; 13%; 95% CI [10, 17]), and 506 were pregnant and underwent diagnostic chest imaging (2%; 95% CI [1.5, 2.6]). These data suggest that pregnancy does not appear to increase the incidence of a VTE-positive diagnosis. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting best evidence.

Vehicle Lightweighting: 40% and 45% Weight Savings Analysis: Technical Cost Modeling for Vehicle Lightweighting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mascarin, Anthony; Hannibal, Ted; Raghunathan, Anand

2015-04-01

The U.S. Department of Energy’s Vehicle Technologies Office, Materials area commissioned a study to model and assess manufacturing economics of alternative design and production strategies for a series of lightweight vehicle concepts. The strategic targets were a 40% and a 45% mass reduction relative to a standard North American midsize passenger sedan at an effective cost of $3.42 per pound (lb) saved. The baseline vehicle was an average of several available vehicles in this class. Mass and cost breakdowns from several sources were used, including original equipment manufacturers’ (OEMs’) input through U.S. Department of Energy’s Vehicle Technologies Office programs andmore » public presentations, A2Mac1 LLC’s teardown information, Lotus Engineering Limited and FEV, Inc. breakdowns in their respective lightweighting studies, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses. Information on lightweighting strategies in this analysis came from these same sources and the ongoing U.S. Department of Energy-funded Vehma International of America, Inc. /Ford Motor Company Multi-Material Lightweight Prototype Vehicle Demonstration Project, the Aluminum Association Transportation Group, and many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs.« less

A data-driven allocation tool for in-kind resources distributed by a state health department.

PubMed

Peterson, Cora; Kegler, Scott R; Parker, Wende R; Sullivan, David

2016-10-02

The objective of this study was to leverage a state health department's operational data to allocate in-kind resources (children's car seats) to counties, with the proposition that need-based allocation could ultimately improve public health outcomes. This study used a retrospective analysis of administrative data on car seats distributed to counties statewide by the Georgia Department of Public Health and development of a need-based allocation tool (presented as interactive supplemental digital content, adaptable to other types of in-kind public health resources) that relies on current county-level injury and sociodemographic data. Car seat allocation using public health data and a need-based formula resulted in substantially different recommended allocations to individual counties compared to historic distribution. Results indicate that making an in-kind public health resource like car seats universally available results in a less equitable distribution of that resource compared to deliberate allocation according to public health need. Public health agencies can use local data to allocate in-kind resources consistent with health objectives; that is, in a manner offering the greatest potential health impact. Future analysis can determine whether the change to a more equitable allocation of resources is also more efficient, resulting in measurably improved public health outcomes.

Assessment and management of febrile neutropenia in emergency departments within a regional health authority—a benchmark analysis

PubMed Central

Szwajcer, D.; Czaykowski, P.; Turner, D.

2011-01-01

Objectives Febrile neutropenia is considered an oncologic emergency, for which prompt initiation of antibiotics is essential. Methods We conducted a retrospective cohort study for the 2006 calendar year involving all adult oncology patients presenting with febrile neutropenia to a regional health authority’s emergency departments. The objective was to determine the time from triage to antibiotic administration and its impact on patient outcomes. Results We identified 68 patients presenting with febrile neutropenia, most of whom (76%) were seen in tertiary care centers. Of those patients, 65% were triaged to be seen within 15 minutes of arrival in the emergency room; however, the median time to reassessment was 57 minutes. The median time from triage to antibiotic administration was 5 hours (range: 1.23–22.8 hours). No increased risk of death or increased length of hospital stay was associated with delayed antibiotic administration. Older patients and patients without caregiver support were more likely to experience delayed antibiotic administration (odds ratio: 3.8 and 12.7 respectively). Conclusions We were not able to show a deleterious effect of delay in antibiotic administration, but our analysis identified several points at which patient flow through the emergency room could be improved. PMID:22184489

Multi-tool accessibility assessment of government department websites:a case-study with JKGAD.

PubMed

Ismail, Abid; Kuppusamy, K S; Nengroo, Ab Shakoor

2017-08-02

Nature of being accessible to all categories of users is one of the primary factors for enabling the wider reach of the resources published through World Wide Web. The accessibility of websites has been analyzed through W3C guidelines with the help of various tools. This paper presents a multi-tool accessibility assessment of government department websites belonging to the Indian state of Jammu and Kashmir. A comparative analysis of six accessibility tools is also presented with 14 different parameters. The accessibility analysis tools used in this study for analysis are aChecker, Cynthia Says, Tenon, wave, Mauve, and Hera. These tools provide us the results of selected websites accessibility status on Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0. It was found that there are variations in accessibility analysis results when using different accessibility metrics to measure the accessibility of websites. In addition to this, we have identified the guidelines which have frequently been violated. It was observed that there is a need for incorporating the accessibility component features among the selected websites. This paper presents a set of suggestions to improve the accessibility status of these sites so that the information and services provided by these sites shall reach a wider spectrum of audience without any barrier. Implications for rehabilitation The following points indicates that this case study of JKGAD websites comes under Rehabilitation focused on Visually Impaired users. Due to the universal nature of web, it should be accessible to all according to WCAG guidelines framed by World Wide Web Consortium. In this paper we have identified multiple accessibility barriers for persons with visual impairment while browsing the Jammu and Kashmir Government websites. Multi-tool analysis has been done to pin-point the potential barriers for persons with visually Impaired. Usability analysis has been performed to check whether these websites are suitable for persons with visual impairment. We provide some valuable suggestions which can be followed by developers and designers to minimize these potential accessibility barriers.Based on aforementioned key points, this article helps the persons with disability especially Visually Impaired Users to access the web resources better with the implementation of identified suggestions.

The business case for payer support of a community-based health information exchange: a humana pilot evaluating its effectiveness in cost control for plan members seeking emergency department care.

PubMed

Tzeel, Albert; Lawnicki, Victor; Pemble, Kim R

2011-07-01

As emergency department utilization continues to increase, health plans must limit their cost exposure, which may be driven by duplicate testing and a lack of medical history at the point of care. Based on previous studies, health information exchanges (HIEs) can potentially provide health plans with the ability to address this need. To assess the effectiveness of a community-based HIE in controlling plan costs arising from emergency department care for a health plan's members. Albert Tzeel. The study design was observational, with an eligible population (N = 1482) of fully insured plan members who sought emergency department care on at least 2 occasions during the study period, from December 2008 through March 2010. Cost and utilization data, obtained from member claims, were matched to a list of persons utilizing the emergency department where HIE querying could have occurred. Eligible members underwent propensity score matching to create a test group (N = 326) in which the HIE database was queried in all emergency department visits, and a control group (N = 325) in which the HIE database was not queried in any emergency department visit. Post-propensity matching analysis showed that the test group achieved an average savings of $29 per emergency department visit compared with the control group. Decreased utilization of imaging procedures and diagnostic tests drove this cost-savings. When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decrease. Although many factors can play a role in this finding, it is likely that HIEs obviate unnecessary service utilization through provision of historical medical information regarding specific patients at the point of care.

Experiences of counselling in the emergency department during the waiting period: importance of family participation.

PubMed

Paavilainen, Eija; Salminen-Tuomaala, Mari; Kurikka, Sirpa; Paussu, Paula

2009-08-01

To describe patients' experiences of counselling, defined as information giving and advice by nursing staff, in the emergency department. A particular focus was on the waiting period and on the importance of family participation in counselling. Counselling is a widely studied topic in nursing. Too little is known about counselling in emergency departments and especially about participation of family members and suitability of counselling for the patient's life situation. Descriptive quantitative study. Data were collected by questionnaires from patients (n = 107) visiting a hospital emergency department. The data were subjected to statistical analysis. Forty-two per cent of patients arrived at the emergency department with a family member: spouse or cohabiting partner, mother, father or daughter. Patients were fairly satisfied with the counselling. The presence of a family member was important to the majority of patients (75%). About half of the patients wanted information concerning their illness, condition and treatment to be given to their family members. Those visiting the department with a family member were more satisfied with counselling and felt that it promoted their participation in care. It is to encourage patients' family members to participate in counselling situations in emergency departments. However, the type of information passed on to family members should be carefully discussed and prepared. Patients' family members seem to be important partners in counselling situations. The presence of family members supports patients in the emergency department during the waiting period and helps them orientate in their situation. When family members are present, issues which patients wish to discuss should be carefully planned. Family presence should be encouraged in emergency departments.

Geospatial-temporal distribution of Tegumentary Leishmaniasis in Colombia (2007–2016)

PubMed Central

Herrera, Giovanny; Pradilla, Iván; Vera, Mauricio

2018-01-01

Background Tegumentary Leishmaniasis (TL) is a neglected disease with worldwide distribution and considered a public health problem, especially in Latin America. In Colombia, the governmental epidemiological surveillance system (SIVIGILA) is responsible for collecting information on the presentation of cases of TL from each of the municipalities and departments. In absence of a study compiling and analyzing currently available metadata of TL in Colombia, this study describes the geospatial-temporal distribution of TL and identifies the regions of the country on which prevention measures should be established in order to control the disease. Methodology/Principal findings This is an exploratory descriptive analysis of the distribution of TL in Colombia. Information was collected on new cases of the disease during the years 2007–2016 from the Colombian reporting system (SIVIGILA). Incidence calculations were made based on population estimates by departments and biogeographical regions. Time evolution is shown in biennial maps. A 10-year series was analyzed, showing that the Amazon region is the most affected in terms of incidence, while the Andean region has the highest number of cases with a high variability among the departments that make it up. In those departments where there is a greater reported diversity of vector species, a large number of cases was observed. Conclusions/Significance Transmission dynamics of TL in Colombia in the past 10 years have been variable, with a greater concentration of cases in the central and southern departments. The present study contributes to improve the understanding of the patterns of distribution of TL in Colombia and can be a basis for future studies of impact evaluation of Health policies in the country and the region. PMID:29624582

[Retrospective calculation of the workload in emergency departments in case of a mass accident. An analysis of the Love Parade 2010].

PubMed

Ackermann, O; Heigel, U; Lazic, D; Vogel, T; Schofer, M D; Rülander, C

2012-04-01

For the clinical planning of mass events the emergency departments are of critical importance, but there are still no data available for the workload in these cases. As this is essential for an effective medical preparation, we calculated the workload based on the ICD codes of the vicitims at the Loveparade 2010 in Duisburg. Based on the patient data of the Loveparade 2010 we used a filter diagnosis to estimate the number of shock room patients, regular admittances, surgical wound treatments, applications of casts or splints, and diagnosis of drug abuse. In addition every patient was classified to a Manchester Triage System category. This resulted in a chronological and quantitative work-load profile of the emergency department, which was evaluated by the clinical experiences of the departmental medical staff. The workload profile as a whole displayed a realistic image of the real true situation on July 24, 2010. While only the number, diagnosis and chronology of medical surgical patients was realistic, the MTS classification was not. The emergency department had a maximum of 6 emergency room admittances, 6 regular admittances, 4-5 surgical wound treatments, 3 casts and 2 drug abuse patients per hour. The calculation of workload from the ICD data is a reasonable tool for retrospective estimation of the workload of an emergency department, the data can be used for future planning. The retrospective MTS grouping is at present not suitable for a realistic calculation. Retrospective measures in the MTS groups are at present not sufficiently suitable for valid data publication. © Georg Thieme Verlag KG Stuttgart · New York.

Performance of the high-sensitivity troponin assay in diagnosing acute myocardial infarction: systematic review and meta-analysis

PubMed Central

Al-Saleh, Ayman; Alazzoni, Ashraf; Al Shalash, Saleh; Ye, Chenglin; Mbuagbaw, Lawrence; Thabane, Lehana; Jolly, Sanjit S.

2014-01-01

Background High-sensitivity cardiac troponin assays have been adopted by many clinical centres worldwide; however, clinicians are uncertain how to interpret the results. We sought to assess the utility of these assays in diagnosing acute myocardial infarction (MI). Methods We carried out a systematic review and meta-analysis of studies comparing high-sensitivity with conventional assays of cardiac troponin levels among adults with suspected acute MI in the emergency department. We searched MEDLINE, EMBASE and Cochrane databases up to April 2013 and used bivariable random-effects modelling to obtain summary parameters for diagnostic accuracy. Results We identified 9 studies that assessed the use of high-sensitivity troponin T assays (n = 9186 patients). The summary sensitivity of these tests in diagnosing acute MI at presentation to the emergency department was estimated to be 0.94 (95% confidence interval [CI] 0.89–0.97); for conventional tests, it was 0.72 (95% CI 0.63–0.79). The summary specificity was 0.73 (95% CI 0.64–0.81) for the high-sensitivity assay compared with 0.95 (95% CI 0.93–0.97) for the conventional assay. The differences in estimates of the summary sensitivity and specificity between the high-sensitivity and conventional assays were statistically significant (p < 0.01). The area under the curve was similar for both tests carried out 3–6 hours after presentation. Three studies assessed the use of high-sensitivity troponin I assays and showed similar results. Interpretation Used at presentation to the emergency department, the high-sensitivity cardiac troponin assay has improved sensitivity, but reduced specificity, compared with the conventional troponin assay. With repeated measurements over 6 hours, the area under the curve is similar for both tests, indicating that the major advantage of the high-sensitivity test is early diagnosis. PMID:25295240

7 CFR 275.15 - Data management.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Data Analysis and Evaluation § 275.15 Data management. (a) Analysis. Analysis is the process of classifying data, such as by areas of...

7 CFR 275.15 - Data management.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Data Analysis and Evaluation § 275.15 Data management. (a) Analysis. Analysis is the process of classifying data, such as by areas of...

7 CFR 275.15 - Data management.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Data Analysis and Evaluation § 275.15 Data management. (a) Analysis. Analysis is the process of classifying data, such as by areas of...

7 CFR 275.15 - Data management.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Data Analysis and Evaluation § 275.15 Data management. (a) Analysis. Analysis is the process of classifying data, such as by areas of...

78 FR 6404 - Agency Information Collection (Loan Analysis) Activities Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... ``OMB Control No. 2900- 0523.'' SUPPLEMENTARY INFORMATION: Title: Loan Analysis, VA Form 26-6393. OMB... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0523] Agency Information Collection (Loan Analysis) Activities Under OMB Review AGENCY: Veterans Benefits Administration, Department of Veterans...

Department of Defense Information Analysis Centers.

ERIC Educational Resources Information Center

Rothschild, M. Cecilia

1987-01-01

Describes the establishment of Department of Defense (DOD) information analysis centers and discusses their purpose and activities, how they differ from special libraries and other information centers, and some problems resulting from the communication of classified information. A list of existing information analysis centers is provided. (CLB)

[Prognostic factors of early 30-day mortality in elderly patients admitted to an emergency department].

PubMed

Morales Erazo, Alexander; Cardona Arango, Doris

The main aim of this study was to identify the variables related to early mortality in the elderly at the time of admission to the emergency department. Using probability sampling, the study included patients 60 years old or older of both genders who were admitted for observation to the emergency department of the University Hospital of Nariño, ¿Colombia? in 2015. Using a questionnaire designed for this study, some multidimensional features that affect the health of the elderly were collected (demographic, clinical, psychological, functional, and social variables). The patients were then followed-up for 30 days in order to determine the mortality rate during this time. Univariate and multivariate logistic regressions and survival analysis were performed. Data were collected from 246 patients, with a mean age of 75.27 years and the majority female. The 30-day mortality rate was 15%. The variables most associated with death were: being female, temperature problems, initial diagnosis of neoplasia, and unable to walk independently in the emergency department. It is possible to determine the multidimensional factors present in the older patient admitted to an emergency department that could affect their 30-day mortality prognosis. and which should be intervened. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Geographic Distribution of Disaster-Specific Emergency Department Use After Hurricane Sandy in New York City.

PubMed

Lee, David C; Smith, Silas W; Carr, Brendan G; Doran, Kelly M; Portelli, Ian; Grudzen, Corita R; Goldfrank, Lewis R

2016-06-01

We aimed to characterize the geographic distribution of post-Hurricane Sandy emergency department use in administrative flood evacuation zones of New York City. Using emergency claims data, we identified significant deviations in emergency department use after Hurricane Sandy. Using time-series analysis, we analyzed the frequency of visits for specific conditions and comorbidities to identify medically vulnerable populations who developed acute postdisaster medical needs. We found statistically significant decreases in overall post-Sandy emergency department use in New York City but increased utilization in the most vulnerable evacuation zone. In addition to dialysis- and ventilator-dependent patients, we identified that patients who were elderly or homeless or who had diabetes, dementia, cardiac conditions, limitations in mobility, or drug dependence were more likely to visit emergency departments after Hurricane Sandy. Furthermore, patients were more likely to develop drug-resistant infections, require isolation, and present for hypothermia, environmental exposures, or administrative reasons. Our study identified high-risk populations who developed acute medical and social needs in specific geographic areas after Hurricane Sandy. Our findings can inform coherent and targeted responses to disasters. Early identification of medically vulnerable populations can help to map "hot spots" requiring additional medical and social attention and prioritize resources for areas most impacted by disasters. (Disaster Med Public Health Preparedness. 2016;10:351-361).

Supporting natural resource management—The role of economics at the Department of the Interior—A workshop report

USGS Publications Warehouse

Pindilli, Emily J.; Crowley, Christian S.L.; Cline, Sarah A.; Good, Anthony J.; Shapiro, Carl D.; Simon, Benjamin M.

2018-04-19

The first U.S. Department of the Interior Economics Workshop was held April 5–7, 2017 in Washington, D.C., to identify, highlight, and better understand needs and opportunities for economic analysis to support the Department of the Interior’s mission. The Economics Workshop, jointly convened by the Department of the Interior Office of Policy Analysis and the U.S. Geological Survey Science and Decisions Center, provided an opportunity for Department of the Interior’s economists to share expertise and experiences and to build collaboration and communication channels across the Department of the Interior.Natural and cultural resource managers face complex questions and often have to balance competing stakeholder interests. Per the mission statement, the Department of the Interior “protects and manages the Nation’s natural resources and cultural heritage; provides scientific and other information about those resources; and honors its trust responsibilities or special commitments to American Indians, Alaska Natives, and affiliated island communities.” Economic analysis is relevant to issues integral to nearly all the land and water management decisions made by the Department of the Interior. More than 80 Department of the Interior economists gathered at the Economics Workshop to share their work, discuss common challenges, and identify approaches to advance the use and contribution of economics at the Department of the Interior.

[Analysis of proposals received and funded in discipline of microbiology of the National Natural Science Foundation of China from 2011 to 2015].

PubMed

Zhang, Xin; Li, Weimin; He, Jianwei; Wen, Mingzhang; Du, Quansheng

2016-02-04

Based on a wrap-up of the research proposals received and awards made during 2011 through 2015 in the discipline of microbiology of the Department of Life Sciences, National Natural Science Foundation of China, this article presents a statistic analysis of award recipient institutions and main research trends, and attempts a prospective prioritization of the funding areas from the points of encouraging interdisciplinary research, optimizing funding instruments and strengthening talent training, with a view to providing reference for scientists and researchers in the field of microbiology.

[Hangings in the material of Department of Forensic Medicine, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, in the years 2000-2010].

PubMed

Sumińska-Ziemann, Barbara; Bloch-Bogusławska, Elzbieta

2013-01-01

This study presents an analysis of suicides based on autopsy protocols from the years 2000-2010. Out of all autopsies conducted at Department of Forensic Medicine, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, 477 cases resulted from hanging. During this period the majority of hangings were recorded in 2010 (61 cases). The parameters assessed in this study included age, sex, post-mortem blood ethanol concentration and place of death of the victims. The age range of the deceased was similar in the group of men and women. Males represented the majority of victims of hanging (89%); only 11% of all the victims were females. The authors observed differences in blood alcohol level of the victims in association with their sex. Not present ethanol was noted in approx. 42% of men and 71% of women. More than 65% cases of suicide hangings were encountered in urban areas, in living quarters and outbuildings.

[Oral rehydration therapy: an analysis of its results and impact on the hospitalization and mortality of children with diarrhea].

PubMed

Dohi-Fujii, B; Godoy-Olvera, L M; Durazo-Ortíz, J

1993-11-01

We present results of four years in oral rehydration therapy (ORT) in the Hospital Infantil del Estado de Sonora. There was 10.2 consults by diarrhoea for day. Children lower of one year old received oral rehydration therapy in 86.8%, were included 11% of prolonged diarrhoea and 32.3% of children with malnutrition. During the procedure diarrhoea there was complicated in 3% with paralytic ileus sepsis and pneumonia. Effectivity of ORT was in 90.9%; 92.8% in light dehydration and 78.7% moderate. Failure in 8.6% was due to vomitus, no acceptation of the oral solution, abundant evacuations and other complication presented. Were observed reduction in hospitalization, rate of 19.2% in 1986 to 38.4% in 1989. The diarrheal mortality decreased in the Urgence Department in 42% and in the Infectology Department in 54%. We considered these results as satisfactory, but are susceptible to better when we diffuse more the oral rehydration therapy in own region.

Nontraumatic head and neck emergencies: a clinical approach. Part 1: cervicofacial swelling, dysphagia, and dyspnea.

PubMed

Brea Álvarez, B; Tuñón Gómez, M; Esteban García, L; García Hidalgo, C Y; Ruiz Peralbo, R M

2016-01-01

Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons: first, they affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Various publications focus on nontraumatic emergencies of the head and neck from the viewpoints of anatomic location or of particular diseases. However, these are not the most helpful viewpoints for dealing with patients in the emergency department, who present with particular signs and symptoms. We propose an analysis starting from the four most common clinical presentations of patients who come to the emergency department for nontraumatic head and neck emergencies: cervical swelling, dysphagia, dyspnea, and loss of vision. Starting from these entities, we develop an approach to the radiologic management and diagnosis of these patients. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Science fiction and the history of the astro-department of Carl Zeiss Jena (German Title: Science Fiction und die Geschichte der Astroabteilung von Carl Zeiss Jena)

NASA Astrophysics Data System (ADS)

Beck, Hans G.

This contribution uses the literary form of science fiction in retrospect, in order to display the initial conditions given in the run-up of the founding of the astro-department of the Zeiss factory. Written minutes (supposedly found during restoration works in the people's house in Jena) introduce the participants of a sort of founding party of the main actors Ernst Abbe, Otto Schott, Siegfried Czapski, Hans Harting, Albert König, Franz Meyer and Walter Villiger. Their contributions to the discussion yield a market analysis, based on the past development of the technology of astronomical instruments, the international competitors' state of the art, and the assessment of the future development in astronomy and especially of astrophysics. The contribution presents a piece of modern history of the year 1987; it was presented as a talk on May 13 of the same year, when Rolf Riekher celebrated his 65th birthday.

Revisit, Subsequent Hospitalization, Recurrent Fall, and Death Within 6 Months After a Fall Among Elderly Emergency Department Patients.

PubMed

Sri-On, Jiraporn; Tirrell, Gregory P; Bean, Jonathan F; Lipsitz, Lewis A; Liu, Shan W

2017-10-01

We seek to describe the risk during 6 months and specific risk factors for recurrent falls, emergency department (ED) revisits, subsequent hospitalizations, and death within 6 months after a fall-related ED presentation. This was a secondary analysis of a retrospective cohort of elderly fall patients who presented to the ED from one urban teaching hospital. We included patients aged 65 years and older who had an ED fall visit in 2012. We examined the frequency and risk factors of adverse events (composite of recurrent falls, ED revisits, subsequent hospitalization, and death, selected a priori) at 6 months. Our study included 350 older adults. Adverse events steadily increased, from 7.7% at 7 days, 21.4% at 30 days, and 50.3% at 6 months. Within 6 months, 22.6% of patients had at least one recurrent fall, 42.6% revisited the ED, 31.1% had subsequent hospitalizations, and 2.6% died. In multivariable logistic regression analysis, psychological or sedative drug use predicted recurrent falls, ED revisits, subsequent hospitalizations, and adverse events. More than half of fall patients had an adverse event within 6 months of presenting to the ED after a fall. The risk during 6 months of these adverse events increased with psychological or sedative drug use. Larger future studies should confirm this association and investigate methods to minimize recurrent falls through management of such medications. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Red flag findings in children with headaches: Prevalence and association with emergency department neuroimaging.

PubMed

Tsze, Daniel S; Ochs, Julie B; Gonzalez, Ariana E; Dayan, Peter S

2018-01-01

Background Clinicians appear to obtain emergent neuroimaging for children with headaches based on the presence of red flag findings. However, little data exists regarding the prevalence of these findings in emergency department populations, and whether the identification of red flag findings is associated with potentially unnecessary emergency department neuroimaging. Objectives We aimed to determine the prevalence of red flag findings and their association with neuroimaging in otherwise healthy children presenting with headaches to the emergency department. Our secondary aim was to determine the prevalence of emergent intracranial abnormalities in this population. Methods A prospective cohort study of otherwise healthy children 2-17 years of age presenting to an urban pediatric emergency department with non-traumatic headaches was undertaken. Emergency department physicians completed a standardized form to document headache descriptors and characteristics, associated symptoms, and physical and neurological exam findings. Children who did not receive emergency department neuroimaging received 4-month telephone follow-up. Outcomes included emergency department neuroimaging and the presence of emergent intracranial abnormalities. Results We enrolled 224 patients; 197 (87.9%) had at least one red flag finding on history. Several red flag findings were reported by more than a third of children, including: Headache waking from sleep (34.8%); headache present with or soon after waking (39.7%); or headaches increasing in frequency, duration and severity (40%, 33.1%, and 46.3%). Thirty-three percent of children received emergency department neuroimaging. The prevalence of emergent intracranial abnormalities was 1% (95% CI 0.1, 3.6). Abnormal neurological exam, extreme pain intensity of presenting headache, vomiting, and positional symptoms were independently associated with emergency department neuroimaging. Conclusions Red flag findings are common in children presenting with headaches to the emergency department. The presence of red flag findings is associated with emergency department neuroimaging, although the risk of emergent intracranial abnormalities is low. Many children with headaches may be receiving unnecessary neuroimaging due to the high prevalence of non-specific red flag findings.

32 CFR 249.5 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... papers and (1) Inform the author that the Department of Defense has no objection to public presentation... proceedings and/or reprints of papers sponsored by the Department of Defense for all scientific and technical... Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS PRESENTATION...

32 CFR 249.5 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... papers and (1) Inform the author that the Department of Defense has no objection to public presentation... proceedings and/or reprints of papers sponsored by the Department of Defense for all scientific and technical... Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS PRESENTATION...

32 CFR 249.5 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... papers and (1) Inform the author that the Department of Defense has no objection to public presentation... proceedings and/or reprints of papers sponsored by the Department of Defense for all scientific and technical... Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS PRESENTATION...

32 CFR 651.12 - Determining appropriate level of NEPA analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Determining appropriate level of NEPA analysis. 651.12 Section 651.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental...

32 CFR 651.6 - NEPA analysis staffing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false NEPA analysis staffing. 651.6 Section 651.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY... depth of analysis required. In cases where the document addresses impacts to an environment whose...

Increasing Information Sharing Among Independent Police Departments

DTIC Science & Technology

2009-03-01

the operational level . 50 Robert Fox (Lieutenant, Los Angeles Police Department – Assigned to the Joint Regional... Angeles Police Department ( LAPD ) is the largest independent police department in Los Angeles County. The department is responsible for patrolling...agencies operating in metropolitan areas based on a quantitative analysis of the 46 independent police

The cost of fall related presentations to the ED: a prospective, in-person, patient-tracking analysis of health resource utilization.

PubMed

Woolcott, J C; Khan, K M; Mitrovic, S; Anis, A H; Marra, C A

2012-05-01

We prospectively collected data on elderly fallers to estimate the total cost of a fall requiring an Emergency Department presentation. Using data collected on 102 falls, we found the average cost per fall causing an Emergency Department presentation of $11,408. When hospitalization was required, the average cost per fall was $29,363. For elderly persons, falls are a major source of mortality, morbidity, and disability. Previous Canadian cost estimates of seniors' falls were based upon administrative data that has been shown to underestimate the incidence of falls. Our objective was to use a labor-intensive, direct observation patient-tracking method to accurately estimate the total cost of falls among seniors who presented to a major urban Emergency Department (ED) in Canada. We prospectively collected data from seniors (>70 years) presenting to the Vancouver General Hospital ED after a fall. We excluded individuals who where cognitively impaired or unable to read/write English. Data were collected on the care provided including physician assessments/consultations, radiology and laboratory tests, ED/hospital time, rehabilitation facility time, and in-hospital procedures. Unit costs of health resources were taken from a fully allocated hospital cost model. Data were collected on 101 fall-related ED presentations. The most common diagnoses were fractures (n = 33) and lacerations (n = 11). The mean cost of a fall causing ED presentation was $11,408 (SD: $19,655). Thirty-eight fallers had injuries requiring hospital admission with an average total cost of $29,363 (SD: $22,661). Hip fractures cost $39,507 (SD: $17,932). Among the 62 individuals not admitted to the hospital, the average cost of their ED visit was $674 (SD: $429). Among the growing population of Canadian seniors, falls have substantial costs. With the cost of a fall-related hospitalization approaching $30,000, there is an increased need for fall prevention programs.

Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study.

PubMed

Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

2016-01-01

Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. "Management and empowerment of human resources'' (weight = 0.465) and "requirements and facilities" (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country's hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems.

Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study

PubMed Central

Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

2016-01-01

Background: Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. Objectives: The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. Materials and Methods: This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. Results: “Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. Conclusion: The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems. PMID:27127577

Building Undergraduate Physics Programs for the 21st Century

NASA Astrophysics Data System (ADS)

Hilborn, Robert

2001-04-01

Undergraduate physics programs in the United States are under stress because of changes in the scientific and educational environment in which they operate. The number of undergraduate physics majors is declining nationwide; there is some evidence that the "best" undergraduate students are choosing majors other than physics, and funding agencies seem to be emphasizing K-12 education. How can physics departments respond creatively and constructively to these changes? After describing some of the details of the current environment, I will discuss the activities of the National Task Force on Undergraduate Physics, supported by the American Institute of Physics, the America Physical Society, the American Association of Physics Teachers and the ExxonMobil Foundation. I will also present some analysis of Task Force site visits to departments that have thriving undergraduate physics programs, pointing out the key features that seem to be necessary for success. Among these features are department-wide recruitment and retention efforts that are the theme of this session.

Stanislaw Smreczynskis legacy and the Department of Zoology of the Jagiellonian University of Krakow (Poland).

PubMed

Jaglarz, Mariusz K

2008-01-01

This article covers the origin and development of scientific interest in insect and amphibian developmental biology at the Department of Systematic Zoology and Zoogeography of the Jagiellonian University. The greater part of this historical account is devoted to Professor Stanislaw Smreczynski (1899-1975), the founding father of the Department, and comments on his biography and research achievements in the field of animal experimental embryology. A particular emphasis is on Smreczynski's contributions to contemporary understanding of early embryonic development of amphibians and insects as well as his expertise in Pleistocene and extant weevils (Curculionidae). A concise survey of developmental phenomena studied by some of Smreczynski's co-workers and followers is also presented, including the early embryogenesis of entognathans as well as germ cell determination and gonad formation in Drosophila virilis conducted by Jura; analysis of oogenesis in Collembola carried out by Krzysztofowicz; investigations of insects and tradigrades by Weglarska, and finally research into various aspects of ovary structure in diverse insect taxa by the Bilinski group.

Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15.

PubMed

Hiscock, Harriet; Neely, Rachel J; Lei, Shaoke; Freed, Gary

2018-05-07

To identify trends in presentations to Victorian emergency departments (EDs) by children and adolescents for mental and physical health problems; to determine patient characteristics associated with these presentations; to assess the relative clinical burdens of mental and physical health presentations. Secondary analysis of Victorian Emergency Minimum Dataset (VEMD) data. Participants, setting: Children and young people, 0-19 years, who presented to public EDs in Victoria, 2008-09 to 2014-15. Absolute numbers and proportions of mental and physical health presentations; types of mental health diagnoses; patient and clinical characteristics associated with mental and physical health presentations. Between 2008-09 and 2014-15, the number of mental health presentations increased by 6.5% per year, that of physical health presentations by 2.1% per year; the proportion of mental health presentations rose from 1.7% to 2.2%. Self-harm accounted for 22.5% of mental health presentations (11 770 presentations) and psychoactive substance use for 22.3% (11 694 presentations); stress-related, mood, and behavioural and emotional disorders together accounted for 40.3% (21 127 presentations). The rates of presentations for self-harm, stress-related, mood, and behavioural and emotional disorders each increased markedly over the study period. Patients presenting with mental health problems were more likely than those with physical health problems to be triaged as urgent (2014-15: 66% v 40%), present outside business hours (36% v 20%), stay longer in the ED (65% v 82% met the National Emergency Access Target), and be admitted to hospital (24% v 18%). The number of children who presented to Victorian public hospital EDs for mental health problems increased during 2008-2015, particularly for self-harm, depression, and behavioural disorders.

Impact of clinical leadership in teams’ course on quality, efficiency, responsiveness and trust in the emergency department: study protocol of a trailing research study

PubMed Central

Husebø, Sissel Eikeland; Olsen, Øystein Evjen

2016-01-01

Introduction Clinical leadership has long been recognised as critical for optimising patient safety, quality of care and interprofessional teamwork in busy and stressful healthcare settings. There is a need to compensate for the absence of the conventional mentor-to-apprentice transfer of clinical leadership knowledge and skills. While young doctors and nurses are increasingly proficient in medical, surgical and technical skills, their training in, and knowledge of clinical leadership skills, is not adequate to meet the demands for these non-technical skills in the emergency department. Thus, the purpose of the paper is to present and discuss the study protocol of clinical leadership in a course for teams that aims to improve quality, efficiency, responsiveness of healthcare services and collegial trust in the emergency department. Methods and analysis The study employs a trailing research design using multiple quantitative and qualitative methods in the summative (pretest and post-test) and formative evaluation. Quantitative data have been collected from a patient questionnaire, the emergency departments’ database and by the observation of team performance. Qualitative data have been collected by shadowing healthcare professionals and through focus group interviews. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation, in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. Ethics and dissemination The study is approved by the ethics committee of the western part of Norway and the hospital. The study is based on voluntary participation and informed written consent. Informants can withdraw at any point in time. The results will be disseminated at research conferences, peer review journals and through public presentations to people outside the scientific community. PMID:27515758

Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department.

PubMed

Testa, Americo; Francesconi, Andrea; Giannuzzi, Rosangela; Berardi, Silvia; Sbraccia, Paolo

2015-12-01

The economic crisis, the growing healthcare demand, and Defensive Medicine wastefulness, strongly recommend the restructuring of the entire medical network. New health technology, such as bedside ultrasonography, might successfully integrate the clinical approach optimizing the use of limited resources, especially in a person-oriented vision of medicine. Bedside ultrasonography is a safe and reliable technique, with worldwide expanding employment in various clinical settings, being considered as "the stethoscope of the 21st century". However, at present, bedside ultrasonography lacks economic analysis. We performed a Cost-Benefit Analysis "ex ante", with a break-even point computing, of bedside ultrasonography implementation in an Internal Medicine department in the mid-term. Number and kind estimation of bedside ultrasonographic studies were obtained by a retrospective study, whose data results were applied to the next 3-year period (foresight study). All 1980 foreseen bedside examinations, with prevailing multiorgan ultrasonographic studies, were considered to calculate direct and indirect costs, while specific and generic revenues were considered only after the first semester. Physician professional training, equipment purchase and working time represented the main fixed and variable cost items. DRG increase/appropriateness, hospitalization stay shortening and reduction of traditional ultrasonography examination requests mainly impacted on calculated revenues. The break-even point, i.e. the volume of activity at which revenues exactly equal total incurred costs, was calculated to be 734 US examinations, corresponding to € 81,998 and the time considered necessary to reach it resulting 406 days. Our economic analysis clearly shows that bedside ultrasonography implementation in clinical daily management of an Internal Medicine department can produce consistent savings, or economic profit according to managerial choices (i.e., considering public or private targets), other than evident medical benefits.

Clinical presentation and blood gas analysis of multiple trauma patients for prediction of standard coagulation parameters at emergency department arrival.

PubMed

Hilbert-Carius, P; Hofmann, G O; Lefering, R; Stuttmann, R; Struck, M F

2016-04-01

Trauma-induced coagulopathy (TIC) in multiple trauma patients is a potentially lethal complication. Whether quickly available laboratory parameters using point-of-care (POC) blood gas analysis (BGA) may serve as surrogate parameters for standard coagulation parameters is unknown. The present study evaluated TraumaRegister DGU® of the German Trauma Society for correlations between POC BGA parameters and standard coagulation parameters. In the setting of 197 trauma centres (172 in Germany), 86,442 patients were analysed between 2005 and 2012. Of these, 40,129 (72% men) with a mean age 46 ± 21 years underwent further analysis presenting with direct admission from the scene of the accident to a trauma centre, injury severity score (ISS) ≥ 9, complete data available for the calculation of revised injury severity classification prognosis, and blood samples with valid haemoglobin (Hb) measurements taken immediately after emergency department (ED) admission. Correlations between standard coagulation parameters and POC BGA parameters (Hb, base excess [BE], lactate) were tested using Pearson's test with a two-tailed significance level of p < 0.05. A subgroup analysis including patients with ISS > 16, ISS > 25, ISS > 16 and shock at ED admission, and patients with massive transfusion was likewise carried out. Correlations were found between Hb and prothrombin time (r = 0.497; p < 0.01), Hb and activated partial thromboplastin time (aPTT; r = -0.414; p < 0.01), and Hb and platelet count (PLT; r = 0.301; p < 0.01). Patients presenting with ISS ≥ 16 and shock (systolic blood pressure < 90 mmHg) at ED admission (n = 4,329) revealed the strongest correlations between Hb and prothrombin time (r = 0.570; p < 0.01), Hb and aPTT (r = -0.457; p < 0.01), and Hb and PLT (r = 0.412; p < 0.01). Significant correlations were also found between BE and prothrombin time (r = -0.365; p < 0.01), and BE and aPTT (r = 0.327, p < 0.01). No correlations were found between Hb, BE and lactate lactate. POC BGA parameters Hb and BE of multiple trauma patients correlated with standard coagulation parameters in a large database analysis. These correlations were particularly strong in multiple trauma patients presenting with ISS > 16 and shock at ED admission. This may be relevant for hospitals with delayed availability of coagulation studies and those without viscoelastic POC devices. Future studies may determine whether clinical presentation/BGA-oriented coagulation therapy is an appropriate tool for improving outcomes after major trauma.

Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.

PubMed

Carroll, Robert; Knipe, Duleeka; Moran, Paul; Gunnell, David

2017-12-01

Socioeconomic deprivation is associated with increased rates of self-harm but its association with levels of clinical care has not previously been explored. The aim of the current study was to investigate socioeconomic differences in the clinical management of people who self-harm. Cross-sectional analysis of 3607 people presenting to a large inner-city hospital following self-harm. People living in the least deprived quintile were more likely to receive a psychosocial assessment (most vs. least deprived: 63.51 vs. 70.14%). This effect persisted in our fully adjusted model (OR 1.45, CI 1.15-1.82, p = 0.002). Mediation analysis suggested this association was in large part explained by higher rates of self-discharge in people presenting from areas of higher deprivation. Compared to those from more deprived areas, people from less deprived areas are more likely to receive a psychosocial assessment when presenting to hospital following self-harm. The occurrence of higher rates of self-discharge from emergency departments among those from more deprived areas may explain the association.

Analysis of 22,655 presentations with back pain to Perth emergency departments over five years.

PubMed

Lovegrove, Michael T; Jelinek, George A; Gibson, Nicholas P; Jacobs, Ian G

2011-09-17

Back pain is a significant cause of disability in the community, but the impact on Emergency Departments (EDs) has not been formally studied. Patients with back pain often require significant time and resources in the ED. To examine the characteristics of patients presenting with back pain to the ED, including final diagnosis, demographics of those attending and temporal distribution of presentations. Emergency presentations in the metropolitan area of Perth, Western Australia, for 2000-2004 were searched using a linked database covering all the major hospitals (Emergency Care Hospitalisation and Outcome Study database). All presentations with the triage code for back pain were extracted and analysed. A total of 22,655 presentations with back pain were identified, representing 1.9% of total presentations. Simple muscular or non-specific back pain accounted for only 43.8% of presentations, with other causes such as renal colic and pyelonephritis accounting for the majority. The young (<15 years old) and elderly (>75 years old) were more likely to have non-muscular causes for their back pain. Muscular back pain presentations occurred mostly between 0800 and 1600, with high proportions presenting on the weekends. Patients with simple muscular back pain spent a mean of 4.4 h in the ED, representing a significant outlay of resources. Back pain has a significant impact on EDs, and staff should be alert for another pathology presenting as back pain. There is a need for multidisciplinary back pain teams to be available 7 days a week, but only during the day.

Economic Analysis of Alternatives for PC Upgrade of OR Department Laboratory

DTIC Science & Technology

1990-09-01

DEPARTMENT LABORATORY by Chen Lung-Shan September, 1990 Thesis Advisor: Thomas E. Halwachs Approved for public release; distribution is unlimited. 91...b. RESTRICTIVE MARKINGS UNCLASSIFIED 2a. SECURITY CLASSIFICATION AUTHORITY 3. DISTRIBUTION/AVAILABILITY OF REPORT Approved for public release...Approved for public release; distribution is unlimited. Economic Analysis Of Alternatives For PC Upgrade Of OR Department Laboratory by Lung-shan Chen

Case Studies of Predictive Analysis Applications in Law Enforcement

DTIC Science & Technology

2015-12-01

analysis to crime problems to be considered effective. To test this hypothesis, case studies were conducted on municipal police departments in the...Forecasting in Law Enforcement Operations. 6 Vlahos, “The Department of Pre -Crime.” 4 studies were conducted on municipal police departments in the... case studies are described and recommendations for future research , as well as recommendations for police executives considering an investment in

Blood pressure documentation in the emergency department

PubMed Central

Daniel, Ana Carolina Queiroz Godoy; Machado, Juliana Pereira; Veiga, Eugenia Velludo

2017-01-01

ABSTRACT Objective To analyze the frequency of blood pressure documentation performed by nursing professionals in an emergency department. Methods This is a cross-sectional, observational, descriptive, and analytical study, which included medical records of adult patients admitted to the observation ward of an emergency department, between March and May 2014. Data were obtained through a collection instrument divided into three parts: patient identification, triage data, and blood pressure documentation. For statistical analysis, Pearson’s correlation coefficient was used, with a significance level of α<0.05. Results One hundred fifty-seven records and 430 blood pressure measurements were analyzed with an average of three measurements per patient. Of these measures, 46.5% were abnormal. The mean time from admission to documentation of the first blood pressure measurement was 2.5 minutes, with 42 minutes between subsequent measures. There is no correlation between the systolic blood pressure values and the mean time interval between blood pressure documentations: 0.173 (p=0.031). Conclusion The present study found no correlation between frequency of blood pressure documentation and blood pressure values. The frequency of blood pressure documentation increased according to the severity of the patient and decreased during the length of stay in the emergency department. PMID:28444085

Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample.

PubMed

Rivera, Donna R; Gallicchio, Lisa; Brown, Jeremy; Liu, Benmei; Kyriacou, Demetrios N; Shelburne, Nonniekaye

2017-10-12

The emergency department (ED) is used to manage cancer-related complications among the 15.5 million people living with cancer in the United States. However, ED utilization patterns by the population of US adults with cancer have not been previously evaluated or described in published literature. To estimate the proportion of US ED visits made by adults with a cancer diagnosis, understand the clinical presentation of adult patients with cancer in the ED, and examine factors related to inpatient admission within this population. Nationally representative data comprised of 7 survey cycles (January 2006-December 2012) from the Nationwide Emergency Department Sample were analyzed. Identification of adult (age ≥18 years) cancer-related visits was based on Clinical Classifications Software diagnoses documented during the ED visit. Weighted frequencies and proportions of ED visits among adult patients with cancer by demographic, geographic, and clinical characteristics were calculated. Weighted multivariable logistic regression was used to examine the associations between inpatient admission and key demographic and clinical variables for adult cancer-related ED visits. Adult cancer-related ED utilization patterns; identification of primary reason for ED visit; patient-related factors associated with inpatient admission from the ED. Among an estimated 696 million weighted adult ED visits from January 2006 to December 2012, 29.5 million (4.2%) were made by a patient with a cancer diagnosis. The most common cancers associated with an ED visit were breast, prostate, and lung cancer, and most common primary reasons for visit were pneumonia (4.5%), nonspecific chest pain (3.7%), and urinary tract infection (3.2%). Adult cancer-related ED visits resulted in inpatient admissions more frequently (59.7%) than non-cancer-related visits (16.3%) (P < .001). Septicemia (odds ratio [OR], 91.2; 95% CI, 81.2-102.3) and intestinal obstruction (OR, 10.94; 95% CI, 10.6-11.4) were associated with the highest odds of inpatient admission. Consistent with national prevalence statistics among adults, breast, prostate, and lung cancer were the most common cancer diagnoses presenting to the ED. Pneumonia was the most common reason for adult cancer-related ED visits with an associated high inpatient admission rate. This analysis highlights cancer-specific ED clinical presentations and the opportunity to inform patient and system-directed prevention and management strategies.

Chicago-St. Louis high speed rail plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stead, M.E.

1994-12-31

The Illinois Department of Transportation (IDOT), in cooperation with Amtrak, undertook the Chicago-St. Louis High Speed Rail Financial and Implementation Plan study in order to develop a realistic and achievable blueprint for implementation of high speed rail in the Chicago-St. Louis corridor. This report presents a summary of the Price Waterhouse Project Team`s analysis and the Financial and Implementation Plan for implementing high speed rail service in the Chicago-St. Louis corridor.

Department of Defense In-House RDT&E Activities. FY2000 Management Analysis Report

DTIC Science & Technology

2000-01-01

Blossom Point, Maryland * White Sands Missile Range (WSMR), WSMR, New Mexico . They are presented in this publication in that location breakout. ADELPHI... MEXICO ULTRA WIDEBAND (UWB) SYNTHETIC-APERTURE RADAR (SAR) TESTBED A mobile UWB SAR testbed, featuring a 150-ft measurement system, is used to...Missile Range (WSMR) in New Mexico , this range performs assembly and live-fire testing of surface-to-air, surface-to-surface weapons, and research rockets

Manpower Staffing, Emergency Department Access and Consequences on Patient Outcomes

DTIC Science & Technology

2007-06-01

distance to the nearest hospital have higher death rates than those zip codes which experience a change. However, we hesitate to conclude that this may...1. Trend Analysis of Mortality Rates by Distance Categories: 1990-2004 Figure 6 presents heart-related death rates for the State of California from...1990- 2004. The graph shows a distinct layering of heart-related death rates across the three distance categories. The population which experiences

Spectrum Management and Electromagnetic Compatibility Issues in the Department of Defense

DTIC Science & Technology

1991-01-01

Interference JEWC Joint Electronic Warfare Center JRFL Joint Restricted Frequency List JSMS Joint Spectrum Management System JT&E Joint Test and Evaluation JTAC...Joint Restricted Frequency List (JRFL) is essentially a list of frequencies prohibited from use by ECM units. Creation and maintenance of the JRFL to...sponsored by CECOM, developed a prototype that primarily acted as an analysis of the restricted frequency list as a predecessor to DECON. Presently the Army

Emergency department crowding in Singapore: Insights from a systems thinking approach.

PubMed

Schoenenberger, Lukas K; Bayer, Steffen; Ansah, John P; Matchar, David B; Mohanavalli, Rajagopal L; Lam, Sean Sw; Ong, Marcus Eh

2016-01-01

Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care. The construction of the qualitative causal loop diagram is based on consultations with Emergency Department experts, direct observation, and a thorough literature review. For the purpose of policy analysis, a novel approach, the path analysis, is applied. The path analysis revealed that both the introduction of geriatric emergency medicine and the expansion of emergency medicine training may be associated with undesirable consequences contributing to Emergency Department crowding. In contrast, enhancing primary care was found to be germane in reducing Emergency Department crowding; in addition, it has apparently no negative side effects, considering the boundary of the model created. Causal loop diagramming was a powerful tool for eliciting the systemic structure of Emergency Department crowding in Singapore. Additionally, the developed model was valuable in testing different policy options.

Proceedings of the 1987 socioeconomic energy research and analysis conference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1990-08-01

The Department of Energy (the Department) convened the first Socioeconomic Energy Research and Analysis Conference in May 1987, in the spirit of constructive dialogue and mutual concern about numerous energy issues and problems. The objective was to provide a national forum for illuminating specific energy and related socioeconomic issues of our nation and discussing realistic approaches to energy policy assessments. This action was based on the Department's commitment to lead the way in developing a pragmatic framework or energy policy determinations, by incorporating constructive policy impact assessment methods into the decisionmaking process. In this rapidly developing industry with high energymore » technologies, a strong federal role and targeted government programs are essential for the development and integration of minorities into various industry segments. Furthermore, a responsive energy program for all segments of the population must be sensitive to (a) the impact of energy policies on the overall growth of the economy; (b) the differential impact of energy policies on various industries; and (c) the pattern of change in the structure of the social environment. The socioeconomic researchers and energy policy analysts who presented papers or participated in this national forum assisted the Department's efforts to build an energy structure which is truly responsive to the needs of the various population segmets of our nation. The conference participants were also given the opportunity to critique some unique energy policy assessment methodologies which have been conducted mainly at Argonne National Laboratory, under the sponsorship and guidance of the Research and Education Divisions of my Office. Individual papers, in this proceedings have been cataloged separately.« less

Biofuel transportation analysis tool : description, methodology, and demonstration scenarios

DOT National Transportation Integrated Search

2014-01-01

This report describes a Biofuel Transportation Analysis Tool (BTAT), developed by the U.S. Department of Transportation (DOT) Volpe National Transportation Systems Center (Volpe) in support of the Department of Defense (DOD) Office of Naval Research ...

Presentations to Alberta emergency departments for asthma: a time series analysis.

PubMed

Rosychuk, Rhonda J; Youngson, Erik; Rowe, Brian H

2015-08-01

Asthma is a common chronic respiratory condition, and exacerbations may cause individuals to seek care in emergency departments (EDs). This study examines the monthly patterns of asthma presentations to EDs in Alberta, Canada. All presentations to the ED for asthma from April 1999 to March 2011 were extracted from provincial administrative health databases. Data included age, sex, and health zone of residence. Crude rates per 100,000 population were calculated. Seasonal autoregressive integrated moving average (SARIMA) time-series models were developed. There were a total of 362,430 ED presentations for asthma, and the monthly rate of presentation declined from 115.5 to 41.6 per 100,000 during the study period. Males made 50.1% of ED presentations, and adults made 52.8%. The absolute number of ED presentations for asthma declined in each of the five administrative health zones in the province, with smaller percentage decreases seen in the most urbanized zones (32.1%) than the other zones (46.9%). One SARIMA model closely predicted overall presentation rates as well as the rates of ED presentations for age and zone subgroups. These models showed strong seasonal components, with the strongest estimates occurring for the pediatric subgroup and the southernmost provincial zone. Rates of ED presentations for asthma have been declining in this province during the past decade. The reasons for this decline warrant further exploration. The SARIMA models quantified the temporal patterns and may be helpful for planning research and health care service needs. © 2015 by the Society for Academic Emergency Medicine.

78 FR 5168 - BE-29: Survey of Foreign Ocean Carriers' Expenses in the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF COMMERCE Bureau of Economic Analysis [Docket No. 130111033-3033-01] XRIN 0691-XC004... Analysis, Commerce. ACTION: Notice of reporting requirements. SUMMARY: By this Notice, the Bureau of Economic Analysis (BEA), Department of Commerce is informing the public that it is conducting the mandatory...

78 FR 5168 - BE-30: Survey of Ocean Freight Revenues and Foreign Expenses of United States Carriers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF COMMERCE Bureau of Economic Analysis [Docket No. 130114035-3035-01] XRIN 0691-XC005... of Economic Analysis, Commerce. ACTION: Notice of reporting requirements. SUMMARY: By this Notice, the Bureau of Economic Analysis (BEA), Department of Commerce, is informing the public that it is...

28 CFR 16.24 - Procedure in the event of a demand where disclosure is not otherwise authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the appearance and testimony of a present or former Department employee, or the production of material... present or former employee of the Department or the production of material from Department files without... resolve a disagreement concerning disclosure, the Assistant Attorneys General in charge of the two...

The Geriatric Emergency Department.

PubMed

Rosenberg, Mark; Rosenberg, Lynne

2016-08-01

This article presents an overview of the complex needs of older patients presenting to the emergency department for care. Discussion points for hospital communities considering emergency services to accommodate the aging population are highlighted. The essential components of a geriatric emergency department, including transition of care strategies, are reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

The US commercial space launch program and the Department of Defense dilemma

NASA Astrophysics Data System (ADS)

Clapp, William G.

1994-08-01

A scenario by which the United States might regain its lost advantage in launching commercial satellites is developed using the Ariane space commercial launch company as a benchmark. Ariane's advantages are identified and low-cost recommendations for countering them are presented The four areas selected for analysis inidentifying an American strategy are launch vehicle: (1) payload characteristics; (2) delivery costs; (3) selection process; and (4) technology. Several of the recommendations require Department of Defense funding even though the primary beneficiary appears to be the commercial space sector. But this will ensure that the military has affordable access to space and it is part of a dual purpose strategy whereby government spending benefits both the public and private sector. There is also a brief discussion of other foreign launch vehicle competition.

New ergonomic and functional design of digital conferencing rooms in a clinical environment

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Amato, Carlos L.; McGill, D. Ric; Liu, Brent J.; Balbona, Joseph A.; McCoy, J. Michael

2003-05-01

Clinical conferences and multidisciplinary medical rounds play a major role in patient management and decision-making relying on presentation of variety of documents: films, charts, videotapes, graphs etc. These conferences and clinical rounds are often carried out in conferencing rooms or department libraries that are usually not suitable for presentation of the data in electronic format. In most instances digital projection equipment is added to existing rooms without proper consideration to functional, ergonomic, acoustical, spatial and environmental requirements. Also, in large academic institutions, the conference rooms serve multiple purposes including as classrooms for teaching and education of students and for administrative meetings among managers and staff. In the migration toward a fully digital hospital we elected to analyze the functional requirements and optimize the ergonomic design of conferencing rooms that can accommodate clinical rounds, multidisciplinary reviews, seminars, formal lectures and department meetings. 3D computer simulation was used for better evaluation and analysis of spatial and ergonomic parameters and for gathering opinions and input from users on different design options. A critical component of the design is the understanding of the different workflow and requirements of different types of conferences and presentations that can be carried out in these conference rooms.

Price Analysis on Commercial Item Purchases Within the Department of Defense

DTIC Science & Technology

2013-10-02

Department of Defense Introduction Background This research builds upon the work conducted in collaboration with the authors’ thesis students ...market research and price analysis methods . Most contract pricing of acquisitions was conducted using cost analysis before these reforms were added to...analysis methods are being used? b) Do market research reports refer to market information that improves the buyers’ understanding of pricing in the

75 FR 5105 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... University, Anthropology Department, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice... objects in the possession of Western Michigan University, Anthropology Department, Kalamazoo, MI. The... analysis. Dr. Robert Sundick, a physical anthropologist in the Anthropology Department at Western Michigan...

Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

PubMed Central

Yamauchi, Sunao; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Funakoshi, Hiraku; Urayama, Kevin Y.; Ohde, Sachiko; Takahashi, Osamu; Shiga, Takashi

2017-01-01

Riding a bicycle under the influence of alcohol is illegal in Japan. Nevertheless, intoxicated bicyclists are frequently treated at hospital emergency departments for bicycle-related injuries. This patient population usually requires more hospital resources, even for relatively minor injuries. Therefore, we hypothesized that bicycle-related crashes involving bicyclists under the influence of alcohol cost more to treat than those that do not involve alcohol intoxication. The aim of the present study was to examine the costs associated with bicycle-related minor injuries and alcohol intoxication of the bicyclist. The study was conducted at the Tokyo Bay Urayasu Ichikawa Medical Center Emergency Department, Japan. All minor bicycle crashes involving 217 individuals aged ≥20 years treated from September 1, 2012 to August 31, 2013 were included in the analysis of data obtained from medical records. Variables included alcohol intoxication, sex, age, collision with a motor vehicle, Glasgow Coma Scale, injury severity score (ISS), laboratory tests, treatment of wounds, number of X-ray images, number of computed tomography scans, and medical costs. Multiple linear regression analysis was performed to evaluate the association between alcohol intoxication and medical costs. Seventy (32%) patients consumed alcohol, and the median medical cost was 253 USD (interquartile range [IQR], 164–330). Multivariable analysis showed that alcohol intoxication was independently associated with higher medical costs (p = 0.030, adjusted R-square value = 0.55). These findings support our hypothesis and should encourage authorities to implement comprehensive measures to prohibit bicycling under the influence of alcohol to prevent injuries and to reduce medical costs. PMID:28329002

The use of emergency contraception in Australasian emergency departments.

PubMed

Millar, J R; Leach, D S; Maclean, A V; Kovacs, G T

2001-09-01

To review the prescribing of emergency contraception by emergency departments in Australasia and compare it with other providers. A postal questionnaire was sent to the director of each of the 79 Australasian College for Emergency Medicine accredited emergency departments in Australasia inquiring about the availability and prescribing habits for emergency contraception within each department. Of the 79 emergency departments, 69 (87.3%) responded to the questionnaire and were aware of the 'emergency contraception regimen'. The majority of departments prescribed appropriately (56%) and only one department did not arrange adequate follow up. Anti-emetics are always used by 45 departments (78.9%). Discussion of future contraceptive needs at the time of presentation was only undertaken by 25 departments (43.9%). Written clinical guidelines for emergency contraception were present in 28 departments (40.6%). Emergency departments are accessed by patients requesting contraception following unprotected intercourse or contraceptive failure. The prescribing of emergency contraception in Australasian emergency departments is comparable with other providers but substantial improvements could be made. Suggestions to assist this improvement include written clinical guidelines and patient information and purpose-made medication packs.

A time series analysis of alcohol-related presentations to emergency departments in Queensland following the increase in alcopops tax.

PubMed

Kisely, Steve; Lawrence, David

2016-02-01

Raising duty on alcohol across the board can reduce morbidity, mortality and other adverse consequences of alcohol use. However, effectiveness is less certain for measures that target specific types of alcohol beverage in isolation. One example from Australia was the increase in tax on alcopops favoured by young people to curb risky drinking in this demographic. We measured alcohol-related health harms in 15-29-year-olds presenting to emergency departments (EDs) in Queensland following the tax increase. These presentations were compared with following ED controls: (1) 15-29-year-olds with asthma or appendicitis; and (2) 30-49-year-olds presenting with alcohol-related harms. We analysed data over a 5-year period (April 2005-April 2010) using a time series analysis. This covered 3 years before, and 2 years after, the tax increase. We investigated both mental and behavioural consequences (F10 codes), and intentional/unintentional injuries (S and T codes). We fitted an ARIMA (autoregressive integrated moving average) model to test for a change following the increased 'alcopops' tax in April 2008. There was no significant decrease in alcohol-related ED presentations in 15-29-year-olds compared to any of the controls. We found similar results for males and females, narrow and broad definitions of alcohol-related harms, under-19s and ED presentations at night-time and weekends. The increase in tax on 'alcopops' did not result in any reduction in alcohol-related harms in this population. Targeting particular alcoholic drinks may therefore not be as effective as more comprehensive policies such as minimum unit pricing for alcohol. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

PubMed Central

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

2015-01-01

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

Effect of race on biochemical disease-free outcome in patients with prostate cancer treated with definitive radiation therapy in an equal-access health care system: radiation oncology report of the Department of Defense Center for Prostate Disease Research.

PubMed

Johnstone, Peter A S; Kane, Christopher J; Sun, Leon; Wu, Hongyu; Moul, Judd W; McLeod, David G; Martin, Douglas D; Kusuda, Leo; Lance, Raymond; Douglas, Robert; Donahue, Timothy; Beat, Michael G; Foley, John; Baldwin, Dalton; Soderdahl, Douglas; Do, Jason; Amling, Christopher L

2002-11-01

To report on the first collaboration of the Department of Defense Center for Prostate Disease Research concerned with the relationship between African American race and biochemical disease-free outcomes after definitive radiation therapy. Information from the medical records of 1,806 patients (1,349 white, 343 African American, 42 of "other" races, and 72 of "unknown" races) treated with definitive radiation therapy between 1973 and 2000 was reviewed. Patients receiving adjuvant hormonal therapy or postoperative adjuvant or salvage radiation therapy were excluded. Biochemical failure was calculated in over 96% of cases by using ASTRO criteria; patients with fewer than three follow-up visits were considered to have biochemical failure with a prostate-specific antigen (PSA) value more than 10-fold the previous value or with any value greater than 50.0 ng/mL. Median radiation therapy doses were similar. The median follow-up was 58.4 months. Kaplan-Meier tests, Cox proportional hazards regression analysis, and log-rank tests were used for data analysis. There was no statistically significant difference in biochemical disease-free survival according to race when patients were stratified according to T stage. African American race conferred a negative prognosis for patients with lesions of Gleason biopsy score 7 (P =.004) but not for patients with lesions of Gleason score 2-4 (P =.14), 5-6 (P =.79), or 8-10 (P =.86). Similarly, African American race conferred a negative prognosis in patients with PSA values of 20.1-50.0 ng/mL (P =.01) at presentation but not in patients with PSA values less than or equal to 4.0 ng/mL (P =.84), 4.1-10.0 ng/mL (P =.71), 10.1-20.0 ng/mL (P =.75), or above 50.0 ng/mL (P =.15) at presentation. At multivariate analysis, race was not a statistically significant predictor of outcome. In the equal-access health care system of the Department of Defense, African American race is not associated with a consistently negative prognosis in patients treated with definitive radiation therapy for prostate cancer. Race appears to confer a negative prognosis only in patients with advanced disease at presentation.

Sport and active recreation injuries in Australia: evidence from emergency department presentations.

PubMed

Finch, C; Valuri, G; Ozanne-Smith, J

1998-09-01

Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Data on 98,040 sports and active recreation emergency department presentations were analysed. Sports and active recreation activities were ranked according to frequency of presentation. Relative proportions of injury type and body region injured were determined. Data are presented separately for children (<15 years of age) and adults (>15 years of age). Among the 10 activities that most commonly led to a sports or active recreation injury presentation for all ages were cycling, Australian football, basketball, soccer, cricket, netball, and rugby. For children, injuries were also commonly associated with roller skating/blading, skateboarding, and trampolining. Hockey, martial arts, and dancing injuries were frequent in adults. Most sporting injuries occurred during organised competition or practice whereas the active recreation injuries occurred in a variety of settings. Fractures, strains, and sprains, particularly to the lower and upper extremities, were common types of injury. The rich, but nevertheless limited, information available about sports and active recreation injuries from data collected in emergency departments indicates that these activities are a common context for injury at the community level in Australia.

Sport and active recreation injuries in Australia: evidence from emergency department presentations

PubMed Central

Finch, C.; Valuri, G.; Ozanne-Smith, J.

1998-01-01

OBJECTIVE: Despite the rise in specialist clinical services for the management of sports and active recreation injury, many patients attend hospital emergency departments for treatment. The purpose of this study was to describe sports injury cases presented to selected hospital emergency departments around Australia for the period 1989-1993. METHODS: Routinely collected emergency department injury presentation data from the Australian National Injury Surveillance Unit were examined. Data on 98,040 sports and active recreation emergency department presentations were analysed. Sports and active recreation activities were ranked according to frequency of presentation. Relative proportions of injury type and body region injured were determined. Data are presented separately for children (<15 years of age) and adults (>15 years of age). RESULTS: Among the 10 activities that most commonly led to a sports or active recreation injury presentation for all ages were cycling, Australian football, basketball, soccer, cricket, netball, and rugby. For children, injuries were also commonly associated with roller skating/blading, skateboarding, and trampolining. Hockey, martial arts, and dancing injuries were frequent in adults. Most sporting injuries occurred during organised competition or practice whereas the active recreation injuries occurred in a variety of settings. Fractures, strains, and sprains, particularly to the lower and upper extremities, were common types of injury. CONCLUSION: The rich, but nevertheless limited, information available about sports and active recreation injuries from data collected in emergency departments indicates that these activities are a common context for injury at the community level in Australia. 


 PMID:9773170

Analysis of fusion neutron spectral widths in high-foot implosions at the National Ignition Facility

NASA Astrophysics Data System (ADS)

Grim, Gary; Caggiano, Joseph; Callahan, Debra; Casey, Daniel; Cerjan, Charles; Clark, Daniel; Tilo, Doeppner; Eckart, Mark; Field, John; Frenje, Lars; Gatu-Johnson, Maria; Hartouni, Edward; Hatarik, Robert; Hurricane, Omar; Kilkenny, Joseph; Knauer, James; Ma, Tammy; Mannion, Owen; Munro, David; Park, Hye-Sook; Sayre, Daniel; Spears, Brian; Yeamans, Charles

2015-11-01

We present the latest results of thermal temperature analyses of cryogenically layered deuterium-tritium implosions at the NIF using data from the ``High Foot'' campaign. Data from new analysis methods and interpreted in the context of new theoretical developments will be reported. These data will include DD and DT apparent ion temperatures, their uniformity with direction, inferred plasma thermal temperature, as well as the magnitude of non-thermal contributions to the spectral widths. Work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under contract DE-AC52-07NA27344.

78 FR 5167 - BE-9: Quarterly Survey of Foreign Airline Operators' Revenues and Expenses in the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF COMMERCE Bureau of Economic Analysis [Docket No. 130111032-3032-01] XRIN 0691-XC003... AGENCY: Bureau of Economic Analysis, Commerce. ACTION: Notice of reporting requirements. SUMMARY: By this Notice, the Bureau of Economic Analysis (BEA), Department of Commerce is informing the public that it is...

An Analysis of the Teaching of Critical Thinking Skills in History in Postsecondary Education

ERIC Educational Resources Information Center

Arrington, Walter T. Ted

2017-01-01

This study is an investigation and analysis of the teaching of critical thinking skills in eight public universities in Texas, in particular the History, Education, and Business departments. The study is, in part, a document analysis of the universities' mission statements, the departments' stated learning objectives, and two upper level…

Photon Throughput Calculations for a Spherical Crystal Spectrometer

NASA Astrophysics Data System (ADS)

Gilman, C. J.; Bitter, M.; Delgado-Aparicio, L.; Efthimion, P. C.; Hill, K.; Kraus, B.; Gao, L.; Pablant, N.

2017-10-01

X-ray imaging crystal spectrometers of the type described in Refs. have become a standard diagnostic for Doppler measurements of profiles of the ion temperature and the plasma flow velocities in magnetically confined, hot fusion plasmas. These instruments have by now been implemented on major tokamak and stellarator experiments in Korea, China, Japan, and Germany and are currently also being designed by PPPL for ITER. A still missing part in the present data analysis is an efficient code for photon throughput calculations to evaluate the chord-integrated spectral data. The existing ray tracing codes cannot be used for a data analysis between shots, since they require extensive and time consuming numerical calculations. Here, we present a detailed analysis of the geometrical properties of the ray pattern. This method allows us to minimize the extent of numerical calculations and to create a more efficient code. This work was performed under the auspices of the U.S. Department of Energy by Princeton Plasma Physics Laboratory under contract DE-AC02-09CH11466.

Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department.

PubMed

de Guadiana Romualdo, Luis García; Torrella, Patricia Esteban; Acebes, Sergio Rebollo; Otón, María Dolores Albaladejo; Sánchez, Roberto Jiménez; Holgado, Ana Hernando; Santos, Enrique Jiménez; Freire, Alejandro Ortín

2017-01-01

Presepsin is a promising biomarker for the diagnosis and prognosis of sepsis. However, results reported about its value to diagnose sepsis in an emergency department (ED) are controversial, probably due to differences in the design of the studies. We have evaluated the diagnostic accuracy of presepsin for infection and sepsis, compared with procalcitonin (PCT) and C-reactive protein (CRP), in patients presenting to the emergency department (ED) with suspected infection. 223 patients with suspected infection were enrolled for the study. Blood samples were collected on admission for measurement of biomarkers. Definitive diagnosis was obtained afterwards by analysis of digital medical records. Receiver operating characteristic (ROC) curve analysis was conducted to determine the diagnostic accuracy. Infection was confirmed in 200 patients, including 130 with non-complicated infection and 70 with sepsis. Median CRP, PCT and presepsin levels were significantly higher in patients with infection and sepsis. PCT was the biomarker with the highest performance for infection (ROC AUC: 0.910); for sepsis, PCT (ROC AUC: 0.815) and presepsin (ROC AUC: 0.775) shown a similar performance. Although presepsin is a valuable biomarker for diagnosis of infection and sepsis, its diagnostic accuracy in our study does not improve that of PCT. Its introduction in clinical practice is not justified. Copyright © 2016 Elsevier B.V. All rights reserved.

Task related doses in Spanish pressurized water reactors over the period 1988-1992

DOE Office of Scientific and Technical Information (OSTI.GOV)

O`Donnell, P.; Labarta, T.; Amor, I.

1995-03-01

In order to evaluate in depth the collective dose trend and its correlation with the effectiveness of the practical application of the ALARA principle in Spanish nuclear facilities, and base the different policy lines to promote this criteria, the CSN has fullfilled an analysis of the task related doses data over the period 1988-1992. Previously, the CSN had required to the utilities the compilation of their refuelling outage collective dose from 1988 according with a predeterminate number of tasks, in order to have available a representative and retrospective set of data in an homogeneous way and coherent with the internationalmore » data banks on occupational exposure in NPP, as the CEC and the NEA ones. The scope of this analysis was the following: first, the collective dose summaries for outage tasks and departments for PWR and for BWR, including the minimum, maximum and average dose (and statistics data) for 18 different refuelling outage tasks and 12 personal departments for each generation of each type of rector, the task and department related collective dose trends in each plant and in each generation, and second, the dose reduction techniques having been used during that period in each plant and the relative level of adoption. In this presentation the main results and conclusions of the first part of the study are reviewed for PWR.« less

A Computerized Information System Model for Decision Making for the Oklahoma State Department of Vocational and Technical Education.

ERIC Educational Resources Information Center

Smith, Hubert Gene

The objectives of the study presented in the dissertation were to identify present and anticipated information requirements of the various departments within the Oklahoma State Department of Vocational and Technical Education, to design a computerized information system model utilizing an integrated systems concept to meet information…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This report contains presentations presented at a technical symposium on oil production. Chapter 1 contains summaries of the presentations given at the Department of Energy (DOE)-sponsored symposium and key points of the discussions that followed. Chapter 2 characterizes the light oil resource from fluvial-dominated deltaic reservoirs in the Tertiary Oil Recovery Information System (TORIS). An analysis of enhanced oil recovery (EOR) and advanced secondary recovery (ASR) potential for fluvial-dominated deltaic reservoirs based on recovery performance and economic modeling as well as the potential resource loss due to well abandonments is presented. Chapter 3 provides a summary of the general reservoirmore » characteristics and properties within deltaic deposits. It is not exhaustive treatise, rather it is intended to provide some basic information about geologic, reservoir, and production characteristics of deltaic reservoirs, and the resulting recovery problems.« less

State Size and Government Level Matter Most: A Structural Equation Model of Local Health Department Policy Behaviors.

PubMed

Meyerson, Beth E; Sayegh, M Aaron

2016-01-01

To explore relationships between local health department policy behaviors, levels of government activity, policy focus areas, and selected health department characteristics. Cross-sectional analysis of secondary data from the 2013 National Association of County & City Health Officials (NACCHO) Profile Survey. Local health departments throughout the United States. A total of 2000 local health departments responding to the 2013 Profile Survey of Local Health Departments. Survey data were gathered by the NACCHO. Secondary analysis of reported policy behaviors for the 2013 NACCHO Profile Survey. A structural equation model tested effects on and between state population size, rurality, census region and policy focus, and the latent variables of policy behavior formed from a confirmatory factor analysis. Policy behaviors, levels of government activity (local, state, and federal), policy focus areas, and selected local health department characteristics. The majority (85.1%) of health departments reported at least one of the possible policy behaviors. State population size increased the probability of local policy behavior, and local behavior increased the probability of state policy behavior. State size increased the likelihood of federal policy behavior and the focus on tobacco, emergency preparedness, and obesity/chronic disease. However, the more rural a state was, the more likely policy behavior was at the state and federal levels and not at local levels. Specific policy behaviors mattered less than the level of government activity. Size of state and rurality of health departments influence the government level of policy behavior.

Analysis of the Research and Studies Program at the United States Military Academy

DTIC Science & Technology

2004-09-01

operational assessment methodology, efficiency analysis, recruiting analysis especially marketing effects and capability analysis and modeling. Lieutenant...Finally, and arguably the most compelling rationale is the market force of increased funding. Figure 3 below shows the increase in funding received by...to integrate in a team of analysts from other departments to assist in the effort. First, bringing in analysts from other departments gave those

Risk of repeated self-harm and associated factors in children, adolescents and young adults.

PubMed

Bennardi, Marco; McMahon, Elaine; Corcoran, Paul; Griffin, Eve; Arensman, Ella

2016-11-24

Repeated self-harm represents the single strongest risk factor for suicide. To date no study with full national coverage has examined the pattern of hospital repeated presentations due to self-harm among young people. Data on consecutive self-harm presentations were obtained from the National Self-Harm Registry Ireland. Socio-demographic and behavioural characteristics of individuals aged 10-29 years who presented with self-harm to emergency departments in Ireland (2007-2014) were analysed. Risk of long-term repetition was assessed using survival analysis and time differences between the order of presentations using generalised estimating equation analysis. The total sample comprised 28,700 individuals involving 42,642 presentations. Intentional drug overdose was the most prevalent method (57.9%). Repetition of self-harm occurred in 19.2% of individuals during the first year following a first presentation, of whom the majority (62.7%) engaged in one repeated act. Overall, the risk of repeated self-harm was similar between males and females. However, in the 20-24-year-old age group males were at higher risk than females. Those who used self-cutting were at higher risk for repetition than those who used intentional drug overdose, particularly among females. Age was associated with repetition only among females, in particular adolescents (15-19 years old) were at higher risk than young emerging adults (20-24 years old). Repeated self-harm risk increased significantly with the number of previous self-harm episodes. Time differences between first self-harm presentations were detected. Time between second and third presentation increased compared to time between first and second presentation among low frequency repeaters (patients with 3 presentations only within 1 year following a first presentation). The same time period decreased among high frequency repeaters (patients with at least 4 to more than 30 presentations). Young people with the highest risk for repeated self-harm were 15-19-year-old females and 20-24-year-old males. Self-cutting was the method associated with the highest risk of self-harm repetition. Time between first self-harm presentations represents an indicator of subsequent repetition. To prevent risk of repeated self-harm in young people, all individuals presenting at emergency departments due to self-harm should be provided with a risk assessment including psychosocial characteristics, history of self-harm and time between first presentations.

Exploring the association of the Minnesota Department of Natural Resources' satellite-detected change with the Forest Inventory and Analysis system of observed removals and mortality

Treesearch

Dale D. Gormanson; Timothy J. Aunan; Mark H. Hansen; Michael Hoppus

2009-01-01

Since 2001, the Minnesota Department of Natural Resources (MN-DNR) has mapped forest change annually by comparison of Landsat satellite image pairs. Over the same timeframe, 1,761 U.S. Department of Agriculture, Forest Service, Forest Inventory and Analysis (FIA) plots in Minnesota have been remeasured on a 5-year cycle, providing field data on growth, removals, and...

Observing real-world groups in the virtual field: The analysis of online discussion.

PubMed

Giles, David C

2016-09-01

This article sets out to establish the naturalistic study of online social communication as a substantive topic in social psychology and to discuss the challenges of developing methods for a formal analysis of the structural and interactional features of message threads on discussion forums. I begin by outlining the essential features of online communication and specifically discussion forum data, and the important ways in which they depart from spoken conversation. I describe the handful of attempts to devise systematic analytic techniques for adapting methods such as conversation and discourse analysis to the study of online discussion. I then present a case study of a thread from the popular UK parenting forum Mumsnet which presents a number of challenges for existing methods, and examine some of the interactive phenomena typical of forums. Finally, I consider ways in which membership categorization analysis and social identity theory can complement one another in the exploration of both group processes and the rhetorical deployment of identities as dynamic phenomena in online discussion. © 2016 The British Psychological Society.

Work Program. Fiscal Year 1972 for The Department of the Army. Research and Development in Training, Motivation, and Leadership

DTIC Science & Technology

1971-07-01

itself. IlumRRO assistance was requested by the Infantry School both for design of experimental tests and for analysis and interpretation of the data from...of Research. To develop an experimental Army literacy training program designed to provide a level of functional literacy appropriate to present...assigned under the provisions of a long- range program (up to two years in duration) designed by tlumRRO. Specially designed experimental

Annual Surveillance Summary: Bacterial Infections in the Military Health System (MHS), 2016

DTIC Science & Technology

2017-06-01

Approved for public release. Distribution is unlimited. The views expressed in this document are those of the authors and do not necessarily reflect...historic IR to the IR of the current analysis year. c Results are presented by two decimal places to account for low incidence rates. Data Source...NMCPHC HL7-formatted CHCS microbiology and M2 databases. Prepared by the EpiData Center Department, Navy and Marine Corps Public Health Center, on 21

Analysis of Novel Prostate Cancer Biomarkers and Their Predictive Utility in an Active Surveillance Protocol

DTIC Science & Technology

2016-05-01

Pathways for CHF, DVT, and Normal Vaginal Delivery with 24 hour LOS . Brigham and Women’s Hospital, Boston, MA. 1994-1995 Research Assistant Adverse...Lecturer 25 Residents 1 hour 5 hours 2008-present Ambulatory Teaching Rounds - Department of Medicine – Uro -oncology for the primary care...Radiofrequency Ablation. In: Ahmed HU, et al. Eds. Interventional Techniques in Uro -Oncology. Oxford, UK: Wiley; 2011. p. 68-85. 5. Feldman AS, Hsu C

Analysis of the U.S. and Soviet Crisis Management Experiences. Technical Report

DTIC Science & Technology

1987-01-01

past and present performance. The current limitations on the use of these techniques are in large part technical -- there is no SPSS for the AT community...STOESSINGER, J.G. (1976) Henry Kissinger: The Anguish of Power. New York: Norton. 4-6 " Presidential books and memoirs, " State Department bulletins and...Policy and Third World Nations. Arlington, VA: Center for Naval Analyses, Professional Paper 155. STOESSINGER, J.G. (1976) Henry Kissinger: The Anguish

Performance-Based Design for Arson Threats: Policy Analysis of the Physical Security for Federal Facilities Standard

DTIC Science & Technology

2013-09-01

2012.0002- IR -EP7-A 12a. DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution is unlimited 12b. DISTRIBUTION CODE A...extremist web forums is directed at Western audiences and supports Homeland attacks. (U.S. Department of Homeland Security Office of Intelligence and...23 In this context, “before the event.” 24 Yung and Benichou’s paper originally was presented at the 5th Fire

77 FR 5614 - Department of State FY11 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... DEPARTMENT OF STATE [Public Notice 7785] Department of State FY11 Service Contract Inventory... Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY11 and its analysis of the FY10 inventory. They are available here: http://csm.state.gov...

15 CFR 807.2 - Department of Commerce rules applicable.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Department of Commerce rules applicable. 807.2 Section 807.2 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF ECONOMIC ANALYSIS, DEPARTMENT OF COMMERCE PUBLIC INFORMATION § 807.2 Department of...

15 CFR 807.2 - Department of Commerce rules applicable.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Department of Commerce rules applicable. 807.2 Section 807.2 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF ECONOMIC ANALYSIS, DEPARTMENT OF COMMERCE PUBLIC INFORMATION § 807.2 Department of...

15 CFR 807.2 - Department of Commerce rules applicable.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Department of Commerce rules applicable. 807.2 Section 807.2 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF ECONOMIC ANALYSIS, DEPARTMENT OF COMMERCE PUBLIC INFORMATION § 807.2 Department of...

Diagnostic performance of procalcitonin for hospitalised children with acute pyelonephritis presenting to the paediatric emergency department.

PubMed

Chen, Shan-Ming; Chang, Hung-Ming; Hung, Tung-Wei; Chao, Yu-Hua; Tsai, Jeng-Dau; Lue, Ko-Huang; Sheu, Ji-Nan

2013-05-01

Urinary tract infection (UTI) is a common bacterial infection in children that can result in permanent renal damage. This study prospectively assessed the diagnostic performance of procalcitonin (PCT) for predicting acute pyelonephritis (APN) among children with febrile UTI presenting to the paediatric emergency department (ED). Children aged ≤10 years with febrile UTI admitted to hospital from the paediatric ED were prospectively studied. Blood PCT, C reactive protein (CRP) and white blood cell (WBC) count were measured in the ED. Sensitivity, specificity, predictive values, multilevel likelihood ratios, receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to assess quantitative variables for diagnosing APN. The 136 enrolled patients (56 boys and 80 girls; age range 1 month to 10 years) were divided into APN (n=87) and lower UTI (n=49) groups according to (99m)Tc-dimercaptosuccinic acid scan results. The cut-off value for maximum diagnostic performance of PCT was 1.3 ng/ml (sensitivity 86.2%, specificity 89.8%). By multivariate regression analysis, only PCT and CRP were retained as significant predictors of APN. Comparing ROC curves, PCT had a significantly greater area under the curve than CRP, WBC count and fever for differentiating between APN and lower UTI. PCT has better sensitivity and specificity than CRP and WBC count for distinguishing between APN and lower UTI. PCT is a valuable marker for predicting APN in children with febrile UTI. It may be considered in the initial investigation and therapeutic strategies for children presenting to the ED.

Molecular evidence for a single taxon, Anopheles nuneztovari s. l., from two endemic malaria regions in Colombia

PubMed Central

Jaramillo, Luz Marina; Gutiérrez, Lina A; Luckhart, Shirley; Conn, Jan E; Correa, Margarita M

2012-01-01

To elucidate the Anopheles nuneztovari s.l. taxonomic status at a microgeographic level in four malaria endemic localities from Antioquia and Córdoba, Colombia, fragments of the Cytochrome oxidase subunit I (COI) and the white gene were used. The COI analysis showed low genetic differentiation with FST levels between −0.02 and 0.137 and Nm values between 3 and infinity, indicating the presence of high gene flow among An. nuneztovari s.l. populations from the four localities. The COI network showed a single most common haplotype, 1 (n=55), present in all localities, as the likely ancestral haplotype. Analysis of the white gene showed that An. nuneztovari s.l. populations from both departments grouped with haplotypes 19 and 20, which are part of lineage 3 previously reported. The results of the present study suggest that An. nuneztovari s.l. is a single taxon in the area of the present study. PMID:22241127

Financial Achievability of the Florida Department of Transportation Research Projects : Putting the Financial Analysis Framework into Action

DOT National Transportation Integrated Search

2018-02-02

The Florida State University Center for Insurance Research conducted research and developed a financial analysis framework, the Financial Achievability Model (FAM), that will allow the Florida Department of Transportation (FDOT) Research Center to be...

77 FR 70875 - Department of State Performance Review Board Members

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

...-Greenfield, Director General of the Foreign Service and Director of Human Resources, Department of State. [FR..., Department of State; Kevin P. O'Keefe, Director, Office of Plans, Policy, and Analysis, Bureau of Political...

Emergency department triage: an ethical analysis

PubMed Central

2011-01-01

Background Emergency departments across the globe follow a triage system in order to cope with overcrowding. The intention behind triage is to improve the emergency care and to prioritize cases in terms of clinical urgency. Discussion In emergency department triage, medical care might lead to adverse consequences like delay in providing care, compromise in privacy and confidentiality, poor physician-patient communication, failing to provide the necessary care altogether, or even having to decide whose life to save when not everyone can be saved. These consequences challenge the ethical quality of emergency care. This article provides an ethical analysis of "routine" emergency department triage. The four principles of biomedical ethics - viz. respect for autonomy, beneficence, nonmaleficence and justice provide the starting point and help us to identify the ethical challenges of emergency department triage. However, they do not offer a comprehensive ethical view. To address the ethical issues of emergency department triage from a more comprehensive ethical view, the care ethics perspective offers additional insights. Summary We integrate the results from the analysis using four principles of biomedical ethics into care ethics perspective on triage and propose an integrated clinically and ethically based framework of emergency department triage planning, as seen from a comprehensive ethics perspective that incorporates both the principles-based and care-oriented approach. PMID:21982119

Impact of high coverage of monovalent human rotavirus vaccine on Emergency Department presentations for rotavirus gastroenteritis.

PubMed

Davey, Heather M; Muscatello, David J; Wood, James G; Snelling, Thomas L; Ferson, Mark J; Macartney, Kristine K

2015-03-30

Australia was one of the first countries to introduce nationally funded rotavirus vaccination. The program has had a substantial impact on both rotavirus and all-cause acute gastroenteritis (AGE) hospitalisations and rotavirus laboratory tests. Evidence for an impact on Emergency Department (ED) presentations is limited. This study assessed changes in ED presentations for rotavirus in children aged <5 years in New South Wales, Australia, following introduction of monovalent human rotavirus vaccine (RV1, Rotarix(®), GlaxoSmithKline Australia Pty Ltd., Victoria, Australia). A time series analysis to examine trends in total non-admitted ED presentations for all-cause AGE and in the rotavirus-attributable fraction using data on rotavirus positive laboratory tests. A decline in the rate of non-admitted ED presentations for all-cause AGE was observed for all ages, being most notable in 1 year old children. Compared with the pre-vaccination period, we estimated the average weekly rate was lower across the first 4.5 years of the program for both all-cause AGE (18.3%; 70.5 versus 57.5 per 100,000 population) and rotavirus attributable (55.4%; 17.3 versus 7.7 per 100,000 population) presentations. In the fourth year of the program, estimated annual rotavirus attributable presentations were 77% lower than the pre-vaccination annual mean (996 versus 4300 per year). The program was associated with a substantial decline in rotavirus attributable non-admitted AGE presentations to ED among children aged <5 years. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Current Educational Topics No. II: Abstracts of Papers Presented at St. Louis, Missouri, February 26-29, 1912, before the National Council of Education of the National Education Association; the Department of Superintendence of the National Education Association; the Department of Normal Schools of the National Education Association; the National Society for the Study of Education; the Society of College Teachers of Education; the National Committee on Agricultural Education. Bulletin, 1912, No. 15. Whole Number 487

ERIC Educational Resources Information Center

Noyes, Frederick K.

1912-01-01

This bulletin presents abstracts of papers presented at St. Louis, Missouri, February 26-29, 1912, before the National Council of Education of the National Education Association; the Department of Superintendence of the National Education Association; the Department of Normal Schools of the National Education Association; the National Society for…

Respiratory dead space measurement in the investigation of pulmonary embolism in outpatients with pleuritic chest pain.

PubMed

Hogg, Kerstin; Dawson, Deborah; Tabor, Ted; Tabor, Beverly; Mackway-Jones, Kevin

2005-10-01

Pleuritic chest pain is a common presenting condition in the emergency department. A noninvasive bedside rule out test for pulmonary embolism would aid investigating this patient group. Our study aimed to compare the clinical utility of three methods for calculating respiratory dead space in the diagnosis of pulmonary embolism in outpatients with pleuritic chest pain. Prospective diagnostic study. Large city-center emergency department. Between February 2002 and June 2003, 425 patients presenting to the emergency department with pleuritic chest pain were prospectively recruited. Data collection for respiratory dead space was performed in the emergency department by two researchers. The respiratory dead space fraction was calculated independently using three different methods. All patients underwent an independent reference standard diagnostic algorithm to establish the presence or absence of pulmonary embolism. Those with a low modified Wells clinical probability and a normal quantitative d-dimer finding were discharged home. All others followed a reference standard protocol using Prospective Investigation of Pulmonary Embolism Diagnosis-interpreted ventilation/perfusion scanning, CT pulmonary angiography, and digital subtraction pulmonary angiography. All patients were followed up clinically for 3 months. For the Bohr calculation, the area under the receiver operating characteristic curve was 0.62 (95% confidence interval [CI], 0.51 to 0.73), the Enghoff calculation was 0.66 (95% CI, 0.55 to 0.77), and the capillary sample Enghoff was 0.62 (95% CI, 0.49 to 0.65). The optimum Bohr cutoff value gave 100.0% sensitivity (95% CI, 84.5 to 100%) but a low specificity of 22.7% (95% CI, 18.8 to 27.2%). The optimum cutoff points for Enghoff and capillary Enghoff calculations gave sensitivities of 95.3% (95% CI, 77.3 to 99.2%) and 94.4% (95% CI, 74.2 to 99.0%), respectively, with poor specificity. Respiratory dead space analysis does not perform well as a stand-alone diagnostic test for pulmonary embolism in outpatients presenting with pleuritic chest pain.

Pattern of presenting complaints recorded as near-drowning events in emergency departments: a national surveillance study from Pakistan.

PubMed

He, Siran; Lunnen, Jeffrey C; Zia, Nukhba; Khan, Uzma; Shamim, Khusro; Hyder, Adnan A

2015-01-01

Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.

JGI Fungal Genomics Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grigoriev, Igor V.

2011-03-14

Genomes of energy and environment fungi are in focus of the Fungal Genomic Program at the US Department of Energy Joint Genome Institute (JGI). Its key project, the Genomics Encyclopedia of Fungi, targets fungi related to plant health (symbionts, pathogens, and biocontrol agents) and biorefinery processes (cellulose degradation, sugar fermentation, industrial hosts), and explores fungal diversity by means of genome sequencing and analysis. Over 50 fungal genomes have been sequenced by JGI to date and released through MycoCosm (www.jgi.doe.gov/fungi), a fungal web-portal, which integrates sequence and functional data with genome analysis tools for user community. Sequence analysis supported by functionalmore » genomics leads to developing parts list for complex systems ranging from ecosystems of biofuel crops to biorefineries. Recent examples of such 'parts' suggested by comparative genomics and functional analysis in these areas are presented here« less

The Business Case for Payer Support of a Community-Based Health Information Exchange: A Humana Pilot Evaluating Its Effectiveness in Cost Control for Plan Members Seeking Emergency Department Care

PubMed Central

Tzeel, Albert; Lawnicki, Victor; Pemble, Kim R.

2011-01-01

Background As emergency department utilization continues to increase, health plans must limit their cost exposure, which may be driven by duplicate testing and a lack of medical history at the point of care. Based on previous studies, health information exchanges (HIEs) can potentially provide health plans with the ability to address this need. Objective To assess the effectiveness of a community-based HIE in controlling plan costs arising from emergency department care for a health plan's members. Albert Tzeel Methods The study design was observational, with an eligible population (N = 1482) of fully insured plan members who sought emergency department care on at least 2 occasions during the study period, from December 2008 through March 2010. Cost and utilization data, obtained from member claims, were matched to a list of persons utilizing the emergency department where HIE querying could have occurred. Eligible members underwent propensity score matching to create a test group (N = 326) in which the HIE database was queried in all emergency department visits, and a control group (N = 325) in which the HIE database was not queried in any emergency department visit. Results Post–propensity matching analysis showed that the test group achieved an average savings of $29 per emergency department visit compared with the control group. Decreased utilization of imaging procedures and diagnostic tests drove this cost-savings. Conclusions When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decrease. Although many factors can play a role in this finding, it is likely that HIEs obviate unnecessary service utilization through provision of historical medical information regarding specific patients at the point of care. PMID:25126351

Complaints from emergency department patients largely result from treatment and communication problems.

PubMed

Taylor, David McD; Wolfe, Rory; Cameron, Peter A

2002-03-01

Emergency department patient complaints are often justified and may lead to apology, remedial action or compensation. The aim of the present study was to analyse emergency department patient complaints in order to identify procedures or practices that require change and to make recommendations for intervention strategies aimed at decreasing complaint rates. We undertook a retrospective analysis of patient complaints from 36 Victorian emergency departments during a 61 month period. Data were obtained from the Health Complaint Information Program (Health Services Commissioner). In all, 2,419 emergency department patients complained about a total of 3,418 separate issues (15.4% of all issues from all hospital departments). Of these, 1,157 complaints (47.80%) were received by telephone and 829 (34.3%) were received by letter; 1,526 (63.1 %) complaints were made by a person other than the patient. Highest complaint rates were received from patients who were female, born in non-English-speaking countries and very young or very old. One thousand one hundred and forty-one issues (33.4%) related to patient treatment, including inadequate treatment (329 issues) and inadequate diagnosis (249 issues); 1079 (31.6%) issues related to communication, including poor staff attitude, discourtesy and rudeness (444 issues); 407 (11.9%) issues related to delay in treatment. Overall, 2516 issues (73.6%) were resolved satisfactorily, usually by explanation or apology. Only 59 issues (1.7%) resulted in a procedure or policy change. Remedial action was taken in 109 issues (3.2%) and compensation was paid to eight patients. Communication remains a significant factor in emergency department patient dissatisfaction. While patient complaints have resulted in major changes to policy and procedure, research and intervention strategies into communication problems are indicated. In the short term, focused staff training is recommended.

The effect of a gold coin fine on C-reactive protein test ordering in a tertiary referral emergency department.

PubMed

Mallows, James L

2013-12-16

To examine the effect of an education campaign based around a gold coin fine on ordering of C-reactive protein (CRP) tests. A retrospective analysis of CRP test ordering before and after the intervention in the emergency department (ED) of a tertiary referral hospital in metropolitan Sydney that sees about 60,000 patients per annum. The date of the intervention - 2 August 2013 - corresponded with Jeans for Genes Day. Number of CRP tests ordered in the ED. 1290 CRP tests were ordered before the intervention (1-31 July), and 394 were ordered after the intervention (2-31 August). This decrease in CRP test ordering was despite an increased number of ED presentations in August compared with July (5219 v 5497 presentations). This represented an absolute reduction in the rate of CRP test ordering of 17.6% (95% CI, 16.2%-18.9%; P < 0.001). The threat of a gold coin fine for ordering a CRP test, as part of a broader education campaign, significantly reduced the number of CRP tests ordered in a tertiary referral ED.

Universities and nursing education.

PubMed

Hayward, J

1982-07-01

Trends reflected by Department of Health and Social Security statistics on the nursing workforce are examined and the ratios between grades discussed. Recruitment into nursing degree courses in the UK is considered in relation to overall recruitment into nursing. The somewhat ambiguous position of nursing degree courses in the UK leads into consideration of policy statements by the universities and the nursing profession. The importance of such policies is emphasized in the current financial climate, as are the potential contributions of university departments to professional debate, for example standards of care. Comparisons are drawn between the goals of courses involving full-time studentships as opposed to part-time apprenticeships and the present boundaries between these noted, especially in relation to the expanding roles of courses. On-going research into the preparation of nurse-tutors in the UK is mentioned, together with a preliminary analysis of the academic basis in the biological sciences possessed by learners and tutors. Out of this is derived a suggestion that the present-day shortage of nurse teachers could be helped by varying the existing patterns of recruitment, especially involving subject specialists in the biological, behavioural and social sciences.

A Comparative Assessment of Knowledge Management Leadership Approaches within the Department of Defense

DTIC Science & Technology

2007-03-01

A COMPARATIVE ASSESSMENT OF KNOWLEDGE MANAGEMENT LEADERSHIP APPROACHES WITHIN THE DEPARTMENT OF DEFENSE... MANAGEMENT LEADERSHIP APPROACHES WITHIN THE DEPARTMENT OF DEFENSE THESIS Presented to the Faculty Department of Systems and Engineering...KNOWLEDGE MANAGEMENT LEADERSHIP APPROACHES WITHIN THE DEPARTMENT OF DEFENSE Tommy V. S. Marshall II, BS Captain, USAF Approved

Scientific inquiry into rhinosinusitis: who is receiving funding from the National Institutes of Health?

PubMed

Folbe, Adam J; Svider, Peter F; Setzen, Michael; Zuliani, Giancarlo; Lin, Ho-Sheng; Eloy, Jean Anderson

2014-06-01

To evaluate National Institutes of Health (NIH) support for rhinosinusitis research and characterize the proportion of funding awarded to otolaryngologists. Analysis of the NIH RePORTER database. Specialty and terminal-degree of primary investigators (PIs) for 131 projects spanning 364 fiscal years (1989 to present) were determined. Awards for projects examining rhinosinusitis were organized by size, academic department, and PI scholarly impact (using h-indices). Analysis of geographic and temporal funding trends was performed and organized by PI specialty. A total of 62.6% of projects were awarded to physicians, one-third of whom were otolaryngologists. Allergists/immunologists had greater median awards than otolaryngologist PIs (P = .02), and pediatric-trained PIs had a greater h-index than otolaryngologist PIs (P = .04). Although year-to-year fluctuation was noted, otolaryngologists have received approximately a quarter of total rhinosinusitis funding since 2000. PIs practicing in the south-Atlantic, east-north-central, and west-north-central states had the greatest funding totals, whereas otolaryngologists had a greater proportion of regional funding in the Pacific and east-south-central states than other regions. Inquiry into the mechanisms underlying rhinosinusitis and optimal therapeutic strategies represents an interdisciplinary venture. PIs in medicine and pediatric departments had greater funding for rhinosinusitis projects than individuals in otolaryngology departments, partly because of greater utilization of PhD faculty. Otolaryngology departments may consider increased recruitment of basic scientists interested in rhinosinusitis as a means to facilitate increased scholarship in this area. Encouraging pursuit of funding opportunities is critical for otolaryngologists, as well-funded practitioners may have greater opportunities to shape advances and serve as an advocate for their approaches. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Population Analysis of Disabled Children by Departments in France

NASA Astrophysics Data System (ADS)

Meidatuzzahra, Diah; Kuswanto, Heri; Pech, Nicolas; Etchegaray, Amélie

2017-06-01

In this study, a statistical analysis is performed by model the variations of the disabled about 0-19 years old population among French departments. The aim is to classify the departments according to their profile determinants (socioeconomic and behavioural profiles). The analysis is focused on two types of methods: principal component analysis (PCA) and multiple correspondences factorial analysis (MCA) to review which one is the best methods for interpretation of the correlation between the determinants of disability (independent variable). The PCA is the best method for interpretation of the correlation between the determinants of disability (independent variable). The PCA reduces 14 determinants of disability to 4 axes, keeps 80% of total information, and classifies them into 7 classes. The MCA reduces the determinants to 3 axes, retains only 30% of information, and classifies them into 4 classes.

Sepsis and Shock Response Team: Impact of a Multidisciplinary Approach to Implementing Surviving Sepsis Campaign Guidelines and Surviving the Process.

PubMed

Grek, Ami; Booth, Sandra; Festic, Emir; Maniaci, Michael; Shirazi, Ehsan; Thompson, Kristine; Starbuck, Angela; Mcree, Chad; Naessens, James M; Moreno Franco, Pablo

The Surviving Sepsis Campaign guidelines are designed to decrease mortality through consistent application of a 7-element bundle. This study evaluated the impact of improvement in bundle adherence using a time-series analysis of compliance with the bundle elements before and after interventions intended to improve the process, while also looking at hospital mortality. This article describes interventions used to improve bundle compliance and hospital mortality in patients admitted through the emergency department with sepsis, severe sepsis, or septic shock. Quality improvement methodology was used to develop high-impact interventions that led to dramatically improved adherence to the Surviving Sepsis Campaign guidelines bundle. Improved performance was associated with a significant decrease in the in-hospital mortality of severe sepsis patients presenting to the emergency department.

Collected Papers on Wind Turbine Technology

NASA Technical Reports Server (NTRS)

Spera, David A. (Editor)

1995-01-01

R and D projects on electricity generating wind turbines were conducted at the NASA Lewis Research Center from 1973 to 1988. Most projects were sponsored by the U.S. Department of Energy (DOE), a major element of its Federal Wind Energy Program. Another large wind turbine project was by the Bureau of Reclamation of the U.S. Department of Interior (DOI). From 1988 to 1995, NASA wind energy activities have been directed toward the transfer of technology to commercial and academic organizations. As part of these technology transfer activities, previously unpublished manuscripts have been assembled and presented here to share the wind turbine research results with the wind energy community. A variety of wind turbine technology topics are discussed: Wind and wake models; Airfoil properties; Structural analysis and testing; Control systems; Variable speed generators; and acoustic noise. Experimental and theoretical results are discussed.

Acute hand and wrist injuries sustained during recreational mountain biking: a prospective study.

PubMed

Bush, Kevin; Meredith, Steve; Demsey, Daniel

2013-12-01

Recreational mountain biking continues to increase in popularity and is a significant source of traumatic injury, including injuries to the hand and wrist. A prospective survey of all hand and wrist injuries sustained while participating in recreational mountain biking presenting to the emergency department at the Municipality of Whistler and the District of Squamish was conducted over a 12-month consecutive period. An analysis of 765 unique emergency department visits with 1,079 distinct injuries was performed. Of these injuries, 511 were sustained to the upper limb. Injury to the metacarpal and metacarpal phalangeal joints was the most common hand injury (52) followed by proximal phalanx and proximal interphalangeal joint (20). Mountain biking is a frequent source of a variety of upper limb trauma, and preventative efforts are necessary to minimize the burden of these injuries.

[Research on survey analysis and development strategies of traditional Chinese preparations in Guangdong Province hospitals].

PubMed

Wang, Wen-ming; Yan, Zhen; Liu, Han-jiang; Zhang, Lei-hong; Xia, Li; Zhao, Zhen-dong

2013-12-01

To provide reference for the government to formulate policies and medical institution to formulate development plan, the present situation of medical institutions of traditional Chinese preparation and some countermeasures for developing the research of traditional Chinese preparation in Guangdong province were studied. Combined with development situation of traditional Chinese preparation of medical institutions in Guangdong province in recent years, the development countermeasure of traditional Chinese preparation was discussed. In order to promote the development of traditional Chinese preparation of medical institutions, suggestions and countermeasures for the government and related departments were proposed. Government departments should formulate policies to support the development of traditional Chinese preparation, the medical institutions should make scientific development planning, strengthen the construction of hardware and software and develop special traditional Chinese preparation to promote the healthy development of traditional Chinese preparation.

Hirsch's index: a case study conducted atthe Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo.

PubMed

Torro-Alves, N; Herculano, R D; Terçariol, C A S; Kinouchi Filho, O; Graeff, C F O

2007-11-01

An analysis of scientific bibliographic productivity using the Hirsch h-index, information from the Institute of Scientific Information database and the Curriculum Lattes (CNPq, Brazil) was performed at the Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo (FFCLRP-USP) that has four departments in natural, biological and social sciences. Bibliometric evaluations of undergraduate programs showed a better performance of the departments of Chemistry (P < 0.001) and Biology (P < 0.001) when compared to the departments of Physics and Mathematics and Psychology and Education. We also analyzed the scientific output of the six graduate programs of FFCLRP: Psychology, Psychobiology, Chemistry, Physics Applied to Medicine and Biology, Comparative Biology, and Entomology. The graduate program in Psychology presented a lower h-index (P < 0.001) and had fewer papers indexed by the ISI web of science (P < 0.001) when compared to the other graduate programs. The poorer performance of the Psychology program may be associated with the limited coverage by the Thompson Institute of Scientific Information database.

Survey of organizational research climates in three research intensive, doctoral granting universities.

PubMed

Wells, James A; Thrush, Carol R; Martinson, Brian C; May, Terry A; Stickler, Michelle; Callahan, Eileen C; Klomparens, Karen L

2014-12-01

The Survey of Organizational Research Climate (SOuRCe) is a new instrument that assesses dimensions of research integrity climate, including ethical leadership, socialization and communication processes, and policies, procedures, structures, and processes to address risks to research integrity. We present a descriptive analysis to characterize differences on the SOuRCe scales across departments, fields of study, and status categories (faculty, postdoctoral scholars, and graduate students) for 11,455 respondents from three research-intensive universities. Among the seven SOuRCe scales, variance explained by status and fields of study ranged from 7.6% (Advisor-Advisee Relations) to 16.2% (Integrity Norms). Department accounted for greater than 50% of the variance explained for each of the SOuRCe scales, ranging from 52.6% (Regulatory Quality) to 80.3% (Integrity Inhibitors). It is feasible to implement this instrument in large university settings across a broad range of fields, department types, and individual roles within academic units. Published baseline results provide initial data for institutions using the SOuRCe who wish to compare their own research integrity climates. © The Author(s) 2014.

The impact of an emergency fee increase on the composition of patients visiting emergency departments.

PubMed

Jung, Hyemin; Do, Young Kyung; Kim, Yoon; Ro, Junsoo

2014-11-01

This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

Cane Creek flood-flow characteristics at State Route 30 near Spencer, Tennessee

USGS Publications Warehouse

Gamble, Charles R.

1983-01-01

The Tennessee Department of Transportation has constructed a new bridge and approaches on State Route 30 over Cane Creek near Spencer, Tennessee. The old bridge and its approaches were fairly low, permitting considerable flow over the road during high floods. The new bridge and its approaches are considerably higher, causing different flow conditions at the site. Analysis of the effects of the new bridge, as compared to the old bridge, on floods of the magnitude of the May 27, 1973, flood is presented. The May 27, 1973, flood was greater than a 100-year flood. Analysis of the 50- and 100-year floods for the new bridge are also presented. Results of the study indicate that the new construction will increase the water-surface elevation for a flood equal to the May 27, 1973, flood by approximately 1 foot upstream from bridge. (USGS)

A 3-D Magnetic Analysis of a Linear Alternator For a Stirling Power System

NASA Technical Reports Server (NTRS)

Geng, Steven M.; Schwarze, Gene E.; Niedra, Janis M.

2000-01-01

The NASA Glenn Research Center and the Department of Energy (DOE) are developing advanced radioisotope Stirling convertors, under contract with Stirling Technology Company (STC), for space applications. Of critical importance to the successful development of the Stirling convertor for space power applications is the development of a lightweight and highly efficient linear alternator. This paper presents a 3-D finite element method (FEM) approach for evaluating Stirling convertor linear alternators. Preliminary correlations with open-circuit voltage measurements provide an encouraging level of confidence in the model. Spatial plots of magnetic field strength (H) are presented in the region of the exciting permanent magnets. These plots identify regions of high H, where at elevated temperature and under electrical load, the potential to alter the magnetic moment of the magnets exists. This implies the need for further testing and analysis.

33 CFR 279.7 - Information collection and preliminary analysis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Information collection and preliminary analysis. 279.7 Section 279.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.7 Information...

33 CFR 279.7 - Information collection and preliminary analysis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Information collection and preliminary analysis. 279.7 Section 279.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.7 Information...

33 CFR 279.7 - Information collection and preliminary analysis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Information collection and preliminary analysis. 279.7 Section 279.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.7 Information...

Implementing evidence-based practices in an emergency department: contradictions exposed when prioritising a flow culture.

PubMed

Kirk, Jeanette W; Nilsen, Per

2016-02-01

An emergency department is typically a place of high activity where practitioners care for unanticipated presentations, which yields a flow culture so that actions that secure available beds are prioritised by the practitioners. How does the flow culture in an emergency department influence nurses' use of a research-based clinical guideline and a nutrition screening routine. Ethnographic fieldwork was carried out over three months. The first author followed nurses, medical secretaries and doctors in the emergency department. Data were also collected by means of semi-structured interviews. An activity system analysis, as described in the Cultural Historical Activity Theory, was conducted to identify various contradictions that could exist between different parts of the activity system. The main contradiction identified was that guidelines and screening routines provided a flow stop. Four associated contradictions were identified: insufficient time to implement guidelines; guilty conscience due to perceived nonadherence to evidence-based practices; newcomers having different priorities; and conflicting views of what constituted being a professional. We found that research-supported guidelines and screening routines were not used if they were perceived to stop the patient flow, suggesting that the practice was not fully evidence based. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

[Equal Opportunities for Care in Obstetrics - A Quantitative Survey of Accessibility in Obstetric Departments in Austria].

PubMed

Schildberger, B; Ortner, N; Zenzmaier, C; König-Bachmann, M

2016-04-01

In everyday life women with disabilities are facing different challenges and discriminatory aspects. Especially the issue of pregnancy and motherhood is still critically discussed and subject to taboo. The aim of the present study is to survey the extent of structural measures on the one hand and additional specific service offers on the other hand that have been implemented in order to ensure accessibility and equitable care for women with disabilities in the obstetric departments in Austria. Data were collected by a self-developed non-standardised questionnaire, evaluating existing or implemented structural measures and specific service offerings that ensure accessibility. Data collection and analysis were performed using the online survey application "LimeSurvey" and SPSS, respectively. The survey data reveal that the obstetric departments largely conform to the requirements of the different building regulations. Additional measures or adaptations of the inventory for women with mobility or sensory impairments are at the discretion of the institution and thus are hardly implemented. Despite the small sample size it becomes obvious that the obstetric departments in Austria lack in many regards structures that ensure accessibility to care, nursing, counselling and support for women with sensory impairments or limited mobility. © Georg Thieme Verlag KG Stuttgart · New York.

Allergen aerosol from pollen-nucleated precipitation: A novel thunderstorm asthma trigger

NASA Astrophysics Data System (ADS)

Beggs, Paul John

2017-03-01

Thunderstorm asthma is the term used to describe epidemics of asthma exacerbation associated with thunderstorms. Most published reports of thunderstorm asthma have come from the United Kingdom, Canada, and Australia, although several studies have been published on the phenomenon in the USA and Europe (particularly Greece and Italy). Such reports usually consider changes in hospital admissions or emergency department attendances for asthma. For example, Celenza et al. (1996) studied an asthma epidemic in London in June 1994 where 40 patients presented to the accident and emergency department of St Mary's Hospital in the 24 hours after a thunderstorm compared to an average of just over 2 asthma presentations per day over the several weeks before and after this event. More recent examples include the 20 patients who presented to an emergency department in Puglia, Italy, for sudden and severe asthmatic symptoms immediately after a thunderstorm in May 2010, where the average daily emergency department presentations for asthma several weeks before and after this event was only 2 to 3 (Losappio et al., 2011); and the 36 emergency department presentations for acute asthma to the Austin Hospital in Melbourne, Australia, on 25 November 2010 immediately after a thunderstorm (with the number of such presentations on days prior to and following the epidemic ranging from 0 to 10) (Howden et al., 2011).

Relationship between Bullying and Suicidal Behaviour in Youth presenting to the Emergency Department

PubMed Central

Alavi, Nazanin; Reshetukha, Taras; Prost, Eric; Antoniak, Kristen; Patel, Charmy; Sajid, Saad; Groll, Dianne

2017-01-01

Objective Increasing numbers of adolescents are visiting emergency departments with suicidal ideation. This study examines the relationship between bullying and suicidal ideation in emergency department settings. Method A chart review was conducted for all patients under 18 years of age presenting with a mental health complaint to the emergency departments at Kingston General or Hotel Dieu Hospitals in Kingston, Canada, between January 2011 and January 2015. Factors such as age, gender, history of abuse, history of bullying, type and time of bullying, and diagnoses were documented. Results 77% of the adolescents had experienced bullying, while 68.9% had suicide ideation at presentation. While controlling for age, gender, grade, psychiatric diagnosis, and abuse, a history of bullying was the most significant predictor of suicidal ideation. Individuals in this study who reported cyber bullying were 11.5 times more likely to have suicidal ideation documented on presentation, while individuals reporting verbal bullying were 8.4 times more likely. Conclusions The prevalence of bullying in adolescent patients presenting to emergency departments is high. The relationship found between suicidal ideation and bullying demonstrates that clinicians should ask questions about bullying as a risk factor for suicide ideation during the assessment of children and adolescents. PMID:28747929

Homeland security in the USA: past, present, and future.

PubMed

Kemp, Roger L

2012-01-01

This paper examines the evolving and dynamic field of homeland security in the USA. Included in this analysis is the evolution of the creation of the Department of Homeland Security, an overview of the National Warning System, a summary of citizen support groups, and how the field of homeland security has had an impact on the location and architecture of public buildings and facilities. Also included are website directories of citizen support groups and federal agencies related to the field of homeland security.

Psychiatric Morbidity Pattern in a Child Guidance Clinic.

PubMed

Chaudhury, S; Prasad, P L; Zacharias, R; Madhusudan, T; Saini, R

2007-04-01

There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces. Retrospective analysis of 213 patients who attended a child guidance clinic was done. Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.

Analysis of Novel Prostate Cancer Biomarkers and their Predictive Utility in an Active Surveillance Protocol

DTIC Science & Technology

2012-05-01

Critical Pathways for CHF, DVT, and Normal Vaginal Delivery with 24 hour LOS . Brigham and Women’s Hospital, Boston, MA. 1994-1995 Research Assistant...prep time Lecturer 25 Residents 1 hour 5 hours 2008-present Ambulatory Teaching Rounds - Department of Medicine – Uro -oncology for the primary... Uro -Oncology. Oxford, UK: Wiley; 2011. p. 68-85. 11. Feldman AS, Hsu C, Kurtz M, Cho KC. Etiology and evaluation of hematuria in adults. In

Image Based Biomarker of Breast Cancer Risk: Analysis of Risk Disparity Among Minority Populations

DTIC Science & Technology

2015-02-01

health disparity. • On August 2-5, 2011, Fengshan Liu and Charlie Wilson attended and presented at the Department of Defense Breast Cancer Research...DSU faculty met with UPENN mentors on January 24, 2011 and August 9, 2010 to discuss the progress and the future work of each DSU faculty. 14...training, focus on parenchymal texture 03/06/2012: Training on MIRC database 03/09/2012: Additional training on MIRC database • In August 2013

Proceedings, U. S. Department of Agriculture interagency gypsy moth research review 1990

Treesearch

Kurt W. Gottschalk; Mark J. Twery; Shirley I. Smith; [Editors

1991-01-01

Eight invited papers and 68 abstracts of volunteer presentations on gypsy moth biology, ecology, impacts, and management presented at the U. S. Department of Agriculture Interagency Gypsy Moth Research Review.

Assessment and management of acute pain in the older person with cognitive impairment: A qualitative study.

PubMed

Fry, Margaret; Chenoweth, Lynn; Arendts, Glenn

2016-01-01

Older Australians experience health disparities in pain management compared to other groups. This article is focused on understanding the emergency nurses' perceptions of pain and pain management for older persons with cognitive impairment and presenting with a long bone fracture. This article is part of a larger study focusing on emergency nurses' pain management practices for older Australians with cognitive impairment. The aim of the study was to understand emergency nurses' perceptions of the management of pain for older persons with cognitive impairment and presenting with a long bone fracture. This is part of a larger multicentre programme of research exploring pain management in older persons with cognitive impairment and who are experiencing pain from a long bone fracture. This study had a qualitative research design, with data collected through focus group interviews and a thematic method of analysis. The study is framed by a constructivist's paradigm, which enabled multiple realities to surface and be interpreted. Eighty emergency nurses participated, with 67 (84%) females and 13 (16%) males, in 16 focus groups across four emergency departments. Nurses had an average of 12.5 years as a Registered Nurse (SD ± 10.06) and 8.6 years (SD ± 8.64) emergency experience. Five themes emerged from data analysis and included: 1) Belief in championing pain management; 2) Pain management and the ageing processes; 3) Lack of pain assessment tools for the cognitively impaired older person; 4) Delivering analgesia--a balancing act; and 5) Policy barriers to nurse initiated pain management. This study makes clear the challenges clinicians' face in managing pain in older patients presenting to emergency departments. More specifically, older persons with cognitive impairment face substantially greater obstacles in receiving effective pain relief given the lack of any standardised pain assessment screening tool within emergency departments. To improve pain management practices emergency clinicians need to test the utility of behavioural pain assessment tools for cognitively impaired older persons within the emergency context. Copyright © 2015 Elsevier Ltd. All rights reserved.

Methods for Functional Connectivity Analyses

DTIC Science & Technology

2012-12-13

motor , or hand motor function (green, red, or blue shading, respectively). Thus, this work produced the first comprehensive analysis of ECoG...Computer Engineering, University of Texas at El Paso , TX, USA 3Department of Neurology, Albany Medical College, Albany, NY, USA 4Department of Computer...Department of Health, Albany, NY, USA bDepartment of Electrical and Computer Engineering, University of Texas at El Paso , TX, USA cDepartment of Neurology

Head injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and football.

PubMed

Delaney, J Scott

2004-03-01

To examine the number and rates of head injuries occurring in the community as a whole for the team sports of ice hockey, soccer, and football by analyzing data from patients presenting to US emergency departments (EDs) from 1990 to 1999. Retrospective analysis. Data compiled for the US Consumer Product Safety Commission using the National Electronic Injury Surveillance System were used to generate estimates for the total number of head injuries, concussions, internal head injuries, and skull fractures occurring on a national level from the years 1990 to 1999. These data were combined with yearly participation figures to generate rates of injuries presenting to the ED for each sport. There were an estimated 17,008 head injuries from ice hockey, 86,697 from soccer, and 204,802 from football that presented to US EDs from 1990 to 1999. The total number of concussions presenting to EDs in the United States over the same period was estimated to be 4820 from ice hockey, 21,715 from soccer, and 68,861 from football. While the rates of head injuries, concussions, and combined concussions/internal head injuries/skull fractures presenting to EDs per 10,000 players were not always statistically similar for all 3 sports in each year data were available, they were usually comparable. While the total numbers of head injuries, concussions, and combined concussions/skull fractures/internal head injuries presenting to EDs in the United States are different for ice hockey, soccer, and football for the years studied, the yearly rates for these injuries are comparable among all 3 sports.

Emergency department presentations for atrial fibrillation and flutter in Alberta: a large population-based study.

PubMed

Rosychuk, Rhonda J; Graham, Michelle M; Holroyd, Brian R; Rowe, Brian H

2017-01-10

Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta. Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Data extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Analysis included summaries and standardized rates. During the study period, there were 63,398 ED AFF visits from 32,104 distinct adults. Median ages for females and males were 75 and 67 years, respectively; more men (52%) and patients > 65 presented. Overall, the standardized rates remained similar (2.8 per 1,000 over the study period). Specific populations of human services recipients and First Nations had higher ED visit rates for AFF than other groups. Predictable daily, weekly, and monthly trends were observed. The ED visits were followed by numerous subsequent visits in non-ED settings; however, First Nations and women had lower rates of specialist follow-up. Annually, over 5,000 ED presentations of patients experiencing AFF occur in Alberta and admissions proportions are declining. While presentation rates across the province are stable, follow-up with physicians, consultation with cardiologists and health outcomes vary based on socio-economic, age, sex, and First Nations status. Further research is required to understand the causes and consequences of these inequalities and to standardize care.

Mathematics and statistics research progress report, period ending June 30, 1983

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beauchamp, J. J.; Denson, M. V.; Heath, M. T.

1983-08-01

This report is the twenty-sixth in the series of progress reports of Mathematics and Statistics Research of the Computer Sciences organization, Union Carbide Corporation Nuclear Division. Part A records research progress in analysis of large data sets, applied analysis, biometrics research, computational statistics, materials science applications, numerical linear algebra, and risk analysis. Collaboration and consulting with others throughout the Oak Ridge Department of Energy complex are recorded in Part B. Included are sections on biological sciences, energy, engineering, environmental sciences, health and safety, and safeguards. Part C summarizes the various educational activities in which the staff was engaged. Part Dmore » lists the presentations of research results, and Part E records the staff's other professional activities during the report period.« less

Multi-Objective data analysis using Bayesian Inference for MagLIF experiments

NASA Astrophysics Data System (ADS)

Knapp, Patrick; Glinksy, Michael; Evans, Matthew; Gom, Matth; Han, Stephanie; Harding, Eric; Slutz, Steve; Hahn, Kelly; Harvey-Thompson, Adam; Geissel, Matthias; Ampleford, David; Jennings, Christopher; Schmit, Paul; Smith, Ian; Schwarz, Jens; Peterson, Kyle; Jones, Brent; Rochau, Gregory; Sinars, Daniel

2017-10-01

The MagLIF concept has recently demonstrated Gbar pressures and confinement of charged fusion products at stagnation. We present a new analysis methodology that allows for integration of multiple diagnostics including nuclear, x-ray imaging, and x-ray power to determine the temperature, pressure, liner areal density, and mix fraction. A simplified hot-spot model is used with a Bayesian inference network to determine the most probable model parameters that describe the observations while simultaneously revealing the principal uncertainties in the analysis. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA-0003525.

Impact of Nitrate Use on Survival in Acute Heart Failure: A Propensity-Matched Analysis.

PubMed

Ho, Edwin C; Parker, John D; Austin, Peter C; Tu, Jack V; Wang, Xuesong; Lee, Douglas S

2016-02-12

There is limited evidence that the use of nitrates in acute decompensated heart failure early after presentation to a hospital can improve clinical outcomes. We aimed to determine whether early nitrate exposure is associated with improved survival in a large retrospective cohort study. We examined 11 078 acute decompensated heart failure patients who presented to emergency departments in Ontario, Canada, between 2004 and 2007, in the Enhanced Feedback For Effective Cardiac Treatment and the Emergency Heart failure Mortality Risk Grade studies. In propensity-matched analyses, we examined the effect of nitrate administration in the acute emergency department setting for its impact on death at 7, 30, and 365 days. In propensity-matched analyses, we found no difference in survival between those who received nitrates in the emergency department and the non-nitrate comparator group. Hazard ratios for mortality were 0.76 (95% CI; 0.51, 1.12) over 7 days, 0.97 (95% CI; 0.77, 1.21) over 30 days, and 0.91 (95% CI; 0.82, 1.02) over 1 year of follow-up. There was no significant difference in survival or hospital length of stay between nitrate and non-nitrate controls in extended follow-up. There was also no significant effect of nitrates in subgroups stratified by presence of chest pain, troponin elevation, chronic nitrate use, and known coronary artery disease. In acute decompensated heart failure, use of nitrates acutely in the emergency department setting was not associated with improvement in short-term or near-term survival. Our study does not support generalized use of nitrates when the primary goal of therapy is to reduce mortality. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Management and Outcomes of Acute Surgical Patients at a District Hospital in Uganda with Non-physician Emergency Clinicians.

PubMed

Dresser, Caleb; Periyanayagam, Usha; Dreifuss, Brad; Wangoda, Robert; Luyimbaazi, Julius; Bisanzo, Mark

2017-09-01

Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care. Relevant de-identified clinical data on patients admitted directly to the operating theater from 2011 to 2014 were analyzed in Microsoft Excel. Overall, 112 Emergency Department patients were included in the analysis and 96% received some form of laboratory testing, imaging, medication, or procedure in the ED, prior to surgery. 72% of surgical patients referred by ED received preoperative antibiotics, and preoperative fluid resuscitation was initiated in 65%. Disposition to operating theater was accomplished within 3 h of presentation for 73% of patients. 79% were successfully followed up to assess outcomes at 72 h. 92% of those with successful follow-up reported improvement in their clinical condition. The confirmed mortality rate was 5%. Specialized non-physician clinicians practicing in a dedicated Emergency Department can perform resuscitation, bedside imaging and laboratory studies to aid in diagnosis of acute surgical patients and arrange transfer to an operating theater in an efficient fashion. This model has the potential to sustainably address structural and human resources problems inherent to Sub-Saharan Africa's current acute surgical care model and will benefit from further study and expansion.

Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services.

PubMed

Arch, Allison E; Weisman, David C; Coca, Steven; Nystrom, Karin V; Wira, Charles R; Schindler, Joseph L

2016-03-01

The failure to recognize an ischemic stroke in the emergency department is a missed opportunity for acute interventions and for prompt treatment with secondary prevention therapy. Our study examined the diagnosis of acute ischemic stroke in the emergency department of an academic teaching hospital and a large community hospital. A retrospective chart review was performed from February 2013 to February 2014. A total of 465 patients with ischemic stroke were included in the analysis; 280 patients from the academic hospital and 185 patients from the community hospital. One hundred three strokes were initially misdiagnosed that is 22% of the included strokes at the combined centers. Fifty-five of these were missed at the academic hospital (22%) [corrected] and 48 were at the community hospital (26%, P=0.11). Thirty-three percent of missed cases presented within a 3-hour time window for recombinant tissue-type plasminogen activator eligibility. An additional 11% presented between 3 and 6 hours of symptom onset for endovascular consideration. Symptoms independently associated with greater odds of a missed stroke diagnosis were nausea/vomiting (odds ratio, 4.02; 95% confidence interval, 1.60-10.1), dizziness (odds ratio, 1.99; 95% confidence interval, 1.03-3.84), and a positive stroke history (odds ratio, 2.40; 95% confidence interval, 1.30-4.42). Thirty-seven percent of posterior strokes were initially misdiagnosed compared with 16% of anterior strokes (P<0.001). Atypical symptoms associated with posterior circulation strokes lead to misdiagnoses. This was true at both an academic center and a large community hospital. Future studies need to focus on the evaluation of identification systems and tools in the emergency department to improve the accuracy of stroke diagnosis. © 2016 American Heart Association, Inc.

75 FR 81217 - Stainless Steel Plate in Coils From Belgium: Preliminary Results of Full Sunset Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... DEPARTMENT OF COMMERCE International Trade Administration [C-423-809] Stainless Steel Plate in..., International Trade Administration, Department of Commerce. SUMMARY: On June 2, 2010, the Department of Commerce... section 751(c) of the Act and 19 CFR 351.218(e)(2). As a result of our analysis, the Department...

77 FR 33605 - Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security Office of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... operations center for the Department of Homeland Security.'' Through the NOC, OPS provides real-time...-003 Operations Collection, Planning, Coordination, Reporting, Analysis, and Fusion System of Records... System of Records.'' The DHS/OPS-003 Operations Collection, Planning, Coordination, Reporting, Analysis...

An Interpretative Phenomenological Analysis of Sense-Making by Department of Defense Employees

ERIC Educational Resources Information Center

Harrison, John L., Sr.

2011-01-01

The purpose of this qualitative, phenomenological study was to explore the perceptions and lived experiences of Department of Defense (DOD) civilian employees to identify how their personal sense-making affects their coaching of adult students. The author used an interpretative phenomenological analysis (IPA) method involving personal interviews…

Additive Manufacturing Design Considerations for Liquid Engine Components

NASA Technical Reports Server (NTRS)

Whitten, Dave; Hissam, Andy; Baker, Kevin; Rice, Darron

2014-01-01

The Marshall Space Flight Center's Propulsion Systems Department has gained significant experience in the last year designing, building, and testing liquid engine components using additive manufacturing. The department has developed valve, duct, turbo-machinery, and combustion device components using this technology. Many valuable lessons were learned during this process. These lessons will be the focus of this presentation. We will present criteria for selecting part candidates for additive manufacturing. Some part characteristics are 'tailor made' for this process. Selecting the right parts for the process is the first step to maximizing productivity gains. We will also present specific lessons we learned about feature geometry that can and cannot be produced using additive manufacturing machines. Most liquid engine components were made using a two-step process. The base part was made using additive manufacturing and then traditional machining processes were used to produce the final part. The presentation will describe design accommodations needed to make the base part and lessons we learned about which features could be built directly and which require the final machine process. Tolerance capabilities, surface finish, and material thickness allowances will also be covered. Additive Manufacturing can produce internal passages that cannot be made using traditional approaches. It can also eliminate a significant amount of manpower by reducing part count and leveraging model-based design and analysis techniques. Information will be shared about performance enhancements and design efficiencies we experienced for certain categories of engine parts.

The use of scenario analysis in local public health departments: alternative futures for strategic planning.

PubMed Central

Venable, J M; Ma, Q L; Ginter, P M; Duncan, W J

1993-01-01

Scenario analysis is a strategic planning technique used to describe and evaluate an organization's external environment. A methodology for conducting scenario analysis using the Jefferson County Department of Health and the national, State, and county issues confronting it is outlined. Key health care and organizational issues were identified using published sources, focus groups, questionnaires, and personal interviews. The most important of these issues were selected by asking health department managers to evaluate the issues according to their probability of occurrence and likely impact on the health department. The high-probability, high-impact issues formed the basis for developing scenario logics that constitute the story line holding the scenario together. The results were a set of plausible scenarios that aided in strategic planning, encouraged strategic thinking among managers, eliminated or reduced surprise about environmental changes, and improved managerial discussion and communication. PMID:8265754

The 'unnecessary' use of emergency departments by older people: findings from hospital data, hospital staff and older people.

PubMed

Faulkner, Debbie; Law, Julia

2015-11-01

Increasing demands are being placed on emergency departments in Australia and there is a view that older Australians are more likely than other age groups to attend for non-urgent conditions. The objective of this paper is to compare and contrast administrative data with the views of hospital staff and older people with regard to their presentation at two emergency departments in metropolitan Adelaide and how this aligns with the Australian Institute of Health and Welfare definition of 'potentially avoidable general practitioner-type presentations'. The study used three sources of data from two emergency departments: hospital data for the financial year 2010-11 for patients aged 65 years and over and identified as triage category four or five; three focus groups with medical, nursing and allied staff from these two hospitals; and interviews with 58 older people who presented at the two emergency departments over a two-week period. The hospital administrative data provided a very limited insight into why older people attended the emergency department, other than the medical diagnosis. Professional staff identified individual determinants, societal determinants and the health services system as explanations. Older people attended the emergency department for a range of reasons that may not necessarily reflect the opinions of health professionals. For many older people the emergency department was an appropriate place to attend considering their condition, though some presentations could be circumvented with appropriate and increased services in the community. However, as many older people suffer comorbidities, careful consideration needs to be given as to the best possible practices to achieve this.

Ureteral stone location at emergency room presentation with colic.

PubMed

Eisner, Brian H; Reese, Adam; Sheth, Sonali; Stoller, Marshall L

2009-07-01

It is thought that the 3 narrowest points of the ureter are the ureteropelvic junction, the point where the ureter crosses anterior to the iliac vessels and the ureterovesical junction. Textbooks describe these 3 sites as the most likely places for ureteral stones to lodge. We defined the stone position in the ureter when patients first present to the emergency department with colic. We retrospectively reviewed the records of 94 consecutive patients who presented to the emergency department with a chief complaint of colic and computerized tomography showing a single unilateral ureteral calculus. Axial, coronal and 3-dimensional reformatted computerized tomography scans were evaluated, and stone position and size (maximal axial and coronal diameters) were recorded, as were the position of the ureteropelvic junction, the iliac vessels (where the ureter crosses anterior to the iliac vessels) and the ureterovesical junction. Patients with a history of nephrolithiasis, shock wave lithotripsy, ureteroscopy or percutaneous nephrolithotripsy were excluded from study. Statistical analysis was performed using Student's t test and Pearson's correlation coefficient. At the time of emergency department presentation for colic ureteral stone position was the ureteropelvic junction in 10.6% cases, between the ureteropelvic junction and the iliac vessels in 23.4%, where the ureter crosses anterior to the iliac vessels in 1.1%, between the iliac vessels and the ureterovesical junction in 4.3% and at the ureterovesical junction in 60.6%. Proximal calculi had a greater axial diameter than distal calculi (mean 6.1 vs 4.0 mm) and a greater coronal diameter than distal calculi (6.8 vs 4.1 mm, each p <0.001). Axial and coronal diameters moderately correlated with stone position (r = -0.47 and -0.55, respectively, each p <0.001). Proximal ureteral stones were larger in axial and coronal diameter than distal ureteral stones. At emergency department presentation for colic most stones were at the ureterovesical junction and in the proximal ureter between the ureteropelvic junction and the iliac vessels. A few stones were at the ureteropelvic junction and only 1 lodged at the level where the ureter crosses anterior to the iliac vessels, despite the literature stating that these locations are 2 of the 3 most likely places for stones to become lodged.

Authorized limits for Fernald copper ingots

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frink, N.; Kamboj, S.; Hensley, J.

This development document contains data and analysis to support the approval of authorized limits for the unrestricted release of 59 t of copper ingots containing residual radioactive material from the U.S. Department of Energy (DOE) Fernald Environmental Management Project (FEMP). The analysis presented in this document comply with the requirements of DOE Order 5400.5, {open_quotes}Radiation Protection of the Public and the Environment,{close_quotes} as well as the requirements of the proposed promulgation of this order as 10 CFR Part 834. The document was developed following the step-by-step process described in the Draft Handbook for Controlling Release for Reuse or Recycle Propertymore » Containing Residual Radioactive Material.« less

Expanding the role of the nurse practitioner in the deployed setting.

PubMed

Dargis, Julie; Horne, Theresa; Tillman-Ortiz, Sophie; Scherr, Diane; Yackel, Edward E

2006-08-01

Today's military is experiencing rapid advances in technology and in manpower utilization. The Army Medical Department is redesigning the structure and function of deployable hospital systems as part of this effort. The transformation of deployable hospital systems requires that a critical analysis of manpower utilization be undertaken to optimize the employment of soldier-medics. The objective of this article was to describe the use of nurse practitioners as primary care providers during deployment. The lived experiences of five nurse practitioners deployed to Operation Iraqi Freedom are presented. Data gathered during the deployment and an analysis of the literature clearly support expanded and legitimized roles for these health care professionals in future conflicts and peacekeeping operations.

Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

PubMed

Qiao, Yuanhua; Keren, Nir; Mannan, M Sam

2009-08-15

Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

Time-frequency representation of a highly nonstationary signal via the modified Wigner distribution

NASA Technical Reports Server (NTRS)

Zoladz, T. F.; Jones, J. H.; Jong, J.

1992-01-01

A new signal analysis technique called the modified Wigner distribution (MWD) is presented. The new signal processing tool has been very successful in determining time frequency representations of highly non-stationary multicomponent signals in both simulations and trials involving actual Space Shuttle Main Engine (SSME) high frequency data. The MWD departs from the classic Wigner distribution (WD) in that it effectively eliminates the cross coupling among positive frequency components in a multiple component signal. This attribute of the MWD, which prevents the generation of 'phantom' spectral peaks, will undoubtedly increase the utility of the WD for real world signal analysis applications which more often than not involve multicomponent signals.

Instrumental neutron activation analysis data for cloud-water particulate samples, Mount Bamboo, Taiwan

USGS Publications Warehouse

Lin, Neng-Huei; Sheu, Guey-Rong; Wetherbee, Gregory A.; Debey, Timothy M.

2013-01-01

Cloud water was sampled on Mount Bamboo in northern Taiwan during March 22-24, 2002. Cloud-water samples were filtered using 0.45-micron filters to remove particulate material from the water samples. Filtered particulates were analyzed by instrumental neutron activation analysis (INAA) at the U.S. Geological Survey National Reactor Facility in Denver, Colorado, in February 2012. INAA elemental composition data for the particulate materials are presented. These data complement analyses of the aqueous portion of the cloud-water samples, which were performed earlier by the Department of Atmospheric Sciences, National Central University, Taiwan. The data are intended for evaluation of atmospheric transport processes and air-pollution sources in Southeast Asia.

Data management and processing plan, Department of Applied Geodesy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-08-01

This plan outlines Data Management and Data Processing requirements of the Department of Applied Geodesy (DAG) and presents the plan to meet these requirements (These requirements are derived from the functional needs of the Department to meet the SSCL alignment tolerances and schedules). In addition, this document presents a schedule for the implementation of this plan. This document is an integral part of the Alignment Plan of the SSCL.

U.S. Department of Energy-Funded Performance Validation of Fuel Cell Material Handling Equipment (Presentation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurtz, J.; Sprik, S.; Ramsden, T.

2013-11-01

This webinar presentation to the UK Hydrogen and Fuel Cell Association summarizes how the U.S. Department of Energy is enabling early fuel cell markets; describes objectives of the National Fuel Cell Technology Evaluation Center; and presents performance status of fuel cell material handling equipment.

From Machiavelli to Martians: The Challenge of Department Chairmanship.

ERIC Educational Resources Information Center

Painter, Lorene H.

1968-01-01

The duties, problems, compensation, and selection procedures of department chairmen in secondary schools need to be clarified. Present duties of an English department chairman include developing an educational philosophy and curriculum for the department; suggesting materials and teaching methods; protecting teacher welfare; working with all…

Declining Enrollments of Sociology Majors: Department Responses.

ERIC Educational Resources Information Center

Fabianic, David

1991-01-01

Discusses the falling enrollments in sociology departments. Suggests that the decline may be a result of quality of subject matter presentation, an increase in career-oriented students, and the development of social work and criminal justice into departments separate from sociology. Urges sociology departments to strengthen their political…

Protocol of the sepsivit study: a prospective observational study to determine whether continuous heart rate variability measurement during the first 48 hours of hospitalisation provides an early warning for deterioration in patients presenting with infection or sepsis to the emergency department of a Dutch academic teaching hospital

PubMed Central

van Meurs, Matijs; Renes, Maurits H; Ligtenberg, Jack J M; ter Maaten, Jan C

2017-01-01

Introduction One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). Methods and analysis The protocol of a prospective observational study in the ED. We will include 171 adult medical patients presenting with suspected infection or sepsis and at least two systemic inflammatory response syndrome criteria. Patients with known pregnancy, cardiac transplantation or not admitted to our hospital are excluded. High sample frequency ECG signals (500 Hz), respiratory rate, blood pressure and peripheral oxygen saturation will be recorded continuously during the first 48 hours of hospitalisation using a bedside patient monitor (Philips IntelliVue MP70). Primary endpoint is patient deterioration, defined as the development of organ dysfunction, unplanned intensive care unit admission or in-hospital mortality. The ECG data will be used for offline HRV analysis. We will compare the HRV between two groups (deterioration/no deterioration) and analyse whether HRV provides an early warning for deterioration. Furthermore, we will create a multivariate predictive model for deterioration based on heart rate, respiratory rate and HRV. As planned secondary analyses, we (1) perform a subgroup analysis for patients with pneumosepsis and urosepsis and (2) determine whether HRV using lower sample frequencies (1 Hz or less) suffices to predict deterioration. Ethics and dissemination The Institutional Review Board of the University Medical Center Groningen granted a waiver for the study (METc 2015/164). Results will be disseminated through international peer-reviewed publications and conference presentations. A lay summary of the results will be provided to the study participants. Trial registration number NTR6168; Pre-results. PMID:29151053

Individual dose monitoring of the nuclear medicine departments staff controlled by Central Laboratory for Radiological Protection.

PubMed

Szewczak, Kamil; Jednoróg, Sławomir; Krajewski, Paweł

2013-01-01

Presented paper describes the results of the individual doses measurements for ionizing radiation, carried out by the Laboratory of Individual and Environmental Doses Monitoring (PDIS) of the Central Laboratory for Radiological Protection in Warsaw (CLOR) for the medical staff employees in several nuclear medicine (NM) departments across Poland. In total there are48 NM departments in operation in Poland [1] (consultation in Nuclear Atomic Agency). Presented results were collected over the period from January 2011 to December 2011 at eight NM departments located in Krakow, Warszawa (two departments), Rzeszow (two departments), Opole, Przemysl and Gorzow Wielkopolski. For radiation monitoring three kinds of thermo luminescence dosimeters (TLD) were used. The first TLD h collected information about whole body (C) effective dose, the second dosimeter was mounted in the ring (P) meanwhile the third on the wrist (N) of the tested person. Reading of TLDs was performed in quarterly periods. As a good approximation of effective and equivalent dose assessment of operational quantities both the individual dose equivalent Hp(10) and the Hp(0.07) were used. The analysis of the data was performed using two methods The first method was based on quarterly estimations of Hp(10)q and Hp(0.07)q while the second measured cumulative annual doses Hp(10)a and Hp(0.07)a. The highest recorded value of the radiation dose for quarterly assessments reached 24.4 mSv and was recorded by the wrist type dosimeter worn by a worker involved in source preparation procedure. The mean values of Hp(10)q(C type dosimeter) and Hp(0.07)q (P and N type dosimeter) for all monitored departments were respectively 0.46 mSv and 3.29 mSv. There was a strong correlation between the performed job and the value of the received dose. The highest doses always were absorbed by those staff members who were involved in sources preparation. The highest annual cumulative dose for a particular worker in the considered time period was 4.22 mSv for Hp(10)a and 67.7 mSv for Hp(0.07)a. In 2011 no case of exceeding the allowed dose limits was noted.

The integripennis species group of Geocharidius Jeannel, 1963 (Carabidae, Bembidiini, Anillina) from Nuclear Central America: a taxonomic review with notes about biogeography and speciation

PubMed Central

Sokolov, Igor M.; Kavanaugh, David H.

2014-01-01

Abstract Our review recognizes 15 species of the integripennis species group of Geocharidius from Nuclear Central America, include three species previously described (Geocharidius gimlii Erwin, Geocharidius integripennis (Bates) and Geocharidius zullinii Vigna Taglianti) and 12 described here as new. They are: Geocharidius andersoni sp. n. (type locality: Chiapas, Chiapas Highlands, Cerro Huitepec) and Geocharidius vignatagliantii sp. n. (type locality: Chiapas, Motozintla, Sierra Madre de Chiapas, Benito Juárez) from Mexico; Geocharidius antigua sp. n. (type locality: Sacatepéquez, 5 km SE of Antigua), Geocharidius balini sp. n. (type locality: Suchitepéquez, 4 km S of Volcan Atitlán), Geocharidius erwini sp. n. (type locality: Quiché Department, 7 km NE of Los Encuentros), Geocharidius jalapensis sp. n. (type locality: Jalapa Department, 4 km E of Mataquescuintla), Geocharidius longinoi, sp. n. (type locality: El Progreso Department, Cerro Pinalón), and Geocharidius minimus sp. n. (type locality: Sacatepéquez Department, 5 km SE of Antigua) from Guatemala; and Geocharidius celaquensis sp. n. (type locality: Lempira Department, Celaque National Park), Geocharidius comayaguanus sp. n. (type locality: Comayagua Department, 18 km ENE of Comayagua), Geocharidius disjunctus sp. n. (type locality: Francisco Morazán, La Tigra National Park), and Geocharidius lencanus sp. n. (type locality: Lempira Department, Celaque National Park) from Honduras. For all members of the group, adult structural characters, including male and female genitalia, are described, and a taxonomic key for all members of the integripennis species group is presented based on these characters. Behavioral and biogeographical aspects of speciation in the group are discussed, based on the morphological analysis. In all cases of sympatry, pairs of closely related species show greater differences in sizes than pairs of more remotely related species. Integripennis group species occupy six different montane areas at elevations above 1300m, with no species shared among them. Major faunal barriers in the region limiting present species distributions include the Motagua Fault Zone and a gap between the Guatemalan Cordillera volcanic chain and the Honduran Interior Highlands no higher than 900m in elevation. Highest species diversity is in the Guatematan Cordillera (six species), second highest in the Honduran Interior Highlands area (four species). PMID:25349497

Understanding drivers of Demand for Emergency Service Trends in Years 2010-2014 in New South Wales: An initial overview of the DESTINY project.

PubMed

Dinh, Michael M; Berendsen Russell, Saartje; Bein, Kendall J; Chalkley, Dane; Muscatello, David; Paoloni, Richard; Ivers, Rebecca

2016-04-01

This study aims to describe the general characteristics and data definitions used in a population-based data set of ED presentations in New South Wales (NSW), used to form the basis of future-trend analyses. Retrospective analysis of the Emergency Department Data Collection registry, which provided clinical and demographic information of ED presentations across all EDs in NSW between 2010 and 2014. Presenting problems and ED diagnoses were classified using broad clinical categories including injury/musculoskeletal, respiratory, cardiovascular, ear nose and throat, and mental health. Presentations were linked by patient to allow for analysis of representations, and population data were obtained from the Australian Bureau of Statistics. There were 11.8 million presentations that were analysed from 150 EDs (80.6% of all EDs). The rate of ED presentations was highest in those aged 85 years and older and appears to increase across all age groups between 2010 and 2014. The most common ED diagnosis categories were injury/musculoskeletal (27.5%) followed by abdominal/gastrointestinal (12.3%), respiratory (9%) and cardiovascular (8%). Both the Systematised Nomenclature of Medicine Clinical Terms (66%) and the International Classification of Diseases (24%) were used to code ED diagnoses. The elderly population had the highest rate of ED attendances. The use of diverse diagnosis classifications and source information systems may present problems with further analysis. Patterns and characteristics of ED presentations in NSW were broadly consistent with those reported in other states in Australia. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Forecasting daily attendances at an emergency department to aid resource planning

PubMed Central

Sun, Yan; Heng, Bee Hoon; Seow, Yian Tay; Seow, Eillyne

2009-01-01

Background Accurate forecasting of emergency department (ED) attendances can be a valuable tool for micro and macro level planning. Methods Data for analysis was the counts of daily patient attendances at the ED of an acute care regional general hospital from July 2005 to Mar 2008. Patients were stratified into three acuity categories; i.e. P1, P2 and P3, with P1 being the most acute and P3 being the least acute. The autoregressive integrated moving average (ARIMA) method was separately applied to each of the three acuity categories and total patient attendances. Independent variables included in the model were public holiday (yes or no), ambient air quality measured by pollution standard index (PSI), daily ambient average temperature and daily relative humidity. The seasonal components of weekly and yearly periodicities in the time series of daily attendances were also studied. Univariate analysis by t-tests and multivariate time series analysis were carried out in SPSS version 15. Results By time series analyses, P1 attendances did not show any weekly or yearly periodicity and was only predicted by ambient air quality of PSI > 50. P2 and total attendances showed weekly periodicities, and were also significantly predicted by public holiday. P3 attendances were significantly correlated with day of the week, month of the year, public holiday, and ambient air quality of PSI > 50. After applying the developed models to validate the forecast, the MAPE of prediction by the models were 16.8%, 6.7%, 8.6% and 4.8% for P1, P2, P3 and total attendances, respectively. The models were able to account for most of the significant autocorrelations present in the data. Conclusion Time series analysis has been shown to provide a useful, readily available tool for predicting emergency department workload that can be used to plan staff roster and resource planning. PMID:19178716

Codifying Information Assurance Controls for Department of Defense (DoD) Supervisory Control and Data Acquisition (SCADA) Systems

DTIC Science & Technology

2010-03-01

CODIFYING INFORMATION ASSURANCE CONTROLS FOR DEPARTMENT OF DEFENSE (DOD) SUPERVISORY CONTROL AND DATA...Force, Department of Defense, or the U.S. Government. AFIT/GCO/ENG/10-13 CODIFYING INFORMATION ASSURANCE CONTROLS FOR DEPARTMENT OF...DEFENSE (DOD) SUPERVISORY CONTROL AND DATA ACQUISITION (SCADA) SYSTEMS THESIS Presented to the Faculty Department of Electrical and Computer

A Study of Corporate Entrepreneurship in a Department of Defense Organization

DTIC Science & Technology

2011-03-01

A STUDY OF CORPORATE ENTREPRENUERSHIP IN A DEPARTMENT OF DEFENSE ORGANIZATION THESIS Wade W. Brower, Civilian AFIT/GEM/ENV...CORPORATE ENTREPRENUERSHIP IN A DEPARTMENT OF DEFENSE ORGANIZATION THESIS Presented to the Faculty Department of Systems and Engineering...2011 APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED AFIT/GEM/ENV/11-M01 A STUDY OF CORPORATE ENTREPRENUERSHIP IN A DEPARTMENT OF

Work-related fear and the threats of fear among emergency department nursing staff and physicians in Finland.

PubMed

Mikkola, Riitta; Huhtala, Heini; Paavilainen, Eija

2017-10-01

To describe fear, the threats causing fear and the occurrence of fear among emergency department nursing staff and physicians. The emergency department is a challenging workplace where the staff is often confronted by factors that cause fear. A cross-sectional study. A survey was conducted in 16 hospitals (n = 544). Nurses, practical nurses, orderlies and physicians from those hospitals participated in the survey. The survey questionnaire was based on the analysis of interviews of 30 nurses from one university hospital and one central hospital. The results of the interviews were analysed using the inductive content analysis method. The analysis of the survey was performed using statistical methods, such as frequencies, cross-tabulation and principal component analysis. The results showed that nearly all of the emergency department personnel had experienced work-related fear. Generally, the fear had been momentary. According to the survey results, fear was most often caused by medication errors, the resuscitation of a child, a catastrophic accident, urgent or violent situations or patients armed with weapons. Threats that caused fear included insecurity, danger in the work environment, threat of loss of one's health and threat of the consequences of one's mistakes and actions. The staff of emergency departments often encountered factors or situations that caused fear. The main threats causing fear that were raised by the respondents were insecurity and danger in the work environment. The data obtained from this study can be utilised in identifying and describing work-related fear and threats of fear among emergency department nursing staff and physicians. Based on the information herein, it will be possible to develop methods to prevent situations that cause fear in emergency departments. © 2016 John Wiley & Sons Ltd.

Historical cohort study of US man-made vitreous fiber production workers: VIII. Exposure-specific job analysis.

PubMed

Quinn, M M; Smith, T J; Youk, A O; Marsh, G M; Stone, R A; Buchanich, J M; Gula, M J

2001-09-01

All jobs held by a cohort of US man-made vitreous fiber production workers were analyzed for airborne fiber exposure. This exposure-specific job analysis was part of an exposure assessment for an epidemiologic study of mortality patterns, with particular focus on respiratory cancer, among 35,145 workers employed in 10 fiberglass and five rock or slag wool plants. The exposure assessment was conducted from the start-up date of each plant (1917 to 1946) to 1990. For the job analysis, 15,465 crude department names and 47,693 crude job titles were grouped into 1668 unique department and job pairs (UDJobs), which represented a job title linked to a specific department within each plant. Every UDJob was evaluated according to a set of job elements related to airborne fiber exposure. The distribution of the cohort person-years by UDJob and the job-exposure elements was then evaluated. The results show the main departments and jobs that employed the workers for each plant. The distribution of person-years varies across the job-exposure elements. The same job title was used in different departments within and across plants. When job titles not linked to departments were evaluated, the values of the job-exposure elements varied considerably across all plants and within plant. (1) exposure misclassification could occur if job title alone were used for the exposure assessment; (2) the job-exposure elements analysis provides an efficient way to identify major job determinants of exposure without relying on the more detailed, resource-intensive task-based approach; and (3) the evaluation of the cohort person-years by UDJobs and job-exposure elements is an effective way to identify which plants, departments, and jobs have sufficient information for making precise risk estimates in the broader epidemiologic study.

Department of Defense In-House RDT&E Activities. Management Analysis Report: Department of the Army, Department of the Navy, Department of the Air Force

DTIC Science & Technology

1985-10-30

HOUSTON, TX "CDR. COL BASIL A. PRUITT, JR. SCI DIR. DR. AUTHUR D. MASON PROGRAM DATA BY FISCAL YEAR (MILLION S) PROGRAM 1986 1986 (ACTUAL) (ACT * EST...METHODF, & MATERIALS. ESTAB HEALTH HAZARD DATA BASES. ... CURRENT IMPORTANT PROGRAMS SIGNIFICANT RESEARCH PROJECTS INCLUDE PESTICIDE DISPERSAL UNIT

Genomic Encyclopedia of Fungi

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grigoriev, Igor

Genomes of fungi relevant to energy and environment are in focus of the Fungal Genomic Program at the US Department of Energy Joint Genome Institute (JGI). Its key project, the Genomics Encyclopedia of Fungi, targets fungi related to plant health (symbionts, pathogens, and biocontrol agents) and biorefinery processes (cellulose degradation, sugar fermentation, industrial hosts), and explores fungal diversity by means of genome sequencing and analysis. Over 150 fungal genomes have been sequenced by JGI to date and released through MycoCosm (www.jgi.doe.gov/fungi), a fungal web-portal, which integrates sequence and functional data with genome analysis tools for user community. Sequence analysis supportedmore » by functional genomics leads to developing parts list for complex systems ranging from ecosystems of biofuel crops to biorefineries. Recent examples of such parts suggested by comparative genomics and functional analysis in these areas are presented here.« less

Repositioning an Academic Department to Stimulate Growth

ERIC Educational Resources Information Center

Elrod, Cassandra C.; Daughton, William J.; Murray, Susan L.; Fisher, Caroline M.; Flachsbart, Barry B.

2011-01-01

The complexity of the market in higher education, and the lack of literature regarding marketing, particularly branding, at the academic department level, presented an opportunity to establish a systematic process for evaluating an academic department's brand meaning. A process for evaluating a brand's meaning for an academic department is…

Enhancing Departmental Leadership: The Roles of the Chairperson.

ERIC Educational Resources Information Center

Bennett, John B., Ed.; Figuli, David J., Ed.

A collection of essays is presented, primarily taken from a quarterly newsletter titled "The Department Advisor." The essays include: "A Few Suggestions to New Department Chairs" (Artin Arslanian); "Chairing the Small Department" (Robert Wolverton); "Common and Uncommon Concerns: The Complex Role of the Community College Department Chair" (Myrna…